Early atherogenic signals identified in young smokers and e-cigarette users
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Key takeaways:
- Young tobacco cigarette smokers showed early signals of atherosclerotic cardiovascular disease compared with nonusers.
- Similar signs were observed among people who vape, although to a lesser extent.
Researchers identified early signals of atherosclerosis in blood samples from young people who smoke tobacco cigarettes or vape, though to a lesser extent among the latter.
Proatherosclerotic signals — monocyte transendothelial migration and monocyte-derived foam cell formation — were elevated among tobacco smokers and those who switched to e-cigarettes compared with those who only ever used e-cigarettes or were nonusers of either, according to a small cross-sectional study published in Arteriosclerosis, Thrombosis and Vascular Biology.
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“There is a large body of data informing our mechanistic understanding of atherosclerosis, a slowly progressive, inflammatory process in which circulating monocytes attach to endothelial cells, then migrate into the subintimal space, where they phagocytize oxidized lipids and become foam cells, generating the fatty streak,” Theodoros Kelesidis, MD, PhD, associate professor of medicine at the University of California Los Angeles, and colleagues wrote. “The role of tobacco cigarettes in increasing oxidative stress and inflammation, thereby accelerating this process, is widely accepted. Whether [e-cigarettes], too, promote this process of monocyte transendothelial migration and foam cell formation is unknown.”
For the present study, Kelesidis and colleagues utilized an in vitro model of early atherosclerotic events to quantify monocyte transendothelial migration and foam cell formation using blood samples from tobacco cigarette smokers and compared proatherogenic changes with those observed among otherwise healthy e-cigarette users and nonusers.
The primary outcomes were monocyte transendothelial migration — defined as proportion of blood monocyte cells that undergo transendothelial migration through a collagen gel — and monocyte-derived foam cell formation.
Foam cell formation was measured using flow cytometry and median fluorescence intensity using Bodipy dye.
A total of 60 participants were included (median age, 24 years; 31 women).
Among people who exclusively used tobacco cigarettes, the researchers reported a 110% mean increase in proatherogenic monocyte transendothelial migration (P < .001). They reported a 40% mean increase among people who exclusively vaped e-cigarettes (P < .01) compared with nonusers.
Similarly, a 100% mean increase in proatherogenic monocyte-derived foam cell formation was also observed among tobacco cigarette users (P < .001) and a 50% mean increase was observed among people who vape (P < .001) compared with nonusers.
Moreover, monocyte transendothelial migration and monocyte-derived foam cell formation was higher among tobacco cigarette smokers compared with e-cigarette users with or without a history of tobacco smoking (P for all < .05), according to the study.
“To our knowledge, this is among the first studies in humans to confirm early alterations in proatherogenic properties of blood monocytes and plasma collected from otherwise healthy young people who smoke [tobacco cigarettes] compared with people who do not use tobacco products,” the researchers wrote. “Although all [e-cigarette] users who were former smokers had quit smoking > 1 year before study enrollment, both proatherogenic processes were significantly greater in current [e-cigarette] users who were former smokers compared with [e-cigarette] users who were never smokers, consistent with a residual effect of prior [tobacco cigarette] smoking.”
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