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Morillas H, Gallego-Cartagena E, Upasen S. Metals, nonmetals and metalloids in cigarette smoke as hazardous compounds for human health. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 923:171351. [PMID: 38432370 DOI: 10.1016/j.scitotenv.2024.171351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/05/2024]
Abstract
Cigarette smoke contains many chemicals that are harmful to both smokers and non-smokers. Breathing just a little cigarette smoke can be harmful. There are >7000 chemicals in cigarette smoke, at least 250 are known to be harmful and many of them can cause cancer. Currently, many studies reported the types of harmful organic compounds in cigarette smoke; instead, there are almost no works that describe the presence of inorganic compounds. In this work, a cost-effective self-made passive sampler (SMPS) was tested as a tool to collect different types of particulate matter (PM) from cigarette smoke containing metals as hazardous compounds (HCs). To determine the nature of the metals, nonmetals and metalloids as HCs, a direct qualitative analysis of the particulate matter (PM) was conducted without developing any special sample preparation procedure. For that, non-invasive elemental (Scanning Electron Microscope coupled to Energy Dispersive X-ray Spectrometry) and molecular (Raman microscopy) micro-spectroscopic techniques were used. Thanks to this methodology, it was possible to determine in deposited PM, the presence of metals such as Fe, Cr, Ni, Ti, Co, Sn, Zn, Ba, Al, Cu, Zr, Ce, Bi, etc. most of them as oxides but also embedded in different clusters with sulfates, aluminosilicates, even phosphates.
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Affiliation(s)
- Héctor Morillas
- Department of Didactic of Mathematics, Experimental and Social Sciences, Faculty of Education and Sport, University of the Basque Country UPV/EHU, 01006 Vitoria-Gasteiz, Basque Country, Spain; Department of Analytical Chemistry, Faculty of Science and Technology, University of the Basque Country UPV/EHU, P.O. Box 644, 48080 Bilbao, Basque Country, Spain.
| | - Euler Gallego-Cartagena
- Department of Civil and Environmental, Universidad de la Costa, Calle 58 #55-66, 080002 Barranquilla, Colombia; Department of Analytical Chemistry, Faculty of Science and Technology, University of the Basque Country UPV/EHU, P.O. Box 644, 48080 Bilbao, Basque Country, Spain
| | - Settakorn Upasen
- Department of Chemical Engineering, Faculty of Engineering, Burapha University, 169 Long-Hard Bangsaen Road, Saensuk Sub-District, Muang District, Chonburi Province 20131, Thailand
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Moore MM, Abraham I, Ballantyne M, Behrsing H, Cao X, Clements J, Gaca M, Gillman G, Hashizume T, Heflich RH, Hurtado S, Jordan KG, Leverette R, McHugh D, Miller-Holt J, Phillips G, Recio L, Roy S, Scian M, Simms L, Smart DJ, Stankowski LF, Tarran R, Thorne D, Weber E, Wieczorek R, Yoshino K, Curren R. Key Challenges and Recommendations for In Vitro Testing of Tobacco Products for Regulatory Applications: Consideration of Test Materials and Exposure Parameters. Altern Lab Anim 2023; 51:55-79. [PMID: 36821083 DOI: 10.1177/02611929221146536] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
The Institute for In Vitro Sciences (IIVS) is sponsoring a series of workshops to identify, discuss and develop recommendations for optimal scientific and technical approaches for conducting in vitro assays, to assess potential toxicity within and across tobacco and various next generation nicotine and tobacco products (NGPs), including heated tobacco products (HTPs) and electronic nicotine delivery systems (ENDS). The third workshop (24-26 February 2020) summarised the key challenges and made recommendations concerning appropriate methods of test article generation and cell exposure from combustible cigarettes, HTPs and ENDS. Expert speakers provided their research, perspectives and recommendations for the three basic types of tobacco-related test articles: i) pad-collected material (PCM); ii) gas vapour phase (GVP); and iii) whole smoke/aerosol. These three types of samples can be tested individually, or the PCM and GVP can be combined. Whole smoke/aerosol can be bubbled through media or applied directly to cells at the air-liquid interface. Summaries of the speaker presentations and the recommendations developed by the workgroup are presented. Following discussion, the workshop concluded the following: that there needs to be greater standardisation in aerosol generation and collection processes; that methods for testing the NGPs need to be developed and/or optimised, since simply mirroring cigarette smoke testing approaches may be insufficient; that understanding and quantitating the applied dose is fundamental to the interpretation of data and conclusions from each study; and that whole smoke/aerosol approaches must be contextualised with regard to key information, including appropriate experimental controls, environmental conditioning, analytical monitoring, verification and performance criteria.
