Relationships among smoking, oxidative stress, inflammation, macromolecular damage, and cancer

Association between secondhand smoke exposure and osteoporosis risk in postmenopausal women: a cross-sectional analysis of NHANES data

BACKGROUND

This study aimed to investigate the association between smoke exposure and the risk of osteoporosis in postmenopausal women in the United States, using data from the National Health and Nutrition Examination Survey (NHANES).

METHODS

A cross-sectional analysis was conducted using NHANES data from 2005 to 2010, 2013 to 2014, and 2017 to 2018. The study population consisted of postmenopausal women aged 18 years and older. Their bone health status was assessed using self-reported osteoporosis and dual-energy X-ray absorptiometry (DXA) measurements, smoke exposure was evaluated through serum cotinine levels, and multivariate logistic regression models were used to examine the association between smoke exposure and osteoporosis risk, adjusting for sociodemographic factors, health behaviours, and comorbidities.

RESULTS

The analysis comprised 4,140 postmenopausal women, and data analysis showed that active smoking was significantly associated with an increased risk of osteoporosis, with an adjusted odds ratio (OR) of 2.020 (95% confidence interval [CI]: 1.35-3.03), after adjusting for potential confounders. Additionally, age, race/ethnicity, socioeconomic status, marital status, and body mass index were identified as significant predictors of osteoporosis risk.

CONCLUSIONS

Smoke exposure, particularly active smoking, was associated with an elevated risk of osteoporosis among postmenopausal women in the United States. The findings underscore the need to address modifiable risk factors, such as smoking cessation, and implement targeted interventions to mitigate disparities in bone health.

Common cancers among the aging population: What NPs need to know

ABSTRACT

The incidence rates for cancer increase from fewer than 25 cases per 100,000 people among those younger than age 20 years to about 350 per 100,000 among those ages 45 to 49 years and to more than 1,000 per 100,000 among those age 60 years and older. This article explores current screening guidelines for the most common cancers in the US among older adults - breast, lung and bronchus, colorectal, and prostate, with a focus on older adults. Other oncologic-focused special considerations for older adults are also addressed.

Impact of smoking on cardiovascular health: Mechanisms, epidemiology and specific concerns regarding congenital heart disease

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The Redox Activity of Protein Disulphide Isomerase Functions in Non-Homologous End-Joining Repair to Prevent DNA Damage

DNA damage is a serious threat to cellular viability, and it is implicated as the major cause of normal ageing. Hence, targeting DNA damage therapeutically may counteract age-related cellular dysfunction and disease, such as neurodegenerative conditions and cancer. Identifying novel DNA repair mechanisms therefore reveals new therapeutic interventions for multiple human diseases. In neurons, non-homologous end-joining (NHEJ) is the only mechanism available to repair double-stranded DNA breaks (DSB), which is much more error prone than other DNA repair processes. However, there are no therapeutic interventions to enhance DNA repair in diseases affecting neurons. NHEJ is also a useful target for DNA repair-based cancer therapies to selectively kill tumour cells. Protein disulphide isomerase (PDI) participates in many diseases, but its roles in these conditions remain poorly defined. PDI exhibits both chaperone and redox-dependent oxidoreductase activity, and while primarily localised in the endoplasmic reticulum it has also been detected in other cellular locations. We describe here a novel role for PDI in DSB repair following at least two types of DNA damage. PDI functions in NHEJ, and following DNA damage, it relocates to the nucleus, where it co-localises with critical DSB repair proteins at DNA damage foci. A redox-inactive mutant of PDI lacking its two active site cysteine residues was not protective, however. Hence, the redox activity of PDI mediates DNA repair, highlighting these cysteines as targets for therapeutic intervention. The therapeutic potential of PDI was also confirmed by its protective activity in a whole organism against DNA damage induced in vivo in zebrafish. Hence, harnessing the redox function of PDI has potential as a novel therapeutic target against DSB DNA damage relevant to several human diseases.

Unraveling the Metabolic Pathways Between Metabolic-Associated Fatty Liver Disease (MAFLD) and Sarcopenia

Metabolic-Associated Fatty Liver Disease (MAFLD) is a public health concern that is constantly expanding, with a fast-growing prevalence, and it affects about a quarter of the world's population. This condition is a significant risk factor for cardiovascular, hepatic, and oncologic diseases, such as hypertension, hepatoma, and atherosclerosis. Sarcopenia was long considered to be an aging-related syndrome, but today, it is acknowledged to be secondarily related to chronic diseases such as metabolic syndrome, cardiovascular conditions, and liver diseases, among other comorbidities associated with insulin resistance and chronic inflammation, besides inactivity and poor nutrition. The physiopathology involving MAFLD and sarcopenia has still not been solved. Inflammation, oxidative stress, mitochondrial dysfunction, and insulin resistance seem to be some of the keys to this relationship since this hormone target is mainly the skeletal muscle. This review aimed to comprehensively discuss the main metabolic and physiological pathways involved in these conditions. MAFLD and sarcopenia are interconnected by a complex network of pathophysiological mechanisms, such as insulin resistance, skeletal muscle tissue production capacity, chronic inflammatory state, oxidative stress, and mitochondrial dysfunction, which are the main contributors to this relationship. In addition, in a clinical analysis, patients with sarcopenia and MAFLD manifest more severe hepatitis fibrosis when compared to patients with only MAFLD. These patients, with both disorders, also present clinical improvement in their MAFLD when treated for sarcopenia, reinforcing the association between them. Lifestyle changes accompanied by non-pharmacological interventions, such as dietary therapy and increased physical activity, undoubtedly improve this scenario.

RBM39 Promotes Base Excision Repair to Facilitate the Progression of HCC by Stabilising OGG1 mRNA

Targeting base excision repair (BER) has been an attractive strategy in cancer therapeutics. RNA-binding motif protein 39 (RBM39) modulates the alternative splicing of numerous genes involved in cancer occurrence and progression. However, whether and how RBM39 regulates BER in hepatocellular carcinoma (HCC) remain unclear. Here, we found that under oxidative stress, RBM39 degradation or knockdown decreased BER efficiency in HCC cells using a well-designed BER reporter. Further assays showed that RBM39 promoted HCC cell proliferation, migration, and invasion, enhancing cell survival and inhibiting apoptosis. Mechanistically, RBM39 interacted with the mRNA of the essential glycosidase 8-oxoguanine-DNA glycosylase 1 (OGG1), thereby stabilising OGG1 mRNA. This in turn increases OGG1 expression and promotes BER efficiency in HCC. Moreover, data suggested that RBM39 degradation, combined with oxidative damage, could be more effective for HCC treatment than monotherapy, both in vitro and in xenograft mice models. Overall, we demonstrated that RBM39 regulated OGG1 stabilisation and improved BER efficiency, suggesting that combining the RBM39 degradant indisulam with the oxidising agent KBrO3 could be an emerging strategy for HCC treatment.

Influence of nitrate-containing arugula juice on nitrate-reducing oral bacteria and periodontopathogens in smokers' biofilm

Green leafy vegetables such as arugula are rich in nitrates that support oral health, yet their effects on oral microbial balance, especially in smokers, remain unclear. This study evaluated the survival and activity of nitrate-reducing bacteria (NRB; Veillonella spp. and Rothia spp.) in biofilm exposed to nitrate-containing arugula juice (3.25 or 6.25 μM). The proportions of NRB were compared with periodontopathogens (Porphyromonas gingivalis and Fusobacterium nucleatum). Using quantitative real-time PCR (qPCR), we assessed bacterial survival and transcription of nitrate reductase genes (narG and napA) in biofilm from smokers and non-smokers. The results revealed that nitrate-containing arugula juice increased NRB bacteria abundance while reducing periodontopathogen growth. A higher level of nitrate (6.25 μM) increased nitrate reductase expression. Prolonged exposure (9 h) sustained the growth-promoting effect on Rothia spp. These results suggest that non-smokers have more nitrate-reducing bacteria in their biofilm, which promotes oral microbial balance. Thus, smokers might be advised to consume nitrate-containing arugula juice to promote NRB, which may have health benefits.

Organochlorine pesticides (OCPs) residues in fruit-flavored/regular waterpipe tobacco and their post-consumption waste: estimating release into inhaled smoke

There is limited information regarding organochlorine pesticides (OCPs) residues in tobacco products found in the Iranian market, especially in various types of waterpipe tobacco. The purpose of this research was to evaluate the concentration of OCPs in various waterpipe tobacco-both fruit-flavored and regular-and compare it with cigarette tobacco. Additionally, by analyzing the OCPs levels in fresh tobacco compared to tobacco wastes, an estimate has been made for the quantity of pesticides released into smoke during consumption. Our results indicated that the average detection frequency (DF) of pesticide residues was 46% for fruit-flavored tobacco, 82% for regular tobacco, and 42% for cigarette tobacco. Hexachlorocyclohexane (HCHs) isomers were the predominant pesticides in all three types of tobacco with the mean of 43.11 ± 31.81, 89.63 ± 56.08, and 41.65 ± 35.37 ng/g for fruit-flavored tobacco, regular tobacco, and cigarette tobaccos, respectively. Both the levels and DF of pesticides in post-consumption wastes were significantly reduced compared to that in fresh tobacco (p < 0.05). For all tobacco types-fruit-flavored, regular, and cigarette-notable OCPs residues were released into the gas phase, with cigarette tobacco having the highest rate at approximately ~ 37% because of greater combustion temperatures. The research points out some limitations, particularly the disregard for bowl water and charcoal as elements of waterpipe waste, which could lead to an overestimation of pesticide levels in inhaled smoke. Further studies are needed on the environmental impact of tobacco wastes and promoting for better waste management practices as well as public awareness.

