Chemical Constituents Involved in E-Cigarette, or Vaping Product Use-Associated Lung Injury (EVALI)

Muthumalage, Thivanka; Friedman, Michelle; McGraw, Matthew D.; Ginsberg, Garry; Friedman, Alan E.; Rahman, Irfan

doi:10.3390/toxics8020025

Cited by 66 publications

(77 citation statements)

References 22 publications

(28 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Overall, based on our data, it is possible that both VEA and e-cig cartridge may have caused acute respiratory distress inducing eosinophilic pneumonia. As we found in our previous study, most of these cartridges contained THC derivatives and VEA [9]. At low concentrations, VEA was not cytotoxic.…”

Section: Resultssupporting

confidence: 64%

“…The patients diagnosed with lipoid-pneumonia suffered from cough, difficulty in breathing, shortness of breath, chest tightness and pain, nausea, vomiting, fatigue, fever, and weight loss. In one of our studies, we analyzed the chemical constituents of e-cig cartridges involved in EVALI [9]. Users of these ENDS products developed varying degrees of respiratory illnesses, but the mechanism of toxicity of developing EVALI is still unknown.…”

Section: Resultsmentioning

confidence: 99%

“…Based on our results, MCT had lesser effects compared to VEA in vivo, but it showed comparable effects to VEA in vitro; overall, cartridges containing both of these components showed the greatest effects. Other than these two primary components, it may be possible that other constituents in cartridges are also responsible for EVALI; those chemicals include cyclooctasiloxane, cyclohexasiloxane, cyclotrisiloxane, tricaprylate, decanoic acid, benzoic acid, 2,2-dimethoxybutane, and tetramethyl silicate [9].…”

Section: Resultsmentioning

confidence: 99%

“…For the cell and mouse exposures in this study, e-cig cartridges used in our previous study characterizing constituents of EVALI were used [9].…”

Section: Methodsmentioning

confidence: 99%

“…Further, we found altered glycerolipids, cholesterol esters, and glycerophospholipids in mouse BALF upon acute VEA and cartridge exposure. We hypothesized that VEA, MCT, and other chemical constituents present in e-cigarette cartridges [9] cause cellular toxicity, and oxidative and inflammatory responses in epithelial cells, monocytes, and in vivo in mouse lung upon inhalation.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Pulmonary toxicity and inflammatory response of e-cigarettes containing medium-chain triglyceride oil and vitamin E acetate: Implications in the pathogenesis of EVALI but independent of SARS-COV-2 COVID-19 related proteins

Muthumalage

Lucas

Wang

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

Recently, there has been an outbreak associated with the use of e-cigarette or vaping products, associated lung injury (EVALI). The primary components of vaping products, vitamin E acetate (VEA) and medium-chain triglycerides (MCT) may be responsible for acute lung toxicity. Currently, little information is available on the physiological and biological effects of exposure to these products. We hypothesized that these e-cig cartridges and their constituents (VEA and MCT) induce pulmonary toxicity, mediated by oxidative damage and inflammatory responses, leading to acute lung injury. We studied the potential mechanisms of cartridge aerosol induced inflammatory response by evaluating the generation of reactive oxygen species by MCT, VEA, and cartridges, and their effects on the inflammatory state of pulmonary epithelium and immune cells both in vitro and in vivo. Cells exposed to these aerosols generated reactive oxygen species, caused cytotoxicity, induced epithelial barrier dysfunction, and elicited an inflammatory response. Using a murine model, the parameters of acute toxicity to aerosol inhalation were assessed. Infiltration of neutrophils and lymphocytes was accompanied by significant increases in IL-6, eotaxin, and G-CSF in the bronchoalveolar lavage fluid (BALF). In mouse plasma, eicosanoid inflammatory mediators, leukotrienes, were significantly increased. Plasma from e-cig users also showed increased levels of hydroxyeicosatetraenoic acid (HETEs) and various eicosanoids. Exposure to e-cig cartridge aerosols showed the most significant effects and toxicity compared to MCT and VEA. In addition, we determined at SARS-COV-2 related proteins and found no impact associated with aerosol exposures from these tested cartridges. Overall, this study demonstrates acute exposure to specific e-cig cartridges induces in vitro cytotoxicity, barrier dysfunction, and inflammation and in vivo mouse exposure induces acute inflammation with elevated pro-inflammatory markers in the pathogenesis of EVALI.

show abstract

Section: Resultssupporting

confidence: 64%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…For the cell and mouse exposures in this study, e-cig cartridges used in our previous study characterizing constituents of EVALI were used [9].…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Pulmonary toxicity and inflammatory response of e-cigarettes containing medium-chain triglyceride oil and vitamin E acetate: Implications in the pathogenesis of EVALI but independent of SARS-COV-2 COVID-19 related proteins

Muthumalage

Lucas

Wang

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

Developmental Effects of Electronic Cigarette Use

Collaco

McGrath‐Morrow

2022

Comprehensive Physiology

View full text Add to dashboard Cite

A review of nicotine‐containing electronic cigarettes—Trends in use, effects, contents, labelling accuracy and detection methods

Taylor

Dunn

Turfus

2021

Drug Testing and Analysis

View full text Add to dashboard Cite

Electronic cigarettes (ECs) are thought to be less harmful than traditional combustible cigarettes and were originally intended to help smokers quit. Over the past two decades, they have especially gained popularity with the younger generation. To date, there are over 7000 unique e‐liquid flavours available and over 400 different e‐cigarette brands. The accuracy of nicotine strength labelling in e‐liquids was assessed in this work. Twenty‐three studies from around the world were chosen to assess the level and frequency of nicotine mislabelling in 545 e‐liquid products. Nicotine strengths were most commonly mislabelled by between 5% and 20%, with the majority testing lower than what the label indicated. Fifteen European e‐liquids that were assessed were labelled as 20 mg/ml or less, yet when tested, they contained more than 20 mg/ml of nicotine. One e‐liquid that was supposed to contain no nicotine in fact contained 23.91 mg/ml of nicotine. Furthermore, the difference between the medians of the available labelled and experimental nicotine concentrations was significant (p < 0.001, Wilcoxon signed rank test). Preliminary studies show that high nicotine levels delivered via aerosol increase the risk for nicotine poisoning and cause airway inflammation. Other EC ingredients, such as flavourings, contribute to EVALI and ‘popcorn lung’. There is evidence that certain flavourings, such as menthol, reinforce the effects of nicotine and modify drug absorption and metabolism. There is a global need for better quality control in EC products in order to make these safe for consumers.

show abstract

Chemical Constituents Involved in E-Cigarette, or Vaping Product Use-Associated Lung Injury (EVALI)

Cited by 66 publications

References 22 publications

Pulmonary toxicity and inflammatory response of e-cigarettes containing medium-chain triglyceride oil and vitamin E acetate: Implications in the pathogenesis of EVALI but independent of SARS-COV-2 COVID-19 related proteins

Pulmonary toxicity and inflammatory response of e-cigarettes containing medium-chain triglyceride oil and vitamin E acetate: Implications in the pathogenesis of EVALI but independent of SARS-COV-2 COVID-19 related proteins

Developmental Effects of Electronic Cigarette Use

A review of nicotine‐containing electronic cigarettes—Trends in use, effects, contents, labelling accuracy and detection methods

Contact Info

Product

Resources

About