Flavored and Nicotine-Containing E-Cigarettes Induce Impaired angiogenesis and Diabetic Wound healing via Increased Endothelial Oxidative Stress and Reduced NO Bioavailability.

Introduction:
This text discusses a study examining the impact of flavored and nicotine-containing e-cigarettes on endothelial dysfunction, oxidative stress, nitric oxide (NO) depletion, apoptosis, angiogenesis, and diabetic wound healing. The study found that these e-cigarettes induce endothelial dysfunction through excessive production of ROS, leading to decreased NO bioavailability, increased endothelial cell apoptosis, and impaired angiogenesis and wound healing, particularly under diabetic conditions. These findings suggest that rigorous regulation of e-cigarette use is necessary, especially for diabetic and surgical patients, to prevent severe consequences from impaired angiogenesis and wound healing.

Key Points:

* The study used e-cigarettes from two major vendors, including nicotine-containing e-cigarettes with varying nicotine concentrations and flavored e-cigarettes.
* E-cigarette smoke extract (e-CSE) was prepared and added to endothelial cell culture media at a final concentration of 10%.
* Endothelial cell superoxide production, determined by dihydroethidium (DhE) fluorescent imaging and electron spin resonance (ESR), was significantly increased by exposure to e-CSE in a nicotine-content dependent manner.
* Flavored e-cigarettes also showed significant effects in increasing superoxide production while diminishing NO bioavailability.
* Endothelial cell apoptosis, assessed by caspase 3 activity, was markedly increased by exposure to e-CSE prepared from flavored and nicotine-containing e-cigarettes.
* Endothelial monolayer wound assays revealed that nicotine-containing and flavored e-cigarettes induced impaired angiogenic wound repair of endothelial cell monolayers.
* Vascular endothelial growth factor (VEGF) stimulated wound healing in diabetic mice was impaired by exposure to e-CSEs prepared from nicotine-containing and flavored e-cigarettes.

Main Message:
The study provides evidence that flavored and nicotine-containing e-cigarettes induce endothelial dysfunction, which can lead to impaired angiogenesis and wound healing, particularly under diabetic conditions. The findings suggest that regulatory measures should be implemented to protect vulnerable populations, such as diabetic and surgical patients, from the harmful effects of e-cigarettes. It is crucial to inform the public about the potential risks associated with e-cigarette use and the need for stricter regulations to ensure public safety.

Liu Z, Zhang Y, Youn JY, et al. Flavored and Nicotine-Containing E-Cigarettes Induce Impaired angiogenesis and Diabetic Wound healing via Increased Endothelial Oxidative Stress and Reduced NO Bioavailability. antioxidants (Basel, Switzerland). 2022;11(5). doi:10.3390/antiox11050904