Prevalence and determinants of oral potentially malignant disorders in western rajasthan

Oral cancer with incidence (10.2%) and mortality (9.3%) ranks as second most prevalent cancers in India. Oral cancer diagnosis at early stages through the detection of oral potentially malignant disorders (OPMDs) can lead to the prevention and reduction of mortality associated with oral cancer. The objective of the study was to estimate the prevalence and the determinants of OPMDs in Jodhpur, Rajasthan. A cross-sectional study was conducted in six blocks of Jodhpur, Rajasthan. The trained Community Health Officers (CHOs) of Ayushman Arogya Mandir (erstwhile Health and Wellness centers) performed an Oral Visual Examination (OVE) to screen the participants for OPMDs. The inclusion criteria comprised men and women aged 30 years or above or aged between 18 and 29 years with tobacco and/or alcohol consumption habits, visiting Ayushman Arogya Mandir. The association of the OPMD with socio-behavioral risk factors was determined through a bivariate chi-square test and multivariate-binary logistic regression analysis. The overall prevalence of OPMD was found to be 14.84%. The prevalence of leukoplakia (8.61%) was the highest, followed by oral submucous fibrosis (4.78%) and erythroplakia (2.87%). OPMD was significantly higher in lower socioeconomic status (SES). Smokeless tobacco consumption [AOR-8.751(1.500-51.046)], smoking [AOR-20.827 (2.204-196.832], and alcohol consumption [AOR-50.806 (3.617-713.687)] were significantly associated with OPMD. The synergistic effect of smokeless tobacco consumption, smoking, and alcohol consumption on OPMD was observed [AOR-26.222 (2.83-243.48)]. The mean duration and frequency per day of smokeless tobacco consumption and smoking were significantly higher in OPMD. We also found that oral cavity symptoms were strongly associated with OPMD, particularly persistent mouth ulcers and repeated biting injuries due to sharp teeth and dentures. To conclude, the study identified a high prevalence of OPMDs (14.84%) in Jodhpur, with leukoplakia being the most common OPMD. There was a significantly higher prevalence of OPMD in individuals from lower SES. The key modifiable risk factors, including smokeless tobacco use, smoking, and alcohol consumption, were strongly associated with OPMDs, with a notable synergistic effect observed when these behaviors coexisted. Additionally, oral cavity symptoms such as persistent mouth ulcers and repeated biting injuries due to sharp teeth and dentures were found to be determinants of OPMD. The study findings emphasize the need for targeted interventions addressing socio-behavioral risk factors to reduce the burden of OPMDs and prevent the progression to oral cancer.

Endplate remodeling: a key indicator of cigarette smoke exposure-induced intervertebral disc degeneration in a male rat model

Recent clinical studies have established a strong association between cigarette smoking and degenerative disc disease. Both in vitro and in vivo research indicated that cigarette smoke disrupts cellular homeostasis in the intervertebral disc (IVD), leading to spatiotemporal remodeling of the extracellular matrix, with a notable reduction in solute diffusivity within the cartilage endplate (CEP). As the CEP serves as a critical mechanical barrier and solute diffusion pathway for the IVD, both roles can be compromised by pathological changes in the tissue. This underscores the need for a more comprehensive examination of endplate remodeling during IVD degeneration, particularly in the context of cigarette smoking and cessation. The objective of this study was to perform a quantitative analysis of the structure-material property relationship changes in the endplate at tissue and cellular levels to determine how endplate mineralization progresses during IVD degeneration in the context of cigarette smoke exposure and cessation, using our previously developed Sprague-Dawley rat model. Our results indicate that cigarette smoke exposure-induced endplate remodeling is characterized by a higher CEP histological grade, increased aberrant CEP calcification level, and elevated bony endplate surface flatness score, all of which correlated with an accelerated chondrocyte cell life cycle. Smoke cessation alone was insufficient to reverse the mineralization progression in the endplate. Principal component analysis further identified alterations in endplate morphometry at the tissue level and disruptions in the chondrocyte life cycle at cellular level as key markers of degenerative remodeling. These findings establish endplate remodeling as a key indicator of smoke exposure-induced IVD degeneration and inform the development of novel therapeutic strategies aimed at preserving or improving disc health.

Modulation of Neurturin Expression by Lumbosacral Spinal Stenosis, Lifestyle Factors, and Glycemic Dysregulation

Background/Objectives: Lumbosacral spinal stenosis (LSS) is a degenerative condition characterized by narrowing of the spinal canal and associated neuropathic pain. While mechanical compression is well-characterized, the molecular mechanisms contributing to symptom severity remain poorly understood. Neurturin (NRTN), a member of the glial cell line-derived neurotrophic factor family, has emerged as a potential mediator of neural plasticity and nociception, but its role in spinal stenosis is largely unexplored. Methods: We analyzed NRTN mRNA and protein expression in ligamentum flavum samples from 96 patients undergoing surgery for LSS and 85 non-degenerative postmortem controls. Quantification was performed using real-time quantitative polymerase chain reaction (RT-qPCR), enzyme-linked immunosorbent assay (ELISA), Western blotting, and immunohistochemistry. Pain severity Visual Analog Scale (VAS), body mass index (BMI), diabetes, smoking, and alcohol use were assessed as modulators of NRTN expression. Results: NRTN expression was significantly elevated in LSS patients versus controls at both transcript and protein levels (p < 0.05). NRTN levels positively correlated with pain intensity (VAS; ANOVA p = 0.032 for mRNA, p = 0.041 for protein). Multivariate regression identified BMI (β = 0.50, p = 0.015) and diabetes (β = 0.39, p = 0.017) as independent predictors of increased NRTN expression. Alcohol use also showed a positive association (p = 0.046), while smoking showed no significant independent effect. Conclusions: Neurturin is upregulated in ligamentum flavum tissue from LSS patients and correlates with pain severity and metabolic risk factors. These findings suggest NRTN as a potential biomarker and therapeutic target in degenerative spine disease. Further longitudinal and mechanistic studies are warranted to elucidate its role in chronic pain and neuroinflammation.

Lung Microbiome in Autoimmune-Associated Interstitial Lung Disease

The lung microbiome is a diverse mucosal environment that has been shown to be implicated in the pathogenesis of various chronic lung diseases including insterstitial lung diseases (ILD) such as idiopathic pulmonary fibrosis (IPF). ILD is a well-established manifestation of several types of autoimmune diseases. This review will highlight recent work exploring the role of the lung microbiome in the pathogenesis of autoimmune-related ILD.

The interaction between circadian syndrome and genetic susceptibility in the risk of incident dementia: A longitudinal cohort study

BACKGROUND

Despite growing interest in circadian disturbances as potential triggers for dementia, the specific impact of circadian syndrome (CircS) on dementia incidence remains poorly understood. Moreover, the role of genetic susceptibility modulating these effects remains to be explored.

METHODS

Dementia-free participants from the UK Biobank cohort were included in the analysis. To evaluate the association between CircS and the incidence of dementia, as well as the modifying influence of genetic susceptibility on this relationship, Cox proportional hazards models were utilized.

RESULTS

During a median follow-up period of 14.55 years, 3,965 incident dementia cases were documented. CircS was found to significantly increased the risk of incident dementia, with a hazard ratio (HR) of 1.401 (95 % confidence interval [CI]: 1.296, 1.516). Compared to a CircS score of ≤3, mild CircS (HR: 1.259, 95 % CI: 1.146-1.383), moderate CircS (HR: 1.667, 95 % CI: 1.461-1.903), and severe CircS (HR: 2.028, 95 % CI: 1.397-2.944) were all significantly associated with an elevated risk of dementia. There were significant multiplicative interactions between CircS and genetic susceptibility (Pinteraction<0.001). Participants with both a high polygenic risk score (PRS) and CircS had the highest risk of incident dementia (HR: 2.551, 95 % CI: 2.169, 3.001), compared to those with a low PRS and no CircS.

CONCLUSIONS

CircS was associated with an increased risk of dementia, which might be aggravated by genetic susceptibility.

Vitamin D receptor gene polymorphism in oral cancer as a function of tobacco consumption: an evidence based systematic review and meta-analysis

Background

The association between Vitamin D Receptor (VDR) polymorphisms and different cancers has attracted growing attention; nonetheless, the function of these genetic variants in tobacco-related oral cancer remains little comprehended. This review assesses and integrates research concerning the influence of VDR gene variants on the development of tobacco-related oral cancer, emphasizing genetic underpinnings of individual vulnerability and possible tailored preventative approaches.

Materials and methods

The search strategy for this systematic review and meta-analysis was devised to comprehensively identify relevant studies from diverse sources. The investigation included three primary components: the VDR gene, oral cancer, and tobacco. The data from the papers included in the study were independently retrieved by two reviewers. The incidence was evaluated as an odds ratio (OR) with 95% confidence interval (95% CI) using SPSS software.

Results

A preliminary search of biomedical electronic research databases (PubMed, Web of Science, Scopus, Embase, and the Cochrane Library) yielded 60,345 papers. After multi-phase exclusions, five studies met the inclusion criteria. The meta-analysis highlights interactions between genetic polymorphisms, smoking, aging, and oral health risks. The CYP24A1 (rs2296241) heterozygote genotype significantly reduces oral cancer risk (OR = 0.281, P = 0.00001). Variants rs1544410 and rs2228570 influence oral health outcomes. The rs2239185 TT (OR = 2.68, P = 0.009) and rs7975232 CC (OR = 2.25, P = 0.026) increase oral lichen planus risk. Older age is significantly linked to OSCC risk (P = 0.001).

Conclusion

This research underscores the role of VDR gene variants in tobacco-related oral cancer. Further studies are essential to validate findings and explore underlying mechanisms.

