Comparison of Urinary Biomarkers of Exposure in Humans Using Electronic Cigarettes, Combustible Cigarettes, and Smokeless Tobacco

Lorkiewicz, Pawel; Riggs, Daniel W.; Keith, Rachel J.; Conklin, Daniel J.; Xie, Zhengzhi; Sutaria, Saurin R.; Lynch, Blake; Srivastava, Sanjay; Bhatnagar, Aruni

doi:10.1093/ntr/nty089

Cited by 77 publications

(65 citation statements)

References 44 publications

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“…Our findings also showed that while being exposed to high nicotine levels, long-term exclusive e-cigarette users showed significantly lower levels of toxicant biomarkers compared with cigarette smokers or dual users. These results are consistent with a number of studies examining toxicant levels in e-cigarette users in contrast to conventional tobacco users [1, 3,4,16,[18][19][20]. In line with prior studies, our findings confirm that while not without some low level risk of exposure, exclusive e-cigarette use results in lower VOC and TSNA exposure compared with use of tobacco cigarettes and dual use.…”

Section: Discussionsupporting

confidence: 93%

Differences in Exposure to Nicotine, Tobacco-Specific Nitrosamines, and Volatile Organic Compounds among Electronic Cigarette Users, Tobacco Smokers, and Dual Users from Three Countries

Smith

Shahab

Blount

et al. 2020

Toxics

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Country-level differences in nicotine vaping products used and biomarkers of exposure among long-term e-cigarette users and dual users remain understudied. This cross-sectional study was conducted in 2014 in the United States (n = 166), United Kingdom (n = 129), and Poland (n = 161). We compared patterns of tobacco product use and nicotine and toxicant exposure among cigarette-only smokers (n = 127); e-cigarette-only users (n = 124); dual users of tobacco cigarettes and e-cigarettes (n = 95); and non-users (control group, n = 110) across three countries using mixed-effects linear regression. Compared with cigarette smokers, e-cigarette-only users had lower levels of toxicant biomarkers, but higher levels of nicotine biomarkers. Dual users had higher levels of toxicant biomarkers than e-cigarette-only users but similar levels to cigarette-only smokers. E-cigarette users in Poland, who overwhelmingly used refillable tank devices, exhibited greater levels of nicotine, and toxicant biomarkers relative to e-cigarette users in US/UK. Despite smoking fewer cigarettes, dual users from Poland exhibited similar levels of nicotine biomarkers compared with UK dual users, but higher than US dual users. Country-level differences in e-cigarette devices used and smoking behaviors (e.g., intensity) may contribute to differences in biomarker levels among users of the same products residing in different countries.

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Section: Discussionsupporting

confidence: 93%

Differences in Exposure to Nicotine, Tobacco-Specific Nitrosamines, and Volatile Organic Compounds among Electronic Cigarette Users, Tobacco Smokers, and Dual Users from Three Countries

Smith

Shahab

Blount

et al. 2020

Toxics

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“…Supplementary Figure 1A depicts a schematic of the exposure protocol in benzene inhalation chambers. This adapted regimen for benzene inhalation resembles human benzene exposure levels in highly polluted gas stations, or exposure to tobacco smoke or e-cigarette vapors aerosols [12,43,44]. Under these conditions, benzene exposure had no effect in white blood cell counts in benzene exposed animals versus control animals breathing room air (Supplementary Figure 1D), while levels of the urine benzene metabolite, t,t-MA were significantly increased in benzene exposed mice (Supplementary Figure 1E).…”

Section: Benzene Exposure Induces Hyperglycemia and Hyperinsulinemia mentioning

confidence: 94%

Acarbose Protects From Central and Peripheral Metabolic Imbalance Induced by Benzene Exposure

