Microbial Toxins in Nicotine Vaping Liquids.

Introduction:
This text consists of three separate letters related to recent research on lung function and respiratory health. The first letter discusses the impact of hIV infection and antiretroviral therapy on lung function decline. The second letter investigates the potential role of microbial toxins in vaping-induced lung injuries. The third letter highlights the importance of multidisciplinary authorship in clinical practice guidelines.

Key Points:

1. The first letter reports that smoking significantly worsens lung function decline in early hIV infection, but the choice of initial antiretroviral therapy does not affect subsequent decline.
2. The study included young participants with recent hIV diagnoses, limiting generalizability to older individuals and those with longer hIV duration.
3. The second letter explores the possibility of microbial toxins as a cause of the 2019 vaping-induced lung illness outbreak, focusing on JUUL pod products.
4. Researchers found that JUUL pod products, particularly tobacco and menthol flavors, were contaminated with microbial toxins, such as endotoxin and (1→3)-b-D-glucan.
5. The third letter emphasizes the significance of multidisciplinary authorship in clinical practice guidelines, ensuring diverse perspectives and expertise.
6. The authors of the third letter used the american Thoracic Society's CaP management guidelines as an example, highlighting the underrepresentation of non-physician professionals.
7. The letter suggests that multidisciplinary authorship can enhance the quality and applicability of clinical practice guidelines.

Main Message:
These letters collectively contribute to our understanding of lung health, addressing various factors affecting lung function, such as hIV infection, smoking, and vaping. They also highlight the importance of multidisciplinary collaboration in research and clinical practice guideline development, ensuring comprehensive and inclusive perspectives for improved patient care.

Lee MS, Christiani DC. Microbial Toxins in Nicotine Vaping Liquids. american journal of respiratory and critical care medicine. 2020;201(6):741-743. doi:10.1164/rccm.201911-2178LE