Electronic Cigarette Aerosol Modulates the Oral Microbiome and Increases Risk of Infection

Pushalkar, Smruti; Paul, Benjamin C.; Li, Qianhao; Yang, Jian; Vasconcelos, Rodrigo Nogueira de; Makwana, Shreya; González, Juan Muñoz; Shah, Shivm; Xie, Chengzhi; Janal, Malvin N.; Queiroz, Erica; Bederoff, Maria; Leinwand, Joshua; Solarewicz, Julia; Xu, Fangxi; Aboseria, Eman; Guo, Yuqi; Aguallo, Deanna; Gómez, Claudia Juliana Díaz; Kamer, Angela R.; Shelley, Donna; Aphinyanaphongs, Yindalon; Barber, Cheryl; Gordon, Terry; Corby, Patricia; Li, Xin; Saxena, Deepak

doi:10.1016/j.isci.2020.100884

Cited by 94 publications

(147 citation statements)

References 53 publications

(54 reference statements)

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“…By using invasive E. coli in co-culture studies with EDMs, we also determine that handling of microbes by the gut epithelium was fundamentally impaired upon chronic and repetitive exposure to e-cig, resulting in higher infectivity and inflammation. Our findings are in keeping with prior studies showing higher infectivity and inflammation in the epithelial lining of the oral mucosa (25) and the lung (36)(37)(38).…”

Section: E-cigarettes Trigger Gut Inflammationsupporting

confidence: 93%

“…The gut is resident to diverse microbiota (symbionts and pathobionts) and its handling of and response to the same is known to regulate several chronic diseases such as inflammatory bowel diseases (IBD), obesity, cardiovascular diseases, cancers and rheumatoid arthritis (24). Beyond the fact that e-cigarette use significantly modulates the oral microbiome by increasing the abundance of oral pathobionts (25), but is not known to significantly impact the gut microbiome (26), nothing is known as to how e-cigarette use may influence the gut barrier. Using a combination of mouse models, transcriptomics, and murine and human gut-derived organoids as ex vivo near-physiologic model systems, here we expose the hitherto unknown effects of e-cigarettes on the gastrointestinal tract and provide insights into the potential long-term effects of e-cigarettes on health.…”

Section: Introductionmentioning

confidence: 99%

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E-cigarettes compromise the gut barrier and trigger gut inflammation

Sharma

Lee

Fonseca

et al. 2020

Preprint

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E-cigarette and vaping device use continue to rise, particularly in adolescents and young adults, but the safety of inhaling the multitude of chemicals within e-cigarette aerosols has been questioned. While several studies have evaluated vaping effects on the lungs and heart; effects on the gastrointestinal tract remain unknown. Using established murine models of acute (1 week) and chronic (3 month) daily e-cigarette aerosol inhalation, both with nicotine-containing and vehicle control e-liquids, murine colon transcriptomics and organoid co-culture models, we assessed the effects of e-cigarette use on the gut barrier and mucosal health. Histologic analyses revealed that chronic exposure to nicotine-free e-cigarette aerosols induced mucosal inflammation. Transcriptome analyses revealed that chronic, but not acute, nicotine-free e-cigarette use significantly reduced expression of tight junction markers, including occluding, and drove expression of pro-inflammatory cytokines. Exposure of murine and human enteroid-derived monolayers (EDMs) to nicotine-free e-cigarette aerosols alone, or in co-culture with invasive E. coli, confirmed that repetitive exposure was sufficient to recapitulate the key findings observed in vivo, i.e., barrier-disruption, downregulation of occludin, inflammation, and an accentuated risk of and response to bacterial infection. These data highlight an unexpected harmful effect of e-cigarette use on the gut barrier and pinpoint non-nicotine chemical components common across >90% of e-cigarette e-liquids as the source of harm. Given the ever-expanding importance of the integrity of the gut barrier for host fitness, and impact of gut mucosal inflammation on a multitude of chronic diseases, these findings are broadly relevant to medicine and public health.SIGNIFICANCEThe safety of electronic cigarettes has been questioned amidst emerging evidence that they may derail our immune system and increase our susceptibility to infections. Despite these insights, their impact on the most critical entity that separates trillions of microbes from the largest immune system in our body, i.e., the gut barrier, remains unexplored. Using a combination of mouse models, gut transcriptomics, and murine and human gut-derived organoids, here we show that chronic exposure to aerosols of electronic-cigarette disrupts the gut barrier, increases its susceptibility to bacterial infections and triggers inflammation. Given the importance of the gut barrier in the maintenance of immune homeostasis, these findings provide valuable insights into the potential long-term harmful effects of electronic cigarettes on health.

