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Am J Physiol Lung Cell Mol Physiol. 2019 Feb 6. doi: 10.1152/ajplung.00492.2018. [Epub ahead of print]

Fourth generation e-cigarette vaping induces transient lung inflammation and gas exchanges disturbances: results from two randomized clinical trials.

Author information

1
Cardiology, Hôpital Erasme, Belgium.
2
Cardiologie, Erasme Hospital, Belgium.
3
Chest Department, Erasme University Hospital, Université libre de Bruxelles, Belgium.
4
Department of Clinical Chemistry, Hôpital Erasme, Belgium.
5
Cardiology, Hôpital Saint-Pierre, Belgium.

Abstract

BACKGROUND:

When heated by an electronic cigarette, propylene glycol and glycerol produce a nicotine-carrying-aerosol. This hygroscopic/hyperosmolar aerosol can deposit deep within the lung. Whether these deposits trigger local inflammation and disturb pulmonary gas exchanges is not known.

AIMS:

To assess the acute effects of high-wattage electronic cigarette vaping with or without nicotine on lung inflammation biomarkers, transcutaneous gas tensions, and pulmonary function tests in young and healthy tobacco-smokers. Acute effects of vaping without nicotine on arterial blood gas tensions were also assessed in heavy-smokers suspected of coronary artery disease.

METHODS:

Using a single-blind within-subjects study design, 25 young tobacco-smokers underwent three experimental sessions in random order: sham-vaping, vaping with and without nicotine at 60 Watts. Twenty heavy-smokers were also exposed to sham-vaping (n=10) or vaping without nicotine (n=10) in an open-label randomized-parallel study.

RESULTS:

In the young tobacco-smokers, when compared to sham-vaping: 1) serum club-cell protein-16 increased after vaping without nicotine (mean±SEM, ‑0.5±0.2µg.L-1 vs. +1.1±0.3µg.L-1; P=0.013) and vaping with nicotine (+1.2±0.3µg.L-1; P=0.009); 2) transcutaneous oxygen tension decreased for 60-minutes after vaping without nicotine (nadir,‑0.3±1mmHg vs. ‑15.3±2.3mmHg; P<0.001) and for 80-minutes after vaping with nicotine (nadir, ‑19.6±2.8mmHg; P<0.001). Compared to sham-vaping, vaping without nicotine decreased arterial oxygen tension for 5-minutes in heavy-smokers patients (+5.4±3.3mmHg vs. ‑5.4±1.9mmHg; P=0.012).

CONCLUSIONS:

Acute vaping of propylene glycol/glycerol aerosol at high wattage with or without nicotine induces airway epithelial injury and sustained decrement in transcutaneous oxygen tension in young tobacco-smokers. Intense vaping conditions also transiently impair arterial oxygen tension in heavy-smokers.

KEYWORDS:

arterial oxygen tension; club-cell-protein-16; e-cigarette; transcutaneous oxygen tension

PMID:
30724099
DOI:
10.1152/ajplung.00492.2018

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