Systemic biomarkers of exposure associated with ENDS use: a scoping review

Hiler, Marzena; Weidner, Anna-Sophie; Hull, Lynn C; Kurti, Allison N.; Mishina, Elena V.

doi:10.1136/tobaccocontrol-2021-056896

Cited by 15 publications

(14 citation statements)

References 69 publications

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“…Multiple studies have evaluated biomarkers of carcinogen and toxicant exposure in subjects who used e-cigarettes versus conventional cigarettes or nonusers of any tobacco product, as recently reviewed. − The vast majority of these studies have made biomarker measurements at a single time point, or more than one time point over a relatively short duration. Although e-cigarette use consistently resulted in significantly lower exposure to carcinogens and toxicants than cigarette smoking, a few of these single time point studies demonstrated elevated levels of certain biomarkers of volatile toxicants or carcinogens such as acrolein and acrylonitrile in e-cigarette users versus nontobacco users, as summarized in Table .…”

Section: Introductionmentioning

confidence: 99%

Increased Levels of the Acrolein Metabolite 3-Hydroxypropyl Mercapturic Acid in the Urine of e-Cigarette Users

Chen

Carmella

Lindgren

et al. 2022

Chem. Res. Toxicol.

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Carcinogen and toxicant uptake by e-cigarette users have not been fully evaluated. In the study reported here, we recruited 30 e-cigarette users, 63 nonsmokers, and 33 cigarette smokers who gave monthly urine samples over a period of 4–6 months. Their product use status was confirmed by measurements of exhaled CO, urinary total nicotine equivalents, cyanoethyl mercapturic acid (CEMA), and total 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol. Urinary biomarkers of exposure to the carcinogens acrolein (3-hydroxypropyl mercapturic acid, 3-HPMA), benzene (S-phenyl mercapturic acid, SPMA), acrylonitrile (CEMA), and a combination of crotonaldehyde, methyl vinyl ketone, and methacrolein (3-hydroxy-1-methylpropyl mercapturic acid, HMPMA) were quantified at each visit. Data from subject visits with CEMA > 27 pmol/mL were excluded from the statistical analysis of the results because of possible unreported exposures to volatile combustion products such as secondhand cigarette smoke or marijuana smoke exposure; this left 22 e-cigarette users with 4 or more monthly visits and all 63 nonsmokers. Geometric mean levels of 3-HPMA (1249 versus 679.3 pmol/mL urine) were significantly higher (P = 0.003) in e-cigarette users than in nonsmokers, whereas levels of SPMA, CEMA, and HMPMA did not differ between these two groups. All analytes were significantly higher in cigarette smokers than in either e-cigarette users or nonsmokers. The results of this unique multimonth longitudinal study demonstrate consistent significantly higher uptake of the carcinogen acrolein in e-cigarette users versus nonsmokers, presenting a warning signal regarding e-cigarette use.

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Section: Introductionmentioning

confidence: 99%

Increased Levels of the Acrolein Metabolite 3-Hydroxypropyl Mercapturic Acid in the Urine of e-Cigarette Users

Chen

Carmella

Lindgren

et al. 2022

Chem. Res. Toxicol.

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“…19 A recent meta-analysis of biomarkers of ENDS versus cigarettes reported a more favorable biomarker profile of ENDS use, though the last author of the study has been reported to have ties to the tobacco industry. 21,22 Another systematic review also reported reduced levels of some biomarkers in ENDS users relative to current cigarette users, but this is not consistent for all biomarkers (Hiler et al, 2021). 23 By examining the correlation in biomarker profiles for vaping, dual use, and smoking, we observed that the vaping profile is largely distinct from both the dual use and smoking profile which are in turn highly correlated to each other.…”

