Effects of medwakh smoking on salivary metabolomics and its association with altered oral redox homeostasis among youth

Abstract

The use of alternative tobacco products, particularly medwakh, has expanded among youth in the Middle East and around the world. The present study is conducted to investigate the biochemical and pathophysiological changes caused by medwakh smoking, and to examine the salivary metabolomics profile of medwakh smokers. Saliva samples were collected from 30 non-smokers and 30 medwakh smokers and subjected to metabolomic analysis by UHPLC-ESI-QTOF-MS. The CRP and Glutathione Peroxidase 1 activity levels in the study samples were quantified by ELISA and the total antioxidant capacity (TAC) by TAC assay kits. Statistical measurements and thorough validation of data obtained from untargeted metabolomics identified 37 uniquely and differentially abundant metabolites in saliva of medwakh smokers. The levels of phthalate, L-sorbose, cytosine, uridine, alpha-hydroxy hippurate, and L-nicotine were noticeably high in medwakh smokers. Likewise, 20 metabolic pathways were differentially altered in medwakh smokers. This study identified a distinctive saliva metabolomics profile in medwakh smokers associated with altered redox homeostasis, metabolic pathways, antioxidant system, and CRP levels. The impact of the altered metabolites in medwakh smokers and their diagnostic utility require further research in large cohorts.

Preliminary Findings on the Salivary Metabolome of Hookah and Cigarette Smokers

“…Few studies have evaluated the salivary metabolome of different forms of smoking, observing different profiles between tobacco users and nonusers. As an example, Mueller et al evaluated conventional cigarette smokers, and Aghila Rani et al evaluated smokers of medwakh. , …”

“…As an example, Mueller et al evaluated conventional cigarette smokers, and Aghila Rani et al evaluated smokers of medwakh. 30,31 Studies on oral squamous cell carcinoma have investigated salivary biomarkers by different spectroscopy methods in order to identify and validate deregulated metabolites. The results showed altered metabolic pathways and differences in the spectral signatures of the saliva between the groups compared.…”

“…As an example, Mueller et al evaluated conventional cigarette smokers, and Aghila Rani et al evaluated smokers of medwakh. 30 , 31 …”

Critical Factors in Sample Collection and Preparation for Clinical Metabolomics of Underexplored Biological Specimens

“…Such stimulus methods have been particularly important in obtaining samples from dehydrated patients with depression and chronic diseases with low salivary rates [ 175 ]. Unstimulated saliva, the most used in studies, is obtained by accumulating the fluid in the mouth, in which the sample can be collected by spitting [ 176 , 177 , 178 ] or through passive drooling [ 179 , 180 ]. Sample collection can be performed in sterile tubes through suction or using commercial device kits such as Salivette ® [ 181 , 182 , 183 ], Genotec ® [ 184 ], or Salimetrics ® [ 185 , 186 ].…”