Waterpipe Tobacco Smoke Inhalation Triggers Thrombogenicity, Cardiac Inflammation and Oxidative Stress in Mice: Effects of Flavouring.

Abderrahim Nemmar,Suhail Al-Salam,Javed Yasin,Badreldin H Ali,Nur Elena Zaaba,Priya Yuvaraju,Sumaya Beegam

doi:10.3390/ijms21041291

Abstract

The consumption of water-pipe smoking (WPS) has been promoted by the use of flavoured tobacco. However, little is known about the impact of flavouring on the cardiovascular toxicity induced by WPS inhalation. Here, we compared the cardiovascular effects and underlying mechanism of actions of plain (P) (unflavoured) versus apple-flavoured (AF) WPS (30 minutes/day, 5 days/week for 1 month) in mice. Control mice were exposed to air. Both P- and AF-WPS inhalation induced an increase in systolic blood pressure, thrombogenicity and plasma concentration of fibrinogen and von Willebrand factor. In heart homogenates, AF-WPS inhalation caused an increase of 8-isoprostane and a decrease in the levels of reduced glutathione (GSH) and superoxide dismutase (SOD). Nevertheless, P-WPS decreased only the activity of SOD. The concentrations of tumour necrosis factor α and interleukin 1β were increased only in heart homogenates of mice exposed to AF-WPS. Although both P- and AF-WPS increased the concentration of troponin I in heart homogenates and induced DNA damage, the concentration of cleaved caspase 3 was only increased in mice exposed to AF-WPS. Immunohistochemical analysis of the hearts showed that both P- and AF- WPS inhalation decreased the expression of SOD. Moreover, the expression of nuclear factor erythroid-derived 2-like 2 at nuclear level in the heart was higher in both AF-WPS and P-WPS compared with control group, and the effect observed in AF-WPS group was more significant than that seen in P-WPS group. Likewise, the concentration of heme oxygenase-1 was significantly increased in both P-WPS and AF-WPS groups compared with control group, and the effect seen in AF-group was higher than that observed in P-WPS group. In conclusion, our findings showed that both P- and AF-WPS induce thrombogenicity and cardiac injury, and that this toxicity is potentiated by the presence of flavouring.

Highlights

Waterpipe smoking (WPS) has developed rapidly into a global tobacco epidemic that has received wide acceptance, predominantly among the youth
We showed that inhalation of both plain water-pipe smoke (P-WPS) and AF-WPS induced a hypercoagulable state, increased systolic blood pressure, troponin I, oxidative stress and DNA damage in heart homogenates
The expression of nuclear factor erythroid-derived 2-like 2 (Nrf2) and oxidative stress markers in the heart were more consistently affected by AF-WPS inhalation

Summary

Methods

Care and Use Committee of United Arab Emirates University [Approval # ERA_20175625]. BALB/C mice of both genders, aged 6–8 weeks, weighing 20–25 g (Taconic Farms Inc., Germantown, NY, USA) were bred in the local central animal facility of the College of Medicine and Health Sciences, United Arab Emirates University. After one week of familiarization to their conditions, mice were indiscriminately separated into 3 groups, air (control), P-WPS and AF-WPS. The WPS inhalation protocol has been performed according to the methods that we have recently described [13,18]. Mice were exposed using nose-only exposure system (InExpose System, Scireq, Montreal, QC, Canada) to mainstream WPS generated by commercially available P tobacco or AF tobacco (Al Fakher Tobacco Trading, Ajman, UAE).

Results

Discussion

Conclusion