Urine 4-(methylnitrosamino)-1-(3) pyridyl-1-butanol and cotinine in Alaska native postpartum women and neonates comparing smokers and smokeless tobacco users

Benowitz, Neal L.; Flanagan, Christie A.; Thomas, Timothy K.; Koller, Kathryn R.; Wolfe, Abbie W.; Renner, Caroline C.; Hughes, Christine; Decker, Paul A.; Hatsukami, Dorothy K.; Murphy, Neil; Patten, Christi A.

doi:10.1080/22423982.2018.1528125

Cited by 8 publications

(10 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Seventy-four (20%) patients had urinary cotinine levels ≥30 µg/g, a threshold established to represent TSE. [24][25][26][27]34 Based on parental reporting, 138 (38%) of the cohort had passive TSE (97.1%) or the patient actively smoked cigarettes (2.9%). Twentyfour (11%) patients who had no parental report of TSE had evidence of TSE based on creatinine corrected urine cotinine levels.…”

Section: Resultsmentioning

confidence: 99%

“…The main exposure, creatinine corrected cotinine level, was defined two ways: (1) binary variable using a threshold of ≥30 µg/g [24][25][26][27][28][29] and (2) continuous variable adjusted for time of collection from hospital admission. Log linear regression assessed the relationship between TSE and total bacterial load, richness, and Shannon diversity.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Tobacco smoke exposure, the lower airways microbiome and outcomes of ventilated children

et al. 2023

View full text Add to dashboard Cite

Background Tobacco smoke exposure increases the risk and severity of lower respiratory tract infections in children, yet the mechanisms remain unclear. We hypothesized that tobacco smoke exposure would modify the lower airway microbiome. Methods Secondary analysis of a multicenter cohort of 362 children between ages 31 days and 18 years mechanically ventilated for >72 h. Tracheal aspirates from 298 patients, collected within 24 h of intubation, were evaluated via 16 S ribosomal RNA sequencing. Smoke exposure was determined by creatinine corrected urine cotinine levels ≥30 µg/g. Results Patients had a median age of 16 (IQR 568) months. The most common admission diagnosis was lower respiratory tract infection (53%). Seventy-four (20%) patients were smoke exposed and exhibited decreased richness and Shannon diversity. Smoke exposed children had higher relative abundances of Serratia spp., Moraxella spp ., Haemophilus spp., and Staphylococcus aureus . Differences were most notable in patients with bacterial and viral respiratory infections. There were no differences in development of acute respiratory distress syndrome, days of mechanical ventilation, ventilator free days at 28 days, length of stay, or mortality. Conclusion Among critically ill children requiring prolonged mechanical ventilation, tobacco smoke exposure is associated with decreased richness and Shannon diversity and change in microbial communities. Impact Tobacco smoke exposure is associated with changes in the lower airways microbiome but is not associated with clinical outcomes among critically ill pediatric patients requiring prolonged mechanical ventilation. This study is among the first to evaluate the impact of tobacco smoke exposure on the lower airway microbiome in children. This research helps elucidate the relationship between tobacco smoke exposure and the lower airway microbiome and may provide a possible mechanism by which tobacco smoke exposure increases the risk for poor outcomes in children.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Tobacco smoke exposure, the lower airways microbiome and outcomes of ventilated children

et al. 2023

View full text Add to dashboard Cite

show abstract

“…8 Postpartum urinary NNAL was reported to be correlated with cotinine (rho=0.78), and associated with neonatal NNAL level (rho=0.71). 9 A few studies have used both questionnaires and biomarkers to assess exposure to tobacco smoke in pregnancy: a cohort study from Korea explored the use of NNAL to assess tobacco smoke exposure and concluded that it added to the information provided by self-report or cotinine 10 ; a mother-child cohort from Greece found that cotinine did not fully summarise exposure to 4-(methylnitrosamin o)−1-(3-pyridyl)−1-butanol uptake 11 ; a study from Poland explored relationships between maternal NNAL and cotinine in women reporting SHS or active smoking, and concluded that NNAL was a useful biomarker of prenatal exposure to carcinogens in newborns. 12 Optimal cut-off points for detecting active and passive smoke exposure in pregnancy have been reported from the INMA Spanish cohort (18% active smokers) 6 and from the Hokkaido Japanese cohort (19% active smokers).…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

“…Urinary NNAL has been compared with cotinine to assess SHS exposure in adolescents by Benowitz and colleagues who reported that both biomarkers detected high percentages with SHS exposure among adolescents 8. Postpartum urinary NNAL was reported to be correlated with cotinine (rho=0.78), and associated with neonatal NNAL level (rho=0.71) 9. A few studies have used both questionnaires and biomarkers to assess exposure to tobacco smoke in pregnancy: a cohort study from Korea explored the use of NNAL to assess tobacco smoke exposure and concluded that it added to the information provided by self-report or cotinine10; a mother–child cohort from Greece found that cotinine did not fully summarise exposure to 4-(methylnitrosamino)−1-(3-pyridyl)−1-butanol uptake11; a study from Poland explored relationships between maternal NNAL and cotinine in women reporting SHS or active smoking, and concluded that NNAL was a useful biomarker of prenatal exposure to carcinogens in newborns 12.…”

