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Ghazi S, Song MA, El-Hellani A. A scoping review of the toxicity and health impact of IQOS. Tob Induc Dis 2024; 22:TID-22-97. [PMID: 38832049 PMCID: PMC11145630 DOI: 10.18332/tid/188867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 05/14/2024] [Accepted: 05/18/2024] [Indexed: 06/05/2024] Open
Abstract
This work aims to summarize the current evidence on the toxicity and health impact of IQOS, taking into consideration the data source. On 1 June 2022, we searched PubMed, Web of Science, and Scopus databases using the terms: 'heated tobacco product', 'heat-not-burn', 'IQOS', and 'tobacco heating system'. The search was time-restricted to update a previous search conducted on 8 November 2021, on IQOS data from 2010-2021. The data source [independent, Philip Morris International (PMI), or other manufacturers] was retrieved from relevant sections of each publication. Publications were categorized into two general categories: 1) Toxicity assessments included in vitro, in vivo, and systems toxicology studies; and 2) The impact on human health included clinical studies assessing biomarkers of exposure and biomarkers of health effects. Generally, independent studies used classical in vitro and in vivo approaches, but PMI studies combined these with modeling of gene expression (i.e. systems toxicology). Toxicity assessment and health impact studies covered pulmonary, cardiovascular, and other systemic toxicity. PMI studies overall showed reduced toxicity and health risks of IQOS compared to cigarettes, but independent data did not always conform with this conclusion. This review highlights some discrepancies in IQOS risk assessment regarding methods, depth, and breadth of data collection, as well as conclusions based on the data source.
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Affiliation(s)
- Sarah Ghazi
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus OH, United States
| | - Min-Ae Song
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus OH, United States
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus OH, United States
| | - Ahmad El-Hellani
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus OH, United States
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus OH, United States
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2
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Klosterhalfen S, Kotz D, Kastaun S. Smokers' perception of the comparative health risks of cigarettes, e-cigarettes and heated tobacco products: a survey among the German population. J Public Health (Oxf) 2024:fdae068. [PMID: 38741461 DOI: 10.1093/pubmed/fdae068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 04/04/2024] [Accepted: 04/25/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Tobacco cigarettes, e-cigarettes and heated tobacco products can pose different health risks (harm continuum). As current tobacco smokers could benefit from switching to less harmful products, we aimed to assess current smokers' perceived comparative health risks of these three products and to explore associations between risk perceptions and specific user characteristics. METHODS We analysed data from 11 waves (2019-2021; N = 5657 current tobacco smokers) of a representative, cross-sectional household survey conducted in Germany. Associations were assessed with multivariable logistic regression models. RESULTS 55.2% of smokers (95%CI = 53.8-56.5%) ranked cigarettes as the most harmful product. 36.1% of smokers (95%CI = 34.8-37.3%) perceived e-cigarettes and 33.8% (95%CI = 32.5-35.0%) heated tobacco products as more harmful than cigarettes. Misperceptions that e-cigarettes or heated tobacco products are more harmful to health than cigarettes increased over the 3-year study period and were more common among those with lower educational attainment. CONCLUSIONS Only half of current tobacco smokers in Germany perceive the comparative health risks of cigarettes adequately and such misperceptions have increased recently. As current smokers could benefit most from switching to less harmful products, educational campaigns are needed to inform this group about the health risks of tobacco smoking and the comparative health risks of the various nicotine and tobacco products along the harm continuum.
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Affiliation(s)
- Stephanie Klosterhalfen
- Addiction Research and Clinical Epidemiology Unit, Centre for Health and Society (chs), Institute of General Practice (ifam), Medical Faculty of the Heinrich-Heine-University, 40225 Duesseldorf, Germany
| | - Daniel Kotz
- Addiction Research and Clinical Epidemiology Unit, Centre for Health and Society (chs), Institute of General Practice (ifam), Medical Faculty of the Heinrich-Heine-University, 40225 Duesseldorf, Germany
- Department of Behavioural Science and Health, University College London, WC1E 7HB London, UK
| | - Sabrina Kastaun
- Addiction Research and Clinical Epidemiology Unit, Centre for Health and Society (chs), Institute of General Practice (ifam), Medical Faculty of the Heinrich-Heine-University, 40225 Duesseldorf, Germany
- Patient-Physician Communication Research Unit, Centre for Health and Society (chs), Institute of General Practice (ifam), Medical Faculty of the Heinrich-Heine-University, 40225 Duesseldorf, Germany
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3
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Souid A, Giambastiani L, Castagna A, Santin M, Vivarelli F, Canistro D, Morosini C, Paolini M, Franchi P, Lucarini M, Raffaelli A, Giorgetti L, Ranieri A, Longo V, Pozzo L, Vornoli A. Assessment of the Antioxidant and Hypolipidemic Properties of Salicornia europaea for the Prevention of TAFLD in Rats. Antioxidants (Basel) 2024; 13:596. [PMID: 38790701 PMCID: PMC11118816 DOI: 10.3390/antiox13050596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/07/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
Halophyte species represent valuable reservoirs of natural antioxidants, and, among these, Salicornia europaea stands out as a promising edible plant. In this study, young and old S. europaea leaves were compared for the content of bioactive compounds and antioxidant activity to assess changes in different growth phases; then, the potential protective effects against low-dose CCl4-induced toxicant-associated fatty liver disease (TAFLD) were investigated by administering an aqueous suspension of young leaves to rats daily for two weeks. Quantification of total and individual phenolic compounds and in vitro antioxidant activity assays (DPPH, FRAP, and ORAC) showed the highest values in young leaves compared to mature ones. Salicornia treatment mitigated CCl4-induced hepatic oxidative stress, reducing lipid peroxidation and protein carbonyl levels, and preserving the decrease in glutathione levels. Electronic paramagnetic resonance (EPR) spectroscopy confirmed these results in the liver and evidenced free radicals increase prevention in the brain. Salicornia treatment also attenuated enzymatic disruptions in the liver's drug metabolizing system and Nrf2-dependent antioxidant enzymes. Furthermore, histopathological examination revealed reduced hepatic lipid accumulation and inflammation. Overall, this study highlights Salicornia's potential as a source of bioactive compounds with effective hepatoprotective properties capable to prevent TAFLD.