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Affiliation(s)
| | | | - Mark Ballantyne
- 63899Labcorp Early Development Laboratories Limited, Harrogate, North Yorkshire, UK
| | - Holger Behrsing
- 329003Institute for In Vitro Sciences, Gaithersburg, MD, USA
| | - Xuefei Cao
- 4136National Center for Toxicological Research, Food and Drug Administration, Jefferson, AR, USA
| | - Julie Clements
- 63899Labcorp Early Development Laboratories Limited, Harrogate, North Yorkshire, UK
| | - Marianna Gaca
- 195179British American Tobacco, R&D, Southampton, Hampshire, UK
| | - Gene Gillman
- 520154Enthalpy Analytical, Inc., Durham, NC, USA
| | - Tsuneo Hashizume
- 74193Japan Tobacco Inc., Scientific Product Assessment Centre, Yokohama, Kanagawa, Japan
| | - Robert H Heflich
- 4136National Center for Toxicological Research, Food and Drug Administration, Jefferson, AR, USA
| | - Sara Hurtado
- 66661Charles River Laboratories - Skokie, LLC., Skokie, IL, USA
| | - Kristen G Jordan
- RAI Services Company, Scientific & Regulatory Affairs, Winston-Salem, NC, USA
| | - Robert Leverette
- RAI Services Company, Scientific & Regulatory Affairs, Winston-Salem, NC, USA
| | - Damian McHugh
- 161931Philip Morris International R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
| | | | - Gary Phillips
- Life Science Technologies Ltd, Eastleigh, Hampshire, UK
| | - Leslie Recio
- 298616ILS, PO Box 13501, Research Triangle Park, NC, USA
| | | | | | | | - Daniel J Smart
- 161931Philip Morris International R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
| | | | - Robert Tarran
- Department of Cell Biology and Physiology, 2332University of North Carolina, Chapel Hill, NC, USA
| | - David Thorne
- 195179British American Tobacco, R&D, Southampton, Hampshire, UK
| | - Elisabeth Weber
- 588402Oekolab Ges. f. Umweltanalytik, A Member of the JT International Group of Companies, Vienna, Austria
| | | | - Kei Yoshino
- 74193Japan Tobacco Inc., Scientific Product Assessment Centre, Yokohama, Kanagawa, Japan
| | - Rodger Curren
- 329003Institute for In Vitro Sciences, Gaithersburg, MD, USA
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Paumgartten FJR, Gomes-Carneiro MR, Oliveira ACAXD. The impact of tobacco additives on cigarette smoke toxicity: a critical appraisal of tobacco industry studies. CAD SAUDE PUBLICA 2017; 33Suppl 3:e00132415. [PMID: 28954055 DOI: 10.1590/0102-311x00132415] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 10/13/2016] [Indexed: 12/21/2022] Open
Abstract
Cigarette production involves a number of substances and materials other than just tobacco, paper and a filter. Tobacco additives include flavorings, enhancers, humectants, sugars, and ammonium compounds. Although companies maintain that tobacco additives do not enhance smoke toxicity and do not make cigarettes more attractive or addictive, these claims are questioned by independent researchers. This study reviewed the studies on the effects of tobacco additives on smoke chemistry and toxicity. Tobacco additives lead to higher levels of formaldehyde and minor changes in other smoke analytes. Toxicological studies (bacterial mutagenicity and mammalian cytoxicity tests, rat 90 days inhalation studies and bone-marrow cell micronucleus assays) found that tobacco additives did not enhance smoke toxicity. Rodent assays, however, poorly predicted carcinogenicity of tobacco smoke, and were clearly underpowered to disclose small albeit toxicologically relevant differences between test (with tobacco additives) and control (without tobacco additives) cigarettes. This literature review led to the conclusion that the impact of tobacco additives on tobacco smoke harmfulness remains unclear.
