PT  - JOURNAL ARTICLE
AU  - Lauren C. Davis
AU  - Elizabeth Sapey
AU  - David R. Thickett
AU  - Aaron Scott
TI  - Predicting the pulmonary effects of long-term e-cigarette use: are the clouds clearing?
AID  - 10.1183/16000617.0121-2021
DP  - 2022 Mar 31
TA  - European Respiratory Review
PG  - 210121
VI  - 31
IP  - 163
4099  - http://err.ersjournals.com/content/31/163/210121.short
4100  - http://err.ersjournals.com/content/31/163/210121.full
SO  - EUROPEAN RESPIRATORY REVIEW2022 Mar 31; 31
AB  - Commercially available since 2007, e-cigarettes are a popular electronic delivery device of ever-growing complexity. Given their increasing use by ex-smokers, smokers and never-smokers, it is important to evaluate evidence of their potential pulmonary effects and predict effects of long-term use, since there has been insufficient time to study a chronic user cohort. It is crucial to evaluate indicators of harm seen in cigarette use, and those potentially unique to e-cigarette exposure. Evaluation must also account for the vast variation in e-cigarette devices (now including at least five generations of devices) and exposure methods used in vivo and in vitro.Thus far, short-term use cohort studies, combined with in vivo and in vitro models, have been used to probe for the effects of e-cigarette exposure. The effects and mechanisms identified, including dysregulated inflammation and decreased pathogen resistance, show concerning overlaps with the established effects of cigarette smoke exposure. Additionally, research has identified a signature of dysregulated lipid processing, which is unique to e-cigarette exposure.This review will evaluate the evidence of pulmonary effects of, and driving mechanisms behind, e-cigarette exposure, which have been highlighted in emerging literature, and highlight the gaps in current knowledge. Such a summary allows understanding of the ongoing debate into e-cigarette regulation, as well as prediction and potential mitigation of future problems surrounding e-cigarette use.Long-term e-cigarette exposure may result in pulmonary inflammation and reduced resistance to respiratory infections, which partially reflects the established effects of cigarette exposure, due to a combination of nicotine exposure and oxidative stress. https://bit.ly/3zwMFE5