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Affiliation(s)
- Aymen Souid
- Department of Agricultural, Food and Agro-Environmental Sciences, University of Pisa, Via del Borghetto 80, 56124 Pisa, Italy; (A.S.); (A.C.); (M.S.); (A.R.)
- Institute of Agricultural Biology and Biotechnology—National Research Council (IBBA-CNR), Via Moruzzi 1, 56124 Pisa, Italy; (L.G.); (A.R.); (L.G.); (V.L.); (A.V.)
| | - Lucia Giambastiani
- Institute of Agricultural Biology and Biotechnology—National Research Council (IBBA-CNR), Via Moruzzi 1, 56124 Pisa, Italy; (L.G.); (A.R.); (L.G.); (V.L.); (A.V.)
| | - Antonella Castagna
- Department of Agricultural, Food and Agro-Environmental Sciences, University of Pisa, Via del Borghetto 80, 56124 Pisa, Italy; (A.S.); (A.C.); (M.S.); (A.R.)
| | - Marco Santin
- Department of Agricultural, Food and Agro-Environmental Sciences, University of Pisa, Via del Borghetto 80, 56124 Pisa, Italy; (A.S.); (A.C.); (M.S.); (A.R.)
| | - Fabio Vivarelli
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum—University of Bologna, Via Irnerio 48, 40126 Bologna, Italy; (F.V.); (D.C.); (C.M.); (M.P.)
| | - Donatella Canistro
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum—University of Bologna, Via Irnerio 48, 40126 Bologna, Italy; (F.V.); (D.C.); (C.M.); (M.P.)
| | - Camilla Morosini
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum—University of Bologna, Via Irnerio 48, 40126 Bologna, Italy; (F.V.); (D.C.); (C.M.); (M.P.)
| | - Moreno Paolini
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum—University of Bologna, Via Irnerio 48, 40126 Bologna, Italy; (F.V.); (D.C.); (C.M.); (M.P.)
| | - Paola Franchi
- Department of Chemistry “G. Ciamician”, Alma Mater Studiorum—University of Bologna, Via S. Giacomo 11, 40126 Bologna, Italy; (P.F.); (M.L.)
| | - Marco Lucarini
- Department of Chemistry “G. Ciamician”, Alma Mater Studiorum—University of Bologna, Via S. Giacomo 11, 40126 Bologna, Italy; (P.F.); (M.L.)
| | - Andrea Raffaelli
- Institute of Agricultural Biology and Biotechnology—National Research Council (IBBA-CNR), Via Moruzzi 1, 56124 Pisa, Italy; (L.G.); (A.R.); (L.G.); (V.L.); (A.V.)
- Crop Science Research Center, Scuola Superiore Sant’Anna, Piazza Martiri della Libertà 33, 56127 Pisa, Italy
| | - Lucia Giorgetti
- Institute of Agricultural Biology and Biotechnology—National Research Council (IBBA-CNR), Via Moruzzi 1, 56124 Pisa, Italy; (L.G.); (A.R.); (L.G.); (V.L.); (A.V.)
| | - Annamaria Ranieri
- Department of Agricultural, Food and Agro-Environmental Sciences, University of Pisa, Via del Borghetto 80, 56124 Pisa, Italy; (A.S.); (A.C.); (M.S.); (A.R.)
| | - Vincenzo Longo
- Institute of Agricultural Biology and Biotechnology—National Research Council (IBBA-CNR), Via Moruzzi 1, 56124 Pisa, Italy; (L.G.); (A.R.); (L.G.); (V.L.); (A.V.)
| | - Luisa Pozzo
- Institute of Agricultural Biology and Biotechnology—National Research Council (IBBA-CNR), Via Moruzzi 1, 56124 Pisa, Italy; (L.G.); (A.R.); (L.G.); (V.L.); (A.V.)
| | - Andrea Vornoli
- Institute of Agricultural Biology and Biotechnology—National Research Council (IBBA-CNR), Via Moruzzi 1, 56124 Pisa, Italy; (L.G.); (A.R.); (L.G.); (V.L.); (A.V.)
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4
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Morosini C, Vivarelli F, Rullo L, Volino E, Losapio LM, Paolini M, Romualdi P, Canistro D, Candeletti S. Unburned Tobacco Smoke Affects Neuroinflammation-Related Pathways in the Rat Mesolimbic System. Int J Mol Sci 2024; 25:5259. [PMID: 38791298 PMCID: PMC11120663 DOI: 10.3390/ijms25105259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/03/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024] Open
Abstract
Tobacco use disorder represents a significant public health challenge due to its association with various diseases. Despite awareness efforts, smoking rates remain high, partly due to ineffective cessation methods and the spread of new electronic devices. This study investigated the impact of prolonged nicotine exposure via a heat-not-burn (HnB) device on selected genes and signaling proteins involved in inflammatory processes in the rat ventral tegmental area (VTA) and nucleus accumbens (NAc), two brain regions associated with addiction to different drugs, including nicotine. The results showed a reduction in mRNA levels for PPARα and PPARγ, two nuclear receptors and anti-inflammatory transcription factors, along with the dysregulation of gene expression of the epigenetic modulator KDM6s, in both investigated brain areas. Moreover, decreased PTEN mRNA levels and higher AKT phosphorylation were detected in the VTA of HnB-exposed rats with respect to their control counterparts. Finally, significant alterations in ERK 1/2 phosphorylation were observed in both mesolimbic areas, with VTA decrease and NAc increase, respectively. Overall, the results suggest that HnB aerosol exposure disrupts intracellular pathways potentially involved in the development and maintenance of the neuroinflammatory state. Moreover, these data highlight that, similar to conventional cigarettes, HnB devices use affects specific signaling pathways shaping neuroinflammatory process in the VTA and NAc, thus triggering mechanisms that are currently considered as potentially relevant for the development of addictive behavior.