Systematic Review Registration

https://www.crd.york.ac.uk/PROSPERO/view/CRD42024587292, identifier: CRD42024587292.

Beyond the Injury: How Does Smoking Impair Stem Cell-Mediated Repair Mechanisms? A Dual Review of Smoking-Induced Stem Cell Damage and Stem Cell-Based Therapeutic Applications

While the literature on molecular and clinical effects of smoking on the lungs and other organs has been expansively reviewed, there is no comprehensive compilation of the effects of smoking on stem cell (SC) populations. Recent research has shown that tobacco exposure severely compromises the function of SC populations, particularly those involved in tissue regeneration: mesenchymal SCs (MSCs), neural progenitors, and hematopoietic SCs. SC-based therapies have emerged as a promising approach to counteract smoking-related damage. In particular, MSCs have been extensively studied for their immunomodulatory properties, demonstrating the ability to repair damaged tissues, reduce inflammation, and slow disease progression in conditions such as chronic obstructive pulmonary disease. Combination therapies, which integrate pharmaceuticals with SC treatments, have shown potential in enhancing regenerative outcomes. This review examines the impact of smoking on SC biology, describes the processes impairing SC-mediated repair mechanisms and highlights recent advancements in SC-based therapies in the treatment of smoking-induced diseases. This review has two prongs: (1) it attempts to explain potential smoking-related disease etiology, and (2) it addresses a gap in the literature on SC-mediated repair mechanisms in chronic smokers.

Association between non-high-density lipoprotein to high-density lipoprotein cholesterol ratio and bowel health in U.S. adults: a cross-sectional study

Background

The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) is a robust predictor of dyslipidemia and cardiovascular disease, strongly linked to the development of various chronic conditions. However, there is a paucity of evidence exploring the relationship between NHHR and bowel health, particularly chronic diarrhea and constipation.

Methods

This cross-sectional study utilized data from the National Health and Nutrition Survey (NHANES) 2005-2010. Sociodemographic, lifestyle, and health status data were collected alongside blood lipid levels. Weighted multivariate logistic regression models assessed the association between NHHR and bowel health. The restricted cubic spline (RCS) method was used to explore their dose-response relationship. Subgroup analyses and sensitivity analyses were conducted to further validate the robustness of our findings.

Results

In our study of 11,268 participants, a significant positive association was identified between elevated NHHR levels and chronic constipation in women, with the highest quartile showing an adjusted OR of 1.57 (95% CI: 1.21-2.03) compared to the lowest quartile. This association was notably stronger among female smokers. Sensitivity analyses excluding individuals with hypercholesterolemia or inflammatory bowel disease confirmed the robustness of the correlation. No significant associations were found in men.

Conclusion

The study findings provide novel evidence of the relationship between NHHR and bowel health in United States women, particularly chronic constipation. However, the cross-sectional design of the study limits our ability to establish causality. Additionally, reliance on self-reported bowel health data may introduce inaccuracies. Further research is needed to explore the mechanisms underlying this association and the impact of lifestyle factors.

Oxidative Stress and Dietary Antioxidants in Head and Neck Cancer

Oxidative stress serves as both a driver and result of redox metabolism across diverse physiological and pathological states, including cancer. Head and neck squamous cell carcinoma (HNSCC), the sixth most prevalent malignancy worldwide, is no exception. HNSCC is strongly linked to modifiable external risk factors such as tobacco smoking, alcohol consumption, and high-risk human papilloma (HR-HPV) infection. These risk factors are associated with elevated oxidative stress, which contributes to carcinogenesis through DNA damage, chronic inflammation, and dysregulation of cell signaling pathways. Current treatment options for HNSCC have limitations and burden of side effects. Studies have been conducted on potent dietary antioxidants for the prevention and adjunctive treatment of HNSCC. This review aims to explore the contribution of oxidative stress to carcinogenesis in general and the three major risk factors for HNSCC. We evaluate latest evidence for nine dietary antioxidants such as vitamin C, vitamin E, carotenoids, epigallocatechin-3-gallate (EGCG), and curcumin, that have shown promise in preclinical and clinical studies. We discuss how these compounds mitigate ROS, influence cancer-related signaling pathways, and modulate tumor microenvironment. Despite encouraging findings, current clinical data remain limited and inconclusive, highlighting the need for further research on possible dietary antioxidants for HNSCC.

Associations of exposure to volatile organic compounds with biological aging: a cross-sectional study

BACKGROUND

Volatile organic compounds (VOCs) are recognized as potentially linked to various health damages. However, the effects of VOCs exposure on biological aging remain unknown. This study aimed to investigate this potential association through cross-sectional analyses.

METHODS

This study analyzed data from the National Health and Nutrition Examination Surveys (2011-2016). There was a total of 29,902 participants and 3,205 participants were finally included. Biological aging was represented by PhenoAge acceleration calculated through multiple indicators including albumin and alkaline phosphatase and so on. We employed weighted multivariate logistic regression to examine the correlation between individual VOC exposure and biological aging. The least absolute shrinkage and selection operator regression was utilized to identify key VOCs for the weighted quantile sum (WQS) regression, which assessed the association between mixed exposure to VOCs and biological aging. In addition, subgroup analyses were conducted using data from the same database on individuals' daily behaviors, such as physical activity levels, smoking, and alcohol consumption, to explore the influence of daily behaviors on the above associations.

RESULTS

Logistic regression analysis indicated that exposure to various individual VOCs was associated with biological aging. The WQS results revealed a significant positive association between mixed exposure to VOCs and biological aging (P < 0.001, OR = 1.523). Additionally, we found that participants with drinking, smoking, and lower levels of physical activity were more affected by exposure to individual VOCs. Mixed VOCs exposures differed only between smoking (P < 0.001, OR = 1.422) and non-smoking populations (P = 0.216, OR = 1.158).

CONCLUSION

VOCs exposure was associated with biological aging, and daily behaviors may influence an individual's susceptibility to such exposure. This discovery provided a new way of thinking about slowing down the aging process and improving overall health.

Electronic Cigarette-Derived Metals: Exposure and Health Risks in Vapers

Despite the popularity of electronic cigarettes (e-cigs) among adolescent and youth never-smokers and adult smokers seeking a less harmful substitute for tobacco cigarettes, the long-term health impact of vaping is largely unknown. Biochemical, molecular, and toxicological analyses of biospecimens from e-cig users as well as assays in relevant in vitro models and in silico studies can identify chemical constituents of e-cig emissions that may contribute to the disease-causing potential of vaping. E-cig aerosol contains a wide range of toxic and carcinogenic compounds, of which metals are of particular concern. This is due to the known or suspected role of various metals in the pathogenesis of numerous diseases. Many metals and metalloids (herein referred to as "metals") have been detected in e-cig liquid (e-liquid) and aerosol and/or in cells, tissues, biofluids, or other specimens from e-cig users. Metals can contaminate the ingredients of e-liquid or corrode from the internal components of the e-cig device. Metals may also be directly aerosolized from the surface of the heating element or other parts of the device. Inhalation of e-cig metal emissions in habitual vapers and nonusers through secondary exposure may increase the body burden of toxic and carcinogenic chemicals. This review summarizes the state of research on e-cig-derived metals and their contributions to the estimated health risks of vaping. Highlighting the chemical composition of e-cig liquid and aerosol, it focuses on the metal contents of the inhaled aerosol and the health risks associated with this exposure. Emphasis is placed on adolescents and youth who are vulnerable populations and bear a disproportionate burden of risk and harm from tobacco products. The gaps in knowledge, methodological challenges, and opportunities ahead are discussed. The importance of translating research findings into actionable information that can be used for the regulation of the manufacturing of tobacco products is underscored.

Association between periodontitis and prostate cancer: A case-control study

BACKGROUND

Recent evidence suggests that chronic inflammation may play a role in the development and clinical course of cancer. In this context, periodontitis (PE) has been associated with prostate cancer (PC), but the results are still inconsistent. Therefore, the aim of this study was to evaluate the potential association between PE and PC, and their shared risk factors.

METHODS

This case-control study comprised 152 cases with PC and 220 controls. All participants underwent a complete periodontal examination, and sociodemographic and medical variables of interest were collected. The association between occurrence and severity of PC and covariates was assessed by binary and multinomial multivariate logistic regression, respectively.

RESULTS

The cases had a higher prevalence (p = 0.012) and severity (p = 0.007) of PE. The occurrence of PC was associated with an educational level <9 years (adjusted odds ratio [OR] = 1.93), smoking (adjusted OR = 2.62), alcohol consumption (adjusted OR = 3.45), diabetes (adjusted OR = 0.32), chronic hypertension (adjusted OR = 2.03), and PE (adjusted OR = 1.80). Regarding the severity of PC, Gleason grades 1 and 2 were associated with PE (adjusted OR = 1.96), but Gleason grades 3-5 were not.

CONCLUSION

PE was associated with the occurrence of PC. Males diagnosed with PE would potentially benefit from being screened for prostate alterations.

PLAIN LANGUAGE SUMMARY

Periodontitis is an infectious disease that affects the supporting structures of the teeth. It has been characterized as a chronic inflammatory stimulus with potential risk for the occurrence or worsening of the clinical course of cancer. We evaluated the potential relationship between periodontitis and prostate cancer, as well as their shared risk factors, in a case-control study comprising 372 male individuals. The participants were recruited in a urology outpatient clinic and underwent a complete periodontal examination. The results showed that individuals with prostate cancer presented a worse periodontal status and a higher prevalence and severity of periodontitis. Prostate cancer was mainly associated with educational level, smoking, alcohol consumption, and periodontitis. Individuals with periodontitis were 1.8 times more likely to have prostate cancer. Prostate-specific antigen levels in individuals with periodontitis were also significantly higher. We concluded that periodontitis was associated with the occurrence of prostate cancer. Therefore, males diagnosed with periodontitis would potentially benefit from being screened for prostate alterations.

