Not all e-cigarette devices are the same. Some fourth-generation models, such as Juul devices, are associated with unique changes in immune response markers within our airways, according to a new paper reviewed by pairs of researchers from the UNC School of Medicine led by toxicologist Ilona Jaspers, PhD, director of the UNC Center for Environmental Medicine, Asthma and Lung Biology and director of the UNC Toxicology and Environmental Medicine Curriculum.
Lead author Elise Hickman, PhD, a recent graduate of Jaspers Laboratory, and colleagues, who published their research in the American Journal of Respiratory and Critical Care Medicine, found that users of devices that contain Fourth-generation nicotine salt show a unique blend. of cellular biomarkers indicative of immune suppression.
Our work demonstrates the importance of considering the type of device in future clinical, epidemiological, and mechanistic studies on the health effects of e-cigarettes. We also think that this research can help regulators determine which products cause the most serious types of biological changes in the cells of the airways that are important for maintaining proper health. “
Ilona Jaspers, Professor of Pediatrics and Microbiology and Immunology, University of North Carolina Health Care
Electronic cigarettes have increased in popularity over the last decade. Some people began using them as a means to quit smoking, thinking that vaping was a safer alternative, both in the short and long term. In addition, because e-cigarettes do not have tar, consumers assumed that vaping decreased the risk of cancer in the future.
“It’s impossible to know if vaporization decreases the risk of cancer or many other long-term conditions,” Jaspers said. “It took 60 years of research to show that smoking causes cancer.” Electronic cigarettes have been around for about 15 years. “However, research from our lab and many others has shown many of the same acute biological effects on the airways that we have documented in smokers,” he said. “And we’ve seen some changes in cells and immune defenses in people who vaporize that, frankly, we’ve never seen before, which is very worrying.”
Most troubling for researchers, doctors and public health officials is the fact that teens who would not otherwise have tried cigarettes began using e-cigarettes, which contain nicotine, a drug with its own implications for smoking. health, even beyond addiction, and thousands of chemicals, many of which were FDA approved for food but not for inhalation.
Several studies have documented that inhaling chemical-laden nicotine aerosols suppresses the immune responses in the airways of smokers and e-cigarette users. Some studies, including some at UNC, have detailed how the different chemicals in various e-cigarettes, including chemicals that make up thousands of different flavors, have adverse effects on airway cells.
The Jaspers Laboratory, which has been at the forefront of this research, set out to study the effects of different varieties of electronic cigarette devices. For this study, his team collected samples of central airways (sputum) from non-smokers, smokers, and users of third- and fourth-generation electronic cigarette devices.
Third-generation devices include vape pens and box mods. The fourth generation includes nicotine-containing e-cigarettes, such as Juul products, and disposable e-cigarettes, which have become increasingly popular following restrictions on the sale of Juul products.
Fourth-generation e-cigarette users had significantly more bronchial epithelial cells in the sputum, and this suggests an airway injury because normally, bronchial epithelial cells constitute an intact airway barrier and are not found in sputum samples. The levels of two proteins, sICAM1 and sVCAM1, were significantly lower in fourth-generation e-cigarette users compared to the other groups. These proteins are important in fighting infections and other diseases.
In addition, CRP, IFN-g, MCP-1, uteroglobin, MMP-2, and VEGF proteins were significantly lower in fourth-versus-third-generation e-cigarette users, and all of these proteins are important for global immune defense. . Thus, the more these proteins are depleted, the more suppressed our immune system is. “Another key finding of the study was that, when examining the mix of immune markers in general rather than one by one, fourth-generation e-cigarette users had the most distinguishable changes of all groups, which which indicates a change in immune homeostasis, “Hickman said.
This research does not reveal evidence that e-cigarettes cause cancer, emphysema, COPD, or other long-term illnesses associated with long-term smoking. But researchers think that altered immune responses to the airways over many years, especially for adolescents, could play an important role in developing long-term health conditions and susceptibility to inhaled pathogens.
Source:
University of North Carolina Health Care
Magazine reference:
Hickman, E., et al. (2022) Biomarkers of respiratory immune homeostasis differ significantly with the generation of electronic cigarettes. American Journal of Respiratory and Critical Care Medicine. doi.org/10.1164/rccm.202202-0373OC