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Affiliation(s)
- Camilla Morosini
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum–University of Bologna, 40126 Bologna, Italy; (C.M.); (F.V.); (E.V.); (L.M.L.); (M.P.); (D.C.); (S.C.)
| | - Fabio Vivarelli
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum–University of Bologna, 40126 Bologna, Italy; (C.M.); (F.V.); (E.V.); (L.M.L.); (M.P.); (D.C.); (S.C.)
| | - Laura Rullo
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum–University of Bologna, 40126 Bologna, Italy; (C.M.); (F.V.); (E.V.); (L.M.L.); (M.P.); (D.C.); (S.C.)
| | - Emilia Volino
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum–University of Bologna, 40126 Bologna, Italy; (C.M.); (F.V.); (E.V.); (L.M.L.); (M.P.); (D.C.); (S.C.)
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum–University of Bologna, 40126 Bologna, Italy
| | - Loredana Maria Losapio
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum–University of Bologna, 40126 Bologna, Italy; (C.M.); (F.V.); (E.V.); (L.M.L.); (M.P.); (D.C.); (S.C.)
| | - Moreno Paolini
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum–University of Bologna, 40126 Bologna, Italy; (C.M.); (F.V.); (E.V.); (L.M.L.); (M.P.); (D.C.); (S.C.)
| | - Patrizia Romualdi
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum–University of Bologna, 40126 Bologna, Italy; (C.M.); (F.V.); (E.V.); (L.M.L.); (M.P.); (D.C.); (S.C.)
| | - Donatella Canistro
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum–University of Bologna, 40126 Bologna, Italy; (C.M.); (F.V.); (E.V.); (L.M.L.); (M.P.); (D.C.); (S.C.)
| | - Sanzio Candeletti
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum–University of Bologna, 40126 Bologna, Italy; (C.M.); (F.V.); (E.V.); (L.M.L.); (M.P.); (D.C.); (S.C.)
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5
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Granata S, Vivarelli F, Morosini C, Canistro D, Paolini M, Fairclough LC. Toxicological Aspects Associated with Consumption from Electronic Nicotine Delivery System (ENDS): Focus on Heavy Metals Exposure and Cancer Risk. Int J Mol Sci 2024; 25:2737. [PMID: 38473984 DOI: 10.3390/ijms25052737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/09/2024] [Accepted: 02/21/2024] [Indexed: 03/14/2024] Open
Abstract
Tobacco smoking remains one of the leading causes of premature death worldwide. Electronic Nicotine Delivery Systems (ENDSs) are proposed as a tool for smoking cessation. In the last few years, a growing number of different types of ENDSs were launched onto the market. Despite the manufacturing differences, ENDSs can be classified as "liquid e-cigarettes" (e-cigs) equipped with an atomizer that vaporizes a liquid composed of vegetable glycerin (VG), polypropylene glycol (PG), and nicotine, with the possible addition of flavorings; otherwise, the "heated tobacco products" (HTPs) heat tobacco sticks through contact with an electronic heating metal element. The presence of some metals in the heating systems, as well as in solder joints, involves the possibility that heavy metal ions can move from these components to the liquid, or they can be adsorbed into the tobacco stick from the heating blade in the case of HTPs. Recent evidence has indicated the presence of heavy metals in the refill liquids and in the mainstream such as arsenic (As), cadmium (Cd), chromium (Cr), nickel (Ni), copper (Cu), and lead (Pb). The present review discusses the toxicological aspects associated with the exposition of heavy metals by consumption from ENDSs, focusing on metal carcinogenesis risk.
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Affiliation(s)
- Silvia Granata
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum-University of Bologna, Via Irnerio 48, 40126 Bologna, Italy
| | - Fabio Vivarelli
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum-University of Bologna, Via Irnerio 48, 40126 Bologna, Italy
| | - Camilla Morosini
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum-University of Bologna, Via Irnerio 48, 40126 Bologna, Italy
| | - Donatella Canistro
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum-University of Bologna, Via Irnerio 48, 40126 Bologna, Italy
| | - Moreno Paolini
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum-University of Bologna, Via Irnerio 48, 40126 Bologna, Italy
| | - Lucy C Fairclough
- School of Life Sciences, University of Nottingham, East Dr, Nottingham NG7 2TQ, UK
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6
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Lenski M, Zarcone G, Maallem S, Garçon G, Lo-Guidice JM, Allorge D, Anthérieu S. Metabolomics Provides Novel Insights into the Potential Toxicity Associated with Heated Tobacco Products, Electronic Cigarettes, and Tobacco Cigarettes on Human Bronchial Epithelial BEAS-2B Cells. TOXICS 2024; 12:128. [PMID: 38393223 PMCID: PMC10893046 DOI: 10.3390/toxics12020128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/24/2024] [Accepted: 01/30/2024] [Indexed: 02/25/2024]
Abstract
Smoking is an established risk factor for various pathologies including lung cancer. Electronic cigarettes (e-cigs) and heated tobacco products (HTPs) have appeared on the market in recent years, but their safety or, conversely, their toxicity has not yet been demonstrated. This study aimed to compare the metabolome of human lung epithelial cells exposed to emissions of e-cigs, HTPs, or 3R4F cigarettes in order to highlight potential early markers of toxicity. BEAS-2B cells were cultured at the air-liquid interface and exposed to short-term emissions from e-cigs set up at low or medium power, HTPs, or 3R4F cigarettes. Untargeted metabolomic analyses were performed using liquid chromatography coupled with mass spectrometry. Compared to unexposed cells, both 3R4F cigarette and HTP emissions affected the profiles of exogenous compounds, one of which is carcinogenic, as well as those of endogenous metabolites from various pathways including oxidative stress, energy metabolism, and lipid metabolism. However, these effects were observed at lower doses for cigarettes (2 and 4 puffs) than for HTPs (60 and 120 puffs). No difference was observed after e-cig exposure, regardless of the power conditions. These results suggest a lower acute toxicity of e-cig emissions compared to cigarettes and HTPs in BEAS-2B cells. The pathways deregulated by HTP emissions are also described to be altered in respiratory diseases, emphasizing that the toxicity of HTPs should not be underestimated.
