Eosinophilic Pneumonia and Lymphadenopathy Associated With Vaping and Tetrahydrocannabinol Use

Mull, Eric; Erdem, Güliz; Nicol, Kathleen; Adler, Brent; Shell, Richard

doi:10.1542/peds.2019-3007

Cited by 13 publications

(5 citation statements)

References 6 publications

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“…Importantly, these effects were prevented by the CB 2 receptor antagonists AM630 and/or SR144528. Consistent with a CB 2 -mediated increased in eosinophil migration, cannabis use has been linked to some cases of acute eosinophilic pneumonia, although no demonstration has proven that this involved the CB 2 receptor ( Sauvaget et al, 2010 ; Liebling and Siu 2013 ; Natarajan et al, 2013 ; Ocal et al, 2016 ; Mull et al, 2020 ). Interestingly, while JWH-133 led to a moderate chemotactic response in human eosinophils, it had no effect on mouse eosinophils ( Frei et al, 2016 ).…”

Section: Impact Of Cb 2 Receptor Activation In Hum...mentioning

confidence: 99%

Expression and Functions of the CB2 Receptor in Human Leukocytes

et al. 2022

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The cannabinoid CB2 receptor was cloned from the promyeloid cell line HL-60 and is notably expressed in most, if not all leukocyte types. This relatively restricted localization, combined to the absence of psychotropic effects following its activation, make it an attractive drug target for inflammatory and autoimmune diseases. Therefore, there has been an increasing interest in the past decades to identify precisely which immune cells express the CB2 receptor and what are the consequences of such activation. Herein, we provide new data on the expression of both CB1 and CB2 receptors by human blood leukocytes and discuss the impact of CB2 receptor activation in human leukocytes. While the expression of the CB2 mRNA can be detected in eosinophils, neutrophils, monocytes, B and T lymphocytes, this receptor is most abundant in human eosinophils and B lymphocytes. We also review the evidence obtained from primary human leukocytes and immortalized cell lines regarding the regulation of their functions by the CB2 receptor, which underscore the urgent need to deepen our understanding of the CB2 receptor as an immunoregulator in humans.

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Section: Impact Of Cb 2 Receptor Activation In Hum...mentioning

confidence: 99%

Expression and Functions of the CB2 Receptor in Human Leukocytes

et al. 2022

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“…The primary histopathologic lesion in EVALI has been acute fibrinous pneumonitis, diffuse alveolar damage (DAD), organizing pneumonia, and bronchiolitis (Butt et al, 2019). Although uncommon, AEP has been reported in a few patients with EVALI during the epidemic in the US and before that (Thota and Latham, 2014;Kamada et al, 2016;Mull et al, 2020;Puebla Neira et al, 2020;Wolf and Richards, 2020;Takigawa et al, 2022;Bonnier et al, 2023).…”

Section: Discussionmentioning

confidence: 99%

Vaping Associated Acute Eosinophilic Pneumonia: A Clinical and Radiologic Mimicker of COVID-19

Bonnier,

Nida,

Chong

et al. 2023

Prague Med. Rep.

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Acute eosinophilic pneumonia (AEP) is a rare cause of respiratory failure. It is primarily a disease of smokers, either a new smoker or an existing one with a recent increase in cigarette consumption. Other risk factors include toxic gas exposure, inhalational illicit drugs, and smoking marijuana. AEP has also been reported in patients with e-cigarette or vaping associated lung injury (EVALI). We present the case of a 20-year-old male who presented to the hospital with acute respiratory failure. The patient has been vaping heavily for the past three months and started smoking three days before presenting to the emergency department. He was hypertensive, tachycardic, tachypneic, and required high-flow nasal cannula to maintain SpO2 > 92%. His condition deteriorated in the first 24 hours following hospitalization requiring noninvasive positive pressure ventilation. Bronchoalveolar lavage revealed an eosinophil count of 36%. Bronchoalveolar lavage (BAL) cytology revealed lipid-laden macrophages. He was diagnosed with AEP due to EVALI, and the patient was treated with high dose corticosteroid with subsequent improvement. Before the bronchoscopic evaluation, the clinical and radiologic findings were consistent with COVID-19, and the patient was tested twice for SARS-CoV-2 PCR. In the appropriate clinical setting, AEP should be considered in the differential diagnoses of community-acquired pneumonia, acute respiratory distress syndrome (ARDS), and COVID-19, especially in this pandemic era.

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“…Other aspects are yet to be understood. For instance, we mention an interesting aspect that is also less clear nowadays: an acute hypersensitivity reaction was suspected to inhale antigen on a 16-year-old female who was confirmed with idiopathic acute eosinophilic pneumonia after she used e-cigarettes for 1 year (tetrahydrocannabinol cartridge) thus suggesting potential (antigen-induced) autoimmune effects [99].…”

Section: Cannabinoid Receptorsmentioning

confidence: 99%

Metabolic and Other Endocrine Elements with Regard to Lifestyle Choices: Focus on E-Cigarettes

Osman,

Petrescu,

Tuculină

et al. 2023

Metabolites

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Our objective was to overview recent data on metabolic/endocrine disorders with respect to e-cigarette (e-cig) use. This is a narrative review; we researched English, full-length, original articles on PubMed (between January 2020 and August 2023) by using different keywords in the area of metabolic/endocrine issues. We only included original clinical studies (n = 22) and excluded case reports and experimental studies. 3 studies (N1 = 22,385; N2 = 600,046; N3 = 5101) addressed prediabetes risk; N1 showed a 1.57-fold increased risk of dual vs. never smokers, a higher risk that was not confirmed in N2 (based on self-reported assessments). Current non-smokers (N1) who were dual smokers still have an increased odd of prediabetes (a 1.27-fold risk increase). N3 and another 2 studies addressed type 2 diabetes mellitus (DM): a lower prevalence of DM among dual users (3.3%) vs. cigarette smoking (5.9%) was identified. 6 studies investigated obesity profile (4 of them found positive correlations with e-cig use). One study (N4 = 373,781) showed that e-cig use was associated with obesity in the general population (OR = 1.6, 95%CI: 1.3–2.1, p < 0.05); another (N5 = 7505, 0.82% were e-cig-only) showed that obesity had a higher prevalence in dual smokers (51%) vs. cig-only (41.2%, p < 0.05), while another (N6 = 3055) found that female (not male) e-cig smokers had higher body mass index vs. non-smokers. Data on metabolic syndrome (MS) are provided for dual smokers (n = 2): one case–control study found that female dual smokers had higher odds of MS than non-smokers. The need for awareness with respect to potential e-cig-–associated medical issues should be part of modern medicine, including daily anamnesis. Whether the metabolic/endocrine frame is part of the general picture is yet to be determined. Surveillance protocols should help clinicians to easily access the medical background of one subject, including this specific matter of e-cig with/without conventional cigarettes smoking and other habits/lifestyle elements, especially when taking into consideration metabolism anomalies.

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Eosinophilic Pneumonia and Lymphadenopathy Associated With Vaping and Tetrahydrocannabinol Use

Cited by 13 publications

References 6 publications

Expression and Functions of the CB2 Receptor in Human Leukocytes

Expression and Functions of the CB2 Receptor in Human Leukocytes

Vaping Associated Acute Eosinophilic Pneumonia: A Clinical and Radiologic Mimicker of COVID-19

Metabolic and Other Endocrine Elements with Regard to Lifestyle Choices: Focus on E-Cigarettes

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