REDOX Imbalance and Oxidative Stress in the Intervertebral Disc: The Effect of Mechanical Stress and Cigarette Smoking on ER Stress and Mitochondrial Dysfunction

Low back pain is a widespread condition that significantly impacts quality of life, with intervertebral disc degeneration (IDD) being a major contributing factor. However, the underlying mechanisms of IDD remain poorly understood, necessitating further investigation. Environmental risk factors, such as mechanical stress and cigarette smoke, elevate reactive oxygen species levels from both endogenous and exogenous sources, leading to redox imbalance and oxidative stress. The endoplasmic reticulum (ER) and mitochondria, two key organelles responsible for protein folding and energy production, respectively, are particularly vulnerable to oxidative stress. Under oxidative stress conditions, ER stress and mitochondrial dysfunction occur, resulting in unfolded protein response activation, impaired biosynthetic processes, and disruptions in the tricarboxylic acid cycle and electron transport chain, ultimately compromising energy metabolism. Prolonged and excessive ER stress can further trigger apoptosis through ER-mitochondrial crosstalk. Given the unique microenvironment of the intervertebral disc (IVD)-characterized by hypoxia, glucose starvation, and region-specific cellular heterogeneity-the differential effects of environmental stressors on distinct IVD cell populations require further investigation. This review explores the potential mechanisms through which environmental risk factors alter IVD cell activities, contributing to IDD progression, and discusses future therapeutic strategies aimed at mitigating disc degeneration.

Association Between Alcohol Consumption, Other Healthy Habits and Sociodemographic Variables and the Values of Different Insulin Resistance Risk Scales in 139,634 Spanish Workers

Background: Alcohol consumption is a major public health concern, influencing metabolic health and insulin resistance (IR). While moderate alcohol intake has been associated with potential metabolic benefits, excessive consumption is linked to IR and related disorders. This study examines the association between sociodemographic variables, health habits, and IR risk using validated metabolic indices. Methods: A dual-phase study was conducted, including a cross-sectional analysis of 139,634 Spanish workers and a retrospective longitudinal follow-up of 40,431 participants (2009-2019). Data on sociodemographic factors (age, sex and socioeconomic status) and health habits (smoking, alcohol consumption, diet and physical activity) were collected through standardized occupational health assessments. IR risk was assessed using the Triglyceride-Glucose Index (TyG), Metabolic Score for Insulin Resistance (METS-IR), and Single-Point Insulin Sensitivity Estimator (SPISE-IR). Binary logistic regression was used for statistical analysis. Results: Age, male sex, lower socioeconomic status, smoking, alcohol consumption, physical inactivity and low adherence to the Mediterranean diet were significantly associated with higher IR risk across all indices (p < 0.001). Alcohol consumption exhibited a dose-dependent relationship with IR, with excessive intake significantly increasing the risk of IR. Longitudinal data revealed a worsening IR profile over time, particularly among older, low-income and physically inactive individuals. Conclusions: Sociodemographic factors and lifestyle habits strongly influence IR. Preventive strategies focused on reducing alcohol consumption, smoking cessation and promoting physical activity and dietary improvements are essential to mitigate the risk of IR, especially in vulnerable populations. Further longitudinal studies are needed to establish causal relationships and refine intervention strategies.

Proteomic and In Silico Analyses Highlight Complement System's Role in Bladder Cancer Immune Regulation

Background and Objectives: Bladder cancer (BLCA), intimately associated with the immune system, represents a substantial global health burden due to its high recurrence rates and limited therapeutic effectiveness. Although immunotherapy shows promise, challenges persist due to the lack of reliable therapeutic targets. This study aims to investigate potential immune-related biomarkers that could influence the tumor microenvironment in BLCA, using proteomic and in silico approaches. Materials and Methods: Tissue samples from BLCA patients (n = 27) and controls (n = 27) were collected from Şişli Hamidiye Etfal Training and Research Hospital. Proteomic analysis was performed by liquid chromatography/mass spectrometry (LC-MS)/MS to reveal the identities of differentially regulated proteins. Protein network analysis and hub protein detection were performed using Cytoscape (v.3.10.3), while functional annotation was carried out using EnrichR. The immunological analysis of hub proteins was performed in Sangerbox platform, and prognostic associations were evaluated through the Kaplan-Meier Plotter tool. Results: LC-MS/MS analysis identified 120 differentially regulated immune-related proteins. STRING analysis, using an immune response dataset (GO:0006955), highlighted the complement cascade as a significantly enriched pathway (p < 0.05). Proteins, namely C4A, CFB, C4B, C8B, CFH, CFI, C5, C4BPA, C3, and C2, that are known to play key roles in the complement system were identified. Immunological analysis with these proteins revealed the phenomena of immune infiltration and immune checkpoint gene associations (p < 0.05). Four hub genes-CFB, C4B, CFI, and C2-demonstrated a significant prognostic value for BLCA (p < 0.05). Conclusions: This study highlights the pivotal role of the complement system in the immune regulation of BLCA. CFI, C4A, and C4B emerged as potential target proteins for BLCA treatment, particularly in immunotherapy, for enhancing survival. Future research on these proteins and the complement system specifically focusing on BLCA may facilitate the development of targeted immunotherapies, ultimately improving treatment outcomes.

Exploring the link between serum uric acid and endometriosis: a cross-sectional analysis utilizing NHANES data from 1999-2006

Background

Substantial impacts on the female reproductive system have been definitively linked to heightened levels of serum uric acid. However, evidence directly linking increased serum uric acid levels to endometriosis in women remains sparse, and the precise characteristics of this influence are still not fully understood.

Objective

To explore the exact relationship between serum uric acid and endometriosis.

Study design

Referencing the data accumulated from the National Health and Nutrition Examination Survey (NHANES), this study covers the period from 1999 to 2006, conducted an analysis of 5,162 female participants aged 20 to 54 years (representing a sample size of approximately 66,927,890 women). The study adopted a cross-sectional methodology to delve into the tie between serum uric acid and the prevalence of endometriosis. Utilizing rigorous methodologies, including weighted multivariable logistic regression models, subgroup analyses, and statistical methodologies for smooth curve fitting.

Results

A positive association was found between continuous serum uric acid and the risk of endometriosis (OR = 1.25, 95% CI [1.09, 1.44], P = 0.003). At the same time, women in the highest quartile had a 133% higher risk of endometriosis compared with women with the lowest quartile of uric acid (OR=2.33,95%CI [1.28, 4.23], P=0.009). At the same time, smooth curve fitting also found a linear positive correlation between serum uric acid and endometriosis. There was no heterogeneity in subgroup analysis.

Conclusion

The study indicates a strong link between increased serum uric acid levels and the appearance of endometriosis in women. Specifically, women with elevated uric acid levels face a higher likelihood of developing endometriosis.

Glymphatic function and choroid plexus volume is associated with systemic inflammation and oxidative stress in major depressive disorder

BACKGROUND

Inflammatory processes were recognized as key factors in the pathophysiology of major depressive disorder (MDD). The choroid plexus (ChP) and glymphatic system played central roles in immune interactions between the brain and periphery. However, their specific roles in MDD and their relationship with systemic inflammation and oxidative stress remained unclear.

METHODS

This study finally included 665 MDD patients and 338 healthy controls. Clinical data and MRI scans were collected, and some patients also underwent blood routine and biochemical tests. ChP volume was manually segmented, and the diffusion tensor imaging along the perivascular space (DTI-ALPS) index, reflecting glymphatic function, was obtained through the FSL pipeline. The differences in these dices between groups were compared, and their associations with systemic inflammation and oxidative stress were analyzed.

RESULTS

MDD patients showed increased ChP volume (total: d = 0.316, p < 0.001; left: d = 0.317, p < 0.001; right: d = 0.268, p = 0.003) and decreased DTI-ALPS index (d = -0.144, p = 0.022), with a negative correlation between them (ρ = -0.135, p < 0.001). In MDD patients, lower DTI-ALPS index was correlated with higher LHR (ρ = -0.107, p = 0.025) and MHR (ρ = -0.126, p = 0.008). Larger right ChP volume was associated with higher MLR (ρ = 0.107, p = 0.009), SIRI (ρ = 0.086, p = 0.036), PIV (ρ = 0.086, p = 0.036), MHR (ρ = 0.136, p = 0.004), and PHR (ρ = 0.126, p = 0.008), while larger total ChP volume was correlated with higher MHR (ρ = 0.097, p = 0.042) and PHR (ρ = 0.114, p = 0.017).

CONCLUSION

MDD appeared to be accompanied by an increase in ChP volume and a decrease in glymphatic function, and these changes were related to systemic inflammation and oxidative stress.

The causal relationship between smoking, alcohol consumption, and sepsis: A 2-sample mendelian randomized study

A Mendelian randomization (MR) study was used to explore whether there is a causal relationship between smoking, alcohol consumption, and sepsis. Genome-wide association studies data on sepsis, alcohol consumption, and 3 smoking behaviors including smoking initiation, age of initiation, and cigarettes per day were extracted from public databases. The inverse variance weighting (IVW), weighted median, and MR-Egger regression method were used to analyze the causal association between smoking, alcohol consumption, and sepsis. Forest plots of the causal relationship between smoking, alcohol consumption, and sepsis were plotted. The MR Analysis based mainly on IVW showed a causal relationship between cigarettes per day and sepsis (OR = 1.24, 95% CI = 1.11-1.37, P = .000). Heterogeneity and horizontal pleiotropy were excluded by sensitivity analysis. MR Analysis showed that there was no causal association between sepsis and smoking initiation, age of initiation, and alcohol consumption. There is a positive causal effect between cigarettes per day and the risk of sepsis. However, there was insufficient evidence for a causal relationship between sepsis and smoking initiation, age of initiation, and alcohol consumption.

