Predicting the pulmonary effects of long-term e-cigarette use: are the clouds clearing?

Predicting the pulmonary effects of long-term e-cigarette use: are the clouds clearing?
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DOI:
10.1183/16000617.0121-2021
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发表时间:
2022-03-31
影响因子:
7.5
通讯作者:
Scott, Aaron
Scott, Aaron
中科院分区:
医学1区
文献类型:
--
作者:
Davis, Lauren C.;Sapey, Elizabeth;Thickett, David R.;Scott, Aaron

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电子烟是一种流行的电子输送设备,其复杂性日益增加。鉴于戒烟者、吸烟者和从不吸烟者越来越多地使用这些药物,评估其潜在肺部影响的证据和预测长期使用的影响是很重要的,因为没有足够的时间来研究慢性使用者群体。至关重要的是要评估在卷烟使用中看到的危害指标,以及那些可能是电子烟暴露所特有的指标。评估还必须考虑到电子烟设备(现在至少包括五代设备)的巨大差异以及体内和体外使用的暴露方法。到目前为止,短期使用队列研究,结合体内和体外模型,已用于探索电子烟暴露的影响。已确定的影响和机制,包括炎症失调和病原体抗性降低,与香烟烟雾暴露的既定影响存在重叠。此外,研究已经确定了脂质加工失调的特征,这是电子烟暴露所特有的。本综述将评估新兴文献中强调的电子烟暴露对肺部影响的证据及其驱动机制,并强调当前知识的空白。这样的总结可以理解正在进行的关于电子烟监管的辩论,以及对未来电子烟使用问题的预测和潜在缓解。长期接触电子烟可能导致肺部炎症和对呼吸道感染的抵抗力下降,这在一定程度上反映了尼古丁暴露和氧化应激共同作用下接触香烟的既定影响。https://bit.ly/3zwMFE5
Commercially available since 2007, e-cigarettes are a popular electronic delivery device of ever-growing complexity. Given their increasing use by ex-smokers, smokers and never-smokers, it is important to evaluate evidence of their potential pulmonary effects and predict effects of long-term use, since there has been insufficient time to study a chronic user cohort. It is crucial to evaluate indicators of harm seen in cigarette use, and those potentially unique to e-cigarette exposure. Evaluation must also account for the vast variation in e-cigarette devices (now including at least five generations of devices) and exposure methods used in vivo and in vitro. Thus far, short-term use cohort studies, combined with in vivo and in vitro models, have been used to probe for the effects of e-cigarette exposure. The effects and mechanisms identified, including dysregulated inflammation and decreased pathogen resistance, show concerning overlaps with the established effects of cigarette smoke exposure. Additionally, research has identified a signature of dysregulated lipid processing, which is unique to e-cigarette exposure. This review will evaluate the evidence of pulmonary effects of, and driving mechanisms behind, e-cigarette exposure, which have been highlighted in emerging literature, and highlight the gaps in current knowledge. Such a summary allows understanding of the ongoing debate into e-cigarette regulation, as well as prediction and potential mitigation of future problems surrounding e-cigarette use. Long-term e-cigarette exposure may result in pulmonary inflammation and reduced resistance to respiratory infections, which partially reflects the established effects of cigarette exposure, due to a combination of nicotine exposure and oxidative stress. https://bit.ly/3zwMFE5
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