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Affiliation(s)
- Marie Lenski
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, ULR 4483, IMPECS—IMPact de l’Environnement Chimique sur la Santé Humaine, F-59000 Lille, France; (M.L.); (G.Z.); (S.M.); (G.G.); (J.-M.L.-G.); (D.A.)
- CHU Lille, Unité Fonctionnelle de Toxicologie, F-59037 Lille, France
| | - Gianni Zarcone
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, ULR 4483, IMPECS—IMPact de l’Environnement Chimique sur la Santé Humaine, F-59000 Lille, France; (M.L.); (G.Z.); (S.M.); (G.G.); (J.-M.L.-G.); (D.A.)
| | - Saïd Maallem
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, ULR 4483, IMPECS—IMPact de l’Environnement Chimique sur la Santé Humaine, F-59000 Lille, France; (M.L.); (G.Z.); (S.M.); (G.G.); (J.-M.L.-G.); (D.A.)
| | - Guillaume Garçon
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, ULR 4483, IMPECS—IMPact de l’Environnement Chimique sur la Santé Humaine, F-59000 Lille, France; (M.L.); (G.Z.); (S.M.); (G.G.); (J.-M.L.-G.); (D.A.)
| | - Jean-Marc Lo-Guidice
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, ULR 4483, IMPECS—IMPact de l’Environnement Chimique sur la Santé Humaine, F-59000 Lille, France; (M.L.); (G.Z.); (S.M.); (G.G.); (J.-M.L.-G.); (D.A.)
| | - Delphine Allorge
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, ULR 4483, IMPECS—IMPact de l’Environnement Chimique sur la Santé Humaine, F-59000 Lille, France; (M.L.); (G.Z.); (S.M.); (G.G.); (J.-M.L.-G.); (D.A.)
- CHU Lille, Unité Fonctionnelle de Toxicologie, F-59037 Lille, France
| | - Sébastien Anthérieu
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, ULR 4483, IMPECS—IMPact de l’Environnement Chimique sur la Santé Humaine, F-59000 Lille, France; (M.L.); (G.Z.); (S.M.); (G.G.); (J.-M.L.-G.); (D.A.)
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7
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Vivarelli F, Morosini C, Rullo L, Losapio LM, Lacorte A, Sangiorgi S, Ghini S, Fagiolino I, Franchi P, Lucarini M, Candeletti S, Canistro D, Romualdi P, Paolini M. Effects of unburned tobacco smoke on inflammatory and oxidative mediators in the rat prefrontal cortex. Front Pharmacol 2024; 15:1328917. [PMID: 38333013 PMCID: PMC10851081 DOI: 10.3389/fphar.2024.1328917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 01/04/2024] [Indexed: 02/10/2024] Open
Abstract
Although the Food and Drug Administration has authorized the marketing of "heat-not-burn" (HnB) electronic cigarettes as a modified risk tobacco product (MRTP), toxicological effects of HnB smoke exposure on the brain are still unexplored. Here, paramagnetic resonance of the prefrontal cortex (PFC) of HnB-exposed rats shows a dramatic increase in reactive radical species (RRS) yield coupled with an inflammatory response mediated by NF-κB-target genes including TNF-α, IL-1β, and IL-6 and the downregulation of peroxisome proliferator-activated receptor (PPAR) alpha and gamma expression. The PFC shows higher levels of 8-hydroxyguanosine, a marker of DNA oxidative damage, along with the activation of antioxidant machinery and DNA repair systems, including xeroderma pigmentosum group C (XPC) protein complex and 8-oxoguanine DNA glycosylase 1. HnB also induces the expression of drug-metabolizing enzymes such as CYP1A1, CYP2A6, CYP2B6, and CYP2E, particularly involved in the biotransformation of nicotine and several carcinogenic agents such as aldehydes and polycyclic aromatic hydrocarbons here recorded in the HnB stick smoke. Taken together, these effects, from disruption of redox homeostasis, inflammation, PPAR manipulation along with enhanced bioactivation of neurotoxicants, and upregulation of cMYC protooncogene to impairment of primary cellular defense mechanisms, suggest a possible increased risk of brain cancer. Although the HnB device reduces the emission of tobacco toxicants, our findings indicate that its consumption may carry a risk of potential adverse health effects, especially in non-smokers so far. Further studies are needed to fully understand the long-term effects of these devices.
