1
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Wold LE, Tarran R, Crotty Alexander LE, Hamburg NM, Kheradmand F, St Helen G, Wu JC. Cardiopulmonary Consequences of Vaping in Adolescents: A Scientific Statement From the American Heart Association. Circ Res 2022; 131:e70-e82. [PMID: 35726609 DOI: 10.1161/res.0000000000000544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although the US Food and Drug Administration has not approved e-cigarettes as a cessation aid, industry has at times positioned their products in that way for adults trying to quit traditional cigarettes; however, their novelty and customizability have driven them into the hands of unintended users, particularly adolescents. Most new users of e-cigarette products have never smoked traditional cigarettes; therefore, understanding the respiratory and cardiovascular consequences of e-cigarette use has become of increasing interest to the research community. Most studies have been performed on adult e-cigarette users, but the majority of these study participants are either former traditional smokers or smokers who have used e-cigarettes to switch from traditional smoking. Therefore, the respiratory and cardiovascular consequences in this population are not attributable to e-cigarette use alone. Preclinical studies have been used to study the effects of naive e-cigarette use on various organ systems; however, almost all of these studies have used adult animals, which makes translation of health effects to adolescents problematic. Given that inhalation of any foreign substance can have effects on the respiratory and cardiovascular systems, a more holistic understanding of the pathways involved in toxicity could help to guide researchers to novel therapeutic treatment strategies. The goals of this scientific statement are to provide salient background information on the cardiopulmonary consequences of e-cigarette use (vaping) in adolescents, to guide therapeutic and preventive strategies and future research directions, and to inform public policymakers on the risks, both short and long term, of vaping.
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2
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Measey MA, Palit V, Hoq M, Vandeleur M, Rhodes A. Parents support strong restrictions controlling e-cigarette use in Australia: findings from a national survey. Tob Control 2022:tobaccocontrol-2021-057074. [PMID: 35581000 DOI: 10.1136/tobaccocontrol-2021-057074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 03/29/2022] [Indexed: 11/03/2022]
Affiliation(s)
- Mary-Anne Measey
- National Child Health Poll, The Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia.,Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
| | - Vikram Palit
- Department of Respiratory and Sleep Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia.,School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Monsurul Hoq
- National Child Health Poll, The Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia.,Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
| | - Moya Vandeleur
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.,Department of Respiratory and Sleep Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Anthea Rhodes
- National Child Health Poll, The Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia .,Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
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3
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Abstract
Vaping, the inhalation of heated aerosols, received widespread attention during the outbreak of electronic-cigarette (e-cigarette) or vaping-associated acute lung injury cases in 2019. E-cigarette use is now widely recognized as a potential cause of acute lung injury. Vaping is often perceived by physicians as referring exclusively to the use of e-cigarette devices. However, inhalation of nicotine or tetrahydrocannabinol-containing aerosol through alternate methods such as "dabbing" and "dripping" are increasingly common. However, the health impact of these alternate methods remains poorly understood. The use of alternate methods and devices may go unrecognized because of lack of clinician familiarity with them. In this review, we discuss e-cigarettes devices, electronic-liquid components, the expanded spectrum of methods used to consume aerosolized substances, and the potential for lung injury.
