High-Wattage E-Cigarettes Induce Tissue Hypoxia and Lower Airway Injury: A Randomized Clinical Trial

Chaumont, Martin; Bernard, Alfred; Pochet, Stéphanie; Mélot, Christian; Khattabi, Charaf El; Reyé, Florence; Boudjeltia, Karim Zouaoui; Antwerpen, Pierre Van; Delporte, Cédric; Borne, Philippe van de

doi:10.1164/rccm.201711-2198le

Cited by 22 publications

(24 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We also examined the effect of pure PG/GLY vaping on arterial oxygen tension (P o 2 ) in tobacco smokers suspected of coronary artery disease (CAD). Some of these results have been published previously in the form of a research letter (8).…”

Section: Introductionmentioning

confidence: 90%

Fourth generation e-cigarette vaping induces transient lung inflammation and gas exchange disturbances: results from two randomized clinical trials

Chaumont

Borne

Bernard

et al. 2019

American Journal of Physiology-Lung Cellular and Molecular Phys

Self Cite

115

109

View full text Add to dashboard Cite

When heated by an electronic cigarette, propylene glycol and glycerol produce a nicotine-carrying-aerosol. This hygroscopic/hyperosmolar aerosol can deposit deep within the lung. Whether these deposits trigger local inflammation and disturb pulmonary gas exchanges is not known. The aim of this study was to assess the acute effects of high-wattage electronic cigarette vaping with or without nicotine on lung inflammation biomarkers, transcutaneous gas tensions, and pulmonary function tests in young and healthy tobacco smokers. Acute effects of vaping without nicotine on arterial blood gas tensions were also assessed in heavy smokers suspected of coronary artery disease. Using a single-blind within-subjects study design, 25 young tobacco smokers underwent three experimental sessions in random order: sham-vaping and vaping with and without nicotine at 60 W. Twenty heavy smokers were also exposed to sham-vaping ( n = 10) or vaping without nicotine ( n = 10) in an open-label, randomized parallel study. In the young tobacco smokers, compared with sham-vaping: 1) serum club cell protein-16 increased after vaping without nicotine (mean ± SE, −0.5 ± 0.2 vs. +1.1 ± 0.3 µg/l, P = 0.013) and vaping with nicotine (+1.2 ± 0.3 µg/l, P = 0.009); 2) transcutaneous oxygen tension decreased for 60 min after vaping without nicotine (nadir, −0.3 ± 1 vs. −15.3 ± 2.3 mmHg, P < 0.001) and for 80-min after vaping with nicotine (nadir, −19.6 ± 2.8 mmHg, P < 0.001). Compared with sham vaping, vaping without nicotine decreased arterial oxygen tension for 5 min in heavy-smoking patients (+5.4 ± 3.3 vs. −5.4 ± 1.9 mmHg, P = 0.012). Acute vaping of propylene glycol/glycerol aerosol at high wattage with or without nicotine induces airway epithelial injury and sustained decrement in transcutaneous oxygen tension in young tobacco smokers. Intense vaping conditions also transiently impair arterial oxygen tension in heavy smokers.

show abstract

Section: Introductionmentioning

confidence: 90%

Fourth generation e-cigarette vaping induces transient lung inflammation and gas exchange disturbances: results from two randomized clinical trials

Chaumont

Borne

Bernard

et al. 2019

American Journal of Physiology-Lung Cellular and Molecular Phys

Self Cite

115

109

View full text Add to dashboard Cite

show abstract

“…28 Certain vape pens allow users to adjust the temperature at which aerosolization occurs, which results in increased concentrations of formaldehyde production and induces increased tissue hypoxia and airway epithelial injury. 18,29 Propylene glycol serves as a common carrier of vape solution and provides the characteristic "smoke" effect of vaping. Although propylene glycol is considered widely to be safe for oral ingestion by the food industry, the safety of inhaling heated propylene glycol products has been called into question.…”

