E-Cigarette Effects ON Markers of Cardiovascular AND Pulmonary Disease Risk

项目摘要/摘要 电子烟在美国的使用正在迅速增加，特别是在年轻人中，这突显了 需要提高对其健康风险的了解。相关数据可以为政策提供信息，指导公共卫生和 临床干预努力，并告知个人谁可能使用或正在使用该产品。 在这项提案中，我们描述了将显著增强我们对健康影响的理解的研究 通过将电子烟和传统香烟(“产品”)的急性和长期使用与良好- 经过验证的心血管和肺部疾病生物标记物。我们将注册4个不同的使用组 参与者(n=440)：独家电子烟使用者(n=110)、独家吸烟者(n=110)、双重产品使用者 (吸烟者和吸烟者：n=110)，从不吸烟者(n=110)。这些小组反映了主要的决策 个人对他们未来的烟草使用所能做的事情：继续吸烟，改用电子烟- 香烟和电子烟，或不使用产品。吸烟者和医疗保健是至关重要的 供应商有关于这些选择对健康影响的准确信息。 产品的使用将与经过充分验证的生物标志物相关，这些生物标志物准确和可重复地反映 与心血管或肺部疾病相关的机制、损伤和未来风险。生物标志物将是相关的 至(1)在实验室中剧烈使用产品(暴露挑战)，(2)产品使用终生历史，和/或(3) 实时测量参与者日常生活中的产品使用情况。主要的心血管生物标志物是 肱动脉血流介导的扩张(内皮功能的衡量标准)和颈动脉内膜-中层厚度 亚临床动脉损伤和动脉粥样硬化的测量。主要的肺部疾病生物标志物将是 肺活量测定仪测量肺容量和流量(预计FEV1、FVC、FEV1/FVC)。我们也 我将进行跑步机运动负荷测试(以评估有氧能力)、心电图(以测量心脏 心率及其变异性)和测量血压、血脂、糖化血红蛋白和炎症/氧化标记物 (白细胞计数、C反应蛋白、尿F2异前列腺素)和呼出的一氧化氮。我们将展示如何 产品使用--不同群体对(1)急性产品使用和(2)长期心血管使用的反应不同 和肺部生物标记物。我们还将确定产品使用历史与生物标记物状态之间的关系。 拟议的研究将产生关于产品使用、亚临床动脉的重要和全面的数据。 损伤、动脉粥样硬化负担、动脉和肺功能、心脏和有氧运动能力、心脏自主神经 调节失调、全身和肺部炎症、氧化应激以及其他关键后果。 这些数据将作为未来对电子烟健康影响的纵向调查的基础，并将为 关于电子烟的公共政策决策、临床干预和患者指导。

Project Summary/Abstract E-cigarette use is increasing rapidly in the United States, especially amongst youth, underscoring the vital need to improve understanding of its health risks. Relevant data could inform policy, guide public health and clinical intervention efforts, and inform individuals who might use or who are using this product. In this proposal, we describe research that will significantly enhance our understanding of the health effects of E-cig use by relating the acute and long-term use of E-cigs and conventional cigarettes (“products”) to well- validated cardiovascular and pulmonary disease biomarkers. We will enroll 4 different “use-groups” of participants (n=440): exclusive E-cig users (n=110), exclusive cigarette smokers (n=110), dual product users (who both smoke and vape: n=110), and never smokers (n=110). These groups reflect the primary decisions that individuals can make regarding their future tobacco use: to continue to smoke cigarettes, to switch to E- cigs, to use both cigarettes and E-cigs, or to not use products. It is essential that smokers and health care providers have accurate information on the health effect of these choices. Product use will be related to well-validated biomarkers that accurately and reproducibly reflect mechanisms, injury, and future risks related to cardiovascular or pulmonary disease. Biomarkers will be related to (1) acute product use in the laboratory (exposure challenges), (2) lifetime history of product use, and/or (3) real-time measures of product use in participants' daily lives. The primary cardiovascular biomarkers are brachial artery flow-mediated dilation (a measure of endothelial function) and carotid intima-media thickness, a measure of subclinical arterial injury and atherosclerosis. The primary pulmonary disease biomarkers will be measures of lung volumes and flow rates (predicted FEV1, FVC, FEV1/FVC) obtained by spirometry. We also will perform treadmill exercise stress testing (to assess aerobic fitness), electrocardiography (to measure heart rate and its variability) and measure blood pressure, lipids, HgbA1c, and inflammation/oxidation markers (leukocyte count, C-reactive protein, urinary F2 isoprostanes) and exhaled nitric oxide. We will show how product use-groups differ in response to (1) acute product use and (2) long-term use regarding cardiovascular and pulmonary biomarkers. We also will determine how history of product use is related to biomarker status. The proposed research will yield vital and comprehensive data regarding product use, subclinical arterial injury, atherosclerosis burden, arterial and pulmonary function, cardiac and aerobic fitness, cardiac autonomic dysregulation, systemic and pulmonary inflammation, and oxidative stress, as well as other key outcomes. These data will serve as a foundation for future longitudinal investigations of E-cig health effects and will inform public policy decisions, clinical interventions, and patient guidance regarding E-cigarettes.