Section: Introductionmentioning

confidence: 99%

Assessing tobacco smoke exposure in pregnancy from self-report, urinary cotinine and NNAL: a validation study using the New Hampshire Birth Cohort Study

et al. 2022

View full text Add to dashboard Cite

ObjectivesAccurate assessment of tobacco smoke exposure is key to evaluate its effects. We sought to validate and establish cut-offs for self-reported smoking and secondhand smoke (SHS) exposure during pregnancy using urinary cotinine and 4-(methylnitrosamino)-1-(-3-pyridyl)-1-butanol (NNAL) in a large contemporary prospective study from the USA, with lower smoking prevalence than has previously been evaluated.DesignProspective birth cohort.SettingPregnancy clinics in New Hampshire and Vermont, USA.Participants1396 women enrolled in the New Hampshire Birth Cohort Study with self-reported smoking, urinary cotinine, NNAL and pregnancy outcomes.Primary and secondary outcome measuresCut-offs for urinary cotinine and NNAL concentrations were estimated from logistic regression models using Youden’s method to predict SHS and active smoking. Cotinine and NNAL were each used as the exposure in separate multifactorial models for pregnancy outcomes.ResultsSelf-reported maternal smoking was: 72% non-smokers, 5.7% ex-smokers, 6.4% SHS exposure, 6.2% currently smoked, 10% unreported. Cotinine and NNAL levels were low and highly intercorrelated (r=0.91). Geometric mean cotinine, NNAL were 0.99 ng/mL, 0.05 pmol/mL, respectively. Cotinine cut-offs for SHS, current smoking were 1.2 ng/mL and 1.8 ng/mL (area under curve (AUC) 95% CI: 0.52 (0.47 to 0.57), 0.90 (0.85 to 0.94)). NNAL cut-off for current smoking was 0.09 pmol/mL (AUC=0.82 (95% CI 0.77 to 0.87)). Using cotinine and NNAL cut-offs combined gave similar AUC to cotinine alone, 0.87 (95% CI 0.82 to 0.91). Cotinine and NNAL gave almost identical effect estimates when modelling pregnancy outcomes.ConclusionsIn this population, we observed high concordance between self-complete questionnaire smoking data and urinary cotinine and NNAL. With respect to biomarkers, either cotinine or NNAL can be used as a measure of tobacco smoke exposure overall but only cotinine can be used to detect SHS.

show abstract

“…8 Investigators in the MAW study found that maternal cotinine and NNAL urinary levels were highly correlated with those in neonatal urine, thus making them a viable biomarker for infant exposure to tobacco-associated compounds. 9 Building on the MAW study findings, we sought to investigate the impact of prenatal tobacco use on placental function. The passage of essential nutrients and exogenous substances across the placenta is regulated by transport proteins expressed in the transporting layer of the placenta, the syncytiotrophoblast.…”

mentioning

confidence: 99%

The Effect of Tobacco Use on the Expression of Placental Transporters in Alaska Native Women

McColl

Kwok

Benowitz

et al. 2022

Clin Pharma and Therapeutics

Self Cite

View full text Add to dashboard Cite

Prenatal tobacco use among Alaska Native (AN) women has decreased substantially over the past two decades. Previous research suggests that providing AN women with feedback regarding fetal exposure to tobacco may further promote cessation. Transporters in the placenta regulate fetal exposure to nutrients and xenobiotics, including compounds associated with tobacco use. We examined whether prenatal tobacco use impacts transporter expression in the placenta, and whether this is influenced by fetal sex, degree of tobacco exposure, or transporter genotype. At delivery, we obtained placental samples from AN research participants who smoked cigarettes, used commercial chew or iqmik (oral tobacco), or did not use tobacco during pregnancy. Transporter expression was evaluated using qRT-PCR and Western blotting and tested for correlations between transcript levels and urinary biomarkers of tobacco use. The impact of BCRP/ABCG2 and OATP2B1/SLCO2B1 genotypes on protein expression was also examined. Oral tobacco use was associated with decreased P-gp and increased MRP1, MRP3, LAT1, and PMAT mRNA expression. Transcript levels of multiple transporters significantly correlated with tobacco biomarkers in maternal and fetal urine. In women carrying male fetuses, both smoking and oral tobacco were associated with decreased P-gp. Oral tobacco was also associated with decreased LAT1 in women carrying female fetuses. BCRP and OATP2B1 genotypes did not appear to impact protein expression. In conclusion, prenatal tobacco use is associated with altered expression of multiple placental transporters which differs by fetal sex. As transcript levels of multiple transporters were significantly correlated with tobacco use biomarkers, eliminating prenatal tobacco use should alleviate these changes.

show abstract

Urine 4-(methylnitrosamino)-1-(3) pyridyl-1-butanol and cotinine in Alaska native postpartum women and neonates comparing smokers and smokeless tobacco users

Cited by 8 publications

References 23 publications

Tobacco smoke exposure, the lower airways microbiome and outcomes of ventilated children

Tobacco smoke exposure, the lower airways microbiome and outcomes of ventilated children

Assessing tobacco smoke exposure in pregnancy from self-report, urinary cotinine and NNAL: a validation study using the New Hampshire Birth Cohort Study

The Effect of Tobacco Use on the Expression of Placental Transporters in Alaska Native Women

Contact Info

Product

Resources

About