In utero thirdhand smoke exposure modulates platelet function in a sex-dependent manner

Sex-Dependent Occlusive Cardiovascular Disease Effects of Short-Term Thirdhand Smoke Exposure

INTRODUCTION

Thirdhand smoke (THS) is associated with many public health and disease concerns, such as respiratory illness, cancer, lipidemia, and cardiovascular disease (CVD). We have previously shown that a moderate to long-term exposure to THS increases the risk of thrombosis. However, whether short-term exposure to THS would produce any effects remains to be discovered. Therefore, this study investigated the impact of 1-month THS exposure on platelet function, in vivo and in vitro, and on cytokine response, in a sex-dependent manner.

AIMS AND METHODS

Secondhand smoke or clean air (CA) exposed upholstery materials for 1 week were kept in cages housed with 5-6 mice, and the procedure was repeated for 4 weeks. These THS-exposed mice were evaluated for thrombogenesis and platelet function assays. In addition, cytokines expression was evaluated from pooled serum.

RESULTS

Compared to the CA group, THS exposure significantly shortened the tail bleeding time and carotid artery thrombus formation. Moreover, the female mice appeared more sensitive to THS exposure than males. Furthermore, platelet aggregation, dense granule secretion, and P-selectin activation markers were significantly elevated due to THS exposure. In addition, high-throughput screening showed at least 30 cytokines differentially modulated by THS in females relative to 26 in male mice.

CONCLUSIONS

Collectively, these results demonstrate that 1 month of THS exposure represents a high health risk, in part, by triggering a prothrombotic phenotype that appears to be more significant in females, who are at a much higher risk for occlusive CVD. Additionally, changes in cytokine levels mediate some of the THS-induced occlusive effects.

IMPLICATIONS

This study revealed that THS exposure for 1 month is detrimental to the cardiovascular health of both sexes; however, females could be more aggressively affected than males. In addition, interleukins and chemokines could be critical factors for initiating prothrombotic activity due to THS exposure.

Investigation of the impact of thirdhand e-cigarette exposure on platelet function: A pre-clinical study

INTRODUCTION

The use of e-cigarettes (ECs) has reached unprecedented levels, due to a variety of reasons, including the misconception regarding their safety. Thus, there have been efforts to characterize the effects of EC exposure, including in the context of thirdhand EC (THEC) on a host of disorders, such as cardiovascular disease (CVD).

METHODS

To address this issue, we sought to characterize the effects of THEC on platelet function and thrombus formation, using a novel mouse exposure protocol that resembles real life scenarios. To assess these effects, a host of related in vivo (i.e. tail bleeding time, and ferric chloride injury induced thrombosis model) assays and in vitro platelet specific (e.g. aggregation, and dense granule secretion) investigative assays were conducted.

RESULTS

Our in vivo characterization demonstrated that THEC exposed mice exhibited a prothrombotic phenotype reflected by their shortened tail bleeding (THEC: 37 ± 15 seconds, versus clean air: 183 ± 56 s) and occlusion times (THEC: 188 ± 39 s, versus clean air: 519 ± 70 s), relative to those exposed to clean air. Importantly, we found no difference in the platelet counts between the THEC and clean air mice. As for the underlying mechanism, separate experiments revealed significantly enhanced platelet aggregation, dense and alpha granule secretion, as well as integrin/GPIIb-IIIa activation and phosphatidylserine exposure in response to thrombin and ADP agonist stimulation.

CONCLUSIONS

Taken together, these results provide evidence that THEC does have the capacity to increase the risk of thrombotic disease, which should increase awareness regarding its underappreciated negative health effects.

Turkish Pediatrician Beliefs About Third-hand Smoking

INTRODUCTION

Although third-hand smoke (THS) is a relatively new concept, it emerges as an important health problem. This study evaluated the beliefs of Turkish Pediatricians about THS.

METHOD

The survey, designed to be self-filled by pediatricians, provided information on demographic data, lifestyle factors, and beliefs about THS. Participant beliefs about THS were evaluated using the Beliefs About Third-Hand Smoke scale. This study was conducted by applying a web-based survey to pediatricians in Turkey.

