Extract
Electronic cigarettes (E-cig) usage in the US has drastically increased in the past 5 years due to age restrictions on conventional cigarettes, aggressive marketing, and perception that E-cig are a healthy alternative. E-cig contain nicotine, water, glycerol, propylene glycol, and optional flavouring. On inhalation, the device heats the ingredients into a vapour [1]. While tobacco cigarette smoke is known to cause a deleterious effect on the cardiovascular system, angiogenesis, and skin capillary perfusion by causing direct injury to blood vessel walls, increased platelet aggregation, microvascular thrombosis [2–4], and inflammation [5], the consequences of E-cig vapour exposure on the lung are still largely unexplored [6, 7]. Recently, Lerner and colleagues reported that vapours produced by E-cig and E-juices with flavourings induced toxicity, oxidative stress, and inflammatory response in human bronchial airway epithelial cells (H292) and foetal lung fibroblasts (HFL1) as well as mouse lung [8]. Garcia-Arcos and colleagues showed that the aerosolized nicotine-containing e-cigarette fluid increased airway hyper-reactivity, distal airspace enlargement, mucin production, cytokine and protease expression in mice, implying the potential dangers of nicotine inhalation during E-cig use [9]. The inflammatory response to E-cig use involved increased neutrophil activation and mucus production [10] and decreased mucociliary clearance [11]. In human embryonic and mouse neural stem cells and human pulmonary fibroblasts [12], as well as skin and lung cells [13], cytotoxicity of E-cig vapour was correlated with the number and concentration of chemicals used to flavour fluids. We recently showed in the skin flap survival model in vivo that nicotine-containing E-cig vapour is just as harmful to the microcirculation as tobacco cigarette smoke (CS) [4].
Footnotes
This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.
Conflict of interest: Dr. Reinikovaite has nothing to disclose.
Conflict of interest: Dr. Rodriguez has nothing to disclose.
Conflict of interest: Dr. Karoor has nothing to disclose.
Conflict of interest: Dr. Rau has nothing to disclose.
Conflict of interest: Dr. Trinh has nothing to disclose.
Conflict of interest: Dr. Deleyiannis has nothing to disclose.
Conflict of interest: Laima Taraseviciene-Stewart
Conflict of interest: Dr. Stewart has nothing to disclose.
- Copyright ©ERS 2018