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Section: E-cigarettes Trigger Gut Inflammationsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

E-cigarettes compromise the gut barrier and trigger gut inflammation

Sharma

Lee

Fonseca

et al. 2020

Preprint

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“…The overall trend in e-cigarette smoking among adolescents (middle school [10-14 years] and high school [14-18 years]) students is higher than in the adult population. The number of current adolescent e-cigarette users has experienced an upward trend since e-cigarettes first arrived in the United States [1][2][3]. According to a US Health and Human Services report in 2017, a nonlinear increase for current use of e-cigarettes among high school students from 1.5 to 11.3% between 2011 and 2017 occurred.…”

Section: Introductionmentioning

confidence: 99%

E-cigarettes use in the United States: reasons for use, perceptions, and effects on health

Sapru¹,

Vardhan²,

Li³

et al. 2020

BMC Public Health

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143

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Background Many researchers claim electronic cigarettes (e-cigarettes) to be a breakthrough invention for tobacco users that aspires to curb their addiction to conventional cigarettes. Claimed to be safer by their promoters, these smokeless devices have become increasingly popular since their arrival on the market among users of all ages, especially adolescents. This paper investigated the trends in e-cigarette usage since the time it arrived in the United States, highlighting the highest surge that has occurred in adolescent e-cigarette use. It also aimed to understand the reasons and perceptions behind the ever-increasing use of e-cigarettes by adolescents. Main body With the advent of e-cigarettes and common positive perceptions regarding their use, we are at risk of reversing the years of efforts regarding tobacco control and instead advance towards a new addiction with currently unknown long-term health hazards. There is substantial data showing a significant increase of e-cigarette users in the United States, especially among adolescents. The aim of this review was to explore the reasons behind this widespread increase in the use of e-cigarettes among the teenage population in the US and also to uncover the common perceptions about these new electronic delivery systems. In addition, this review attempted to summarize health benefits and hazards associated with e-cigarette use as it crucial to have the right information among its users regarding the health effects of e-cigarette use. Conclusion E-cigarettes are more appealing than c-cigarettes for a variety of reasons, including cost, choice of different flavors, ease of accessibility, and use and impact of social media. There are also different perceptions among e-cigarette users, including both adolescents and adults. The former group may use them because of the sense of fashion associated with this novel device, and the latter might intend to quit conventional/combustible cigarettes (c-cigarettes) by switching to e-cigarettes. However, it is important to note that e-cigarettes are a recent phenomenon; therefore, there is a lack of many long-term studies that can identify future health risks associated with e-cigarette use. We need more detailed studies that focus on the long-term health effects of e-cigarette use. Moreover, with the ever-increasing usage of e-cigarettes by adolescents (10 and 19 years), it is very important that e-cigarettes be incorporated into the current tobacco-free laws and ordinances. We conclude by stating that e-cigarettes need stronger regulations to prevent youth access and use.

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“…In 2019, it found that over 1400 respiratory cases linked to VALI in the United States, a term characterised by respiratory distress with bilateral (sometimes haemorrhagic) infiltrates within 3 months of using ENDS/ ENNDS 83 . Aside from respiratory illness, recent studies also found that vaping can change the oral and lung microbiome, leading to implications in cavities, gum disease and other health issues 84 . The oral microbiome in participants who vape was found to contain significantly higher levels of Porphyromonas and Veillonella bacteria, the latter being found in cigarette smokers as well.…”

Section: Concentration (Ppm)mentioning

confidence: 99%

“…The oral microbiome in participants who vape was found to contain significantly higher levels of Porphyromonas and Veillonella bacteria, the latter being found in cigarette smokers as well. The altered microbiome was found to contribute to a higher concentration of inflammatory response cytokines 84 . It also remains to be seen whether a history of VALI could pose higher risks for influenza and other viral lung infection complications 85 .…”

Section: Concentration (Ppm)mentioning

confidence: 99%

Policy, toxicology and physicochemical considerations on the inhalation of high concentrations of food flavour

et al. 2020

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Food flavour ingredients are required by law to obtain prior approval from regulatory bodies, such as the U.S. Food and Drug Administration (FDA) or the European Food Safety Authority (EFSA) in terms of toxicological data and intended use levels. However, there are no regulations for labelling the type and concentration of flavour additives on the product, primarily due to their low concentration in food and generally recognised as safe (GRAS) status determined by the flavour and extract manufacturers’ association (FEMA). Their status for use in e-cigarettes and other vaping products challenges these fundamental assumptions, because their concentration can be over ten-thousand times higher than in food, and the method of administration is through inhalation, which is currently not evaluated by the FEMA expert panel. This work provides a review of some common flavour ingredients used in food and vaping products, their product concentrations, inhalation toxicity and aroma interactions reported with different biological substrates. We have identified several studies, which suggest that the high concentrations of flavour through inhalation may pose a serious health threat, especially in terms of their cytotoxicity. As a result of the wide range of possible protein-aroma interactions reported in our diet and metabolism, including links to several non-communicable diseases, we suggest that it is instrumental to update current flavour- labelling regulations, and support new strategies of understanding the effects of flavour uptake on the digestive and respiratory systems, in order to prevent the onset of future non-communicable diseases.

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Electronic Cigarette Aerosol Modulates the Oral Microbiome and Increases Risk of Infection

Cited by 94 publications

References 53 publications

E-cigarettes compromise the gut barrier and trigger gut inflammation

E-cigarettes compromise the gut barrier and trigger gut inflammation

E-cigarettes use in the United States: reasons for use, perceptions, and effects on health

Policy, toxicology and physicochemical considerations on the inhalation of high concentrations of food flavour

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