e-CIGARETTE: Inflammation of the lungs, inflammation of the colon?

E-cigarettes based on pods or cartridges have only become popular over the past 5 years, so “their long-term health effects are still poorly understood,” says Dr Laura Crotty Alexander, Associate Professor of Medicine. at UC San Diego and Chief of Pulmonary Critical Care. Thus, most of the research conducted to date has focused on short-term usage times, older devices, or nicotine concentrations in e-liquids, significantly lower than those of modern refillable pod-based systems. This new study shows, precisely, that the daily use of electronic cigarettes (Juul) thus modifies the inflammatory state of several organ systems, suggesting that this use could influence the susceptibility to certain infections including SARS-CoV-2 infection. .

The inflammatory effect is most marked in the brain

The study: the team therefore focused on the most popular electronic cigarette brand, Juul, and its most popular flavors: mint and mango. The researchers “modeled” its use in young adult mice exposed to flavored aerosols 3 times a day for 3 months. Then the researchers assessed the various effects including signs of inflammation throughout the body. This analysis reveals:

  • strongest effects in the brain, where several inflammatory markers are found to be higher;
  • changes in the expression of neuroinflammatory genes in the nucleus accumbens, a brain region critical for motivation and reward processing; worrying findings as neuroinflammation in this region is linked to anxiety, depression and addictive behaviors;
  • an increase in the expression of inflammatory genes also in the colon, in particular after 1 month of exposure to electronic cigarettes: an observation which also suggests an increased risk of gastrointestinal disease;
  • a -surprising- decrease in the levels of inflammatory markers in the heart, analyzed as a state of immunosuppression by the authors with a possible increased vulnerability of the heart tissue to infections;
  • if the lungs do not show particular signs of inflammation at the level of the tissues, many changes in gene expression are observed in the biopsies, which justify additional research;
  • the inflammatory response of each organ varies depending on the flavor used. Thus, the hearts of mice who inhaled mint aerosols become much more susceptible to the effects of bacterial pneumonia than those who inhaled mango aerosols.
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Chemical aromas also in question: the study shows all the complexity of analyzing the effects of electronic cigarettes, due to low but long-term exposure levels, the wide variety of devices on the market, but also e-liquids and flavors. Because the choice of aroma also determines part of the pathological changes.

What about COVID? Researchers address this clinical case: Frequent use of menthol-flavored e-cigarettes in the event of COVID-19 could induce a very different response to infection, because in each individual, the immune environment of each organ has its own setting.

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