Cardiac Toxicity of Flavorings in Electronic Nicotine Delivery Systems

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CARDIAC TOXICITY OF FLAVORINGS IN ELECTRONIC NICOTINE DELIVERY SYSTEMS Tobacco cigarette smoking is on the decline, but the usage of electronic nicotine delivery systems (ENDS) is gaining popularity, specifically in the teen and young adult age groups. While the cardiac toxicity of tobacco cigarette smoking has been widely studied and is well established, the possible cardiac toxicity of ENDS products and their design characteristics, such as added flavorings, are largely underexplored. For instance, a form of electronic nicotine delivery known as vaping, uses “e-liquid” in order to generate “e-vapor”, an inhalable smoke-like aerosolized mixture containing nicotine and flavors. Here, we propose to investigate how e-liquids with different flavors affect cardiac in-vitro and in-vivo toxicity, in cell culture and in animal models. Our hypothesis is that inhalation exposure to e-liquid flavorings increases cardiac oxidative stress, leading to electrophysiological toxicity and arrhythmogenesis. We will conduct our studies in three aims: 1)- To investigate the in-vitro cardiac harm and toxicity of e-liquid flavorings, 2)- To investigate the in-vivo cardiac harm and toxicity of e-liquid flavorings, and 3)- To investigate the role of oxidative stress in mediating the cardiac toxicity of e-liquid flavorings. We believe that this proposal will produce new, useful and focused insights into the potential in-vivo and in-vitro adverse effects of e-liquid flavorings using functional and cellular indicators of cardiac harm. Our findings will hopefully be valuable in increasing our understanding of whether the flavoring aspect of ENDS products design could cause cardiac in- vivo and in- vitro toxicities.