Effectiveness of nurse-initiated smoking cessation intervention: a systematic review and meta-analysis

BACKGROUND

Smoking is a major preventable cause of death, associated with cancers and chronic diseases. Nurse-initiated smoking cessation programs have proven effective, providing counseling, education, and mental health support. These interventions increase quit rates by tackling nicotine addiction, emphasizing the important role of nurses and the need for targeted training. Systematic reviews and meta-analyses are essential for gaining a deeper understanding of the effectiveness of various cessation strategies.

METHODS

A literature search was conducted using eight electronic databases (CINAHL, EMbase, MEDLINE, Cochrane, RISS, KMbase, KISS, and NDSL). The literature search was conducted from March, 27, 2024, to August 1, 2024. All included studies were randomized controlled trials (RCTs). Quality assessment was conducted using the Risk of Bias (ROB) tool. RevMan 5.4 was used for qualitative analysis, with effect sizes measured as odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS

Thirteen studies, all published after 2005, were included in the evidence assessment of nurse-initiated smoking cessation programs. The interventions examined comprised 11 intensive or personalized counseling programs and 3 telephone-based approaches. The OR for self-reported quit success 7-day smoking cessation rate at 6-month follow-up was 1.43 (95% CI [1.08, 1.90]), indicating a significant difference in quit effectiveness (Z = 2.27, p =.01), with moderate heterogeneity observed across studies (I2 = 67.0%, p =.001). A meta-analysis of 7-day point abstinence rate at 12-month follow-up revealed a pooled OR of 1.18 (95% CI [0.96, 1.44]), showing no significant difference in quit effectiveness (Z = 1.58, p =.11) and moderate heterogeneity among the studies (I2 = 55.0%, p =.02).

CONCLUSIONS

A comprehensive approach by trained nursing professionals is essential in addressing the complexities of smoking cessation. Further clinical trials are needed to assess intervention methods and follow-up strategies. Future research should emphasize long-term outcomes and ongoing support to sustain behavior change, contributing to more effective, tailored cessation programs and improved public health outcomes.

Tobacco smoke exposure is a driver of altered oxidative stress response and immunity in head and neck cancer

BACKGROUND

Exposomes are critical drivers of carcinogenesis. However, how they modulate tumor behavior remains unclear. Extensive clinical data show cigarette smoke to be a key exposome that promotes aggressive tumors, higher rates of metastasis, reduced response to chemoradiotherapy, and suppressed anti-tumor immunity. We sought to determine whether smoke itself can modulate aggressive tumor behavior in head and neck squamous cell carcinoma (HNSCC) through reprogramming of the cellular reductive state.

METHODS

Using established human and murine HNSCC cell lines and syngeneic mouse models, we utilized conventional western blotting, steady state and flux metabolomics, RNA sequencing, quantitative proteomics and flow cytometry to analyze the impact of smoke exposure on HNSCC tumor biology and anti-tumor immunity.

RESULTS

Cigarette smoke persistently activated Nrf2 target genes essential for maintenance of the cellular reductive state and survival under conditions of increased oxidative stress in HNSCC regardless of human papillomavirus (HPV) association. In contrast to e-cigarette vapor, conventional cigarette smoke mobilizes cellular metabolism toward oxidative stress adaptation, resulting in development of cross-resistance to cisplatin. In parallel, smoke exposure modulates expression of PDL1 and the secretory phenotype of HNSCC cells resulting in an altered tumor immune microenvironment (TIME) in syngeneic mouse models and downregulated expression of antigen presentation and costimulatory genes in myeloid cells.

CONCLUSION

The cigarette smoke exposome is a potent activator of the Nrf2 pathway and appears to be the primary trigger for a tripartite phenotype of aggressive HNSCC consisting of: (1) reduced chemotherapy sensitivity, (2) enhanced metastatic potential and (3) suppressed anti-tumor immunity.

Maternal Immune Activation: Implications for Congenital Heart Defects

Congenital heart defects (CHD) are the most common major birth defects and one of the leading causes of death from congenital defects after birth. CHD can arise in pregnancy from the combination of genetic and non-genetic factors. The maternal immune activation (MIA) hypothesis is widely implicated in embryonic neurodevelopmental abnormalities. MIA has been found to be associated with the development of asthma, diabetes mellitus, and other diseases in the offspring. Given the important role of cardiac immune cells and cytokines in embryonic heart development, it is hypothesized that MIA may play a significant role in embryonic heart development. This review aims to stimulate further investigation into the relationship between MIA and CHD and to highlight the gaps in the knowledge. It evaluates the impact of MIA on CHD in the context of pregnancy complications, immune-related diseases, infections, and environmental and lifestyle factors. The review outlines the mechanisms by which immune cells and their secretome indirectly regulate the immuno-microenvironment of the embryonic heart by influencing placental development. Furthermore, the inflammatory cytokines cross the placenta to induce related reactions including oxidative stress in the embryonic heart directly. This review delineates the role of MIA in CHD and underscores the impact of maternal factors, especially immune factors, as well as the embryonic cardiac immuno-microenvironment, on embryonic heart development. This review extends our understanding of the importance of MIA in the pathogenesis of CHD and provides important insights into prenatal prevention and treatment strategies for this congenital condition.

Comparative Evaluation of Cigarette Smoke and a Heated Tobacco Product on Corneal Oxidative Stress in an Air/Liquid Interface Model

Purpose

Tobacco smoke harbors toxic combustion by-products contributing to inflammatory diseases. Cigarette smoke's impact on ocular diseases has been poorly characterized, despite conjunctival mucosa's sensitivity to these toxicants. Of note, cigarette smoke triggers redness, tearing, and discomfort, accounting as a risk factor for glaucoma, macular degeneration, cataracts, and other eye conditions. Low quit rates of cessation highlight the need for alternatives. Heated tobacco products (HTPs), may represent a less toxic alternative for those smokers. This study evaluates cigarette smoke and HTPs effects on cornea under standard and clinically relevant conditions.

Methods

Corneal tissues collected from donors and in vitro model in two different cell lines of corneal epithelium were exposed to cigarette (1R6F) smoke and HTPs vapor. Air exposure was included as a control. Tissue pathological evaluation was carried out by hematoxylin and eosin staining. Reactive oxygen species (ROS) were measured, and quantitative PCR assessed inflammatory and antioxidant genes expression. Proteome analysis was used to evaluate differentially expressed proteins related to the oxidative stress. Scratch assay measured smoke and HTPs impact on cells.

Results

Hematoxylin & eosin staining highlighted that cigarette smoke impairs corneal tissue integrity, leading to ROS accumulation and inflammation, as proved by qPCR analysis. Proteomic analysis showed that corneal tissue's proteins were differently oxidized by the different experimental conditions. HTP targeted structural intracellular proteins, whereas 1R6F affects different members of collagen family. Finally, cigarette smoke, but not HTPs, impairs epithelial cells wound closure.

Conclusions

Smoking increases oxidative stress, leading to significant corneal damage and inflammation. HTPs may offer a less toxic alternative.

Comparative Analysis of Inflammatory and Heavy Metal Biomarkers in Exclusive E-Cigarette Users, Combustible Tobacco Users, and Non-Users Aged 18-30: A Cross-Sectional NHANES Analysis

While cigarette smoking has declined, e-cigarette use among young adults has increased in the USA. This cross-sectional study compared complete blood counts, C-reactive protein, and select blood metals (lead, cadmium, mercury, selenium, manganese) among exclusive combustible tobacco users, exclusive e-cigarette users, and non-users using NHANES data from 2013-2023 in the USA. The goal of this study was to compare biomarker data from e-cigarette users and combustible tobacco users to that of non-users. Among 756 participants aged 18-30, 229 reported no tobacco use, 74 used only e-cigarettes, and 453 smoked only combustible tobacco. Survey-weighted analyses adjusted for age, sex, race/ethnicity, and body mass index revealed that exclusive combustible use was associated with significantly elevated white blood cell counts, hemoglobin, hematocrit, mean corpuscular volume, lymphocytes, monocytes, neutrophils, and higher blood lead and cadmium. E-cigarette-only use showed fewer deviations overall but included higher mean corpuscular hemoglobin concentration and lower cadmium, selenium, and methyl mercury relative to non-users. Neither group differed significantly in red blood cell count or C-reactive protein, and inorganic/ethyl mercury and manganese levels were largely unchanged. These findings underscore pronounced hematologic and metal-related alterations in combustible tobacco users and fewer, but not negligible, changes among e-cigarette users. Further research is needed to determine the long-term health implications of exclusive e-cigarette use, including potential impacts on antioxidant micronutrient levels.

