E-cigs can trigger same lung changes seen in smokers, emphysema

barbara

Pioneer Founding member
Science Daily
Date: August 22, 2019
Source: University of North Carolina Health Care
Summary: Scientists found that the lungs of vapers -- like the lungs of smokers -- have elevated levels of protease enzymes, a condition known to cause emphysema in smokers. The researchers also found that the nicotine in vaping liquids is responsible for the increase in protease enzymes.

E-cigarette "vaping" is widely assumed to be safer than cigarette smoking, but scientists at the University of North Carolina School of Medicine have uncovered evidence suggesting that vaping promotes the same cellular responses found in smokers who suffer with emphysema.

In a study published in the American Journal of Respiratory and Critical Care Medicine, the UNC scientists found that the lungs of vapers -- like the lungs of smokers -- have elevated levels of protease enzymes, a condition known to cause emphysema in smokers. The researchers also found that the nicotine in vaping liquids is responsible for the increase in protease enzymes.

"Our findings in this study indicate that vaping may not be safer than cigarette smoking," said study senior author Robert Tarran, PhD, a professor in the department of cell biology and physiology and member of the Marsico Lung Institute at the UNC School of Medicine.

The U.S. Centers for Disease Control and Prevention (CDC) has estimated that in 2014 about 9 million adults in the country were regular vapers and that close to 30 million had tried vaping at least once. But vaping on this scale has been going on for less than a decade, and so the long-term health effects of vaping are not yet well understood.

Tarran and colleagues in the study measured levels of three key protease enzymes in lung fluid sampled from 41 subjects -- nonsmokers, smokers, and vapers. The three protease enzymes are neutrophil elastase and matrix metalloproteases 2 and 9. Immune cells in the lungs are known to secrete these enzymes at higher levels in a reaction to cigarette smoke. Chronic over activity of these protein-chewing enzymes damages the tiny sensitive air sac structures in the lungs that allow people to breathe. In smokers, this damage is thought to be the cause of emphysema, a form of chronic obstructive pulmonary disease (COPD) involving progressive shortness of breath and for which there is no cure.

The UNC scientists found that the levels of these three proteases were significantly elevated in both smokers and vapers, but not in nonsmokers. This finding suggests vaping, like smoking, may promote emphysema.

The scientists also found evidence that nicotine in vaping liquids is the cause of the elevated-protease reaction. When Tarran's team administered nicotine to immune cells cultured in the laboratory -- at concentrations like those seen in vapers sputum and lung fluid -- they observed that the cells overproduced the proteases. And this overproduction increased when the researchers exposed the immune cells to higher nicotine levels.

Vaping is thought to be much safer than cigarette smoking, which involves the high-temperature burning of tobacco leaves and the creation of toxic and carcinogenic combustion products. Some researchers have urged that smokers switch to vaping as a much less harmful alternative. The jury is still very much out when it comes to cancer risk associated with vaping. But this latest study suggests that the potential harm of vaping may have been underestimated, especially when it comes to emphysema and COPD, two of the most common debilitating conditions historically associated with smoking.

Tarran noted that the findings are not the first to warn of vaping's potential adverse health effects. A different study in 2018, from a team led by UNC Marsico Lung Institute researcher Mehmet Kesimer, PhD, found that sputum from vapers and smokers contained elevated levels of emphysema-promoting proteases and other immune defense proteins.

Moreover, a study from Tarran's lab last year found evidence of toxic compounds in commonly used vaping liquids, and the CDC currently is investigating about 100 recent cases in the U.S. of sudden, serious lung disease in otherwise healthy young vapers.

Tarran and his colleagues plan to follow up their new study with a larger study of lung protease levels in hundreds of participants.

Story Source:

Materials provided by University of North Carolina Health Care. Note: Content may be edited for style and length.

Journal Reference:

Arunava Ghosh, Raymond D Coakley, Andrew J. Ghio, Marianne S Muhlebach, Charles R Esther Jr, Neil E. Alexis, Robert Tarran. Chronic E-Cigarette Use Increases Neutrophil Elastase and Matrix Metalloprotease Levels in the Lung. American Journal of Respiratory and Critical Care Medicine, 2019; DOI: 10.1164/rccm.201903-0615OC
 

barbara

Pioneer Founding member
And then there's this from Reason.com
8-23-19

That 'Vaping-Linked Lung Disease' Might Not Really Be Linked to Vaping

There's a bit of panic brewing in the press over lung problems that could be linked to vape products. The Centers for Disease Control and Prevention (CDC) "reports more than 150 cases of possible vaping-linked lung disease," says The Hill. Others make even bolder claims.

"More than 100 vapers have contracted a severe lung disease," The Verge reports. "Vaping lung disease: CDC reports 153 cases," says USA Today. Ars Technica warns that "vaping-linked lung disease cases" have jumped "from 94 to 153 in 5 days."

But read closely, and it becomes apparent that nobody actually knows if vaping is causing this mystery disease or not. Nobody even knows if there is a disease, or how many people actually have it. That's what the CDC is at the beginning of investigating.

For now, all officials know is that states keep reporting people with cases of mysterious lung and chest problems. "Many states have alerted CDC to possible (not confirmed) cases and investigations into these cases are ongoing," says the CDC. Symptoms include shortness of breath, chest pain, and coughing—all common issues that can stem from a range of causes and ailments.

"The CDC and impacted states haven't identified a cause," notes The Verge. Nor has it actually verified suspected cases.

Those reporting the problems all say they have used vape products—albeit not what sort. Which leaves us with another possibility: that some particular faulty product or line of products is indeed causing trouble, but that this is not an issue with vaping at large.

We know that some patients in potential cases used THC-containing vape products, not nicotine-containing e-cigarettes. The Vapor Technology Association told The Hill that no nicotine e-cigarettes have been linked to the lung issues:

The e-cigarette makers' trade group called for public health officials to "refrain from assigning unsubstantiated blame until the facts are known," and said traditional nicotine-containing e-cigarettes are being wrongly conflated with THC-containing products.

In actuality, we don't know at all what folks with many of the suspected cases were smoking, nor what other habits they may have shared, such as any history of regular cigarette or marijuana smoking. We don't—and this is pretty damn crucial—even know if all of these patients suffer from the same affliction at all.

The fact that cases have spiked dramatically in the brief time since news of this "vaping lung disease" started spreading suggests we may have a different sort of contagion on our hands. Perhaps people who vape have been starting to freak out upon hearing the "lung disease" news and either suddenly noticed new symptoms (which also sound a lot like symptoms of a panic attack) or began interpreting ongoing symptoms in a new way.

Or maybe vaping is going to kill us! That's certainly possible. The point is that right now, anything is possible. And until we know more, it's irresponsible for folks to spread panic about products that have been helping many people leave more dangerous habits behind.
 
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