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4
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Forno E, Abman SH, Singh J, Robbins ME, Selvadurai H, Schumacker PT, Robinson PD. Update in Pediatrics 2020. Am J Respir Crit Care Med 2021; 204:274-284. [PMID: 34126039 DOI: 10.1164/rccm.202103-0605up] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Erick Forno
- Division of Pediatric Pulmonary Medicine, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.,University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Steven H Abman
- Department of Pediatrics, Children's Hospital Colorado, Denver, Colorado.,University of Colorado Anschutz School of Medicine, Denver, Colorado
| | - Jagdev Singh
- Department of Respiratory Medicine, Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Discipline of Pediatrics and Child Health, University of Sydney, Sydney, New South Wales, Australia
| | - Mary E Robbins
- Division of Neonatology, Ann and Robert H. Lurie Children's Hospital, Chicago, Illinois; and.,Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Hiran Selvadurai
- Department of Respiratory Medicine, Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Discipline of Pediatrics and Child Health, University of Sydney, Sydney, New South Wales, Australia
| | - Paul T Schumacker
- Division of Neonatology, Ann and Robert H. Lurie Children's Hospital, Chicago, Illinois; and.,Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Paul D Robinson
- Department of Respiratory Medicine, Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Discipline of Pediatrics and Child Health, University of Sydney, Sydney, New South Wales, Australia
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5
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Felner JK, Andrzejewski J, Strong D, Kieu T, Ravindran M, Corliss HL. Vaping disparities at the intersection of gender identity and race/ethnicity in a population-based sample of adolescents. Nicotine Tob Res 2021; 24:349-357. [PMID: 34297103 DOI: 10.1093/ntr/ntab152] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 07/21/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Transgender adolescents use vape products (e.g., e-cigarettes) at higher rates than cisgender adolescents. Little is known about how these disparities differ from the intersectional perspective of both gender identity and race/ethnicity. METHODS We examined disparities in past 30-day vaping frequency at the intersection of gender identity and race/ethnicity among adolescents participating in two pooled waves of the population-based California Healthy Kids Survey (N=953,445; 2017-19). Generalized linear mixed models included gender identity-by-race/ethnicity interactions and adjusted for potential confounders. Stratified models quantified relationships between gender identity and vaping within race/ethnicity strata and between race/ethnicity and vaping within gender identity strata. RESULTS Transgender adolescents of color were more likely to report a higher frequency of vaping than cisgender white adolescents. In models stratified by race/ethnicity, transgender adolescents evidenced greater odds of more frequent vaping than cisgender adolescents of the same race/ethnicity; disparities were greatest between transgender and cisgender Black adolescents (adjusted odds ratio [AOR]: 6.05, 95% CI: 4.76-7.68) and smallest between transgender and cisgender white adolescents (AOR: 1.20, 95% CI: 1.06-1.35). In models stratified by gender identity, disparities were greatest between transgender Black and transgender white adolescents (AOR: 2.85, 95% CI: 2.20-3.70) and smallest between transgender multiracial and white adolescents (AOR: 1.28, 95% CI: 1.05-1.58). Similar, though less consistent, patterns emerged for adolescents of color unsure of their gender identity relative to cisgender white adolescents. CONCLUSION Transgender adolescents of color may be especially vulnerable to vaping disparities. Future research should identify and intervene on causal mechanisms undergirding disparities. IMPLICATIONS Research finds that transgender adolescents use vape products at higher rates than their cisgender peers, however, little is known about how patterns of adolescent vaping may differ by both gender identity and race/ethnicity-information needed to inform culturally-tailored prevention and control initiatives to decrease adolescent vaping disparities. Our analysis of data from a population-based adolescent health survey finds evidence of magnified disparities in vaping frequency among transgender adolescents of color.
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Affiliation(s)
- Jennifer K Felner
- San Diego State University, Institute for Behavioral and Community Health and School of Public Health
| | - Jack Andrzejewski
- San Diego State University-University of California, San Diego, Joint Doctoral Program in Public Health
| | - David Strong
- Herbert Wertheim School of Public Health University of California San Diego
| | - Talia Kieu
- San Diego State University, Institute for Behavioral and Community Health and School of Public Health.,University of North Carolina at Chapel Hill, Gillings School of Global Public Health
| | - Madhumitha Ravindran
- San Diego State University, Institute for Behavioral and Community Health and School of Public Health
| | - Heather L Corliss
- San Diego State University, Institute for Behavioral and Community Health and School of Public Health
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6
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Hansen J, Morgenstern M, Isensee B, Galimov A, Hanewinkel R. Association between bullying victimization and e-cigarette use among German students. Aggress Behav 2021; 47:421-429. [PMID: 33559193 DOI: 10.1002/ab.21951] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 01/19/2021] [Accepted: 01/25/2021] [Indexed: 12/31/2022]
Abstract
This study examined the association between bullying victimization and e-cigarette use. Data from a 2019-2020 German student survey were used (N = 16,476). The target population consisted of students enrolled in grades 5-10, with a mean age of 13.1 years (SD = 1.8), and equal gender distribution (49.5% female). Mixed-effect multivariable logistic regression models were used to examine the association between bullying victimization (attacked physically, assaulted verbally, experienced relational bullying, sexual harassment, cyberbullying) and current e-cigarette use. The multivariable analysis controlled for age, sex, sensation-seeking, socioeconomic status, school performance, type of school attended, and substance use (current cigarette smoking, hookah smoking, and alcohol drinking). Overall 510 (3.7%) students reported current use of e-cigarettes. The odds for using e-cigarettes increased each step of being bullied from "never," "rarely," "sometimes," "once a week," to "several times a week" by 2.03 (95% confidence interval [CI]: 1.81, 2.29) in the unadjusted model, and by 1.46 (95% CI: 1.24, 1.71) in the covariate-adjusted model. Data indicate an empirical association between victimization and e-cigarette use among German students. Design limitations prevent the conclusion of a causal relationship, calling for well-designed longitudinal studies to investigate the temporal sequence between victimization and e-cigarette use.
