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Systemic biomarkers in electronic cigarette users: implications for noninvasive assessment of vaping-associated pulmonary injuries

Kameshwar P. Singh, Gina Lawyer, Thivanka Muthumalage, Krishna P. Maremanda, Naushad Ahmad Khan, Samantha R. McDonough, Dongxia Ye, Scott McIntosh, Irfan Rahman
ERJ Open Research 2019 5: 00182-2019; DOI: 10.1183/23120541.00182-2019
Kameshwar P. Singh
1Dept of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA
3These authors contributed equally to this work
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Gina Lawyer
1Dept of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA
3These authors contributed equally to this work
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Thivanka Muthumalage
1Dept of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA
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Krishna P. Maremanda
1Dept of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA
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Naushad Ahmad Khan
1Dept of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA
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Samantha R. McDonough
1Dept of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA
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Dongxia Ye
1Dept of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA
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Scott McIntosh
2Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
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Irfan Rahman
1Dept of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA
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  • For correspondence: irfan_rahman@urmc.rochester.edu
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  • FIGURE 1
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    FIGURE 1

    Plasma biomarkers of systemic inflammation, anti-inflammatory, vascular and lipid mediators, and extracellular matrix breakdown in normal subjects and e-cigarette (e-cig) users. IL: interleukin; GM-CSF: granulocyte−macrophage colony-stimulating factor; MMP: matrix metalloproteinase; MCP: monocyte chemoattractant protein; MIP: macrophage inflammatory protein; TNF: tumour necrosis factor; IFN: interferon; CRP: C-reactive protein; PAI: plasminogen activator inhibitor; ICAM: intracellular adhesion molecule. Data are presented as mean±sem (n=4–20). *: p<0.05; **: p<0.01; ***: p<0.001.

  • FIGURE 2
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    FIGURE 2

    Plasma biomarkers of oxidative stress in normal subjects and e-cigarette (e-cig) users. Data are presented as mean±sem (n=15–20). *: p<0.05; **: p<0.01.

  • FIGURE 3
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    FIGURE 3

    Plasma growth factors in normal subjects and e-cigarette (e-cig) users. BDNF: brain-derived neurotrophic factor; EGF: endothelial growth factor; VEGF: vascular endothelial growth factor; HGF: hepatocyte growth factor; BMP: bone morphogenetic protein; PIGF: placental growth factor; NGF: nerve growth factor; PDGF: platelet-derived growth factor; SCF: stem cell factor; TGF: transforming growth factor; bFGF: basic fibroblast growth factor. Data are presented as mean±sem (n=10–21). *: p<0.05; **: p<0.01.

  • FIGURE 4
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    FIGURE 4

    a) Urinary, b) salivary and c) exhaled breath condensate biomarkers of systemic inflammation, vascular mediators, oxidative stress, tissue injury repair, oxidative DNA damage, extracellular matrix breakdown and triglycerides in normal subjects and e-cigarette (e-cig) users. MCP: monocyte chemoattractant protein; MIP: macrophage inflammatory protein; IL: interleukin; GM-CSF: granulocyte−macrophage colony-stimulating factor; IFN: interferon; MMP: matrix metalloproteinase; PAI: plasminogen activator inhibitor. Data are presented as mean±sem (n=5–23). *: p<0.05.

Tables

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  • TABLE 1

    Baseline demographic, anthropometric and spirometry characteristics of study participants: normal subjects and electronic cigarette (e-cig) users

    Normal subjects#E-cig users#
    Subjects2622
    Age years
     Overall33.88±14.0735.54±12.21
     Male37.27±14.2232.00±14.50
     Female31.40±13.9138.50±9.58
    Sex
     Male11 (42.3)10 (45.5)
     Female15 (57.7)12 (54.5)
    BMI kg·m−224.86±5.0627.39±5.39
    Ethnicity
     White18 (69.2)11 (50.0)
     African-American3 (11.5)6 (27.3)
     Asian4 (15.4)3 (13.6)
     Hispanic1 (3.9)2 (9.1)
    E-cig vaping status
     Vaping duration years2.00±1.64
     Vaping frequency day−17.75±3.14
     Vaping session min8.79±5.50
    Lung function variables
     FEV1 % pred98.08±12.7291.22±10.46
     FVC %99.17±11.6995.72±13.20
     FEV1/FVC %99.26±6.1295.50±8.98
     PEF % pred84.56±18.4876.90±19.82

    Data are presented as n, mean±sd or n (%). BMI: body mass index; FEV1: forced expiratory volume in 1 s; FVC: forced vital capacity; PEF: peak expiratory flow. #: not all biological samples collected from normal subjects and e-cig users were used for each biomarker analysis.

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    Systemic biomarkers in electronic cigarette users: implications for noninvasive assessment of vaping-associated pulmonary injuries
    Kameshwar P. Singh, Gina Lawyer, Thivanka Muthumalage, Krishna P. Maremanda, Naushad Ahmad Khan, Samantha R. McDonough, Dongxia Ye, Scott McIntosh, Irfan Rahman
    ERJ Open Research Oct 2019, 5 (4) 00182-2019; DOI: 10.1183/23120541.00182-2019

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    Systemic biomarkers in electronic cigarette users: implications for noninvasive assessment of vaping-associated pulmonary injuries
    Kameshwar P. Singh, Gina Lawyer, Thivanka Muthumalage, Krishna P. Maremanda, Naushad Ahmad Khan, Samantha R. McDonough, Dongxia Ye, Scott McIntosh, Irfan Rahman
    ERJ Open Research Oct 2019, 5 (4) 00182-2019; DOI: 10.1183/23120541.00182-2019
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