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Affiliation(s)
- Fabio Vivarelli
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum–University of Bologna, Bologna, Italy
| | - Camilla Morosini
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum–University of Bologna, Bologna, Italy
| | - Laura Rullo
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum–University of Bologna, Bologna, Italy
| | - Loredana Maria Losapio
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum–University of Bologna, Bologna, Italy
| | - Antonio Lacorte
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum–University of Bologna, Bologna, Italy
| | - Stefano Sangiorgi
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum–University of Bologna, Bologna, Italy
| | - Severino Ghini
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum–University of Bologna, Bologna, Italy
| | | | - Paola Franchi
- Department of Chemistry “G. Ciamician”, Alma Mater Studiorum–University of Bologna, Bologna, Italy
| | - Marco Lucarini
- Department of Chemistry “G. Ciamician”, Alma Mater Studiorum–University of Bologna, Bologna, Italy
| | - Sanzio Candeletti
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum–University of Bologna, Bologna, Italy
| | - Donatella Canistro
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum–University of Bologna, Bologna, Italy
| | - Patrizia Romualdi
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum–University of Bologna, Bologna, Italy
| | - Moreno Paolini
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum–University of Bologna, Bologna, Italy
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8
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Zarcone G, Lenski M, Martinez T, Talahari S, Simonin O, Garçon G, Allorge D, Nesslany F, Lo-Guidice JM, Platel A, Anthérieu S. Impact of Electronic Cigarettes, Heated Tobacco Products and Conventional Cigarettes on the Generation of Oxidative Stress and Genetic and Epigenetic Lesions in Human Bronchial Epithelial BEAS-2B Cells. TOXICS 2023; 11:847. [PMID: 37888697 PMCID: PMC10611330 DOI: 10.3390/toxics11100847] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/05/2023] [Accepted: 10/05/2023] [Indexed: 10/28/2023]
Abstract
Electronic cigarettes (e-cig) and heated tobacco products (HTP) are often used as smoking cessation aids, while the harm reduction effects of these alternatives to cigarettes are still the subject of controversial debate, in particular regarding their carcinogenic potential. The objective of this study is to compare the effects of e-cig, HTP and conventional cigarette emissions on the generation of oxidative stress and genetic and epigenetic lesions in human bronchial epithelial BEAS-2B cells. Our results show that HTP were less cytotoxic than conventional cigarettes while e-cig were not substantially cytotoxic in BEAS-2B cells. E-cig had no significant effect on the Nrf2 pathway, whereas HTP and cigarettes increased the binding activity of Nrf2 to antioxidant response elements and the expression of its downstream targets HMOX1 and NQO1. Concordantly, only HTP and cigarettes induced oxidative DNA damage and significantly increased DNA strand breaks and chromosomal aberrations. Neither histone modulations nor global DNA methylation changes were found after acute exposure, regardless of the type of emissions. In conclusion, this study reveals that HTP, unlike e-cig, elicit a biological response very similar to that of cigarettes, but only after a more intensive exposure: both tobacco products induce cytotoxicity, Nrf2-dependent oxidative stress and genetic lesions in human epithelial pulmonary cells. Therefore, the health risk of HTP should not be underestimated and animal studies are required in order to determine the tumorigenic potential of these emerging products.
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Goebel I, Mohr T, Axt PN, Watz H, Trinkmann F, Weckmann M, Drömann D, Franzen KF. Impact of Heated Tobacco Products, E-Cigarettes, and Combustible Cigarettes on Small Airways and Arterial Stiffness. TOXICS 2023; 11:758. [PMID: 37755768 PMCID: PMC10535653 DOI: 10.3390/toxics11090758] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/29/2023] [Accepted: 08/31/2023] [Indexed: 09/28/2023]
Abstract
Smoking cessation is difficult but maintaining smoke-free without nicotine replacement therapy is even harder. During the last few years, several different alternative products, including heated tobacco products (HTP), have been introduced to the market. In this study, we investigated the acute effects of IQOSTM and gloTM (two HTP) consumption on small airway function and arterial stiffness in a head-to-head design, comparing them to combustible cigarettes, nicotine-free e-cigarettes and a sham smoking group. Seventeen healthy occasional smokers were included in a single-center, five-arm, crossover study. The parameters of small airway function and hemodynamics were collected at several time points before and after consumption using Mobil-O-Graph™ (I.E.M., Stolberg, Germany) and TremoFlo® c-100 (THORASYS Thoracic Medical Systems Inc., Montreal, QC, Canada). Small airway obstruction and resistance were both significantly increased after the consumption of cigarettes and substitute products. All products containing nicotine led to similar significant increases in blood pressure and arterial stiffness. Hemodynamic parameters were also increased after the consumption of e-cigarettes without nicotine, but compared to nicotine-containing products, the increase was shorter and weaker. We conclude that, although it has yet to be determined why, HTP have acute harmful effects on small airway function, possibly even exceeding the effects of combustible cigarettes. Like other nicotine-containing products, HTP leads to a nicotine-related acute increase in arterial stiffness and cardiovascular stress, similar to combustible cigarettes, which associates these products with an increased cardiovascular risk.
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Affiliation(s)
- Isabel Goebel
- Medical Clinic III, Site Lübeck, University Hospital Schleswig-Holstein, 23538 Lübeck, Germany
- Airway Research Center North (ARCN), DZL, 35392 Lübeck, Germany
| | - Theresa Mohr
- Medical Clinic III, Site Lübeck, University Hospital Schleswig-Holstein, 23538 Lübeck, Germany
- Airway Research Center North (ARCN), DZL, 35392 Lübeck, Germany
| | - Paul N. Axt
- Medical Clinic III, Site Lübeck, University Hospital Schleswig-Holstein, 23538 Lübeck, Germany
- Airway Research Center North (ARCN), DZL, 35392 Lübeck, Germany
| | - Henrik Watz
- Airway Research Center North (ARCN), DZL, 35392 Lübeck, Germany
- Pulmonary Research Institute (PRI) at LungenClinic Großhansdorf, 22927 Großhansdorf, Germany
| | - Frederik Trinkmann
- Thoraxklinik Heidelberg, Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University Hospital Heidelberg, 69126 Heidelberg, Germany
- Department of Biomedical Informatics, Center for Preventive Medicine and Digital Health (CPD), University Medical Center Mannheim, Heidelberg University, 68167 Mannheim, Germany
| | - Markus Weckmann
- Airway Research Center North (ARCN), DZL, 35392 Lübeck, Germany
- Clinic for Pediatric, Site Lübeck, University Hospital Schleswig-Holstein, 23538 Lübeck, Germany
| | - Daniel Drömann
- Medical Clinic III, Site Lübeck, University Hospital Schleswig-Holstein, 23538 Lübeck, Germany
- Airway Research Center North (ARCN), DZL, 35392 Lübeck, Germany
| | - Klaas F. Franzen
- Medical Clinic III, Site Lübeck, University Hospital Schleswig-Holstein, 23538 Lübeck, Germany
- Airway Research Center North (ARCN), DZL, 35392 Lübeck, Germany
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10
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Granata S, Canistro D, Vivarelli F, Morosini C, Rullo L, Mercatante D, Rodriguez-Estrada MT, Baracca A, Sgarbi G, Solaini G, Ghini S, Fagiolino I, Sangiorgi S, Paolini M. Potential Harm of IQOS Smoke to Rat Liver. Int J Mol Sci 2023; 24:12462. [PMID: 37569836 PMCID: PMC10419033 DOI: 10.3390/ijms241512462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/24/2023] [Accepted: 08/03/2023] [Indexed: 08/13/2023] Open
Abstract
The Food and Drug Administration has recently classified the IQOS electronic cigarette as a modified-risk tobacco product. However, IQOS cigarettes still release various harmful constituents typical of conventional cigarettes (CCs), although the concentrations are markedly lower. Here, we investigated the damaging effects of IQOS smoking on the liver. Male Sprague Dawley rats were exposed, whole body, 5 days/week for 4 weeks to IQOS smoke (4 sticks/day), and hepatic xenobiotic metabolism, redox homeostasis and lipidomic profile were investigated. IQOS boosted reactive radicals and generated oxidative stress. Exposure decreased cellular reserves of total glutathione (GSH) but not GSH-dependent antioxidant enzymes. Catalase and xanthine oxidase were greater in the exposed group, as were various hepatic CYP-dependent monooxygenases (CYP2B1/2, CYP1A1, CYP2A1, CYP2E1-linked). Respiratory chain activity was unaltered, while the number of liver mitochondria was increased. IQOS exposure had an impact on the hepatic lipid profile. With regard to the expression of some MAP kinases commonly activated by CC smoking, IQOS increased the p-p38/p38 ratio, while erythroid nuclear transcription factor 2 (Nrf2) was negatively affected. Our data suggest that IQOS significantly impairs liver function, supporting the precautionary stance taken by the WHO toward the use of these devices, especially by young people and pregnant women.