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Affiliation(s)
- Julia Hansen
- Institute for Therapy and Health Research IFT‐Nord Kiel Schleswig‐Holstein Germany
| | - Matthis Morgenstern
- Institute for Therapy and Health Research IFT‐Nord Kiel Schleswig‐Holstein Germany
| | - Barbara Isensee
- Institute for Therapy and Health Research IFT‐Nord Kiel Schleswig‐Holstein Germany
| | - Artur Galimov
- Department of Preventive Medicine, Institute for Health Promotion and Disease Prevention Research Keck School of Medicine of University of Southern California Los Angeles California USA
| | - Reiner Hanewinkel
- Institute for Therapy and Health Research IFT‐Nord Kiel Schleswig‐Holstein Germany
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7
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Moshensky A, Du M, Shin J, Advani I, Gunge D, Mathew D, Alkolla R, Du A, Javier C, Ma L, Tran A, Nguyen N, Olay J, Nilaad S, Ding J, Najhawan M, Watrous JD, Bojanowksi CM, Jain M, Christiani DC, Crotty Alexander LE. Vaping-induced metabolomic signatures in the circulation of mice are driven by device type, e-liquid, exposure duration and sex. ERJ Open Res 2021; 7:00229-2021. [PMID: 34262972 PMCID: PMC8273396 DOI: 10.1183/23120541.00229-2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 04/24/2021] [Indexed: 12/15/2022] Open
Abstract
Each type of vaping device (vape pen, box Mod and JUUL), as well as nicotine and flavourings, induces a disparate metabolite profile or signature, such that each device and liquid is likely to lead to its own set of health effects https://bit.ly/3eExKzi.
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Affiliation(s)
- Alexander Moshensky
- Pulmonary Critical Care Section, VA San Diego Healthcare System, La Jolla, CA, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Dept of Medicine, University of California San Diego (UCSD), La Jolla, CA, USA
| | - Mulong Du
- Dept of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - John Shin
- Pulmonary Critical Care Section, VA San Diego Healthcare System, La Jolla, CA, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Dept of Medicine, University of California San Diego (UCSD), La Jolla, CA, USA
| | - Ira Advani
- Pulmonary Critical Care Section, VA San Diego Healthcare System, La Jolla, CA, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Dept of Medicine, University of California San Diego (UCSD), La Jolla, CA, USA
| | - Deepti Gunge
- Pulmonary Critical Care Section, VA San Diego Healthcare System, La Jolla, CA, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Dept of Medicine, University of California San Diego (UCSD), La Jolla, CA, USA
| | - Denzil Mathew
- Pulmonary Critical Care Section, VA San Diego Healthcare System, La Jolla, CA, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Dept of Medicine, University of California San Diego (UCSD), La Jolla, CA, USA
| | - Rita Alkolla
- Pulmonary Critical Care Section, VA San Diego Healthcare System, La Jolla, CA, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Dept of Medicine, University of California San Diego (UCSD), La Jolla, CA, USA
| | - Ashley Du
- Pulmonary Critical Care Section, VA San Diego Healthcare System, La Jolla, CA, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Dept of Medicine, University of California San Diego (UCSD), La Jolla, CA, USA
| | - Christian Javier
- Pulmonary Critical Care Section, VA San Diego Healthcare System, La Jolla, CA, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Dept of Medicine, University of California San Diego (UCSD), La Jolla, CA, USA
| | - Lauren Ma
- Pulmonary Critical Care Section, VA San Diego Healthcare System, La Jolla, CA, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Dept of Medicine, University of California San Diego (UCSD), La Jolla, CA, USA
| | - Albert Tran
- Pulmonary Critical Care Section, VA San Diego Healthcare System, La Jolla, CA, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Dept of Medicine, University of California San Diego (UCSD), La Jolla, CA, USA
