Recent updates on electronic cigarette aerosol and inhaled nicotine effects on periodontal and pulmonary tissues

Abstract

E-cigarette derived inhaled nicotine may contribute to the pathogenesis of periodontal and pulmonary diseases in particular via lung inflammation, injurious and dysregulated repair responses. Nicotine is shown to have anti-proliferative properties and affects fibroblasts in vitro, which may interfere in tissue myofibroblast differentiation in e-cig users. This will affect the ability to heal wounds by decreasing wound contraction. In periodontics, direct exposure to e-vapor has been shown to produce harmful effects in periodontal ligament and gingival fibroblasts in culture. This is due to the generation of reactive oxygen species/aldehydes/carbonyls from e-cig aerosol, leading to protein carbonylation of extracellular matrix and DNA adducts/damage. A limited number of studies regarding the effects of e-cig in oral and lung health are available. However, no reports are available to directly link the deleterious effects on e-cigs, inhaled nicotine, and flavorings aerosol on oral periodontal and pulmonary health in particular to identify the risk of oral diseases by e-cigarettes and nicotine aerosols. This mini-review summarizes the recent perspectives on e-cigarettes including inhaled nicotine effects on several pathophysiological events, such as oxidative stress, DNA damage, innate host response, inflammation, cellular senescence, pro-fibrogenic and dysregulated repair, leading to lung remodeling, oral submucous fibrosis and periodontal diseases.

Dysregulated repair and inflammatory responses by e‐cigarette‐derived inhaled nicotine and humectant propylene glycol in a sex‐dependent manner in mouse lung

“…Electronic nicotine delivery systems (ENDS) have recently emerged as an alternative to cigarette smoking . Electronic cigarettes (e‐cigs) are devices which use heat to aerosolize a small amount of e‐liquid containing nicotine (up to 24‐100 mg/mL) solubilized in propylene glycol (PG) or vegetable glycerin (VG) as a base constituent, humectant .…”

Proinflammatory cytokine levels and peri‐implant parameters among cigarette smokers, individuals vaping electronic cigarettes, and non‐smokers

“…From the dental health perspective, vaping has been associated with several oral disorders including submucous fibrosis and periodontal diseases . A laboratory investigation by Sundar et al .…”

A Review of Pulmonary Toxicity of Electronic Cigarettes in the Context of Smoking: A Focus on Inflammation

“…Experimental animal studies have also shown that there are some toxic effects in the lungs of e-cig aerosols, which includes pro-inflammatory responses (12, 184, 198). While in vivo studies indicate that aerosolized PG or VG alone only have slight toxic effects in the lung (199–202), more recent data using e-cig devices are identifying various effects on inflammatory and other responses.…”

“…Other studies report lung oxidant reactivity and reactive oxygen species increasing inflammatory cytokines (i.e., increasing IL-8), changes in lung fibroblasts thought to be part of COPD pathogenesis, and altered redox balance (204). There also is evidence that e-cig aerosols may promote oxidative damage, mitochondrial reactive oxygen species, a dose-dependent loss of lung epithelial barrier function and increased inflammation-related intracellular ceramides and myosin light chain phosphorylation (198). A recent animal study showed measurable effects on inflammation and lung injury for both cigarette smoke and e-cigs, but much less for the latter (186).…”

“…It is well established that nicotine is highly bioactive in that it induces proliferation, inhibits apoptosis, promotes the epithelial to mesenchymal transition (EMT), and promotes angiogenesis (55, 241). All of these are important components of cancer and COPD development (55, 198). To date, nicotine is not considered a carcinogen for humans, as nicotine replacement therapy (NRT) and low-TSNA smokeless tobacco (snus) have not demonstrated increased risks of cancer (242).…”