Current E-Cigarette Research in the Context of Asthma
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ALLERGIES AND THE ENVIRONMENT (T MORAN, SECTION EDITOR)
Current E-Cigarette Research in the Context of Asthma Elise Hickman 1,2 & Ilona Jaspers 1,2,3
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review The purpose of this review is to integrate recent research on the respiratory immune effects of e-cigarettes with the pathogenesis of asthma to better understand how e-cigarettes may affect asthmatics and to note critical knowledge gaps regarding the effects of e-cigarettes on asthmatics. Recent Findings Human, rodent, and cell culture studies show that key cellular functions of epithelial cells, macrophages, and neutrophils are altered by e-cigarette exposure. Summary Because respiratory immunity is already dysregulated in asthma, further alteration of cellular function by e-cigarettes could impact asthma development, severity, and/or exacerbations. Future research is needed to more directly investigate this relationship using controlled human exposure studies and exposure of cell culture or animal models of asthma to e-cigarettes. Keywords E-cigarettes . Vaping . Environmental exposure . Asthma . Immune
Introduction Approximately 7 million adults and more than 5 million youth are current electronic cigarette, or e-cigarette, users [1–3]. These devices were introduced in the U.S. in 2007 and have since gained popularity both among those trying to quit smoking and never-smokers, particularly teenagers and young adults. E-cigarettes have been touted as smoking cessation devices, but their efficacy for this purpose is still debated [4, 5]. In recent years, there has been a spike in youth use of ecigarettes, with 27.5% of high schoolers in the U.S. reporting current e-cigarette use [6], reversing the previous decline in youth tobacco use. The rapid evolution and adoption of ecigarette devices (Fig. 1), the diversity of e-liquids, and the individual variation in e-cigarette use patterns have made e-
This article is part of the Topical Collection on Allergies and the Environment * Ilona Jaspers [email protected] 1
Curriculum in Toxicology & Environmental Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
2
Center for Environmental Medicine, Asthma, and Lung Biology, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
3
Department of Pediatrics, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
cigarette research challenging, and many questions remain regarding the respiratory effects of e-cigarettes. E-cigarettes heat and aerosolize e-liquids containing flavoring chemicals and nicotine dissolved in humectants propylene glycol (PG) and vegetable glycerin (VG). The composition of e-cigarette aerosol is highly dependent on e-liquid composition, device type, wattage, and coil resistance. Higher power aerosolization generates more aerosol and results in more thermal decomposition of the e-liquid [7–9]. Lower resistance aerosolization is associated with an increase in carbonyl generation, though even
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