| | - Nicholas Nguyen
- Pulmonary Critical Care Section, VA San Diego Healthcare System, La Jolla, CA, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Dept of Medicine, University of California San Diego (UCSD), La Jolla, CA, USA
| | - Jarod Olay
- Pulmonary Critical Care Section, VA San Diego Healthcare System, La Jolla, CA, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Dept of Medicine, University of California San Diego (UCSD), La Jolla, CA, USA
| | - Sedtavut Nilaad
- Pulmonary Critical Care Section, VA San Diego Healthcare System, La Jolla, CA, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Dept of Medicine, University of California San Diego (UCSD), La Jolla, CA, USA
| | - Jeffrey Ding
- Depts of Medicine and Pharmacology, UCSD, La Jolla, CA, USA
| | - Mahan Najhawan
- Depts of Medicine and Pharmacology, UCSD, La Jolla, CA, USA
| | | | - Christine M. Bojanowksi
- Pulmonary Critical Care Section, VA San Diego Healthcare System, La Jolla, CA, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Dept of Medicine, University of California San Diego (UCSD), La Jolla, CA, USA
| | - Mohit Jain
- Depts of Medicine and Pharmacology, UCSD, La Jolla, CA, USA
| | - David C. Christiani
- Dept of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Pulmonary and Critical Care Medicine, Dept of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Laura E. Crotty Alexander
- Pulmonary Critical Care Section, VA San Diego Healthcare System, La Jolla, CA, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Dept of Medicine, University of California San Diego (UCSD), La Jolla, CA, USA
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8
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Chopyk J, Bojanowski CM, Shin J, Moshensky A, Fuentes AL, Bonde SS, Chuki D, Pride DT, Crotty Alexander LE. Compositional Differences in the Oral Microbiome of E-cigarette Users. Front Microbiol 2021; 12:599664. [PMID: 34135868 PMCID: PMC8200533 DOI: 10.3389/fmicb.2021.599664] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 04/26/2021] [Indexed: 12/18/2022] Open
Abstract
Electronic (e)-cigarettes have been advocated as a safer alternative to conventional tobacco cigarettes. However, there is a paucity of data regarding the impact of e-cigarette aerosol deposition on the human oral microbiome, a key component in human health and disease. We aimed to fill this knowledge gap through a comparative analysis of the microbial community profiles from e-cigarette users and healthy controls [non-smokers/non-vapers (NSNV)]. Moreover, we sought to determine whether e-cigarette aerosol exposure from vaping induces persistent changes in the oral microbiome. To accomplish this, salivary and buccal mucosa samples were collected from e-cigarette users and NSNV controls, with additional oral samples collected from e-cigarette users after 2 weeks of decreased use. Total DNA was extracted from all samples and subjected to PCR amplification and sequencing of the V3-V4 hypervariable regions of the 16S rRNA gene. Our analysis revealed several prominent differences associated with vaping, specific to the sample type (i.e., saliva and buccal). In the saliva, e-cigarette users had a significantly higher alpha diversity, observed operational taxonomic units (OTUs) and Faith's phylogenetic diversity (PD) compared to NSNV controls, which declined with decreased vaping. The buccal mucosa swab samples were marked by a significant shift in beta diversity between e-cigarette users and NSNV controls. There were also significant differences in the relative abundance of several bacterial taxa, with a significant increase in Veillonella and Haemophilus in e-cigarette users. In addition, nasal swabs demonstrated a trend toward higher colonization rates with Staphylococcus aureus in e-cigarette users relative to controls (19 vs. 7.1%; p = n.s.). Overall, these data reveal several notable differences in the oral bacterial community composition and diversity in e-cigarette users as compared to NSNV controls.
