| 1. |
- Antoniewicz, Lukasz, et al.
(författare)
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Acute Effects of Electronic Cigarette Inhalation on the Vasculature and the Conducting Airways
- 2019
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Ingår i: Cardiovascular Toxicology. - : Springer. - 1530-7905 .- 1559-0259. ; 19:5, s. 441-450
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Tidskriftsartikel (refereegranskat)abstract
- The use of electronic cigarettes has increased exponentially since its introduction onto the global market in 2006. However, short- and long-term health effects remain largely unknown due to the novelty of this product. The present study examines the acute effects of e-cigarette aerosol inhalation, with and without nicotine, on vascular and pulmonary function in healthy volunteers. Seventeen healthy subjects inhaled electronic cigarette aerosol with and without nicotine on two separate occasions in a double-blinded crossover fashion. Blood pressure, heart rate, and arterial stiffness measured by pulse wave velocity and pulse wave analysis were assessed at baseline, and then at 0 h, 2 h, and 4 h following exposure. Dynamic spirometry and impulse oscillometry were measured following vascular assessments at these time points, as well as at 6 h following exposure. e-Cigarette aerosol with nicotine caused a significant increase in heart rate and arterial stiffness. Furthermore, e-cigarette aerosol-containing nicotine caused a sudden increase in flow resistance as measured by impulse oscillometry, indicating obstruction of the conducting airways. Both aerosols caused an increase in blood pressure. The present study indicates that inhaled e-cigarette aerosol with nicotine has an acute impact on vascular and pulmonary function. Thus, chronic usage may lead to long-term adverse health effects. Further investigation is warranted.
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| 2. |
- Antoniewicz, Lukasz, et al.
(författare)
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Brief exposure to Swedish snus causes divergent vascular responses in healthy male and female volunteers
- 2018
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Ingår i: PLOS ONE. - : PUBLIC LIBRARY SCIENCE. - 1932-6203. ; 13:4
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The use of Swedish oral moist snuff, known as snus, has for a long time been limited to the Scandinavian countries. With declining cigarette sales in the western world, tobacco companies have looked to the development of alternative tobacco products. In 2006 snus products were launched in the US. Even though several studies have demonstrated negative health effects, snus is often depicted as harmless.The aim of the present study was to investigate acute vascular effects of snus as measured by arterial stiffness as well as blood pressure and heart rate.Methods: Two separate randomized double-blind crossover studies with the same study design were pooled for analysis. Twenty-nine healthy snus-users (17 females, 12 males) were included. Snus (Göteborgs Rapé) and tobacco free snus (Onico) were administered in a randomized order at two separate visits. Arterial stiffness, blood pressure and heart rate were measured at baseline as well as every five minutes for 40 minutes during exposure. Following snus removal, measurements continued for 30 minutes post exposure. Arterial stiffness was measured using pulse wave velocity (Vicorder) and pulse wave analysis (Sphygmocor).Results: Compared to placebo, snus significantly increased systolic and diastolic blood pressure as well as heart rate, however, only in females (p = 0.004, p = 0.006 and p<0.001 respectively). No changes were seen in arterial stiffness measurements in either gender.Conclusion: We observed an increase in blood pressure and heart rate only in females, but not in males due to snus usage as compared to placebo. This novel finding was surprising and needs to be further investigated considering most of the earlier studies have mainly focused on male snus users and the increasing usage of snus among females.
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| 3. |
- Antoniewicz, Lukasz, et al.