Debarba

Mulka

Lima

et al. 2020

Preprint

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Abbreviations:CNS, central nervous system; ARC, arcuate nucleus of the hypothalamus; DMH, dorsomedial hypothalamic nucleus; LHA, lateral hypothalamus; PVH, paraventricular hypothalamic nucleus; AbstractBenzene is a well-known human carcinogen that is one of the major components of air pollution. Sources of benzene in ambient air include cigarette smoke, e-cigarettes vaping and evaporation of benzene containing petrol processes. While carcinogenic effects of benzene exposure have been well studied, less is known about metabolic effects of benzene exposure.We show that chronic exposure to benzene at low levels induces severe metabolic imbalance in a sex-specific manner, which is associated with hypothalamic inflammation and endoplasmic reticulum (ER) stress. Benzene exposure rapidly activates hypothalamic ER stress and neuroinflammatory responses in male mice, while pharmacological inhibition of ER stress response by inhibiting IRE1α-XBP1 pathway significantly alleviates benzene-induced glial inflammatory responses. Additionally, feeding mice with Acarbose, a clinically available anti-diabetes drug, protected against benzene induced central and peripheral metabolic imbalance. Acarbose imitates the slowing of dietary carbohydrate digestion, suggesting that choosing a diet with a low glycemic index might be a potential strategy for reducing the negative metabolic effect of chronic exposure to benzene for smokers or for people living/working in urban environments with high concentrations of exposure to automobile exhausts.

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“…All 22 included studies were published since 2015. Participant mean/ median age was infrequently reported, but the median age of those reported was 36 yr [1,8,12,23,25,26,[31][32][33][34]. Study designs were primarily cross-sectional and longitudinal studies.…”

Section: Study Sourcesmentioning

confidence: 99%

“…As a result, it is challenging to determine the amount of residual biomarkers from prior or undisclosed current cigarette smoking that contributed to a biomarker level. Importantly, few of the reviewed studies used washout periods to minimize the risk of exposure contamination (range <1 d [9,23,25,36,37] to 48 h [33]).…”

Section: 4mentioning

confidence: 99%

Carcinogen Biomarkers in the Urine of Electronic Cigarette Users and Implications for the Development of Bladder Cancer: A Systematic Review

Bjurlin

Matulewicz

Roberts

et al. 2021

European Urology Oncology

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Context: Use of electronic cigarettes (e-cigarettes) has rapidly increased despite unclear longitudinal health effects. Once thought to be a safer alternative to tobacco smoke, it is possible that e-cigarettes expose the user to similar carcinogenic byproducts during the vaping process. These toxicants are metabolized and excreted in the urine, and may have oncogenic implications for bladder urothelium. Objective: To characterize and summarize known urinary carcinogenic biomarkers in e-cigarette users as they relate to the risk of developing bladder cancer. Evidence acquisition: A systematic literature search was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and included PubMed, Embase, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL). Relevant articles published in peerreviewed journals, through January 2019, that reported on urinary biomarkers in e-cigarettes users were included. Parent compounds and urinary biomarkers were classified according to the International Agency for Research on Cancer Monographs on the Evaluation of Carcinogenic Risks to Humans and cross referenced using the Collaborative on Health and the Environment, Toxicant and Disease Database to determine a link to bladder cancer, grouped by strength of evidence. Evidence synthesis: Our initial search identified 1385 articles, 22 of which met final inclusion criteria and were included for analysis. In summation, these studies described 40 different parent compounds and four metals found in the urine of ecigarette users. Since each parent compound can be metabolized several different ways, 63 unique toxicant or carcinogenic metabolite biomarkers were identified. Compared with nonuser controls, e-cigarette users had higher concentrations of urinary biomarkers of several carcinogenic compounds linked to bladder cancer.

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Comparison of Urinary Biomarkers of Exposure in Humans Using Electronic Cigarettes, Combustible Cigarettes, and Smokeless Tobacco

Cited by 77 publications

References 44 publications

Differences in Exposure to Nicotine, Tobacco-Specific Nitrosamines, and Volatile Organic Compounds among Electronic Cigarette Users, Tobacco Smokers, and Dual Users from Three Countries

Differences in Exposure to Nicotine, Tobacco-Specific Nitrosamines, and Volatile Organic Compounds among Electronic Cigarette Users, Tobacco Smokers, and Dual Users from Three Countries

Acarbose Protects From Central and Peripheral Metabolic Imbalance Induced by Benzene Exposure

Carcinogen Biomarkers in the Urine of Electronic Cigarette Users and Implications for the Development of Bladder Cancer: A Systematic Review

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