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February 26, 2020
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Vaping alters oral microbiome, leading to increased infection risk

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Vaping changes the microbiome of the mouth, making those who vape more prone to infections and inflammation, according to research published in iScience.

“Our study suggests that vaping electronic cigarettes causes shifts in the oral environment and highly influences the colonization of complex microbial biofilms, which raises the risk for oral inflammation and infection,” Deepak Saxena, PhD, professor of basic science and craniofacial biology at the College of Dentistry at New York University, said in a press release.

The study authors explained that the mouth is a “gateway” for many microbial species to colonize the respiratory and gastrointestinal tract, and that oral microbial imbalances have been shown to contribute to oral diseases like periodontitis and halitosis, and even other medical conditions like diabetes, CVD and cancer.

Saxena and colleagues also explained that cigarette smoking has previously been shown to increase the risk for infection through tobacco-induced physiological and structural changes along with increases in bacterial virulence and immune dysfunction.

Reference: Pushalkar S, et al. iScience. 2020;doi:10.1016/j.isci.2020.100884.

To determine the effects of e-cigarette vapor on the mouth’s microbiome and immune health, the researchers conducted oral exams and collected saliva samples from 119 participants. Of those, 40 were e-cigarette smokers, 40 were regular cigarette smokers and 39 were nonsmokers.

The researchers also measured proinflammatory immune mediators and used a novel e-cigarette aerosol generating machine to determine how vaping affects the effectiveness of oral pathogens in cell lines.

They found that the prevalence of severe periodontal status was highest among cigarette smokers, at 72.5%, followed by e-cigarette users at 42.5% and never smokers at 28.2%.

Using a technique to profile microbial communities in participants’ saliva, Saxena and colleagues identified different microorganisms among e-cigarette users, cigarette smokers and nonsmokers. They found that the salivary taxa Porphyromonas was higher in e-cigarette users, and Veillonella was increased among both e-cigarette users and cigarette smokers. They explained that those periodontal pathogens reflect “severely compromised periodontal health” in both e-cigarette users and cigarette smokers.

In addition, the researchers found that the microbiome of e-cigarette users affected the local host immune environment. Cytokines involved in inflammatory responses, IL-6 and IL-1-beta, were much higher in e-cigarette users, although not significantly compared with nonsmokers and cigarette smokers.

In cell studies, exposure to e-cigarette aerosol led to upregulation of IL-6, causing an increased inflammatory response, according to the researchers. In addition, the increased IL-6 expression after exposure to Porphyromonas gingivalis, Fusobacterium nucleatum, and Escherichia coli observed by researchers suggests that e-cigarette users are more susceptible to infection.

“Given the popularity of vaping, it is critical that we learn more about the effects of e-cigarette aerosols on the oral microbiome and host inflammatory responses in order to better understand the impact of vaping on human health,” Xin Li, PhD, an associate professor of basic science and craniofacial biology at the College of Dentistry at New York University, said in a press release. – by Erin Michael

Disclosures: The authors report no relevant financial disclosures.