In vitro and in vivo evidence of the effectiveness of gallic acid on glycerol-induced acute kidney injuries

Because acute kidney injuries (AKI) are one of the critical health problems worldwide, studies on the risk factors, mechanisms, and treatment strategies seem necessary. Glycerol (GLY), known to induce cell necrosis via myoglobin accumulation in renal tubules, is widely used as an AKI model. This study aimed to evaluate the protective effects of gallic acid (GA) against GLY-induced AKI. The study utilized both in vivo and in vitro models. In vivo, healthy rats were divided into six groups: control (normal saline), GLY (10 mg/kg, intramuscularly), GLY + GA10 (10 mg/kg), GLY + GA50 (50 mg/kg), GLY + GA100 (100 mg/kg), and GA (100 mg/kg). GA was administered by gavage for seven consecutive days, followed by a single intramuscular injection of GLY. Kidney biomarkers, lactate dehydrogenase (LDH), oxidative stress markers, inflammatory indices, and histological parameters were assessed 72 h post-injection. In vitro, human embryonic kidney 2 (HK-2) cells were incubated with GLY and GA at different concentrations (30, 60, and 125 μg/ml) to evaluate cell viability, reactive oxygen species (ROS) production, oxidative stress, and inflammatory cytokines. GLY administration significantly elevated renal dysfunction markers, including blood urea nitrogen and creatinine, alongside oxidative stress and reduced cell viability. GA treatment improved kidney biomarkers, enhanced antioxidant enzyme activity, and reduced inflammatory cytokines. Histological analyses also showed improved kidney structural integrity in GA-treated rats compared to the GLY group. This study confirmed that GLY induces AKI through oxidative stress, inflammation, and structural damage. GA exhibited significant renal protective effects by enhancing antioxidant defenses and reducing inflammation. These findings support GA as a potential natural supplement for preventing or treating renal diseases.

The relationship between epigenetic biomarkers and the risk of diabetes and cancer: a machine learning modeling approach

Introduction

Epigenetic biomarkers are molecular indicators of epigenetic changes, and some studies have suggested that these biomarkers have predictive power for disease risk. This study aims to analyze the relationship between 30 epigenetic biomarkers and the risk of diabetes and cancer using machine learning modeling.

Methods

The data for this study were sourced from the NHANES database, which includes DNA methylation arrays and epigenetic biomarker datasets. Nine machine learning algorithms were used to build models: AdaBoost, GBM, KNN, lightGBM, MLP, RF, SVM, XGBoost, and logistics. Model stability was evaluated using metrics such as Accuracy, MCC, and Sensitivity. The performance and decision-making ability of the models were displayed using ROC curves and DCA curves, while SHAP values were used to visualize the importance of each epigenetic biomarker.

Results

Epigenetic age acceleration was strongly associated with cancer risk but had a weaker relationship with diabetes. In the diabetes model, the top three contributing features were logA1Mort, family income-to-poverty ratio, and marital status. In the cancer model, the top three contributing features were gender, non-Hispanic White ethnicity, and PACKYRSMort.

Conclusion

Our study identified the relationship between epigenetic biomarkers and the risk of diabetes and cancer, and used machine learning techniques to analyze the contributions of various epigenetic biomarkers to disease risk.

Smoking-induced gut microbial dysbiosis mediates cancer progression through modulation of anti-tumor immune response

Cigarette smoke exposure (CSE) increases the risk for a plethora of cancers. Recent evidence indicates that the gut microbiome can influence cancer progression by immune system modulation. Since CSE alters the gut microbiome, we hypothesized that the gut microbiome serves as a causative link between smoking and cancer growth. Through a combination of syngeneic animal models and fecal microbiota transplantation studies, we established an essential role for smoke-induced dysbiosis in cancer growth. 16s rRNA sequencing and liquid chromatography-mass spectrometry indicated a unique CSE-associated microbial and metabolomic signature. Immunophenotyping of tumor specimens and experiments in Rag1-KO and CD8-KO demonstrated that smoke-induced tumor growth requires functional adaptive immunity. Finally, utilizing gut microbial ablation strategies with broad- and narrow-spectrum antibiotics, we demonstrated the reversal of phenotypic effects of CSE. Our study provides evidence for gut microbiome as an actionable target to mitigate CSE-induced tumor promotion.

Grey matter morphometry in young adult e-cigarette users, tobacco cigarette users & non-using controls

Despite the rise in electronic cigarette use in recent years, the neurobiological effects of daily e-cigarette use versus smoking cigarettes in young adults remains unknown. This study aimed to investigate the impact of regular, exclusive e-cigarette use on grey matter morphometry in young adults, age 18-25. Structural MRI data were collected from 3 distinct groups of participants (n = 78): daily, exclusive e-cigarette users; tobacco cigarette users; and non-using controls, to assess grey matter volume (GMV) differences. Voxel-based morphometry revealed significant GMV reductions in tobacco cigarette users in the left fusiform gyrus (FG), left and right inferior temporal gyrus (IFG), right middle temporal gyri, and right middle cingulate gyrus (MCG), compared to controls, as well as the anterior cingulate cortex (ACC), compared to both e-cigarette users and controls, even after adjusting for nicotine exposure history. Partial correlation analyses revealed that in tobacco cigarette users, GMV in the FG, ITG, MTG, and MCG displayed a strong, negative association with exposure history but not with nicotine dependence. GMV of the ACC was not associated with duration of use or nicotine dependence score, suggesting distinct relationships between ACC volume and smoking status and FG/ITG/MTG/MCG volume and smoking status. This indicates a distinct difference between regular tobacco cigarette and e-cigarette use, perhaps a relatively safer profile of e-cigarette use on GMV. These findings suggest that factors beyond nicotine, such as other toxicants in tobacco cigarette smoke, may contribute to the observed brain atrophy, or imply potential pre-existing vulnerabilities that might predispose individuals to take up smoking.

The inverse relationship between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and testosterone in adult males in the United States: a cross-sectional study based on the NHANES database

Background

Testosterone is a crucial hormone for male health, influencing metabolism, cardiovascular function, bone density, and cognitive abilities. Elevated non-HDL cholesterol to HDL cholesterol ratio (NHHR) has been implicated in lipid metabolism disorders, which may adversely affect testosterone levels. This study investigates the association between NHHR and testosterone levels in adult males, utilizing data from the National Health and Nutrition Examination Survey (NHANES).

Methods

This cross-sectional study analyzed data from 2,859 adult males from the NHANES cycles 2011-2016. Total testosterone levels were measured using isotope dilution liquid chromatography-tandem mass spectrometry (ID-LC-MS/MS). NHHR was calculated and analyzed as both a continuous variable and in quartiles. Multivariable linear and logistic regression models, adjusted for demographic, biochemical, lifestyle factors, and medical comorbidities, were used to assess the relationship between NHHR and total testosterone levels and the risk of testosterone deficiency (TD).

Results

Higher NHHR was significantly associated with lower total testosterone levels and increased risk of TD. In fully adjusted models, each unit increase in NHHR was associated with a decrease in total testosterone levels (β = -16.31, 95% CI: -26.58 to -6.04, P = 0.003) and an increased risk of TD (OR = 1.24, 95% CI: 1.07 to 1.44, P = 0.01). When NHHR was analyzed in quartiles, participants in the highest quartile (Q4) had significantly lower testosterone levels (β = -54.98, 95% CI: -86.21 to -23.74, P = 0.001) and a higher risk of TD (OR = 2.04, 95% CI: 1.20 to 3.49, P = 0.01) compared to those in the lowest quartile (Q1). Subgroup analyses confirmed these findings across different age groups, BMI categories, smoking status, and presence of comorbidities. Smooth curve fitting demonstrated a linear relationship among them.

Conclusion

Our study is the first to identify a significant association between elevated NHHR and both reduced total testosterone levels and increased risk of TD in a large, representative sample of adult American males. These findings suggest that NHHR could serve as a valuable marker for early identification of individuals at risk for testosterone decline and TD, enabling timely and targeted clinical interventions.

Relationship Between Metabolic Age Determined by Bioimpedance and Insulin Resistance Risk Scales in Spanish Workers

Introduction: Metabolic age (MA) is the difference between an individual's actual age and the age of their body based on physiological and biological factors. It is an indicator that reflects a person's physical and biological state, regardless of chronological age. Insulin resistance (IR) is a health disorder in which tissues exhibit a reduced response to the circulating glucose uptake stimulated by insulin. Objective: The aim of this study is to evaluate the association between MA, determined through bioelectrical impedance analysis, and the risk of IR, assessed using validated scales, in a cohort of Spanish workers. Methodology: A descriptive cross-sectional study was conducted on 8590 Spanish workers to assess the association between MA and a set of sociodemographic variables, health habits, and IR risk scales such as the Triglyceride-Glucose Index (TyG Index), Metabolic Score for Insulin Resistance (METS-IR), and Single Point Insulin Sensitivity Estimator (SPISE). Results: All analyzed variables were associated with MA values, with the strongest associations observed for IR risk scale values (OR 4.88 [95% CI 4.12-5.65] for METS-IR, 4.42 [95% CI 3.70-5.15] for SPISE, and 3.42 [95% CI 2.97-3.87] for the TyG Index) and physical activity. Conclusions: Metabolic age is influenced by sociodemographic variables such as age, sex, and social class; health habits such as smoking, physical activity, and adherence to the Mediterranean diet; and by IR risk scale values.

Oxidative Stress Biomarkers in Laryngeal Squamous Cell Carcinoma and Their Clinical Implications: Preliminary Results

Background/Objectives: Laryngeal squamous cell carcinoma represents one of the most common head and neck cancers with a five-year survival rate that, despite diagnostic and therapeutic advances, has not shown any significant improvement in recent decades. Oxidative stress, generated by an imbalance between reactive oxygen species and cellular antioxidant systems, is considered a central mechanism in the carcinogenesis of laryngeal squamous cell carcinoma, causing DNA damage and genomic alterations. Methods: This prospective observational paired case-control study focused on the evaluation of antioxidant proteins, such as superoxide dismutase, catalase, heme-oxygenase 1, vimentin, metallothionein, and nuclear factor erythroid 2-related factor 2, in cancer tissues from fifteen patients with laryngeal squamous cell carcinoma, using adjacent healthy tissues as controls. Results: The results show a statistically significant overexpression of all proteins analyzed in cancer tissues compared to controls, with relevant correlations between specific biomarkers and clinical characteristics, age, sex, smoking habits, and degree of tumor differentiation. Conclusions: These preliminary studies, while limited by sample size and the complexity of molecular regulation, indicate that the overexpression of antioxidant enzymes in laryngeal squamous cell carcinoma tissues, along with their correlations with key clinical parameters, underscores a context-dependent role of oxidative stress in tumor progression. A deeper understanding of oxidative stress mechanisms could contribute to advance personalized management strategies for laryngeal squamous cell carcinoma, potentially improving treatment outcomes and patient prognosis.