Section: Science Behind the Harms Of Vapingmentioning

confidence: 99%

Vaping-Related Acute Parenchymal Lung Injury

Jonas

Raj

2020

Chest

View full text Add to dashboard Cite

The outbreak of vaping-related acute lung injury in the United States, named EVALI (e-cigarette or vaping product use associated acute lung injury), has reignited concerns about the health effects of vaping. Initial case reports of vaping-related lung injury date back to 2012, but the ongoing outbreak of EVALI began in the summer of 2019 and has been implicated in 2,807 cases and 68 deaths as of this writing. Review of the scientific literature revealed 216 patient cases that spanned 41 reports of parenchymal lung injury attributed to vaping. In this review, we detail the clinical, radiographic, and pathologic patterns of lung injury that are attributable to vaping and provide an overview of the scientific literature to date on the effects of vaping on respiratory health. Tetrahydrocannabinol was the most commonly vaped substance, and vitamin E acetate was found in BAL specimens from many affected individuals. However, no specific component or contaminant has been identified conclusively to date as the cause for the injury. Patients present with cough, dyspnea, constitutional symptoms, and GI symptoms. Radiologic and histopathologic findings demonstrate a spectrum of nonspecific acute injury patterns. A high index of suspicion combined with a good history are the keys to an accurate diagnosis. Treatment is supportive; the mortality rate is low, and most patients recover. Corticosteroids have been used with apparent success in patients with severe disease, but more rigorous studies are needed to clarify their role in the treatment of vaping-related lung injury.

show abstract

“…Although the NASEM report concluded that there was no available evidence regarding whether e‐cigarettes cause respiratory diseases in humans, we identified two subsequently published studies which compared the spectrum of bronchial proteins in non‐smokers, smokers and e‐cigarette users. They demonstrated alterations in the bronchial proteome and identified changes unique to e‐cigarettes, including markers of an aberrant neutrophilic response 18,19 . In vivo studies have identified specific e‐cigarette flavourants that have potential adverse effects on human health, 20,21 and a study in humans showed addition of a flavourant led to increased plasma nicotine levels 22 …”

Section: Health Impacts Of E‐cigarettesmentioning

confidence: 99%

Electronic cigarettes: A position statement from the Thoracic Society of Australia and New Zealand*

et al. 2020

View full text Add to dashboard Cite

The TSANZ develops position statements where insufficient data exist to write formal clinical guidelines. In 2018, the TSANZ addressed the question of potential benefits and health impacts of electronic cigarettes (EC). The working party included groups focused on health impacts, smoking cessation, youth issues and priority populations. The 2018 report on the Public Health Consequences of E‐Cigarettes from the United States NASEM was accepted as reflective of evidence to mid‐2017. A search for papers subsequently published in peer‐reviewed journals was conducted in August 2018. A small number of robust and important papers published until March 2019 were also identified and included. Groups identified studies that extended, modified or contradicted the NASEM report. A total of 3793 papers were identified and reviewed, with summaries and draft position statements developed and presented to TSANZ membership in April 2019. After feedback from members and external reviewers, a collection of position statements was finalized in December 2019. EC have adverse lung effects and harmful effects of long‐term use are unknown. EC are unsuitable consumer products for recreational use, part‐substitution for smoking or long‐term exclusive use by former smokers. Smokers who require support to quit smoking should be directed towards approved medication in conjunction with behavioural support as having the strongest evidence for efficacy and safety. No specific EC product can be recommended as effective and safe for smoking cessation. Smoking cessation claims in relation to EC should be assessed by established regulators.

show abstract

High-Wattage E-Cigarettes Induce Tissue Hypoxia and Lower Airway Injury: A Randomized Clinical Trial

Cited by 22 publications

References 10 publications

Fourth generation e-cigarette vaping induces transient lung inflammation and gas exchange disturbances: results from two randomized clinical trials

Fourth generation e-cigarette vaping induces transient lung inflammation and gas exchange disturbances: results from two randomized clinical trials

Vaping-Related Acute Parenchymal Lung Injury

Electronic cigarettes: A position statement from the Thoracic Society of Australia and New Zealand*

Contact Info

Product

Resources

About