Abstract
BackgroundLittle is known about health risks associated with electronic cigarette (EC) use although EC are rising in popularity and have been advocated as a means to quit smoking cigarettes.MethodsTen never-smokers, without exposure history to tobacco products or EC, were assessed at baseline with questionnaire, chest X-ray, lung function, plasma levels of endothelial microparticles (EMP), and bronchoscopy to obtain small airway epithelium (SAE) and alveolar macrophages (AM). One week later, subjects inhaled 10 puffs of “Blu” brand EC, waited 30 min, then another 10 puff; n = 7 were randomized to EC with nicotine and n = 3 to EC without nicotine to assess biological responses in healthy, naive individuals.ResultsTwo hr. post-EC exposure, subjects were again assessed as at baseline. No significant changes in clinical parameters were observed. Biological changes were observed compared to baseline, including altered transcriptomes of SAE and AM for all subjects and elevated plasma EMP levels following inhalation of EC with nicotine.ConclusionsThis study provides in vivo human data demonstrating that acute inhalation of EC aerosols dysregulates normal human lung homeostasis in a limited cohort of healthy naïve individuals. These observations have implications to new EC users, nonsmokers exposed to secondhand EC aerosols and cigarette smokers using EC to quit smoking.Trial registrationClinicalTrials.gov NCT01776398 (registered 10/12/12), NCT02188511 (registered 7/2/14).
Highlights
Little is known about health risks associated with electronic cigarette (EC) use EC are rising in popularity and have been advocated as a means to quit smoking cigarettes
For both EC exposure groups, with and without nicotine, the mean %angiotensin converting enzyme (ACE)+ CD42b−CD31+/ total CD42b−CD31+ was 76 ± 6% (+nicotine vs no nicotine, p > 0.09), consistent with the majority of endothelial microparticles (EMP) derived from pulmonary capillaries [22]
Exposure to EC with nicotine resulted in significantly higher levels of total EMPs compared to baseline levels of total EMPs for the same individuals (Fig. 1b)
Summary
Little is known about health risks associated with electronic cigarette (EC) use EC are rising in popularity and have been advocated as a means to quit smoking cigarettes. EC are marketed as a substitute for cigarettes that deliver nicotine but not the toxic products of cigarette smoke [8,9,10], and are used as a strategy to reduce cigarette smoking, with the concept that EC are “safer” [2, 3, 8, 9, 11] This view has been supported by reports from the Royal College of Physicians [3] and Public Health England [2] encouraging cigarette smokers to switch to EC as a strategy for cigarette smoking cessation
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