Randomized Clinical Trial
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Methodol. Jun 20, 2024; 14(2): 89284
Published online Jun 20, 2024. doi: 10.5662/wjm.v14.i2.89284
Is there a correlation between the changes in airway inflammation and the changes in respiratory mechanics after vaping in patients with asthma?
Serafeim-Chrysovalantis Kotoulas, Kalliopi Domvri, Alexandros Tsantos, Ioanna Papagiouvanni, Anastasia Michailidou, Dionisios G Spyratos, Konstantinos Porpodis, Ioanna Grigoriou, Despina Papakosta, Athanasia Pataka
Serafeim-Chrysovalantis Kotoulas, Intensive Care Unit, Hippokration General Hospital, Thessaloniki 54642, Greece
Kalliopi Domvri, Pulmonary Department-Oncology Unit, Aristotle University of Thessaloniki, Thessaloniki 57010, Greece
Alexandros Tsantos, 2nd Department of Internal Medicine, General Hospital of Thessaloniki ‘’Ippokration’’, Thessaloniki 54642, Greece
Ioanna Papagiouvanni, Fourth Department of Internal Medicine, Aristotle University of Thessaloniki, Thessaloniki 54642, Thessaloniki, Greece
Anastasia Michailidou, 2nd Propaedeutic Department of Internal Medicine, General Hospital of Thessaloniki “Ippokration”, Thessaloniki 54642, Greece
Dionisios G Spyratos, Konstantinos Porpodis, Despina Papakosta, Department of Pulmonary, Aristotle University of Thessaloniki, Thessaloniki 57001, Greece
Ioanna Grigoriou, Respiratory Failure Clinic, Papanikolaou General Hospital, Thessloniki 57001, Greece
Athanasia Pataka, Department of Respiratory Medicine, Aristotle Univ Thessaloniki, Sch Med, G Papanikolaou Hosp, Resp Failure Unit, Aristotle University of Thessaloniki, Thessaloniki 57001, Greece
Author contributions: Kotoulas SC, Spyratos DG, Porpodis K, Papakosta D, and Pataka A designed the research; Kotoulas SC, Domvri K, Tsantos A, Papagiouvanni I, Michailidou A, and Grigoriou I performed the research; Domvri K contributed new reagents or analytic tools; Kotoulas SC analyzed the data; Kotoulas SC, Domvri K, Tsantos A, Papagiouvanni I, Michailidou A, Spyratos DG, Porpodis K, Grigoriou I, Papakosta D, and Pataka A wrote the paper.
Institutional review board statement: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The protocol of the study was approved by the Ethics Committee of the Medical School, Aristotle University of Thessaloniki, reference 369-8/22.2.2017, before the initiation of enrolment. The protocol of the study was also registered in ISRCTN-registry (ISRCTN89151172).
Clinical trial registration statement: This study is registered at ISRCTN Clinical Trial Registry. The registration identification number is ISRCTN89151172.
Informed consent statement: All participants gave their informed written consent to participate in the study.
Conflict-of-interest statement: All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.
Data sharing statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Serafeim-Chrysovalantis Kotoulas, PhD, Doctor, Intensive Care Unit, Hippokration General Hospital, Kostantinoupoleos 49, Thessaloniki 54642, Greece. akiskotoulas@hotmail.com
Received: October 26, 2023
Peer-review started: October 26, 2023
First decision: November 30, 2023
Revised: January 8, 2024
Accepted: February 26, 2024
Article in press: February 26, 2024
Published online: June 20, 2024
Processing time: 231 Days and 20.1 Hours
Abstract
BACKGROUND

Electronic cigarettes (ECs) have been promoted as alternatives to traditional cigarettes.

AIM

To investigate ECs’ effects on respiratory system, especially in patients with respiratory diseases.

METHODS

We randomly selected 25 smokers with stable moderate asthma and matched them with 25 healthy smokers. All were subjucted to pulmonary function tests (PFTs), impulse oscillometry (IOS), fraction exhaled Nitric Oxide (FeNO), exhaled breathe condensate (EBC) and biomarker measurements before and after vaping one nicotine-containing EC.

RESULTS

The increase in FeNO 30 minutes after EC, reflecting airway inflammation, significantly correlated with increase of residual volume (RV), total lung capacity, respiratory impedance at 5 Hz (Z5Hz) and respiratory resistance at 5 and 20 Hz (R5Hz and R20Hz). No significant correlations were found between EBC biomarkers' changes and respiratory mechanics.

CONCLUSION

This is the first study demonstrating that the changes in airway inflammation caused by EC have direct effects in respiratory mechanics of asthmatic patients.

Keywords: Asthma, Electronic cigarette, Airway inflammation, Lung function, Impulse oscillometry, FeNO

Core Tip: This is the first study that correlates the acute changes in pulmonary function and in airway inflammation in patients with asthma after vaping one electronic cigarette.