Electronic Cigarettes’ Toxicity: From Periodontal Disease to Oral Cancer

Alexandra Jităreanu,Carmen Savin,Bianca Profire,Diana Diaconu Popa,Ancuța Goriuc,Simona Tătărușanu,Ovidiu Dumitru Aungurencei,Luminița Agoroaei,Ioana-Cezara Caba,Ioana Mârțu

doi:10.3390/app11209742

Alexandra Jităreanu, Carmen Savin + Show 8 more

Open Access

https://doi.org/10.3390/app11209742

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Abstract

Electronic nicotine delivery systems first appeared on the market in 2003 and have been promoted as healthier alternatives to conventional tobacco cigarettes. The rapid evolution of technology for these products generated a wide variety of models, and electronic cigarettes have quickly gained worldwide popularity. However, research regarding the effects of both short-term and long-term exposure revealed a wide variety of potential negative effects on human health, and the first system to be affected by these electronic smoking devices is the oral cavity. This review makes an up-to-date extensive presentation of the possible mechanisms that associate electronic cigarette smoking with increased prevalence and progression of oral cancer. Oxidative stress, inflammation response, and DNA damage are the main mechanisms that explain e-cigarettes’ cytotoxicity, but there are still questions to be answered. At present, tens of thousands of e-liquids are available, with distinct compositions, which makes the research even more challenging. Another aspect approached in the present paper is the effect of nicotine on chemotherapy drug resistance. Nicotine activates nicotinic acetylcholine receptors, consecutively inhibiting apoptosis, increasing tumor cells proliferation and survival, and reducing the effects of chemotherapy drugs.

Highlights

Electronic nicotine delivery systems have been on the market for almost two decades
Alanazi et al demonstrated that electronic cigarettes affect periodontal tissue by inhibiting the proliferation of human gingival fibroblasts through apoptotic mechanisms
Nicotine can induce the over-expression of human telomerase reverse transcriptase mRNA in oral keratinocytes, which may play a role in the progression and malignancy of oral submucous fibrosis

Summary

Introduction

Electronic nicotine delivery systems have been on the market for almost two decades. In a short period, they became very popular, because their marketing strategies emphasized the ideas of safety and harm reduction in comparison to traditional tobacco products. Numerous microbial species colonize the oral cavity and form the oral microbiome It is a well-known fact that cigarette smoking is a major factor for the alteration of the eubiotic balance, and there is evidence that vaping can affect the profile of the oral microbiome, the studies on this issue are still scarce. Due to the direct interaction with the carcinogens from cigarette smoke and e-vapors, and to the fact that oral epithelium possesses xenobiotic enzymes capable of converting proximate carcinogens to reactive metabolites, this tissue becomes a major target for smoking/vaping-associated cancer [23]. Due to the direct interaction with the carcinogens from cigarette smoke and e-vapors, and to the fact that oral epithelium possesses xenobiotic enzymes capable of converting proximate carcinogens to reactive metabolites, this tissue becomes a 4moaf j1o9r target for smoking/vaping-associated cancer [23]. The conclusion of the study was that continued smoking in oral cancer patients can enhance the metastatic potential of cancer cells, reducing the survival rates [12]

DNA Damage and Genotoxic Mechanism

Genetic and Epigenetic Alterations

Findings

Tobacco-Specific Nitrosamines