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Flavored tobacco products confer endothelial dysfunction
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An endothelial cell phenotype related to CV toxicity was adversely affected by short-term exposure to flavoring compounds used in electronic cigarettes and related tobacco products, according to a study published in Arteriosclerosis, Thrombosis, and Vascular Biology.
“Increased inflammation and a loss of nitric oxide are some of the first changes to occur leading up to cardiovascular disease and events like heart attacks and stroke, so they are considered early predictors of heart disease,” Jessica L. Fetterman, PhD, assistant professor of medicine at Boston University School of Medicine, said in a press release. “Our findings suggest that these flavoring additives may have serious health consequences.”
Researchers assessed endothelial cells from nine participants who were nonsmokers (mean age, 29 years; five women), six who were nonmenthol cigarette smokers (mean age, 40 years; two women) and six participants who smoked menthol cigarettes (mean age, 39 years, two women).
Commercially available human aortic endothelial cells also were evaluated for the effects of flavoring compounds on endothelial cell phenotype. The cells were incubated with menthol, vanillin, eugenol, cinnamaldehyde, diacetyl, 2,5-dimethylpyrazine, eucalyptol, isoamyl acetate and proinflammatory marker interleukin-6 for 90 minutes.
Flavored tobacco products confer endothelial dysfunction
Researchers also measured reactive oxygen species production, cell death, nitric oxide production and interleukin-6.
Compared with cells from participants who did not smoke, those who smoked nonmenthol or menthol cigarettes had impaired A23187-stimulated nitric oxide production. Cells from participants who did not smoke had decreased A23187-stimulated nitric oxide production when they were treated with 0.01 mmol/L of eugenol or 0.01 mmol/L of menthol.
Reactive oxygen species production and cell death were activated at high concentration, which were unlikely to be achieved in vivo. Inflammation and impaired A23187-stimulated nitric oxide production, which is consistent with endothelial dysfunction, was induced with lower concentrations of selected flavors, including menthol, vanillin, eugenol, cinnamaldehyde and acetylpyridine.
“The toxicity data generated herein, using a variety of common flavorings, provide quantitative support for the regulatory prohibition or the establishment of limitations on allowable levels of these flavorings in electronic liquids and other tobacco products,” Fetterman and colleagues wrote. “Future studies will focus on how the toxicity of the flavorings is altered with heating and characterization of the levels obtained in the circulation after use of an e-cigarette.” – by Darlene Dobkowski
Disclosures: The authors report no relevant financial disclosures.
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