(författare)
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Chronic snus use in healthy males alters endothelial function and increases arterial stiffness
- 2022
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 17:6
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Tidskriftsartikel (refereegranskat)abstract
- Background: Snus usage is commonly touted as a safer alternative to cigarette smoking. However, recent studies have demonstrated possible adverse cardiovascular effects in chronic snus users. The present study evaluates the effects of chronic snus use on vascular function by assessing central arterial stiffness and endothelial vasodilatory function in healthy chronic snus users as compared to matched non-users.Methods and results: Fifty healthy males (24 snus users, 26 age-matched controls) with a mean age of 44 years were included in the study. Arterial stiffness was assessed employing both pulse wave velocity and pulse wave analysis. Endothelial vasodilatory function was measured by venous occlusion plethysmography, utilizing intra-arterial administration of acetylcholine, glyceryl trinitrate and bradykinin to further gauge endothelium-dependent and -independent vasodilatory function. Arterial stiffness was significantly higher in chronic snus users as compared to controls: pulse wave velocity [m/s]: 6.6±0.8 vs 7.1±0.9 resp. (p = 0.026), augmentation index corrected for heart rate [%]: 0.1±13.2 vs 7.3±7.8 resp. (p = 0.023). Endothelial independent vasodilation, i.e. the reaction to glyceryl trinitrate, was significantly lower in snus users as measured by venous occlusion plethysmography.Conclusions: The results of this study show an increased arterial stiffness and an underlying endothelial dysfunction in daily snus users as compared to matched non-tobacco controls. These findings indicate that long-term use of snus may alter the function of the endothelium and therefore reinforces the assertion that chronic snus use is correlated to an increased risk of development of cardiovascular disease.
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| 4. |
- Antoniewicz, Lukasz
(författare)
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Effects of cigarettes, e-cigarettes and Swedish snus on vascular function
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Cigarette smoking is considered one of the leading causes of preventable morbidity and premature death worldwide. A large portion of this is attributable to cardiovascular disease such as ischemic heart disease and stroke. However, with the public’s increasing awareness of the harm and diseases related directly to cigarette smoke, alternative combustion-free nicotine delivery products have gained in popularity. Two of the products which have seen substantial market growths during the last few years are Swedish snus and electronic cigarettes. In recent years, an increasing number of studies have demonstrated a correlation between snus usage and increased mortality in coronary heart disease and stroke. Although there are studies with contradictory results, regarding the general underlying increase of cardiovascular risk. So far, there is limited data available on the potential negative health effects of e-cigarette smoking. The overall aim of this thesis was to investigate vascular health effects caused by acute cigarette and e-cigarette inhalation as well as chronic snus usage. Methods and Results: In Paper I, twelve healthy volunteers were subjected to cigarette smoking or not-smoking in a cross-over study. Microvesicles and endothelial progenitor cells were analyzed in collected blood samples at baseline and 1h, 4h and 24h following exposure. Cigarette smoking caused an acute increase in endothelial progenitor cells and in microvesicles of platelet, leukocyte and endothelial origin. Paper II was a randomized, cross-over study where 16 healthy volunteers were exposed to electronic cigarette inhalation with nicotine vs non-inhalation. Biomarkers were analyzed in the same approach as in Paper I. E-cigarette inhalation caused an acute increase in endothelial progenitor cells. Microvesicles, with the exception of endothelial derived microvesicles, were unaffected. In Paper III, seventeen healthy volunteers inhaled e-cigarette vapor with and without nicotine. In this double-blinded, randomized, cross-over study arterial stiffness was analyzed at baseline and at predetermined intervals for 4 hours following exposure. E-cigarette vapor inhalation containing nicotine caused a transient acute increase in heart rate and arterial stiffness. Paper IV was a cross-sectional study investigating healthy long-term snus users (mean age 44.8 years) and age-matched controls. Arterial stiffness, forearm blood flow as well as fibrinolytic function and endothelial progenitor cells in blood samples were analyzed. Snus users had significantly higher arterial stiffness as well as impaired endothelial function, i.e. decreased forearm blood flow upon glyceryl tri-nitrate infusion. There was no difference in fibrinolytic function and endothelial progenitor cells between the two groups. Discussion: Smoking a single cigarette causes a rapid activation of endothelial cells, platelets and leukocytes. As cigarette smoking has known detrimental effects on vascular health, our results were not unexpected. However, e-cigarette inhalation as well as smoking a conventional cigarette, causes a similar swift mobilization of endothelial progenitor cells. This may be interpreted as an acute endothelial stress caused by nicotine. Furthermore, inhaled nicotine is linked to increases in arterial stiffness, which is chronically altered in daily snus users. This elucidates that nicotine alone may alter endothelial function, both upon acute and chronic exposure. Snus users also display an attenuated effect of glyceryl tri-nitrate which further strengthens the findings that snus use is associated with increased mortality following myocardial infarction. In summary, we demonstrate that the nicotine content in combustion-free nicotine delivering products may alter vascular function. E-cigarettes and snus should therefore not be considered as harmless recreational products.