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Ge SL, She SK, Xu YB, Ning M, Wang CH, Tian ZF, Zhou S, Huang L, Zhang Z, Sheng LS. Influence of Ammonium Polyphosphate on Thermal Decomposition of Reconstituted Tobacco and CO Evolution. CHINESE J CHEM PHYS 2014. [DOI: 10.1063/1674-0068/27/02/243-248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Discriminatory power of standard toxicity assays used to evaluate ingredients added to cigarettes. Regul Toxicol Pharmacol 2011; 62:49-61. [PMID: 22178773 DOI: 10.1016/j.yrtph.2011.11.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Revised: 11/29/2011] [Accepted: 11/30/2011] [Indexed: 11/24/2022]
Abstract
A tiered approach for testing ingredients in a cigarette matrix was developed and includes chemical-analytical testing and a standard battery of biological toxicity assays. These assays were adapted for comparative evaluation of mainstream smoke from experimental cigarettes with or without ingredients at various inclusion levels. This adaptation to test cigarette mainstream smoke may impact assay response. Since it is difficult to a priori determine discriminatory power, it was evaluated using a large experimental dataset from a multi-year program of cigarette ingredient testing performed at two separate laboratories. A statistical method, minimum detectable difference (MDD), was used as a measure of assay discriminatory power. MDD of cigarette smoke constituents ranged from 6% to 29% of the average. Salmonella mutagenicity and cytotoxicity test MDDs ranged from 20% to 81% and 18% to 49%, respectively. Body weight gain in 90-day nose-only inhalation studies yielded an MDD of 30-40%. Histopathological findings with severity scores between 0.5 and 1.5 had the lowest MDDs of 23% and higher. In general, discriminatory power decreased with increasing biological complexity and toxicological relevance of the assay. Beyond statistical analysis, however, a weight-of-the-evidence analysis by experienced researchers is required for toxicological assessment of a cigarette ingredient.
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Dempsey R, Coggins CRE, Roemer E. Toxicological assessment of cigarette ingredients. Regul Toxicol Pharmacol 2011; 61:119-28. [PMID: 21771627 DOI: 10.1016/j.yrtph.2011.07.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2011] [Revised: 06/30/2011] [Accepted: 07/01/2011] [Indexed: 01/02/2023]
Abstract
Ingredients have been used in industrial manufacture of tobacco products since the early part of the 20th century. However, unlike other consumer goods, until now no regulatory authority has determined how tobacco ingredients should be assessed. Although there is currently no consensus on how added cigarette ingredients should be evaluated, this paper reviews some of the institutional guidance alongside published literature with a view to determining if there is a generally accepted approach in the absence of any strict regulation. Our aim was to review the recommendations, to compare them to the working practices as demonstrated from published studies, and to draw conclusions on currently used methodologies for testing ingredients added to cigarettes. The extent of testing is discussed in the light of practical and theoretical constraints and an example of an industry testing program is presented.
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Affiliation(s)
- Ruth Dempsey
- Philip Morris International, Neuchâtel, Switzerland
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Gaworski CL, Wagner KA, Morton MJ, Oldham MJ. Insights from a multi-year program designed to test the impact of ingredients on mainstream cigarette smoke toxicity. Inhal Toxicol 2011; 23 Suppl 1:172-83. [PMID: 21545299 DOI: 10.3109/08958378.2010.546440] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONTEXT Cigarette tobacco ingredients may alter the distribution of chemical constituents present in smoke. When considering the toxicological relevance of potential ingredient-related effects on chemical and biological measurements assessing cigarette smoke toxicity, it is critical to understand the intrinsic variability of tobacco and cigarette smoke that is influenced by the environmental conditions during growing, agricultural practices during preparation, cigarette manufacturing tolerances, and stability of the assay methods. OBJECTIVE To understand possible effects of ingredients on cigarette smoke toxicity, various chemical and biological endpoints were measured in smoke from experimental cigarettes (added ingredient) to the intrinsic variability of control cigarettes (no added ingredient). MATERIALS AND METHODS Data were collected during a multi-year program testing a variety of cigarette ingredients from several chemical classes. Chemical analysis of mainstream cigarette smoke,and biological procedures (Salmonella mutagenicity, cytotoxicity, and smoke inhalation) were performed using validated and controlled laboratory methods. The within-study and temporal variation of control cigarettes manufactured in parallel with experimental cigarettes was calculated and used to measure intrinsic variability. RESULTS The overwhelming majority of data generated from experimental cigarettes fell within the experiment variability represented by the pooled standard error of the entire multi-year dataset for the control cigarettes. CONCLUSION The results of this evaluation add to a growing body of the literature regarding a weight of evidence assessment of cigarette ingredient toxicity. When assessed against the variability of assay methodology, natural agricultural change, and manufacturing control, the ingredients studied here demonstrated little relevant influence on the mainstream cigarette smoke toxicity endpoints measured.
