Electronic Nicotine Delivery System Induced Inflammatory Responses and Related Risk of COVID-19: A Literature Review

Kriti Bomb, Dr. Kenneth Witwer, and Dr. Zhaohao Liao, Witwer Lab, Johns Hopkins University, 733 N Broadway, Baltimore, MD 21205

Electronic nicotine delivery systems (ENDS) have recently gained popularity as “healthy” alternatives to smoking cigarettes. However, the mechanism of use and the chemicals in ENDS are severely damaging, especially in adolescents and immunocompromised persons. Most ENDS devices contain e-liquid cartridges that are heated to produce aerosolized vapors, and inhaling these vapors can result in inflammation, pulmonary cytotoxicity, and vaping-associated lung injury. Increased ENDS use is a pandemic of its own, with limited research into its biological consequences, especially in younger users. Here, we examine why ENDS users might be at greater risk for developing COVID-19 complications, primarily focusing on inflammatory responses induced by aerosol inhalation. This literature review was limited to studies of ENDS users, excluding nicotine/tobacco products such as cigarettes. Only SARS-CoV-2 studies were considered, excluding other coronavirus infections. After thorough assessment of around n=50 articles with ENDS and COVID-19 keywords, n=10 papers satisfied all consideration criteria. Patients with severe cases of COVID-19 may present with inflammation-related complications such as acute respiratory distress syndrome (ARDS) and acute respiratory pneumonia, and aerosol vapors can aggravate such inflammation. If an ENDS user is exposed to SARS-CoV-2, inflammasome complexes may be activated. Release of extracellular vesicles (EVs) from exposed pulmonary epithelium or platelets may initiate an inflammatory cascade or trigger a cytokine storm. Further, in ENDS users, there is increased expression of the angiotensin-converting enzyme-2 (ACE-2) receptor in the lungs, which is also upregulated by smoking and acts as the viral receptor for SARS-CoV-2. To addresses these responses, we explore two experimental therapies as well: HMGB1 gene therapy and MSC-derived EV treatments. Understanding COVID-19 complications in ENDS users can further develop existing literature on the risks of long-term ENDS use and also provide an avenue for minimizing vaping-induced injuries.



Additional Abstract Information

Presenter: Kriti Bomb

Institution: Johns Hopkins University

Type: Poster

Subject: Biology

Status: Approved

Time and Location

Session: Poster 3
Date/Time: Mon 4:30pm-5:30pm
Session Number: 3129