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| 5. |
- Antoniewicz, Lukasz, et al.
(författare)
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Electronic cigarettes increase endothelial progenitor cells in the blood of healthy volunteers
- 2016
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Ingår i: Atherosclerosis. - : Elsevier BV. - 0021-9150 .- 1879-1484. ; 255, s. 179-185
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: The use of electronic cigarettes is increasing dramatically on a global scale and its effects on human health remain uncertain. In the present study, we measured endothelial progenitor cells (EPCs) and microvesicles (MVs) in healthy young volunteers following short-term exposure to inhalation of e-cigarette vapor (ECV) to determine vascular changes.Methods: Sixteen healthy seldom smokers were randomized into two groups either exposed or not exposed to 10 puffs of ECV for 10 min, in a crossover design. Blood samples were obtained at baseline and 1, 4 and 24 h following exposure. EPCs (CD34 + CD309) and MVs were analyzed by flow cytometry. MVs were phenotyped according to origin (platelet (CD41), endothelial (CD144), leukocytes (CD45), monocytes (CD14)) and nuclear content (SYTO 13 dye). In addition, expression of inflammation markers such P-selectin (CD62P), E-selectin (CD62E), CD40-ligand (CD154) and HMGB1 was investigated. Fractional exhaled nitric oxide (FeNO) was also measured at baseline and after 24 h.Results: EPC levels in blood were significantly increased 1 h following exposure to ECV and returned to baseline values after 24 h. Only E-selectin positive MVs (endothelial origin) were slightly elevated (p < 0.038). FeNO was unaffected by exposure to ECV. Conclusions: In healthy volunteers, ten puffs of e-cigarette vapor inhalation caused an increase in EPCs. This increase was of the same magnitude as following smoking of one traditional cigarette, as we previously demonstrated. Taken together, these results may represent signs of possible vascular changes after short e-cigarette inhalation. Further studies analyzing potential cardiovascular health effects are critical as the e-cigarette market continues to burgeon.
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| 6. |
- Lundback, Magnus, et al.
(författare)
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Acute effects of e-cigarette inhalation with or without nicotine on levels of microvesicles in the blood of human volunteers
- 2018
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Ingår i: European Respiratory Journal. - : European Respiratory Society. - 0903-1936 .- 1399-3003. ; 52
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: The e-cigarette use has increased dramatically. Our group has demonstrated signs of possible vascular damage following e-cigarette use.We study the effects of e-cigarette inhalation (vaping) on vascular function, inflammation and hemostasis. Microvesicles (MV) of endothelial, leukocyte and platelet origin is measured in blood. MV are biomarkers that reflect cell function and can be used when assessing the risk of cardiovascular complications. We have recently shown that cigarette smoking causes an acute increase in MV in blood of healthy volunteers, suggesting vascular injury, inflammation and negative impact on hemostasis. We now investigate if the e-cigarette has similar effects.Methods: Seventeen healthy sporadic smokers vaped 30 puffs from an e-cigarette with and without nicotine in a crossover fashion. Blood sampling was performed at 0, 2, 4 and 6 hours following exposures. MVs was determined by flow cytometry and measured from platelets (PMV), leukocytes (LMV) and endothelial cells (EMV).Results: Inhalation of e-cigarettes containing nicotine caused a significant increase in PMV and EMV over time. PMV that exposed P-selectin and/or CD40L increased significantly as well. Nicotine free e-cigarette vapour did not cause a significant increase in PMV and EMV over time.Discussion: As little as 30 puffs of nicotine containing e-cigarette vapor cause increased levels of circulating MVs of endothelial and platelet origin, indicating possible vascular injury. This may lead to increased progression of atherosclerosis, the underlying cause of myocardial infarction and stroke.