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Coggins CRE, Sena EJ, Oldham MJ. A comprehensive evaluation of the toxicology of cigarette ingredients: inorganic compounds. Inhal Toxicol 2011; 23 Suppl 1:157-71. [PMID: 21545298 DOI: 10.3109/08958378.2010.547229] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONTEXT Two ammonia compounds, diammonium phosphate and ammonium hydroxide, are typically used in the processing or flavoring of tobacco used in the manufacture of cigarettes. OBJECTIVE A battery of tests was used to compare the toxicity of mainstream smoke from experimental cigarettes containing different added levels of diammonium phosphate (target maximal inclusion level, 50,000 ppm) or both ammonium hydroxide (target maximal inclusion level 11,160 ppm) and diammonium phosphate. MATERIALS AND METHODS The tests included analytical chemistry, with over 40 constituents in mainstream cigarette smoke; in vitro bacterial (Salmonella) mutagenicity and cytotoxicity (neutral red uptake) assays, and 90-day smoke inhalation studies using rats. Diammonium phosphate acted as a burn retardant, and consequently, the highest planned inclusion level could not be used. Ammonium hydroxide could not be added to cigarettes at meaningfully different levels. RESULTS Apart from a substantial reduction in smoke concentrations of formaldehyde seen in the smoke chemistry analysis and animal exposure characterization, there were very few endpoints in any of the analyses that showed significant differences as a result of the addition of either of the two ammonia compounds. These differences, when present, occurred only sporadically, with no evidence of any dose-response relationships. CONCLUSION The results of these experiments show that the ammonia compounds, diammonium phosphate and ammonium hydroxide, when added to cigarette tobacco, even at high inclusion levels, have minimal toxicological sequelae.
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Gaworski CL, Oldham MJ, Wagner KA, Coggins CRE, Patskan GJ. An evaluation of the toxicity of 95 ingredients added individually to experimental cigarettes: approach and methods. Inhal Toxicol 2011; 23 Suppl 1:1-12. [PMID: 21417965 DOI: 10.3109/08958378.2010.543187] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONTEXT Ingredients have been used in modern cigarette manufacturing to facilitate tobacco processing, provide flavor, and preserve tobacco. Concern has been raised regarding the use of ingredients in cigarette manufacturing due to the possible generation of toxic chemicals resulting from their combustion when added to tobacco. OBJECTIVE Investigate the impact of individual ingredients on cigarette smoke toxicity. MATERIALS AND METHODS A total of 95 ingredients were tested individually through addition at different concentrations to the tobacco of experimental cigarettes. Mainstream cigarette smoke chemistry analysis, bacterial mutagenicity testing, and cytotoxicity testing were conducted. Additionally, 31 of the ingredients were tested in 90-day nose-only rat inhalation studies using mainstream cigarette smoke. Studies were designed following conventional toxicity testing methods employed for food additives and other consumer products. RESULTS The studies reported here demonstrate that high levels of some ingredients can change the quantity of some smoke constituents, altering the smoke chemistry profile. From the panel of biological endpoints monitored, these added ingredients produced minimal changes in the overall toxicity profile of mainstream cigarette smoke. In some cases, the addition of high levels of an ingredient caused a small reduction in toxicity findings, probably due to displacement of burning tobacco. CONCLUSION The battery of testing results presented here is a useful addition to the available scientific information for cigarette ingredients and extends the dataset which can be used for evaluating their appropriate use.
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Affiliation(s)
- Charles L Gaworski
- Development & Engineering, Altria Client Services, Inc, Richmond, Virginia 23261, USA
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Roemer E, Ottmueller T, Urban HJ, Baillet-Mignard C. SKH-1 mouse skin painting: A short-term assay to evaluate the tumorigenic activity of cigarette smoke condensate. Toxicol Lett 2010; 192:155-61. [DOI: 10.1016/j.toxlet.2009.10.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2009] [Revised: 10/14/2009] [Accepted: 10/15/2009] [Indexed: 10/20/2022]
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Gaworski CL, Oldham MJ, Coggins CRE. Toxicological considerations on the use of propylene glycol as a humectant in cigarettes. Toxicology 2010; 269:54-66. [PMID: 20079797 DOI: 10.1016/j.tox.2010.01.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2009] [Revised: 12/21/2009] [Accepted: 01/06/2010] [Indexed: 11/30/2022]
Abstract
Propylene glycol (PG) is a humectant commonly used in cigarettes. Previous toxicological examinations of the effects on the addition of PG to tobacco used mixtures with several other flavoring agents. In the present work, toxicological comparisons were made of experimental cigarettes containing no added PG against otherwise similar cigarettes with three different amounts of PG added to the tobacco. The main toxicological comparison was a sub-chronic inhalation study with mainstream smoke in Sprague-Dawley rats (exposures of 150 mg/m(3) of total particulate matter, 6h exposure per day, for 90 consecutive days). The target PG concentrations in the tobacco of the four cigarette types were 0, 4, 7 and 10%. Additional studies with mainstream smoke were bacterial mutagenicity (5 Salmonella strains, both with and without metabolic activation, particulate phase only), cytotoxicity of both particulate and gas/vapor phases (using the neutral red uptake assay), and analytical chemistry (41 analytes). The graded inclusion of PG into experimental cigarettes resulted in increases in the smoke concentrations of propylene oxide, at very low concentrations. Broadly similar responses were seen across the four cigarette types, and the responses were similar to those previously described in the scientific literature. The addition of PG to experimental cigarettes reduced concentrations of some smoke components (e.g. nicotine), but had minimal effects on the biological responses. Most of the changes produced in the 90-days of exposure were resolved in a 42-day post-inhalation period.