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Affiliation(s)
- Silvia Granata
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum, University of Bologna, Via Irnerio 48, 40126 Bologna, Italy; (S.G.); (D.C.); (C.M.); (L.R.); (S.G.); (S.S.); (M.P.)
- Department of Medicine and Surgery, University of Milan–Bicocca, Via Cadore 48, 20900 Monza, Italy
| | - Donatella Canistro
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum, University of Bologna, Via Irnerio 48, 40126 Bologna, Italy; (S.G.); (D.C.); (C.M.); (L.R.); (S.G.); (S.S.); (M.P.)
| | - Fabio Vivarelli
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum, University of Bologna, Via Irnerio 48, 40126 Bologna, Italy; (S.G.); (D.C.); (C.M.); (L.R.); (S.G.); (S.S.); (M.P.)
| | - Camilla Morosini
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum, University of Bologna, Via Irnerio 48, 40126 Bologna, Italy; (S.G.); (D.C.); (C.M.); (L.R.); (S.G.); (S.S.); (M.P.)
| | - Laura Rullo
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum, University of Bologna, Via Irnerio 48, 40126 Bologna, Italy; (S.G.); (D.C.); (C.M.); (L.R.); (S.G.); (S.S.); (M.P.)
| | - Dario Mercatante
- Department of Agricultural and Food Sciences, Alma Mater Studiorum, University of Bologna, Viale Giuseppe Fanin, 40-50, 40127 Bologna, Italy; (D.M.); (M.T.R.-E.)
| | - Maria Teresa Rodriguez-Estrada
- Department of Agricultural and Food Sciences, Alma Mater Studiorum, University of Bologna, Viale Giuseppe Fanin, 40-50, 40127 Bologna, Italy; (D.M.); (M.T.R.-E.)
- Inter-Departmental Centre for Agri-Food Industrial Research, Alma Mater Studiorum, University of Bologna, Via Quinto Bucci 336, 47521 Cesena, Italy
| | - Alessandra Baracca
- Laboratory of Biochemistry and Mitochondrial Pathophysiology, Department of Biomedical and Neuromotor Sciences, University of Bologna, Via Irnerio, 48, 40126 Bologna, Italy; (A.B.); (G.S.); (G.S.)
| | - Gianluca Sgarbi
- Laboratory of Biochemistry and Mitochondrial Pathophysiology, Department of Biomedical and Neuromotor Sciences, University of Bologna, Via Irnerio, 48, 40126 Bologna, Italy; (A.B.); (G.S.); (G.S.)
| | - Giancarlo Solaini
- Laboratory of Biochemistry and Mitochondrial Pathophysiology, Department of Biomedical and Neuromotor Sciences, University of Bologna, Via Irnerio, 48, 40126 Bologna, Italy; (A.B.); (G.S.); (G.S.)
| | - Severino Ghini
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum, University of Bologna, Via Irnerio 48, 40126 Bologna, Italy; (S.G.); (D.C.); (C.M.); (L.R.); (S.G.); (S.S.); (M.P.)
| | - Ivan Fagiolino
- Gruppo CSA—S.p.A., Via al Torrente 22, 47923 Rimini, Italy;
| | - Stefano Sangiorgi
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum, University of Bologna, Via Irnerio 48, 40126 Bologna, Italy; (S.G.); (D.C.); (C.M.); (L.R.); (S.G.); (S.S.); (M.P.)
| | - Moreno Paolini
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum, University of Bologna, Via Irnerio 48, 40126 Bologna, Italy; (S.G.); (D.C.); (C.M.); (L.R.); (S.G.); (S.S.); (M.P.)
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11
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Popp W, Reese L, Scotti E. Heated Tobacco Products and Chronic Obstructive Pulmonary Disease: A Narrative Review of Peer-Reviewed Publications. EUROPEAN MEDICAL JOURNAL 2023. [DOI: 10.33590/emj/10309781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
An estimated 65 million people worldwide have moderate or severe chronic obstructive pulmonary disease (COPD), an umbrella term used to describe a group of progressive lung diseases that obstruct airflow such as emphysema and chronic bronchitis. Smoking contributes to an estimated 90% of COPD cases, as the harmful chemicals produced during tobacco combustion damage the lungs and airways. Although smoking cessation is the only intervention shown to improve COPD prognosis in smokers, many patients who try to quit continue to smoke. The continued use of conventional cigarettes exacerbates COPD symptoms, and globally more than 3 million people die from the disease every year. The last two decades have seen the introduction of combustion-free nicotine delivery alternatives that produce significantly lower levels of the harmful components in cigarette smoke, and researchers have begun to assess the impact of switching from cigarettes to these products. Several studies have examined how patients with COPD use e-cigarettes as assistance for quitting, but few have examined how heated tobacco products (HTP) may reduce risk. This narrative review summarises results from pre-clinical, clinical, and real-world evidence studies showing possible harm reduction benefits for patients with COPD who switch to HTPs rather than continuing to smoke cigarettes. Epidemiological studies, real-world data analyses, and randomised clinical trials must be conducted to determine whether switching from cigarettes to HTPs can improve health outcomes in patients with COPD who would otherwise continue to smoke combustible cigarettes.