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| 7. |
- Lyytinen, Gustaf, et al.
(författare)
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Electronic cigarette vaping with nicotine causes increased thrombogenicity and impaired microvascular function in healthy volunteers : a randomised clinical trial
- 2023
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Ingår i: Cardiovascular Toxicology. - : Springer Nature. - 1530-7905 .- 1559-0259. ; 23:7-8, s. 255-264
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Tidskriftsartikel (refereegranskat)abstract
- Electronic cigarette (EC) vaping is increasingly popular, despite growing evidence of adverse health effects. To further evaluate the impact of EC use on vascular health, we investigated the effects of brief EC inhalation on flow-dependent thrombus formation and microcirculation in healthy volunteers. The study was performed with a randomised double-blind crossover design. Twenty-two healthy subjects aged between 18 and 45 years with occasional tobacco use were recruited. Subjects inhaled 30 puffs of EC aerosol with and without nicotine on two occasions separated by a wash-out period of at least 1 week. Blood samples were collected at baseline and at 15 and 60 min following exposure and analysed with the Total-Thrombus-formation analysis system evaluating fibrin-rich thrombus formation and platelet thrombus formation in whole blood under flow. Microvascular function was assessed at baseline and 30 min after exposure by laser speckle contrast imaging and iontophoresis of acetylcholine and sodium nitroprusside (SNP) to evaluate the endothelium-dependent and independent pathways of vasodilation. Compared with nicotine free EC aerosol, exposure to EC aerosol with nicotine significantly increased platelet thrombus formation and fibrin-rich thrombus formation at 15 min (p = 0.017 and p = 0.037, respectively) with normalisation after 60 min. Peak SNP-mediated microvascular perfusion, i.e. endothelium-independent vasodilation, was reduced following EC vaping with nicotine compared with baseline (p = 0.006). Thirty puffs of EC aerosol with nicotine increased platelet and fibrin-dependent thrombus formation and reduced microvascular dilatation capacity. No compelling effects of EC vaping without nicotine were observed, indicating nicotine as the main effector.Trial registration: ClinicalTrials.gov Identifier: NCT04175457 URL: https://clinicaltrials.gov/ct2/show/NCT04175457.
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| 8. |
- Lyytinen, Gustaf, et al.
(författare)
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Use of heated tobacco products (IQOS) causes an acute increase in arterial stiffness and platelet thrombus formation
- 2024
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Ingår i: Atherosclerosis. - : Elsevier. - 0021-9150 .- 1879-1484. ; 390
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: Heated tobacco products (HTPs) are novel alternative tobacco products being promoted as an alternative to cigarettes. To evaluate the impact of HTP use on vascular function, we investigated the effects of a brief HTP usage on arterial stiffness and platelet thrombus formation in healthy volunteers.Methods: In a randomised crossover study, twenty-four healthy young adults with occasional tobacco use smoked the HTP IQOS 3 Multi (Phillip Morris Int.) and “no-exposure” was used as a control, with a wash-out period of at least one week in-between. Arterial stiffness was assessed through pulse wave velocity and pulse wave analysis. Blood samples, collected at baseline and 5 min following exposure, were analysed with the Total-Thrombus-formation analysis system evaluating platelet and fibrin-rich thrombus formation tendency.Results: HTP exposure caused immediate heightened pulse wave velocity (+0.365 m/s, 95% CI: +0.188 to 0.543; p = 0.004) and enhanced augmentation index corrected to heart rate (+6.22%, 95% CI: +2.33 to 10.11; p = 0.003) compared to the no-exposure occasion. Similarly, blood pressure and heart rate transiently increased immediately following HTP inhalation. Platelet thrombus formation significantly increased following HTP exposure (area under the curve +59.5, 95% CI: +25.6 to 93.4; p < 0.001) compared to no-exposure. No effect was seen on fibrin-rich thrombus formation following HTP-exposure.Conclusions: Brief HTP use in healthy young adults had immediate adverse effects on vascular function resulting in increased arterial stiffness and platelet thrombus formation, known risk factors for the development of atherosclerosis. Further research is needed to address long term health impacts.
