RT Journal Article SR Electronic T1 Non-Invasive Systemic Biomarker of E-cigarette or Vaping use-Associated Lung Injury (EVALI): A pilot study JF ERJ Open Research JO erjor FD European Respiratory Society SP 00639-2021 DO 10.1183/23120541.00639-2021 A1 Stephanie Podguski A1 Gagandeep Kaur A1 Thivanka Muthumalage A1 Matthew D. McGraw A1 Irfan Rahman YR 2022 UL http://openres.ersjournals.com/content/early/2022/01/20/23120541.00639-2021.abstract AB Background Electronic cigarettes (e-cig) vaping, containing nicotine and/or Δ8, Δ9 or Δ10 or Δo tetrahydrocannabinol (Δn−THC) are associated with an outbreak of e-cig, or vaping product use, associated lung injury (EVALI). Despite thousands hospitalised with EVALI, much remains unknown about diagnosis, treatment and disease pathogenesis. Biomarkers of inflammation, oxidative stress, and lipid mediators may help identify e-cig users with EVALI.Methods We collected plasma and urine along with demographic and vaping-related data of EVALI subjects (ages: 18–35 years) and non-users matched for sex and age in a pilot study. Biomarkers were assessed by ELISA/EIA and Luminex-based assays.Results Elevated levels of THC metabolite (11-nor-9-carboxy-THC) were found in plasma from EVALI subjects compared to non-users. Levels of 8-hydroxy-2′-deoxyguanosine (8-OHdG), an oxidative DNA damage biomarker, and 8-isoprostane, an oxidative stress marker, were slightly increased in urine samples from EVALI subjects compared to non-users. Conversely, plasma levels of lipid mediators, including Resolvin D1 (RvD1) and Prostaglandin E2 (PGE2), were significantly lower in EVALI subjects compared to non-users. Both pro-inflammatory biomarkers, such as TNF-α, MIP-1β, RANTES, and GM-CSF, as well as anti-inflammatory biomarkers, such as IL-9 and CC10/16, were decreased in plasma from EVALI subjects compared to non-users, supportive of a possible dysregulated inflammatory response in EVALI subjects.Conclusions Significant elevations in urine and plasma biomarkers of oxidative stress, as well as reductions in lipid mediators, were shown in EVALI subjects. These non-invasive biomarkers of 8-OHdG, 8-isoprostane, RvD1, and CC10/16, either individually or collectively, may serve as biomarkers in diagnosing future EVALI subjects.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: Dr. Podguski has nothing to disclose.Conflict of interest: Dr. Kaur has nothing to disclose.Conflict of interest: Dr. Muthumalage has nothing to disclose.Conflict of interest: Dr. McGraw reports a grant from NIH/NHLBI, outside the submitted work. Dr. McGraw reports grants from NIH/NHLBI, outside the submitted work;.Conflict of interest: Dr. Rahman has nothing to disclose.