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Affiliation(s)
- Wolfgang Popp
- Ordinationszentrum and Privatklinik Döbling, Vienna, Austria
| | - Lindsay Reese
- Philip Morris International R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Elena Scotti
- Philip Morris International R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
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12
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Koike S, Sato K, Sawa M, Inaba Y, Hattori K, Nakadate K, Ushiyama A, Ogasawara Y. Exposure to Heated Tobacco Products Aerosol Causes Acute Stress Responses in the Lung of Mouse. Antioxidants (Basel) 2022; 11:antiox11122329. [PMID: 36552537 PMCID: PMC9774187 DOI: 10.3390/antiox11122329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/14/2022] [Accepted: 11/22/2022] [Indexed: 11/27/2022] Open
Abstract
In the present study, we evaluated the acute response of mice exposed to IQOS aerosol, a brand-name heated tobacco product (HTP), in the lung tissue. First, the thiobarbituric acid-reactive substances (TBA-RS) value was measured as an index to assess oxidative stress, and a significant increase was observed after exposure, followed by a significant increase in the total lung GSH concentration. The stress responses induced by IQOS aerosols was then analyzed by focusing on the changes in Nrf2 and ATF4, which are transcription factors that induce the expression of genes involved in GSH biosynthesis or metabolism. Although Nrf2 activation was not observed, significant accumulation of ATF4 in the nuclear fraction was noted three hours after exposure to IQOS aerosols. Upon an examination of changes in factors in the GSH biosynthetic system, a significant increase in cystine concentration in the lung tissue was measured, and an increase in xCT expression level was observed in the cell membrane fraction three-six hours after IQOS exposure. Furthermore, characteristic changes in HO-1, a stress-response protein regulated by ATF4, was discovered six hours after IQOS exposure. Moreover, analysis of the upstream ATF4 regulatory system revealed that phosphorylation of eIF2α was enhanced in the lung cytoplasmic fraction three hours after exposure to IQOS aerosols. These findings suggest that ER stress might be induced as an early response to IQOS aerosol exposure, accompanied by the activation of the eIF2α-ATF4 axis. These intracellular changes have also been reported after exposure to combustible cigarette smoke. Thus, the acute response found in the lungs of mice in the present study demonstrate that the inhalation of aerosols from IQOS elicits a biological response similar to that of combustible cigarette smoke. In conclusion, our results provide evidence that the biological effects of HTPs, such as IQOS, cannot be ignored in the lungs.
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Affiliation(s)
- Shin Koike
- Department of Analytical Biochemistry, Meiji Pharmaceutical University, 2-522-1 Noshio, Tokyo 204-8588, Japan
| | - Kohei Sato
- Department of Analytical Biochemistry, Meiji Pharmaceutical University, 2-522-1 Noshio, Tokyo 204-8588, Japan
| | - Marie Sawa
- Department of Environmental Science, Meiji Pharmaceutical University, 2-522-1 Noshio, Tokyo 204-8588, Japan
| | - Yohei Inaba
- Department of Environmental Health, National Institute of Public Health, 2-3-6 Minami, Saitama 351-0197, Japan
| | - Kenji Hattori
- Department of Environmental Science, Meiji Pharmaceutical University, 2-522-1 Noshio, Tokyo 204-8588, Japan
| | - Kazuhiko Nakadate
- Department of Basic Science, Educational and Research Center for Pharmacy, Meiji Pharmaceutical University, 2-522-1 Noshio, Tokyo 204-8588, Japan
| | - Akira Ushiyama
- Department of Environmental Health, National Institute of Public Health, 2-3-6 Minami, Saitama 351-0197, Japan
| | - Yuki Ogasawara
- Department of Analytical Biochemistry, Meiji Pharmaceutical University, 2-522-1 Noshio, Tokyo 204-8588, Japan
- Correspondence:
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13
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Morishita Y, Hasegawa S, Koie S, Ueda S, Miyabe S, Watanabe S, Goto M, Miyachi H, Nomoto S, Nagao T. Cytotoxic, genotoxic, and toxicogenomic effects of heated
tobacco products and cigarette smoke in human primary
keratinocytes. Tob Induc Dis 2022; 20:82. [PMID: 36249345 PMCID: PMC9523519 DOI: 10.18332/tid/152510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/22/2022] [Accepted: 07/29/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Yoshihisa Morishita
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University Graduate School of Medicine, Nagoya, Japan
| | - Shogo Hasegawa
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University Graduate School of Medicine, Nagoya, Japan
| | - Shin Koie
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University Graduate School of Medicine, Nagoya, Japan
| | - Sei Ueda
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University Graduate School of Medicine, Nagoya, Japan
| | - Satoru Miyabe
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University Graduate School of Medicine, Nagoya, Japan
| | - Satoshi Watanabe
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University Graduate School of Medicine, Nagoya, Japan
| | - Mitsuo Goto
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University Graduate School of Medicine, Nagoya, Japan
| | - Hitoshi Miyachi
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University Graduate School of Medicine, Nagoya, Japan
| | - Shuji Nomoto
- Department of Surgery, School of Dentistry, Aichi Gakuin University Graduate School of Medicine, Nagoya, Japan
| | - Toru Nagao
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University Graduate School of Medicine, Nagoya, Japan
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14
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Uguna CN, Snape CE. Should IQOS Emissions Be Considered as Smoke and Harmful to Health? A Review of the Chemical Evidence. ACS OMEGA 2022; 7:22111-22124. [PMID: 35811880 PMCID: PMC9260752 DOI: 10.1021/acsomega.2c01527] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 05/24/2022] [Indexed: 06/15/2023]
Abstract
