Blood RNA and protein biomarkers are associated with vaping and dual use, and prospective health outcomes

Abstract

Introduction: Electronic nicotine delivery systems (ENDS) are driving an epidemic of vaping. Identifying biomarkers of vaping and dual use (concurrent vaping and smoking), will facilitate studies of the health effects of vaping. We conducted a blood biomarker discovery study for vaping and dual use in a longitudinal cohort of current and former adult smokers with high-throughput transcriptomic and proteomic data, and we tested biomarkers for association to multiple health outcomes. Methods: We studied 3,892 COPDGene study participants with blood transcriptomics and/or plasma proteomics data according to their self-reported current vaping and smoking behavior. Biomarkers of vaping and dual use were identified through differential expression analysis and related to prospective health events over six years of follow-up. To assess the predictive accuracy of multi-biomarker panels, we constructed predictive models for vaping and smoking categories and prospective health outcomes. Results: We identified 3 transcriptomic and 3 proteomic associations to vaping, and 90 transcriptomic and 100 proteomic associations to dual use (FDR 10%). Many of these vaping or dual use biomarkers were significantly associated with prospective health outcomes, such as FEV1 decline (3 transcripts and 62 proteins), overall mortality (18 transcripts and 73 proteins), respiratory mortality (2 transcripts and 23 proteins), respiratory exacerbations (13 proteins) and incident cardiovascular disease (24 proteins). Multimarker models showed good performance discriminating between vaping and smoking behavior and produced informative, modestly powerful predictions of future FEV1 decline, mortality and respiratory exacerbations. Conclusion: Vaping and dual use are associated with multiple blood-based biomarkers that are also associated with adverse health outcomes.

Blood RNA and protein biomarkers are associated with vaping and dual use, and prospective health outcomes

“…Definitions of respiratory exacerbations, incident comorbidities, and mortality assessment are included in the Extended data. 28 Written informed consents were obtained for all subjects, and each clinical site obtained institutional review board approval.…”

“…Zenodo: Blood RNA and Protein Biomarkers Are Associated with Vaping and Dual use and Prospective Health Outcomes, https://doi.org/10.5281/zenodo.7562784. 28 This project contains the following extended data:…”