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Affiliation(s)
- Jessica Chopyk
- Department of Pathology, University of California San Diego (UCSD), La Jolla, CA, United States
| | - Christine M. Bojanowski
- Section of Pulmonary Diseases, Critical Care and Environmental Medicine, Department of Medicine, Tulane University, New Orleans, LA, United States
- Pulmonary Critical Care Section, VA San Diego Healthcare System, La Jolla, CA, United States
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California San Diego (UCSD), La Jolla, CA, United States
| | - John Shin
- Pulmonary Critical Care Section, VA San Diego Healthcare System, La Jolla, CA, United States
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California San Diego (UCSD), La Jolla, CA, United States
| | - Alex Moshensky
- Pulmonary Critical Care Section, VA San Diego Healthcare System, La Jolla, CA, United States
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California San Diego (UCSD), La Jolla, CA, United States
| | - Ana Lucia Fuentes
- Pulmonary Critical Care Section, VA San Diego Healthcare System, La Jolla, CA, United States
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California San Diego (UCSD), La Jolla, CA, United States
| | - Saniya S. Bonde
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California San Diego (UCSD), La Jolla, CA, United States
| | - Dagni Chuki
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California San Diego (UCSD), La Jolla, CA, United States
| | - David T. Pride
- Department of Pathology, University of California San Diego (UCSD), La Jolla, CA, United States
- Department of Medicine, University of California San Diego (UCSD), La Jolla, CA, United States
| | - Laura E. Crotty Alexander
- Pulmonary Critical Care Section, VA San Diego Healthcare System, La Jolla, CA, United States
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California San Diego (UCSD), La Jolla, CA, United States
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9
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Sharma A, Lee J, Fonseca AG, Moshensky A, Kothari T, Sayed IM, Ibeawuchi SR, Pranadinata RF, Ear J, Sahoo D, Crotty-Alexander LE, Ghosh P, Das S. E-cigarettes compromise the gut barrier and trigger inflammation. iScience 2021. [PMID: 33537654 DOI: 10.1101/2020.07.29.227348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023] Open
Abstract
E-cigarette usage continues to rise, yet the safety of e-cigarette aerosols is questioned. Using murine models of acute and chronic e-cigarette aerosol inhalation, murine colon transcriptomics, and murine and human gut-derived organoids in co-culture models, we assessed the effects of e-cigarette use on the gut barrier. Histologic and transcriptome analyses revealed that chronic, but not acute, nicotine-free e-cigarette use increased inflammation and reduced expression of tight junction (TJ) markers. Exposure of murine and human enteroid-derived monolayers (EDMs) to nicotine-free e-cigarette aerosols alone or in co-culture with bacteria also causes barrier disruption, downregulation of TJ protein, and enhanced inflammation in response to infection. These data highlight the harmful effects of "non-nicotine" component of e-cigarettes on the gut barrier. Considering the importance of an intact gut barrier for host fitness and the impact of gut mucosal inflammation on a multitude of chronic diseases, these findings are broadly relevant to both medicine and public health.
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Affiliation(s)
- Aditi Sharma
- Department of Pathology, University of California, San Diego, CA 92093, USA
| | - Jasper Lee
- Department of Pathology, University of California, San Diego, CA 92093, USA
| | - Ayden G Fonseca
- Department of Cellular and Molecular Medicine, University of California, San Diego, CA 92093, USA
| | - Alex Moshensky
- Department of Medicine, University of California, San Diego, CA 92093, USA
| | - Taha Kothari
- Department of Pathology, University of California, San Diego, CA 92093, USA
| | - Ibrahim M Sayed
- Department of Pathology, University of California, San Diego, CA 92093, USA
| | | | - Rama F Pranadinata
- Department of Cellular and Molecular Medicine, University of California, San Diego, CA 92093, USA
| | - Jason Ear
- Department of Cellular and Molecular Medicine, University of California, San Diego, CA 92093, USA
- Department of Medicine, University of California, San Diego, CA 92093, USA
| | - Debashis Sahoo
- Department of Pediatrics, University of California, San Diego, CA 92093, USA
- Department of Computer Science and Engineering, Jacobs School of Engineering, University of California, San Diego, CA 92093, USA
- Rebecca and John Moore Comprehensive Cancer Center, University of California, San Diego, CA 92093, USA
| | - Laura E Crotty-Alexander