Section: Discussionmentioning

confidence: 89%

“…21,22 Another systematic review also reported reduced levels of some biomarkers in ENDS users relative to current cigarette users, but this is not consistent for all biomarkers (Hiler et al, 2021). 23 By examining the correlation in biomarker profiles for vaping, dual use, and smoking, we observed that the vaping profile is largely distinct from both the dual use and smoking profile which are in turn highly correlated to each other. We did however observe multiple examples of shared RNA and protein biomarkers between smoking, vaping, and dual use, such as GPR15, a regulator of Linear discrimination analysis models were used to classify vaping and smoking groups.…”

Section: Discussionmentioning

confidence: 89%

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

et al. 2023

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Background: 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. To identify putative biomarkers of vaping and dual use, we performed association analysis in an observational cohort of 3,892 COPDGene study participants with blood transcriptomics and/or plasma proteomics data and self-reported current vaping and smoking behavior. Methods: 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 three transcriptomic and three proteomic associations with vaping, and 90 transcriptomic and 100 proteomic associations to dual use. Many of these vaping or dual use biomarkers were significantly associated with prospective health outcomes, such as FEV1 decline (three transcripts and 62 proteins), overall mortality (18 transcripts and 73 proteins), respiratory mortality (two 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. Conclusions: In summary, vaping and dual use are associated with RNA and protein blood-based biomarkers that are also associated with adverse health outcomes.

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“…There is an urgent need for nonnicotine biomarkers of ENDS use to study its long-term effects on health compared to traditional cigarettes. A recent review suggests that many volatile organic compounds and heavy metals are present in both cigarette smokers and ENDS users, but propylene glycol levels may differentiate ENDS users from tobacco smokers (Hiler et al, 2021). Another potential biomarker may be DNA methylation patterns, as some unique methylation patterns have already been linked to combustible tobacco use (Philibert et al, 2013; Reynolds et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

Biochemical validation of self-reported electronic nicotine delivery system and tobacco heaviness of use.

Addicott¹,

Sutfin²,

Reynolds³

et al. 2023

Experimental and Clinical Psychopharmacology

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Research on tobacco use disorder relies on a combination of self-reported use (e.g., cigarettes per day) and biochemical validation to quantify heaviness of use. However, electronic nicotine delivery system (ENDS) users may be unaware of how much they have vaped per day. The aim of this study was to test the relationship between self-reported heaviness of ENDS/tobacco use and nicotine biomarkers. Young adults (n = 30) who currently use ENDS and other tobacco products completed a detailed tobacco use history, timeline follow-back, and an ENDS topography session. We evaluated the self-reports of own-brand ENDS use and tested correlations to determine which self-report measures of own-brand use, and which self-reported measures of puff topography, had the strongest correlations with urine and/or blood biomarkers of nicotine use. Participants reported using a variety of different ENDS devices and had a range of usage. The sum of the self-reported number of occasions or hours of ENDS use, along with the number of cigarettes and other tobacco products used, over the past 24 hr was significantly correlated with plasma cotinine levels. Puff topography measures correlated with increased nicotine concentrations, although participants underestimated the number of puffs they took during the topography session. This study provides preliminary evidence that summing together the hours of ENDS use, or the number of occasions of ENDS use, in addition to the number of other tobacco products used (i.e., cigarettes) based on self-report may be an accurate method of quantification. Public Health SignificanceA simple, reliable self-report measure is urgently needed to estimate heaviness of e-cigarette use. This study shows that self-reports of number of occasions or hours of e-cigarette use per day is related to nicotine biomarkers. An accurate measure of e-cigarette use is vital to understanding nicotine addiction as well as the health impact of e-cigarettes.

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Systemic biomarkers of exposure associated with ENDS use: a scoping review

Cited by 15 publications

References 69 publications

Increased Levels of the Acrolein Metabolite 3-Hydroxypropyl Mercapturic Acid in the Urine of e-Cigarette Users

Increased Levels of the Acrolein Metabolite 3-Hydroxypropyl Mercapturic Acid in the Urine of e-Cigarette Users

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

Biochemical validation of self-reported electronic nicotine delivery system and tobacco heaviness of use.

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