Dihydromyricetin Alleviated Acetaminophen-Induced Acute Kidney Injury via Nrf2-Dependent Anti-Oxidative and Anti-Inflammatory Effects

Acute kidney injury (AKI) is a common side effect of acetaminophen (APAP) overdose. Dihydromyricetin (DHM) is the most abundant flavonoid in rattan tea, which has a wide range of pharmacological effects. In the current study, APAP-induced AKI models were established both in vivo and in vitro. The results showed that DHM pretreatment remarkably alleviated APAP-induced AKI by promoting antioxidant capacity through the nuclear factor erythroid-related factor 2 (Nrf2) signaling pathway in vivo. In addition, DHM reduced ROS production and mitochondrial dysfunction, thereby alleviating APAP-induced cytotoxicity in HK-2 cells. The way in which DHM improved the antioxidant capacity of HK-2 cells was through promoting the activation of the Nrf2-mediated pathway and inhibiting the expression levels of inflammation-related proteins. Furthermore, Nrf2 siRNA partially canceled out the protective effect of DHM against the cytotoxicity caused by APAP in HK-2 cells. Altogether, the protective effect of DHM on APAP-induced nephrotoxicity was related to Nrf2-dependent antioxidant and anti-inflammatory effects.

Early-life exposure to PCBs and PFAS exerts negative effects on the developing central nervous system

Persistent organic pollutants (POPs) are ubiquitous in the environment and display the capacity to bioaccumulate in living organisms, constituting a hazard to both wildlife and humans. Although restrictions have been applied to prohibit the production of several POPs since the 1960s, high levels of these compounds can still be detected in many environmental and biological matrices, due to their chemical properties and significantly long half-lives. Some POPs can be passed from mother to the fetus and can gain entry to the central nervous system (CNS), by crossing the blood-brain barrier (BBB), resulting in significant deleterious effects, including neurocognitive and psychiatric abnormalities, which may lead to long-term socio-economic burdens. A growing body of evidence obtained from clinical and experimental studies has increasingly indicated that these POPs may influence neurodevelopment through several cellular and molecular mechanisms. However, studies assessing their mechanisms of action are still incipient, requiring further research. Polychlorinated biphenyls (PCBs) and per- and polyfluoroalkyl substances (PFAS) are two of the main classes of POPs associated with disturbances in different human systems, mainly the nervous and endocrine systems. This narrative review discusses the main PCB and PFAS effects on the CNS, focusing on neuroinflammation and oxidative stress and their consequences for neural development and BBB integrity. Moreover, we propose which mechanisms could be involved in POP-induced neurodevelopmental defects. In this sense, we highlight potential cellular and molecular pathways by which these POPs can affect neurodevelopment and could be further explored to propose preventive therapies and formulate public health policies.

Smoking-induced shifts in salivary exosomal cytokines and amino acid profiles as potential early biomarkers for oral cancer

BACKGROUND

Chronic smoking is an established risk factor for oral cancer (OC). The role of tobacco in oral squamous cell cancer (OSCC) emphasizes the need for non-invasive diagnostic approaches to identify early molecular alterations and improve patient outcomes. Salivary exosomes, which contain proteins, lipids, and nucleic acids, accessible and rich in biological content, making them interesting candidate biomarkers.

METHODS

Saliva samples were collected from non-smokers (n = 20), smokers (n = 20), and patients with oral cancer (n = 20). Salivary exosomes were isolated and characterized using various techniques, including estimation of protein concentrations and amino acid profiling using High-Performance Liquid Chromatography (HPLC). Fourier Transform Infrared (FTIR) spectroscopy analyzed protein and amino acid peaks, while enzyme-linked immunosorbent assay (ELISA) measured pro-inflammatory cytokines IL-6 and IL-8.

RESULTS

Elevated levels of salivary exosomal proteins (p = 0.017), IL-6 (p = 0.008), and IL-8 (p = 0.0004), along with significant alterations in amino acid profiles, were observed in smokers compared with non-smokers. Additionally, protein (p = 0.005) and IL-6 (p = 0.004) levels were significantly elevated in oral cancer compared to non-smoker group. FTIR spectroscopy revealed distinct molecular fingerprints in exosomes, highlighting changes in protein and amino acid concentrations and indicating altered metabolism.

CONCLUSION

This comparative cross-sectional study demonstrated that chronic smoking induces significant biochemical changes in salivary exosomes, establishing them as promising non-invasive biomarkers for early oral cancer detection. Elevated pro-inflammatory cytokines IL-6 and IL-8, along with altered amino acid profiles, may create pre-cancerous conditions. Notably, along with altered amino acid profiles, IL-6 levels progressively increase from smoking to oral cancer, highlighting its potential role in cancer progression.

Maternal exposure to nicotine causes oxidative stress and inflammatory changes in the ovaries of rats' adult offspring

Nicotine is one of the most toxic substances found in cigarettes, but also found in chewing tobacco gum, patches and vaping products (electronic cigarettes). In addition to being a highly addictive chemical, it is capable of reducing fertility in men and women. In the ovaries, it can induce morphological changes and impair the formation of follicles, being a possible cause of changes in the reproductive cycle and anticipation of menopause in women whose mothers smoked during pregnancy. By increasing the generation of free radicals, nicotine can induce oxidation in biological samples and change the expression of inflammatory cytokines. It damages the immune system and many other cells of newborns exposed prenatally. Despite its teratogenic potential, many women continue to use this drug during pregnancy and lactation. Thus, this work aims to analyze the effects of maternal exposure to nicotine on the ovaries of adult rats. To this end, 10 rats received nicotine throughout pregnancy and lactation. Their offspring were euthanized around 90 days-old, in the metestrus phase, for ovary collection and analysis of oxidative stress and inflammation. The results showed that exposure to nicotine increased MDA level, but did not cause damage to the DNA of ovarian cells (8-OHdG). It also increased IL-1β and anti-inflammatory protein AnxA1 and receptor Fpr1, and reduced the mast cell population in ovaries. We concluded that maternal exposure to nicotine is capable of inducing oxidative stress and leading to inflammatory changes in the ovaries of adult offspring exposed during the intrauterine and breastfeeding phases.

Unveiling causal relationships between addiction phenotypes and inflammatory cytokines: insights from bidirectional mendelian randomization and bibliometric analysis

Observational studies have suggested associations between multiple inflammatory factors and tobacco and alcohol use, but establishing causation is challenging in epidemiological investigations. We employed genetic association data about the circulating levels of 41 cytokines obtained from the genome-wide association study (GWAS), which contained 8293 Finnish participants. Genetic data on 5 substance use phenotypes were obtained from the GWAS dataset containing 1.2 million European subjects. Then, we conducted a bidirectional mendelian randomization (MR) study. The forward results indicated that smoking cessation was positively correlated with hepatocyte growth factor (HGF), interleukin-10 (IL-10), and stem cell factor (SCF); cigarettes per day was a risk factor associated with high expression in stromal cell-derived factor 1α (SDF-1 A), interferon-γ (IFN-G), IL-4, and granulocyte colony-stimulating factor (G-CSF); drinks per week and smoking initiation were risk factors respectively correlated with reduced HGF and IL-2RA levels. During inverse MR analysis, the findings revealed that both IL-16 and IL-18 increased the risk of cigarettes per day; macrophage inflammatory protein-1β (MIP-1B) and tumor necrosis factor-β (TNF-B) inhibited and promoted smoking cessation, respectively; macrophage colony-stimulating factor (M-CSF) elevated the risk of drinks per week, while interferon inducible protein 10 (IP-10) had a contrary role; IL-7 and M-CSF respectively prolonged and shortened age of initiation of regular smoking. This study provides genetic proof supporting a causal relationship between various inflammatory factors and addiction phenotypes. Further comprehensive investigations are required to uncover underlying biological mechanisms. In addition, bibliometric studies have shown that oxidative stress is one of the most important orientations in alcohol and tobacco addiction research, where an in-depth investigation of its pro-inflammatory mechanisms would facilitate the development of potential therapeutic biological targets and drugs.

Effects of propolis intake on endurance exercise and molecular signaling related to inflammation and oxidative stress

Honey bees extract sticky material from the exudates of different plants which transform afterwards to propolis. Propolis from several global locations has been shown to contain a wide variety of polyphenolic chemicals. Recent studies have revealed that propolis possesses antioxidant, anti-inflammatory, and immunomodulatory abilities. In laboratory animal studies, it has been demonstrated that propolis can enhance the functioning of the antioxidant defense system and decrease the activity of nuclear factor-kappa B. As a result, they can effectively alleviate the damage caused by exercise. One of the main flavonoids found in propolis, quercetin, has been demonstrated to enhance muscle mitochondrial biogenesis and exercise capacity. Propolis may aid athletes in preventing oxidative and inflammatory damage to their muscles during exercise and enhance their athletic performance. The goal of the current review was to evaluate how propolis consumption affected the molecular signaling associated with antioxidant/oxidant state, pro/anti-inflammatory cytokines, and anaerobic/aerobic endurance.