RESULTS

The Beliefs About Third-Hand Smoke scale scores were lower in participants who were male (odds ratio [OR] = 1.479; 95% confidence interval [CI], 0.246-0.526; p < .001), have children (OR = 0.656; 95% CI, 0.156-0.665; p = .002), widowed/separated (OR = 0.498; 95% CI, -1.072 to -0.360; p < .001), a smoker (OR = 0.586; 95% CI, -0.711 to -0.355; p < .001), worked in State Hospital (OR = 0.574; 95% CI, -0.768 to -0.423; p < .001), and specialists (OR = 0.621; 95% CI, -0.608 to -0.207; p < .001).

DISCUSSION

This study showed that pediatricians who were male, widowed/separated, a smoker, with children, working in a State Hospital, and specialists had less belief in the side effects of THS.

Thirdhand Smoke Knowledge, Beliefs and Behaviors among Parents and Families: A Systematic Review

Families play a primary role in protecting children. Thirdhand smoke (THS) is an underestimated public health issue, and health effects correlated to its exposition are emerging. The aim of this systematic review was to analyze papers focusing on knowledge, beliefs, and behaviors regarding THS among parents, families, and caregivers, published until May 2022 on MEDLINE, CINAHL, EMBASE, and the Cochrane Library. Critical appraisal of the included studies was conducted by two independent reviewers using the Joanna Briggs Institute Critical Appraisal tool. Out of the 97 articles, 8 were included in this review (two from the USA, one from Europe, and five from Asia). Although there were no restrictions on the date of publication, all the articles were published in the last 10 years, underlining that THS is an emerging concept. They were characterized by relevant heterogeneity in the study design and assessment tools. The results showed that percentages of parents who believed that THS is harmful ranged from 42.4% to 91%, but parental awareness was not always associated with the adoption of a home- and car-smoking ban or healthy behaviors. Further research is needed to understand the resistance and problems faced by parents who are aware of THS risks but unable to improve good practices.

Knowledge and Opinions of Healthcare Professionals about Thirdhand Smoke: A Multi-National, Cross-Sectional Study

There is scarce evidence on the knowledge and opinions about third-hand smoke (THS) of health care professionals. The main aim of this study was to explore the knowledge and opinions of health care professionals about THS and, secondarily, to explore the factors that are associated with this knowledge. Cross-sectional study using a snowball sample of multi-national health care professionals (n = 233). Data were obtained from an exploratory, online questionnaire. The health care professionals’ knowledge and opinions on THS were described with absolute frequency and percentage. Chi-square and Fisher-Freeman-Halton exact tests, and simple logistic regression models, were used to explore the bivariate association between the knowledge of the concept THS and sex, continent of birth, educational level, occupation, years of experience, and attitude towards smoking. Finally, a multivariable logistic regression model incorporating all the above variables was fitted. A total of 65.2% of the participants were unaware of the term THS before the study began. In the bivariate analysis, an association was found between prior knowledge of the term THS and continent of birth (p-value = 0.030) and occupation (p-value = 0.014). In the multivariable logistic regression model, a significant association was observed between prior knowledge of the concept THS and sex (p-value = 0.005), continent of birth (p-value = 0.012), and occupation (p-value = 0.001). Almost two out of three health care professionals who participated in our study did not know what THS was. Educational activities on this topic should be implemented.

Exposure of Mice to Thirdhand Smoke Modulates In Vitro and In Vivo Platelet Responses

Smoking is a risk factor for a variety of deleterious conditions, such as cancer, respiratory disease and cardiovascular disease. Thrombosis is an important and common aspect of several cardiovascular disease states, whose risk is known to be increased by both first- and secondhand smoke. More recently, the residual cigarette smoke that persists after someone has smoked (referred to as thirdhand smoke or THS) has been gaining more attention, since it has been shown that it also negatively affects health. Indeed, we have previously shown that 6-month exposure to THS increases the risk of thrombogenesis. However, neither the time-dependence of THS-induced thrombus formation, nor its sex dependence have been investigated. Thus, in the present study, we investigated these issues in the context of a shorter exposure to THS, specifically 3 months, in male and female mice. We show that the platelets from 3-month THS-exposed mice exhibited enhanced activation by agonists. Moreover, we also show that mice of both sexes exposed to THS have decreased tail bleeding as well as decreased thrombus occlusion time. In terms of the role of sex, intersex disparities in thrombus development and hemostasis as well as in platelet aggregation were, interestingly, observed. Together, our findings show that exposing mice to THS for 3 months is sufficient to predispose them to thrombosis; which seems to be driven, at least in part, by an increased activity in platelets, and that it does not manifest equally in both sexes.