Summary
Introduction:
This text provides an in-depth analysis of the impact of Electronic Nicotine Delivery Systems (ENDS) on systemic circulation and the blood-brain barrier, with implications for cognitive decline. The authors compare the effects of e-cigarettes and combustible tobacco on vascular disease and discuss the role of non-nicotinic components in e-cigarette aerosol and their involvement in vascular disease. The study also explores the impact of nicotine and nicotinic signaling on peripheral immune and endothelial cell populations.
Key Points:
* The study used preclinical evidence to demonstrate electronic nicotine delivery system (ENDS) associated neurovascular impairment.
* Non-nicotinic elements in e-cigarettes exert a proinflammatory effect that is functionally antagonized by the presence of nicotine.
* The prevalence of ENDS use among US high school students has increased significantly, and little is known about their safety and long-term health impact.
* E-cigarettes expose users to more reactive aldehydes than nonusers under normal use conditions.
* The deleterious effects of ROS contribute substantially to smoking-associated vascular disease, and free radicals have been detected in ENDS aerosols using an adduct formation approach.
* The insoluble particulate fraction of cigarette smoke is an impactful harm-associated component of smoke, and exposure to particulate has been linked to hypertension, myocardial infarction, heart failure, and cerebrovascular disease.
* The net emission of particulate is lower in ENDS than in conventional smoke, but the health impact of differing size proļ¬les is unclear.
* Computational models indicate that deposition and absorption of particulate in the lungs of ENDS users may exceed those of cigarette smokers because of the smaller average particulate weight and diameter.
Main Message:
The widespread availability of ENDS has ushered in a new era of youth tobacco use, with increasing concentrations of nicotine and potential health hazards. Despite the trend toward vaporized polysubstance use, the vast majority of products contain nicotine, which may be more addictive or increase the odds of future combustible cigarette use in adolescents. The text highlights the need for further research to provide insight into these long-term health care and public health questions.
Citation
heldt Na, Reichenbach N, McGary hM, Persidsky Y. Effects of Electronic Nicotine Delivery Systems and Cigarettes on Systemic Circulation and Blood-Brain Barrier: Implications for Cognitive Decline. The american journal of pathology. 2021;191(2):243-255. doi:10.1016/j.ajpath.2020.11.007
