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Am J Respir Crit Care Med. 2019 Aug 7. doi: 10.1164/rccm.201903-0615OC. [Epub ahead of print]

Chronic E-Cigarette Use Increases Neutrophil Elastase and Matrix Metalloprotease Levels in the Lung.

Author information

1
University of North Carolina, Marsico Lung Institute, Chapel Hill, North Carolina, United States.
2
University of North Carolina at Chapel Hill, 2331, Marsico Lung Institute, Chapel Hill, North Carolina, United States.
3
Human Studies facility EPA, Chapel Hill, North Carolina, United States.
4
UNC Chapel Hill, Pediatrics, Chapel Hill, North Carolina, United States.
5
University of North Carolina at Chapel Hill, Division Pediatric Pulmonology, Chapel Hill, North Carolina, United States.
6
University of North Carolina, Department of Cell Biology & Physiology, Chapel Hill, North Carolina, United States.
7
University of North Carolina at Chapel Hill, 2331, Marsico Lung Institute, Chapel Hill, North Carolina, United States; robert_tarran@med.unc.edu.

Abstract

RATIONALE:

Proteolysis is a key aspect of the lung's innate immune system. Proteases, including neutrophil elastase and matrix metalloproteases (MMPs), modulate cell signaling, inflammation, tissue remodeling and leukocyte recruitment via cleavage of their target proteins. Excessive proteolysis occurs with chronic tobacco use and is causative for bronchiectasis and emphysema. The effect of e-cigarettes (vaping) on proteolysis is unknown.

OBJECTIVES:

We used protease levels as biomarkers of harm to determine the impact of vaping on the lung.

METHODS:

We performed research bronchoscopies on healthy non-smokers, cigarette smokers and e-cigarette users (vapers) and determined protease levels in bronchoalveolar lavage (BAL). In parallel, we studied the effects of e-cigarette components on protease secretion in isolated human blood neutrophils and BAL-derived macrophages. We also analyzed the nicotine concentration in induced sputum and BAL.

MEASUREMENTS AND MAIN RESULTS:

Neutrophil elastase, MMP-2 and MMP-9 activities/protein levels were equally elevated in both vapers' and smokers' BAL relative to non-smokers. In contrast, antiprotease levels were unchanged. We also found that exposure of isolated neutrophils and macrophages to nicotine elicited dose-dependent increases in protease release. After vaping, measurable levels of nicotine were detectable in sputum and BAL, which corresponded to the EC50s for protease release seen in immune cells.

CONCLUSIONS:

We conclude that vaping induces nicotine-dependent protease release from resident pulmonary immune cells. Thus, chronic vaping disrupts the protease-antiprotease balance by increasing proteolysis in lung, which may place vapers at risk of developing chronic lung disease. These data indicate that vaping may not be safer than tobacco smoking.

KEYWORDS:

Vaping, Protease, Antiprotease, Broncho-alveolar Lavage, Nicotine

PMID:
31390877
DOI:
10.1164/rccm.201903-0615OC

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