- Department of Medicine, University of California, San Diego, CA 92093, USA
- Veterans Affairs Medical Center, VA San Diego Healthcare System, La Jolla, San Diego, CA 92093, USA
| | - Pradipta Ghosh
- Department of Cellular and Molecular Medicine, University of California, San Diego, CA 92093, USA
- Department of Medicine, University of California, San Diego, CA 92093, USA
- Rebecca and John Moore Comprehensive Cancer Center, University of California, San Diego, CA 92093, USA
- Veterans Affairs Medical Center, VA San Diego Healthcare System, La Jolla, San Diego, CA 92093, USA
| | - Soumita Das
- Department of Pathology, University of California, San Diego, CA 92093, USA
- Rebecca and John Moore Comprehensive Cancer Center, University of California, San Diego, CA 92093, USA
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10
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Sharma A, Lee J, Fonseca AG, Moshensky A, Kothari T, Sayed IM, Ibeawuchi SR, Pranadinata RF, Ear J, Sahoo D, Crotty-Alexander LE, Ghosh P, Das S. E-cigarettes compromise the gut barrier and trigger inflammation. iScience 2021; 24:102035. [PMID: 33537654 PMCID: PMC7841355 DOI: 10.1016/j.isci.2021.102035] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 11/15/2020] [Accepted: 12/31/2020] [Indexed: 12/13/2022] Open
Abstract
E-cigarette usage continues to rise, yet the safety of e-cigarette aerosols is questioned. Using murine models of acute and chronic e-cigarette aerosol inhalation, murine colon transcriptomics, and murine and human gut-derived organoids in co-culture models, we assessed the effects of e-cigarette use on the gut barrier. Histologic and transcriptome analyses revealed that chronic, but not acute, nicotine-free e-cigarette use increased inflammation and reduced expression of tight junction (TJ) markers. Exposure of murine and human enteroid-derived monolayers (EDMs) to nicotine-free e-cigarette aerosols alone or in co-culture with bacteria also causes barrier disruption, downregulation of TJ protein, and enhanced inflammation in response to infection. These data highlight the harmful effects of "non-nicotine" component of e-cigarettes on the gut barrier. Considering the importance of an intact gut barrier for host fitness and the impact of gut mucosal inflammation on a multitude of chronic diseases, these findings are broadly relevant to both medicine and public health.
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Affiliation(s)
- Aditi Sharma
- Department of Pathology, University of California, San Diego, CA 92093, USA
| | - Jasper Lee
- Department of Pathology, University of California, San Diego, CA 92093, USA
| | - Ayden G. Fonseca
- Department of Cellular and Molecular Medicine, University of California, San Diego, CA 92093, USA
| | - Alex Moshensky
- Department of Medicine, University of California, San Diego, CA 92093, USA
| | - Taha Kothari
- Department of Pathology, University of California, San Diego, CA 92093, USA
| | - Ibrahim M. Sayed
- Department of Pathology, University of California, San Diego, CA 92093, USA
| | | | - Rama F. Pranadinata
- Department of Cellular and Molecular Medicine, University of California, San Diego, CA 92093, USA
| | - Jason Ear
- Department of Cellular and Molecular Medicine, University of California, San Diego, CA 92093, USA
- Department of Medicine, University of California, San Diego, CA 92093, USA
| | - Debashis Sahoo
- Department of Pediatrics, University of California, San Diego, CA 92093, USA
- Department of Computer Science and Engineering, Jacobs School of Engineering, University of California, San Diego, CA 92093, USA
- Rebecca and John Moore Comprehensive Cancer Center, University of California, San Diego, CA 92093, USA
| | - Laura E. Crotty-Alexander
- Department of Medicine, University of California, San Diego, CA 92093, USA
- Veterans Affairs Medical Center, VA San Diego Healthcare System, La Jolla, San Diego, CA 92093, USA
| | - Pradipta Ghosh
- Department of Cellular and Molecular Medicine, University of California, San Diego, CA 92093, USA
- Department of Medicine, University of California, San Diego, CA 92093, USA
- Rebecca and John Moore Comprehensive Cancer Center, University of California, San Diego, CA 92093, USA
- Veterans Affairs Medical Center, VA San Diego Healthcare System, La Jolla, San Diego, CA 92093, USA
| | - Soumita Das
- Department of Pathology, University of California, San Diego, CA 92093, USA
- Rebecca and John Moore Comprehensive Cancer Center, University of California, San Diego, CA 92093, USA
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11
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Wills TA, Soneji SS, Choi K, Jaspers I, Tam EK. E-cigarette use and respiratory disorders: an integrative review of converging evidence from epidemiological and laboratory studies. Eur Respir J 2021; 57:13993003.01815-2019. [PMID: 33154031 PMCID: PMC7817920 DOI: 10.1183/13993003.01815-2019] [Citation(s) in RCA: 103] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 10/10/2020] [Indexed: 12/11/2022]
