VpALI—Vaping-related Acute Lung Injury: A New Killer Around the Block

Fuentes, Xavier Fonseca; Kashyap, Rahul; Hays, J. Taylor; Chalmers, Sarah; Buchwald, Claudia Lama von; Gajic, Ognjen; Moraes, Alice Gallo De

doi:10.1016/j.mayocp.2019.10.010

Cited by 31 publications

(38 citation statements)

References 85 publications

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“…To the authors knowledge at the time of publication there are 7 reviews on e-cigarette-related health effects and case reports, each specifically focusing on one aspect of the e-cigarette-related injury: The respiratory effects [18,19], poisonings [20], burn injuries [21,22], radiologic appearance of lung injuries [23], and histologic findings [24]. The majority of those reviews were published before the 2019 e-cigarette-related injury outbreak.…”

Section: Introductionmentioning

confidence: 99%

A Systematic Literature Review of E-Cigarette-Related Illness and Injury: Not Just for the Respirologist

Tzortzi

Kapetanstrataki

Evangelopoulou

et al. 2020

IJERPH

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Following the recent electronic cigarette (e-cigarette) illness outbreak, the current review aimed to collect all related clinical cases for study and analysis and provide a critical synopsis of the proposed injury mechanism. Adhering to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) guidelines, e-cigarette-related clinical cases were identified via Google Scholar and PubMed databases. Additionally, references of published case reports and previous review papers were manually searched, revealing 159 publications presenting e-cigarette-related case reports and 19 reports by the Centers for Disease Control and Prevention. 238 individual cases were identified; 53% traumatic injuries due to e-cigarette explosion or self-combustion, 24% respiratory cases, and 12% poisonings. Additional cases pertained to oral, cardiovascular, immunologic, hematologic, allergic reactions, infant complications, and altered medication levels. Case reports were mainly published between 2016–2019 (78%). The oldest case, a lipoid pneumonia, was published in 2012. The current review showed that e-cigarette-related health effects extend beyond the acute lung injury syndrome, including traumatic, thermal injuries and acute intoxications. Physicians should be aware of the distinct clinical presentations and be trained to respond and treat effectively. Regulators and public health authorities should address the regulatory gap regarding electronic nicotine delivery systems (ENDS) and novel tobacco products.

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Section: Introductionmentioning

confidence: 99%

A Systematic Literature Review of E-Cigarette-Related Illness and Injury: Not Just for the Respirologist

Tzortzi

Kapetanstrataki

Evangelopoulou

et al. 2020

IJERPH

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“…In many studies, IL-6 has been shown to increase with exposure to any insult causing acute lung injury to maintain the homeostasis of the in ammatory response [36][37][38]. The increase in G-CSF and eotaxin along with the increase in CD4 cells in BALF suggest that acute exposure may be leaning toward the Th2 pathway, implicating potential eosinophilic pneumonia with prolonged exposure [39][40][41]. Excessive in ammation results in lung damage in diseases.…”

Section: Discussionmentioning

confidence: 99%

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

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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.

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“…The use of such e-cigarettes is called JUULing [7]. Between 2017 and 2018, JUULing increased from 11.7% to 20.8%; in 2018 3.7 million high school students were affected [11,12]. The observations about vaping in Europe and the United States gradually revealed vaping-associated complications, most commonly lung complications leading to acute respiratory failure (fatal in some cases) [13][14][15].…”

mentioning

confidence: 99%

“…According to American estimates, 700 various e-liquids were FIGURE 1. A diagram of e-cigarette (elaborated according to [9,12] Heating element (atomiser) Battery…”

mentioning

confidence: 99%

“…Other products may be vaporised. Vaporisation at similar technical parameters to those of e-cigarettes predominantly serves for smoking for marihuana or similar substances heated to 180-220 o C. Vaporisation of marijuana is to reduce potential toxicity and increase THC content in the inhaled aerosol [7,12]. The potential side effects of e-cigarettes, particularly those inducing respiratory and gas exchange pathologies, have resulted in increased surveillance provided by health monitoring and control authorities.…”

mentioning

confidence: 99%

See 1 more Smart Citation

E-cigarette or vaping product use-associated acute lung injury (EVALI) as a therapeutic problem in anaesthesiology and intensive care departments

Bizoń¹,

Maciejewski²,

Kolonko³

2020

ait

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Many civilizational and environmental factors may cause acute or subacute inhalational injuryassociated lung diseases [1, 2]. This term covers a diverse group of injuries to the bronchial tree, alveoli, and lung parenchyma; in most cases, such injuries result from inadvertent inhalation of hazardous substances. The extent of lung injury depends on the type, duration and quantity of the substance inhaled, as well as its composition and physicochemical properties (density, solubility). The current knowledge regarding inhalation lung injuries comes mainly from experience in the treatment of fire victims, patients professionally exposed to toxic inhalants, victims of chemical explosions or those excessively exposed to chemical vapours [2, 3]. Inhalation-induced lung injury may result directly from the physical properties of the inhaled agent (temperature, size of a suspended molecule), its chemical structure and direct contact with toxic components of vapours. Hydrogen cyanide, ammonia, formaldehyde, hydrogen sulphide and similar agents represent an obvious risk of lung injury, associated predominantly with the release of proteolytic

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VpALI—Vaping-related Acute Lung Injury: A New Killer Around the Block

Cited by 31 publications

References 85 publications

A Systematic Literature Review of E-Cigarette-Related Illness and Injury: Not Just for the Respirologist

A Systematic Literature Review of E-Cigarette-Related Illness and Injury: Not Just for the Respirologist

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

E-cigarette or vaping product use-associated acute lung injury (EVALI) as a therapeutic problem in anaesthesiology and intensive care departments

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