E-cigarette use and respiratory disorders: an integrative review of converging evidence from epidemiological and laboratory studies.
E-cigarette use and respiratory disorders: an integrative review of converging evidence from epidemiological and laboratory studies.
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DOI：
10.1183/13993003.01815-2019
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发表时间：
2021-01
期刊：
影响因子：
--
通讯作者：
Tam EK
中科院分区：
文献类型：
--
作者：
Wills TA;Soneji SS;Choi K;Jaspers I;Tam EK
电子烟（电子烟）的使用在青少年和年轻人中很普遍，但人们对人类健康后果的了解有限。我们对来自一般人群样本的呼吸系统疾病研究结果进行了系统回顾和荟萃分析，并考虑将这些结果与对照实验室研究中与电子烟相关的生物过程的发现相关联。我们对电子烟使用与哮喘和慢性阻塞性肺病之间关系的流行病学研究进行了文献检索和荟萃分析。我们讨论了电子烟对四个生物过程影响的实验室研究结果：细胞毒性、氧化应激/炎症、感染易感性和基因表达。横断面和纵向流行病学研究表明，在控制吸烟和其他协变量的情况下，使用电子烟与哮喘和慢性阻塞性肺病有显著关联。对于哮喘（n=15项研究），合并校正优势比（aOR）为1.39 (95% CI 1.28-1.51)；对于COPD （n=9项研究），aOR为1.49 （95% CI 1.36-1.65）。实验室研究一致表明，电子烟对与呼吸系统伤害和疾病易感性相关的生物过程有影响，电子烟的情况与清洁空气对照有很大不同，尽管有时不如香烟。来自流行病学研究的证据符合一致性、效果强度、时效性以及在某些情况下剂量-反应梯度的既定标准。来自多个实验室研究的证据表明了生物学上的合理性。我们的结论是，电子烟的使用对哮喘和慢性阻塞性肺病有影响，这是呼吸学和公共卫生关注的问题。流行病学研究表明，使用电子烟与哮喘和慢性阻塞性肺病有关，实验室研究表明，电子烟对四种生物过程有不利影响。可以得出结论，电子烟的使用对公共卫生有重大影响。https://bit.ly/3drH4pj
Use of electronic cigarettes (e-cigarettes) is prevalent among adolescents and young adults, but there has been limited knowledge about health consequences in human populations. We conduct a systematic review and meta-analysis of results on respiratory disorders from studies of general-population samples and consider the mapping of these results to findings about biological processes linked to e-cigarettes in controlled laboratory studies. We conducted a literature search and meta-analysis of epidemiological studies on the association of e-cigarette use with asthma and with COPD. We discuss findings from laboratory studies about effects of e-cigarettes on four biological processes: cytotoxicity, oxidative stress/inflammation, susceptibility to infection and genetic expression. Epidemiological studies, both cross-sectional and longitudinal, show a significant association of e-cigarette use with asthma and COPD, controlling for cigarette smoking and other covariates. For asthma (n=15 studies), the pooled adjusted odds ratio (aOR) was 1.39 (95% CI 1.28–1.51); for COPD (n=9 studies) the aOR was 1.49 (95% CI 1.36–1.65). Laboratory studies consistently show an effect of e-cigarettes on biological processes related to respiratory harm and susceptibility to illness, with e-cigarette conditions differing significantly from clean-air controls, although sometimes less than for cigarettes. The evidence from epidemiological studies meets established criteria for consistency, strength of effect, temporality, and in some cases a dose–response gradient. Biological plausibility is indicated by evidence from multiple laboratory studies. We conclude that e-cigarette use has consequences for asthma and COPD, which is of concern for respirology and public health. Epidemiological studies show a relationship of e-cigarette use with asthma and COPD, and laboratory studies show their adverse effects on four biological processes. It can be concluded that e-cigarette use is of significant concern for public health. https://bit.ly/3drH4pj
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