Abstract
Background Use of electronic cigarettes (e-cigarettes) is prevalent among adolescents and young adults, but there has been limited knowledge about health consequences in human populations. We conduct a systematic review and meta-analysis of results on respiratory disorders from studies of general-population samples and consider the mapping of these results to findings about biological processes linked to e-cigarettes in controlled laboratory studies. Method We conducted a literature search and meta-analysis of epidemiological studies on the association of e-cigarette use with asthma and with COPD. We discuss findings from laboratory studies about effects of e-cigarettes on four biological processes: cytotoxicity, oxidative stress/inflammation, susceptibility to infection and genetic expression. Results Epidemiological studies, both cross-sectional and longitudinal, show a significant association of e-cigarette use with asthma and COPD, controlling for cigarette smoking and other covariates. For asthma (n=15 studies), the pooled adjusted odds ratio (aOR) was 1.39 (95% CI 1.28–1.51); for COPD (n=9 studies) the aOR was 1.49 (95% CI 1.36–1.65). Laboratory studies consistently show an effect of e-cigarettes on biological processes related to respiratory harm and susceptibility to illness, with e-cigarette conditions differing significantly from clean-air controls, although sometimes less than for cigarettes. Conclusions The evidence from epidemiological studies meets established criteria for consistency, strength of effect, temporality, and in some cases a dose–response gradient. Biological plausibility is indicated by evidence from multiple laboratory studies. We conclude that e-cigarette use has consequences for asthma and COPD, which is of concern for respirology and public health. Epidemiological studies show a relationship of e-cigarette use with asthma and COPD, and laboratory studies show their adverse effects on four biological processes. It can be concluded that e-cigarette use is of significant concern for public health.https://bit.ly/3drH4pj
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Affiliation(s)
- Thomas A Wills
- Cancer Prevention Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Samir S Soneji
- Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD, USA
| | - Ilona Jaspers
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Elizabeth K Tam
- Dept of Medicine, John A. Burns School of Medicine, Honolulu, HI, USA
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Wills TA, Soneji SS, Choi K, Jaspers I, Tam EK. E-cigarette use and respiratory disorders: an integrative review of converging evidence from epidemiological and laboratory studies. Eur Respir J 2020. [PMID: 33154031 DOI: 10.1183/13993003.01815‐2019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Use of electronic cigarettes (e-cigarettes) is prevalent among adolescents and young adults, but there has been limited knowledge about health consequences in human populations. We conduct a systematic review and meta-analysis of results on respiratory disorders from studies of general-population samples and consider the mapping of these results to findings about biological processes linked to e-cigarettes in controlled laboratory studies. METHOD We conducted a literature search and meta-analysis of epidemiological studies on the association of e-cigarette use with asthma and with COPD. We discuss findings from laboratory studies about effects of e-cigarettes on four biological processes: cytotoxicity, oxidative stress/inflammation, susceptibility to infection and genetic expression. RESULTS Epidemiological studies, both cross-sectional and longitudinal, show a significant association of e-cigarette use with asthma and COPD, controlling for cigarette smoking and other covariates. For asthma (n=15 studies), the pooled adjusted odds ratio (aOR) was 1.39 (95% CI 1.28-1.51); for COPD (n=9 studies) the aOR was 1.49 (95% CI 1.36-1.65). Laboratory studies consistently show an effect of e-cigarettes on biological processes related to respiratory harm and susceptibility to illness, with e-cigarette conditions differing significantly from clean-air controls, although sometimes less than for cigarettes. CONCLUSIONS The evidence from epidemiological studies meets established criteria for consistency, strength of effect, temporality, and in some cases a dose-response gradient. Biological plausibility is indicated by evidence from multiple laboratory studies. We conclude that e-cigarette use has consequences for asthma and COPD, which is of concern for respirology and public health.