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| 9. |
- Mobarrez, Fariborz, et al.
(författare)
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Electronic cigarettes containing nicotine increase endothelial and platelet derived extracellular vesicles in healthy volunteers
- 2020
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Ingår i: Atherosclerosis. - : Elsevier. - 0021-9150 .- 1879-1484. ; 301, s. 93-100
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: E-cigarette use is increasingly common. Whether e-cigarettes are harmful to human health is an intensely debated subject. In order to investigate whether e-cigarettes with and without nicotine cause different vascular responses, we obtained blood samples from healthy young volunteers who performed brief active e-cigarette inhalations. Extracellular vesicles (EVs) of endothelial and platelet origin were measured to determine vascular changes.METHODS: Using a randomized, double-blind, crossover design, 17 healthy occasional smokers inhaled 30 puffs of e-cigarette vapor during 30 min. Blood samples were collected at baseline, as well as at 0, 2, 4 and 6 h post-exposure. EVs from platelets and endothelial cells were measured by flow cytometry.RESULTS: Platelet and endothelial derived EVs were significantly increased with peak levels seen at 4 h following exposure to active inhalation of e-cigarette vapor with nicotine. Moreover, platelet derived EVs, expressing platelet activation marker P-selectin and the inflammation marker, CD40 ligand, were also significantly increased following inhalation of e-cigarette vapor with nicotine. In addition, platelet derived EVs expressing CD40 ligand was increased after inhalation of e-cigarette vapor without nicotine.CONCLUSION: As few as 30 puffs of nicotine-containing e-cigarette vapor caused an increase in levels of circulating EVs of endothelial and platelet origin, which may signify underlying vascular changes. Although e-cigarette vapor without nicotine caused an increase in platelet EVs expressing CD40 ligand, nicotine, as a component in the vapor, seems to have a more compelling effect on extracellular vesicle formation and protein composition.
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| 10. |
- Mobarrez, Fariborz, et al.
(författare)
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The Effects of Smoking on Levels of Endothelial Progenitor Cells and Microparticles in the Blood of Healthy Volunteers
- 2014
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Ingår i: PLOS ONE. - San Francisco : Public Library of Science. - 1932-6203. ; 9:2, s. e90314-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Cigarette smoking, both active and passive, is one of the leading causes of morbidity and mortality in cardiovascular disease. To assess the impact of brief smoking on the vasculature, we determined levels of circulating endothelial progenitor cells (EPCs) and circulating microparticles (MPs) following the smoking of one cigarette by young, healthy intermittent smokers. Materials and Methods: 12 healthy volunteers were randomized to either smoking or not smoking in a crossover fashion. Blood sampling was performed at baseline, 1, 4 and 24 hours following smoking/not smoking. The numbers of EPCs and MPs were determined by flow cytometry. MPs were measured from platelets, leukocytes and endothelial cells. Moreover, MPs were also labelled with anti-HMGB1 and SYTO 13 to assess the content of nuclear molecules. Results: Active smoking of one cigarette caused an immediate and significant increase in the numbers of circulating EPCs and MPs of platelet-, endothelial-and leukocyte origin. Levels of MPs containing nuclear molecules were increased, of which the majority were positive for CD41 and CD45 (platelet-and leukocyte origin). CD144 (VE-cadherin) or HMGB1 release did not significantly change during active smoking. Conclusion: Brief active smoking of one cigarette generated an acute release of EPC and MPs, of which the latter contained nuclear matter. Together, these results demonstrate acute effects of cigarette smoke on endothelial, platelet and leukocyte function as well as injury to the vascular wall.
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