Do E-Cigarette Users Airways Have an Altered Lipid Content?

令人信服的新数据表明，电子烟对肺部有毒。事实上，现在已经有700多个 因电子烟使用者急性肺损伤而住院的病例。这种伤害的原因知之甚少， 虽然许多住院的vapers说他们使用了稀释在维生素E油中的THC，但许多人没有。我们 先前从健康的从不吸烟者、吸烟者或电子烟使用者收集的血清、唾液和痰。我们也 进行研究性支气管镜检查并收集支气管肺泡灌洗液（BALF）。从这些样本中， 我们的小组发现了支气管和分泌蛋白质组的独特变化。我们还发现， 导致肺气肿和支气管扩张的肺蛋白酶水平。我们的初步数据显示 吸烟者的巨噬细胞与非吸烟者和吸烟者的巨噬细胞在表型上不同， 更大的M1/促炎表型和基因表达的显著下调。此外，我们的新 数据表明，vapers'巨噬细胞的细胞内空泡数量增加，这可能是由于 通过脂质积累。因为我们在吸烟者的肺部样本中看到了广泛而显著的变化， 他们是“健康的”，我们建议他们是一个理想的生物库数据集，可用于评估程度 其中存在改变的肺脂质含量和充满脂质/泡沫的巨噬细胞。重要的是，由于我们获得了 国家卫生研究院的保密证书，我们也知道任何潜在的药物使用。我们最近开发了一种 检测vapers的BALF和痰中的尼古丁，我们还建议开发我们的分析技术， 检测这些样本中的THC及其代谢物，我们将把肺巨噬细胞/脂质的任何变化 肺部尼古丁和四氢大麻酚含量为实现这些目标，我们提出以下具体目标： 目标1.为了测定BAL、痰液和尿液生物库样本中表面活性蛋白的浓度， 以及非吸烟者吸烟者和电子烟使用者的唾液 目标2.进行脂质组学，用油红O染色肺泡巨噬细胞，以寻找改变的脂质 吸电子烟的巨噬细胞和气道分泌物中的含量 目标3.对来自非吸烟者的BAL、痰液和唾液的生物库样本进行代谢组学分析， 吸烟者和vapers。 这些研究将使用来自CTP资助研究（P50 HL 120100）的生物库肺样本。我们认为这 该提案响应了以下FDA关注的领域：（i）检查各种 烟草产品类型，不包括香烟;（二）检查长期和短期的健康影响 从可燃烟草到不可燃烟草的转变，以及从不可燃烟草到可燃烟草的转变， 使用生物标志物和/或健康结果;（iii）将生物标志物表达谱与自我报告的 烟草制品，并分析与可能告知风险的暴露生物标志物相关的措施 按年龄、性别和种族/民族列出与烟草暴露相关的死亡率/发病率。

Compelling new data suggests that e-cigarettes are toxic to the lungs. Indeed, there have now been over 700 hospitalization cases due to acute lung injury in vapers. The cause(s) of this injury are poorly understood and whilst many hospitalized vapers said that they have used THC diluted in Vitamin E oil, many did not. We previously collected serum, saliva and sputum from healthy never-smokers, tobacco smokers or vapers. We also performed research bronchoscopies and collected bronchoalveolar lavage fluid (BALF). From these samples, our group found unique changes to the bronchial and secreted proteomes. We also found that vaping increased levels of lung proteases that are known to cause emphysema and bronchiectasis. Our preliminary data indicate that vapers’ macrophages are phenotypically different to non-smokers’ and smokers’ macrophages, have a greater M1/pro-inflammatory phenotype and significant downregulation of gene expression. Moreover, our new data indicate that vapers’ macrophages have increased numbers of intracellular vacuoles, which may be caused by lipid accumulation. Since we see extensive and significant changes in the vaper’s lung samples, even though they are “healthy”, we propose that they are an ideal biobanked data set that can be used to assess the extent to which altered lung lipid content and lipid-laden/foamy macrophages exist. Importantly, since we obtained an NIH certificate of confidentiality, we also know about any potential drug use. We have recently developed assays to detect nicotine in vapers’ BALF and sputum and we also propose to develop our analytic techniques in order to detect THC and its metabolites in these samples, and we will correlate any changes in lung macrophages/lipids with lung nicotine and THC levels. To achieve these goals, we propose the following specific aims: Aim 1. To determine the concentrations of surfactant proteins in biobanked samples of BAL, sputum and saliva from non-smokers, smokers and vapers. Aim 2. To perform lipidomics and stain alveolar macrophages with Oil Red O to look for altered lipid content in vaper’s macrophages and airway secretions. Aim 3. To perform metabolomics on biobanked samples of BAL, sputum and saliva from non-smokers, smokers and vapers. These studies will use biobanked lung samples from a CTP-funded study (P50 HL120100). We believe that this proposal is responsive to the following FDA areas of interest: (i)Examine health outcomes from various tobacco product types, not to include cigarettes; (ii) Examine the long- and short-term health effects of transitioning from combustible to non-combustible tobacco, and from non-combustible to combustible tobacco, using biomarker and/or health outcomes; (iii) Compare biomarker expression profiles with self-reported use of tobacco products, and analyze measures associated with biomarkers of exposure that may inform risk associated with tobacco exposure for mortality/morbidity by age, sex, and race/ethnicity.