The chemical evidence that IQOS emissions fit the definition of both an aerosol and smoke, and that IQOS and potentially other heated tobacco products (HTPs) pose some harmful health threats from the range of compounds released even at somewhat lower concentrations is reviewed. Further, we address the yields of harmful and potentially harmful compounds (HPHCs), including polycyclic aromatic hydrocarbons (PAHs), and the constituents of IQOS emission that are diagnostic of pyrolysis to provide information on the temperatures reached in IQOS tobacco sticks. The HPHCs present in IQOS emissions are the same as in conventional cigarette smoke (CCs), analogous to emissions from earlier generation of HTPs classed as smoke. However, Philip Morris International (PMI) studies have to some degree underestimated IQOS aerosol HPHC yields, which are a factor of between 3.2 and 3.6 higher when expressed on a tobacco rather than an IQOS stick basis compared to the reference 3R4F cigarette. Further, IQOS emissions contain carbon particles, which fit definition of both aerosol and smoke. Continual reheating of deposited tar in the IQOS device will occur with real-life use, likely leading to generation of even higher concentrations of HPHCs and particulate matter. Despite IQOS not exceeding 350 °C, local hot spots could exist, causing formation of species (phenol/cresols, PAHs). It is recommended that the impact of repeated use to determine the levels of black carbon (insoluble organic matter) in the particulate matter, and the extent to which compounds in IQOS emissions are formed by pyrolysis need to be assessed rigorously. To address whether uneven temperature profiles in heat sticks can lead to potential hot spots that could, for example, lead to PAH formation, it is recommended that pyrolysis studies on tobacco and other constituents of HTPs are required in conjunction with more effort on heating tobacco blends under controlled temperature/time conditions.
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15
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Sawa M, Ushiyama A, Inaba Y, Hattori K. Increased oxidative stress and effects on inflammatory cytokine secretion by heated tobacco products aerosol exposure to mice. Biochem Biophys Res Commun 2022; 610:43-48. [PMID: 35462100 DOI: 10.1016/j.bbrc.2022.04.042] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 04/09/2022] [Indexed: 11/23/2022]
Abstract
Although the amount of chemicals in heated tobacco products (HTPs) aerosols is reduced compared to conventional combustible cigarette smoke, the association between HTPs and reduced health effects remains unclear. In this study, we hypothesized that exposure to IQOS, an HTP, would increase oxidative stress and affect the secretion of inflammatory cytokines. First, C57BL/6 mice exposed to IQOS aerosols were evaluated to determine the adverse effects of IQOS exposure. IQOS exposure significantly decreased the concentration of GSH in alveolar macrophages in a dose-dependent manner and increased the percentage of GSSG in lung tissues. These results indicate that IQOS exposure increases oxidative stress, and GSH is consumed to remove oxidative stress. In addition, foamy alveolar macrophages were observed in the bronchial alveolar lavage fluid after IQOS exposure. Although the concentration of inflammatory cytokines, IL-6, and GM-CSF, in the plasma increased significantly after IQOS exposure, there were no significant changes in other cytokines. These results indicate that short-term exposure to IQOS aerosols may increase oxidative stress and induce the secretion of inflammatory cytokines. Lastly, the longer-term effects of IQOS aerosols exposure should be evaluated in the future.
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Affiliation(s)
- Marie Sawa
- Department of Environmental Toxicology, Meiji Pharmaceutical University, 2-522-1 Noshio, Kiyose, Tokyo, 204-8588, Japan
| | - Akira Ushiyama
- Department of Environmental Health, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan.
| | - Yohei Inaba
- Department of Environmental Health, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan
| | - Kenji Hattori
- Department of Environmental Toxicology, Meiji Pharmaceutical University, 2-522-1 Noshio, Kiyose, Tokyo, 204-8588, Japan
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16
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Hird TR, Gallagher AWA, Evans-Reeves K, Zatoński M, Dance S, Diethelm PA, Edwards R, Gilmore AB. Understanding the long-term policy influence strategies of the tobacco industry: two contemporary case studies. Tob Control 2022; 31:297-307. [PMID: 35241603 DOI: 10.1136/tobaccocontrol-2021-057030] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 12/22/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVE This paper explores transnational tobacco companies' (TTCs) long-term policy influence strategies using two case studies, harm reduction and illicit tobacco, to identify lessons for the tobacco control movement and wider efforts to address the commercial determinants of health. METHODS Evidence from a broad combination of sources including leaked documents and findings from over two decades of TTC monitoring were reviewed for each case study and categorised using the Policy Dystopia Model, focusing on the primary discursive strategy and key instrumental (action-based) strategies used. RESULTS In both case studies, TTCs seek to advance their interests by engaging primarily in reputation management, coalition management and information management strategies over the long-term to propagate their over-riding discursive strategy-'we've changed, we are part of the solution'-despite clear evidence from both case studies that this is not the case. These strategies are globally coordinated and attempt primarily to reshape norms towards TTC involvement in tobacco control policy and delivery. Findings also suggest that industry denormalisation and the advent of Article 5.3 have led to the TTCs growing use of increasingly complex and opaque 'webs of influence'. CONCLUSIONS The tobacco control community must develop its own proactive long-term strategies which should include industry denormalisation, new ways to fund research that reduce industry control, and improved transparency measures for research and policy. These findings, including TTC adaptations to Article 5.3, also indicate the need for more structural solutions, addressing corporate power and the underlying political and economic system. These lessons can be applied to other unhealthy commodity industries.
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Affiliation(s)
| | | | | | | | - Sarah Dance
- Department for Health, University of Bath, Bath, UK
| | | | - Richard Edwards
- Department of Public Health, University of Otago, Wellington, New Zealand
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