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Electronic (e-) cigarettes are growing in popularity despite uncertainties regarding their long-term health implications. The link between cigarette smoking and initiation of chronic lung disease took decades to unpick so in vitro studies mimicking e-cigarette exposure aim to detect early indicators of harm. In response to e-cigarette exposure, alveolar macrophages adopt a proinflammatory phenotype of increased secretion of proinflammatory cytokines, reduction in phagocytosis, and efferocytosis and reactive oxygen species generation. These effects are largely driven by free radical exposure, changes in PI3K/Akt signaling pathways, nicotine-induced reduction in phagocytosis receptors, and impaired lipid homeostasis leading to a foam-like lipid-laden phenotype. Neutrophils exhibit disrupted chemotaxis and transmigration to chemokines, reduced phagocytosis and bacterial killing, and an increase in protease secretion without corresponding antiproteases in response to e-cigarette exposure. This is driven by an altered ability to respond and to polarize toward chemoattractants, an activation of the p38 MAPK signaling pathway and inability to assemble NADPH oxidase. E-cigarettes induce lung epithelial cells to display decreased ciliary beat frequency and ion channel conductance as well as changes in chemokine secretion and surface protein expression. Changes in gene expression, mitochondrial function, and signaling pathways have been demonstrated in lung epithelial cells to explain these changes. Many functional outputs of alveolar macrophages, neutrophils, and lung epithelial cells have not been fully explored in the context of e-cigarette exposure and the underlying driving mechanisms are poorly understood. This review discusses current evidence surrounding the effects of e-cigarettes on alveolar macrophages, neutrophils, and lung epithelial cells with particular focus on the cellular mechanisms of change.
|Journal||American journal of physiology. Lung cellular and molecular physiology|
|Early online date||10 Aug 2021|
|Publication status||Published - Aug 2021|
Bibliographical noteFunding Information:
This work was supported in part by Health Data Research-UK PIONEER 2019 (to E. Sapey), British Lung Foundation Grant PPRG16-12 (to D. R. Thickett and A. Scott), National Institute for Health Research Health Technology Assessment Programme Grant NIHR129593 (to E. Sapey, D. R. Thickett, and A. Scott), and United Kingdom Research and Innovation Medical Research Council Grant MR/S002782/1 (to E. Sapey, D. R. Thickett, and A. Scott).
Copyright © 2021 The Authors. Licensed under Creative Commons Attribution CC-BY 4.0.
- Alveolar macrophages
- Lung epithelial cells
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Physiology (medical)
- Cell Biology
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- 2 Finished
1/12/16 → 3/08/20