Vaping simulation kills lung macrophages, inhibits phagocytosis

  • Scott A & al.
  • Thorax
  • 13 Aug 2018

  • curated by Jenny Blair, MD
  • Clinical Essentials
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Takeaway

  • Exposure to e-cigarette vapor condensate (ECVC) leads to dose-dependent cell death, inflammatory response, inhibited phagocytosis in alveolar macrophages (AMs). 
  • Vaping and nicotine contributed independently to harm.
  • Authors: “We caution against the widely held opinion that e-cigarettes are safe.”

Why this matters

  • Though touted as a smoking-cessation aid, vaping's long-term safety is unclear.
  • Many studies assess nonvaporized e-cigarette liquid (ECL), but vaping process alters composition.
  • Authors devised a way to generate and study ECVC. 

Key results

  • Viabilities of AMs exposed to ECVC and unvaped ECL, vs untreated controls (UTCs): 
    • ECVC 0.8% volume/volume (v/v): 18.2% viable (interquartile range [IQR], 15.7%-19.5%; P<.001 nicotine-free ecvc viable p>
    • ECL 2.5% v/v: 78.8% viable; nicotine-free ECL, 84.6% viable;
    • All effects were dose-dependent.
  • Compared with UTCs, AMs subject to ECVC exposure also:
    • Increased apoptosis, necrosis;
    • Increased multiplied reactive oxygen species release 50-fold;
    • Increased IL-6, TNF-α, matrix metalloprotease 9;
    • Reduced phagocytosis by 30%.

Study design

  • Researchers assessed viability of AMs from never-smokers after 24-hour exposure to regular, nicotine-free ECVC and regular, nicotine-free ECL.
  • ECVC simulates vaped ECL.
  • Funding: Medical Research Council (UK); British Lung Foundation. 

Limitations

  • In vitro study reflecting acute exposure only.
  • Flavors not assessed.
  • Real-life nicotine dosage during vaping varies widely. 

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