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Affiliation(s)
- Thomas A Wills
- Cancer Prevention Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Samir S Soneji
- Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD, USA
| | - Ilona Jaspers
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Elizabeth K Tam
- Dept of Medicine, John A. Burns School of Medicine, Honolulu, HI, USA
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Tsai M, Byun MK, Shin J, Crotty Alexander LE. Effects of e-cigarettes and vaping devices on cardiac and pulmonary physiology. J Physiol 2020; 598:5039-5062. [PMID: 32975834 PMCID: PMC10506663 DOI: 10.1113/jp279754] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 08/21/2020] [Indexed: 12/11/2022] Open
Abstract
E-cigarette aerosols are exceedingly different from conventional tobacco smoke, containing dozens of chemicals not found in cigarette smoke. It is highly likely that chronic use of e-cigarettes will induce pathological changes in both the heart and lungs. Here we review human and animal studies published to date and summarize the cardiopulmonary physiological changes caused by vaping. In terms of cardiac physiology, acute exposure to e-cigarette aerosols in human subjects led to increased blood pressure and heart rate, similar to traditional cigarettes. Chronic exposure to e-cigarette aerosols using animal models caused increased arterial stiffness, vascular endothelial changes, increased angiogenesis, cardiorenal fibrosis and increased atherosclerotic plaque formation. Pulmonary physiology is also affected by e-cigarette aerosol inhalation, with increased airway reactivity, airway obstruction, inflammation and emphysema. Research thus far demonstrates that the heart and lung undergo numerous changes in response to e-cigarette use, and disease development will depend on how those changes combine with both environmental and genetic factors. E-cigarettes have been advertised as a healthy alternative to cigarette smoking, and users are under the impression that vaping of e-cigarettes is harmless, but these claims that e-cigarettes are safer and healthier are not based on evidence. Data from both humans and animal models are consistent in demonstrating that vaping of e-cigarettes causes health effects both similar to and disparate from those of cigarette smoking. Further work is needed to define the long-term cardiopulmonary effects of e-cigarette use in humans.
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Affiliation(s)
- MuChun Tsai
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Min Kwang Byun
- Pulmonary and Critical Care Section, VA San Diego Healthcare System, La Jolla, CA, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California San Diego (UCSD), La Jolla, CA, USA
- Division of Pulmonology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - John Shin
- Pulmonary and Critical Care Section, VA San Diego Healthcare System, La Jolla, CA, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California San Diego (UCSD), La Jolla, CA, USA
| | - Laura E Crotty Alexander
- Pulmonary and Critical Care Section, VA San Diego Healthcare System, La Jolla, CA, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California San Diego (UCSD), La Jolla, CA, USA
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Bhatt JM, Ramphul M, Bush A. An update on controversies in e-cigarettes. Paediatr Respir Rev 2020; 36:75-86. [PMID: 33071065 PMCID: PMC7518964 DOI: 10.1016/j.prrv.2020.09.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 09/17/2020] [Indexed: 12/12/2022]
Abstract
E-cigarettes are electronic nicotine delivery systems (ENDS) which mimic tobacco smoking without the combustion of tobacco. These devices have been misleadingly marketed as "less harmful" alternatives to conventional smoking tobacco products. The e-liquid in e-cigarettes include nicotine, a humectant and other additives including flavourings, colourants, or adulterants such as bacterial and fungal products. In this review, we discuss the contrasting views of the tobacco lobby and most professional societies. We describe the epidemiology of the use of these devices, with a widespread and significant rise in youth e-cigarette use seen in both the USA and Europe. We also describe what is known about the toxicity and mechanisms of EVALI (e-cigarette or vaping associated lung injury). This characterised by respiratory failure with an intense inflammatory response. The presentations are diverse and clinicians should consider vaping as a possible cause of any unusual respiratory illness in patients who have a history of vaping or other use of e-cigarette-related products. Second hand exposure to e-cigarettes is also harmful through respiration and transdermal absorption. E-cigarettes have a worse acute toxicity than tobacco and their long-term toxicity is unknown, and we advocate for the immediate, most vigorous anti-vaping legislation possible.
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Affiliation(s)
- Jayesh Mahendra Bhatt
- Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, NG7 2UH, United Kingdom.
| | - Manisha Ramphul
- Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, NG7 2UH, United Kingdom.
| | - Andrew Bush
- Paediatrics and Paediatric Respirology, National Heart and Lung Institute, United Kingdom; Paediatric Chest Physician, Royal Brompton & Harefield NHS Foundation Trust, United Kingdom; Imperial Centre for Paediatrics and Child Health, United Kingdom; Royal Brompton Hospital, Sydney Street, London SW3 6NP, United Kingdom.
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E-Cigarette, or Vaping, Product Use-associated Lung Injury: A Response to Perez and Crotty Alexander. Ann Am Thorac Soc 2020; 17:907. [PMID: 32320262 PMCID: PMC7328172 DOI: 10.1513/annalsats.202002-138le] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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16
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Reply: E-Cigarette, or Vaping, Product Use–associated Lung Injury: A Response to Perez and Crotty Alexander. Ann Am Thorac Soc 2020; 17:908. [PMID: 32320261 PMCID: PMC7328184 DOI: 10.1513/annalsats.202003-260le] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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