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Affiliation(s)
- Charles L Gaworski
- Altria Client Services, 601 East Jackson Street, Richmond, VA 23261, USA.
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Johnson MD, Schilz J, Djordjevic MV, Rice JR, Shields PG. Evaluation of in vitro assays for assessing the toxicity of cigarette smoke and smokeless tobacco. Cancer Epidemiol Biomarkers Prev 2009; 18:3263-304. [PMID: 19959677 PMCID: PMC2789344 DOI: 10.1158/1055-9965.epi-09-0965] [Citation(s) in RCA: 129] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND In vitro toxicology studies of tobacco and tobacco smoke have been used to understand why tobacco use causes cancer and to assess the toxicologic impact of tobacco product design changes. The need for toxicology studies has been heightened given the Food and Drug Administration's newly granted authority over tobacco products for mandating tobacco product performance standards and evaluate manufacturers' health claims about modified tobacco products. The goal of this review is to critically evaluate in vitro toxicology methods related to cancer for assessing tobacco products and to identify related research gaps. METHODS PubMed database searches were used to identify tobacco-related in vitro toxicology studies published since 1980. Articles published before 1980 with high relevance also were identified. The data were compiled to examine (a) the goals of the study, (b) the methods for collecting test substances, (c) experimental designs, (d) toxicologic end points, and (e) relevance to cancer risk. RESULTS A variety of in vitro assays are available to assess tobacco smoke that address different modes of action, mostly using non-human cell models. However, smokeless tobacco products perform poorly in these assays. Although reliable as a screening tool for qualitative assessments, the available in vitro assays have been poorly validated for quantitative comparisons of different tobacco products. Assay batteries have not been developed, although they exist for nontobacco assessments. Extrapolating data from in vitro studies to human risks remains hypothetical. CONCLUSIONS In vitro toxicology methods are useful for screening toxicity, but better methods are needed for today's context of regulation and evaluation of health claims.
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Affiliation(s)
- Michael D Johnson
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20057-1465, USA
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Ejaz S, Insan-ud-din, Ashraf M, Nawaz M, Lim CW, Kim B. Cigarette smoke condensate and total particulate matter severely disrupts physiological angiogenesis. Food Chem Toxicol 2009; 47:601-14. [PMID: 19138718 DOI: 10.1016/j.fct.2008.12.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2008] [Revised: 12/06/2008] [Accepted: 12/15/2008] [Indexed: 10/21/2022]
Abstract
The cigarette smoke condensate (CSC) and total particulate matter (TPM) in cigarette smoke is extremely toxic and may produce several pathologies. In our study, we used a chicken chorioallantoic membrane assay (CAM) to study the toxicological effects of CSC and TPM on different aspects of angiogenesis. CSC and TPM from four different commercial filtered cigarettes were applied to the CAMs on day 6 of incubation. Macroscopic vascular transformations were observed among all treated CAMs. The application of CSC disks caused obliteration of main blood vessels, while the entire architecture of the secondary and tertiary vasculature was completely destroyed. Likewise, the application of TPM from all brands of cigarette caused the disproportionate thinning of all primary and secondary blood vessels. A reduction in the total area and diameter of the primary, secondary, and tertiary blood vessels was observed after treatment with CSC and TPM. Histological evaluations revealed the loss of ectodermal and mesodermal integrity with both types of treatments. We also noted a profound inflammatory reaction restricted to the disk area with a novel filopodial deformity of the endoderm in the CSC treated groups. Scanty capillary plexus formation, deterioration of the extracellular matrix, and delayed migration of blood vessels were prominent findings among all treated groups. Results obtained from the CSC treated groups were more localized, while more generalized results were recorded in the TPM treated groups. Special caution should be taken for the presence of CSC and TPM while smoking during pregnancy or after surgery because it may severely affect the process of angiogenesis, which is vital to the maintenance of pregnancy and wound healing.
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Affiliation(s)
- Sohail Ejaz
- Department of Clinical Neurosciences, Neurology Unit, Addenbrookes Hospital, University of Cambridge, Cambridge, UK.
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