Dispersive liquid-liquid microextraction for the determination of urinary 8-hydroxy 2'-deoxyguanosine in COVID-19 patients by gas chromatography-mass spectrometry

COVID-19 disease has led to many deaths worldwide and early detection of people at a high risk of severe forms of this disease would greatly help physicians. The presence of oxidative stress biomarkers may help identify high-risk individuals early in the course of the disease. 8-Hydroxy-2'-deoxyguanosine (8-OHdG) is a widely used biomarker for assessing endogenous oxidative DNA damage. In this study, the urinary 8-OHdG levels were determined in COVID-19 patients and COVID-19 patients with cancer by a dispersive liquid-liquid microextraction (DLLME) method using gas chromatography-mass spectrometry (GC-MS). The effects of essential parameters on the extraction method were investigated. The LOD and LOQ are equal to 1.7 nM and 5.1 nM, respectively. At varied concentrations of 8-OHdG (300, 400, and 600 nM), the relative standard deviation (RSD) ranged from 18.35% to 22.36%. The mean urinary 8-OHdG levels of cancer and COVID-19 patients were 13.20 ± 6.20 nmol mmol-1, while the mean levels in COVID-19 patients and healthy volunteers were 6.67 ± 5.80 nmol mmol-1 and 1.61 ± 1.72 nmol mmol-1, respectively. The results of this study showed that the level of 8-OHdG urine biomarkers in people with COVID-19 is significantly higher than in healthy people. In this study, the DLLME approach was used for the first time to determine the value of 8-OHdG using GC-MS. According to the results of this research, the DLLME method was successfully used as a biomarker of DNA oxidative stress for extracting 8-OHdG urine. Compared to other methods, this technique has advantages such as shorter extraction time and low cost.

Metabolomic Insights into Smoking-Induced Metabolic Dysfunctions: A Comprehensive Analysis of Lipid and Amino Acid Metabolomes

BACKGROUND

Cigarette smoking is a leading cause of preventable mortality, largely due to the absence of effective, non-invasive biomarkers for early disease detection. Profiling serum metabolomics to identify metabolic changes holds the potential to accelerate the detection process and identify individuals at risk of developing smoking-related diseases.

OBJECTIVES

This study investigated the biochemical and metabolomic changes induced by nicotine exposure, with a focus on disruptions in amino acid, lipid, and carbohydrate metabolism.

METHODS

Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was employed to observe significant disruptions in lipid and amino acid metabolism, along with alterations in key metabolic pathways. A total of 400 smokers and 100 non-smokers were included to evaluate the biomarkers related to insulin resistance, blood lipid profile, inflammation, and kidney and liver function.

RESULTS

The results demonstrated significantly elevated (p < 0.05) levels of glycemic markers in smokers, including fasting blood glucose; glycated hemoglobin (HbA1c); and inflammatory markers such as interleukin-6 (IL-6) and C-reactive protein (CRP). Smokers also exhibited dyslipidemia, with increased total cholesterol (154.888 ± 35.565) and LDL levels (117.545 ± 24.138). Impaired liver and kidney function was evident, with significantly higher levels (p < 0.05) of AST, ALP, ALT, blood urea nitrogen, and creatinine in smokers. A total of 930 metabolites were identified, of which 343 exhibited significant alterations (p < 0.05) in smokers compared to non-smokers. Among these, 116 metabolites were upregulated, and 127 were downregulated. Metabolomic pathway analysis revealed eight significant pathways. The study also identified three lipid metabolites specific to smokers and seven unique to non-smokers. Through LC-MS/MS, fragments of phenylalanine, tryptophan, valine, histidine, carnitine, and sphinganine were detected. Several lipidomic changes associated with insulin resistance and cardiovascular complications were observed. Cadmium (Cd) levels were higher in smokers than non-smokers (1.264 ppb vs. 0.624 ppb) and showed a strong negative correlation (R2 = 0.8061, p-value = 0.015) with serum zinc (Zn), likely due to Cd displacing Zn in proteins and causing nephrotoxicity through accumulation.

CONCLUSIONS

This study highlights the distinct metabolic disruptions caused by smoking that could serve as potential biomarkers for the early detection of metabolic diseases. It emphasizes the importance of metabolomics in identifying systemic indicators of smoking-related health issues, providing new opportunities for preventive and therapeutic interventions.

Global, regional, and national burden of pancreatic cancer from 1990 to 2021, its attributable risk factors, and projections to 2050: a systematic analysis of the global burden of disease study 2021

BACKGROUND

The incidence and mortality rates of pancreatic cancer are rising globally. This study examines global and regional trends in pancreatic cancer incidence, Disability Adjusted Life Years (DALYs), and mortality from 1990 to 2021, utilizing data from the most recent Global Burden of Disease (GBD) 2021 database.

METHODS

Data were sourced from the GBD database over the period from 1990 to 2021. Age-standardized rates for incidence, DALYs, and mortality were calculated per 100,000 population. We also calculated the proportion of DALYs and mortality attributable to risk factors. The Bayesian age-period-cohort model was applied to project future trends until 2050.

RESULTS

Between 1990 and 2021, the global incidence of pancreatic cancer increased significantly, with the number of cases rising from approximately 207,905 to 508,533 and the age-standardized incidence rate (ASIR) increasing from 5.47 to 5.96 per 100,000 population. The global burden of pancreatic cancer, measured in DALYs, rose from 5.21 million to 11.32 million. Mortality rates showed a similar upward trend, with the number of deaths increasing from around 211,613 to 505,752, and the age-standardized mortality rate (ASMR) rising from 5.655 to 5.948 per 100,000 population. Notable increases in ASIR and ASMR were observed in low-middle and low sociodemographic index regions with males experienced higher rates compared to females. Age-standardized DALYs rate (ASDR) and ASMR worldwide were attributable to tobacco smoking, high BMI, and high fasting plasma glucose. Furthermore, our projection model estimates that the ASIR and ASMR of pancreatic cancer will significantly decline, while the ASDR is anticipated to maintain a steady downward trend by 2050.

CONCLUSION

This study offers a comprehensive analysis of pancreatic cancer trends, providing crucial insights for public health planning and policy-making. Addressing identified risk factors and targeting high-risk populations are essential for effective strategies to reduce the global burden of pancreatic cancer.

Molecular mechanism of genetic, epigenetic, and metabolic alteration in lung cancer

Lung cancer, a leading cause of cancer-related deaths worldwide, is primarily linked to smoking, tobacco use, air pollution, and exposure to hazardous chemicals. Genetic alterations, particularly in oncogenes like RAS, EGFR, MYC, BRAF, HER, and P13K, can lead to metabolic changes in cancer cells. These cells often rely on glycolysis for energy production, even in the presence of oxygen, a phenomenon known as aerobic glycolysis. This metabolic shift, along with other alterations, contributes to cancer cell growth and survival. To develop effective therapies, it's crucial to understand the genetic and metabolic changes that drive lung cancer. This review aims to identify specific genes associated with these metabolic alterations and screen phytochemicals for their potential to target these genes. By targeting both genetic and metabolic pathways, we hope to develop innovative therapeutic approaches to combat lung cancer.

Current cigarette smoking and decreased serum levels of α-Klotho, an anti-aging hormone, among US adult participants

BACKGROUND AND AIMS

Cigarette smoking is a well-established risk factor for cardiovascular disease and other aging-related disorders; yet the pathogenesis of these diseases induced by smoking remains relatively underexplored. This study was to assess the association between cigarette smoking and serum α-Klotho levels, an anti-aging protein, in US adults.

METHODS AND RESULTS

Data on 4196 participants aged 40-79 years from the 2013-2016 National Health and Nutrition Examination Survey was analyzed for the association using multiple general linear models. Smoking was assessed using both questionnaire data and serum cotinine measurements. Both past and current smokers exhibited significantly lower levels of α-Klotho, with the light smokers exhibiting the lowest levels [geometric mean: 720.85 pg/mL; 95% CI: 662.53, 784.31], compared with non-smokers [806.75 (790.69, 823.13)]. A significantly inverse association between current smoking and α-Klotho levels was revealed. This relationship extended across smoking intensities, with even light smokers displaying the strongest association. After adjusting for potential confounders, light (smoked <5 pack-years), moderate (5-19 pack-years), and heavy smoking (≥20 pack-years) were associated with reductions of 10.81% (-16.91, -4.28), 6.43% (-10.24, -2.47), and 3.38% (-6.83, 0.19) of Klotho levels, respectively, when compared to non-smoking. Active smoking, defined as serum cotinine levels ≥10 ng/mL, was associated with a 4.59% decrease (-6.91, -2.23) in α-Klotho levels.

CONCLUSION

The study demonstrates an inverse relationship between current smoking and serum α-Klotho levels among middle-aged and older adults. Our findings suggest that Klotho may play an important role in smoking-induced diseases. Further investigations are warranted to explore these interactions.

Epigenomic Dysregulation in Youth Vapers: Implications for Disease Risk Assessment

Despite the ongoing epidemic of youth vaping, the long-term health consequences of electronic cigarette use are largely unknown. We report the effects of vaping versus smoking on the oral cell methylome of healthy young vapers and smokers relative to nonusers. Whereas vapers and smokers differ in the number of differentially methylated regions (DMRs) (831 vs. 2,863), they share striking similarities in the distribution and patterns of DNA methylation, chromatin states, transcription factor binding motifs, and pathways. There is substantial overlap in DMR-associated genes between vapers and smokers, with the shared subset of genes enriched for transcriptional regulation, signaling, tobacco use disorders, and cancer-related pathways. Of significance is the identification of a common hypermethylated DMR at the promoter of HIC1 (hypermethylated in cancer 1), a tumor suppressor gene frequently silenced in smoking-related cancers. Our data support a potential link between epigenomic dysregulation in youth vapers and disease risk. These novel findings have significant implications for public health and tobacco product regulation.