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©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
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
ARTICLE HIGHLIGHTS
Research background
Electronic cigarette (EC) is a novel smoking product promoted to replace tobacco cigarette in smokers' daily habits. However, despite the fact that the effects of the tobacco cigarette have been investigated thoroughly the last decades, this is not the case for EC. There is evidence that EC have several acute effects on lung function of healthy individuals, and on lung function and airway inflammation of patients with asthma and chronic obstructive pulmonary disease. In a previous study, we have evaluated the acute effects of EC on lung function and airway inflammation in patients with asthma compared to healthy individuals. However, we did not evaluate the possible correlations of the changes on airway inflammation with the acute effects of EC on lung function.
Research motivation
With this study we investigate the correlations between the changes in airway inflammation, reflected by the changes in fraction exhaled Nitric Oxide (FeNO) and exhaled breathe condensate (EBC) biomarkers, with the changes in pulmonary function tests (PFTs) and impulse oscillometry after vaping one nicotine-containing EC.
Research objectives
With this study we investigate the correlations between the changes in airway inflammation, reflected by the changes in FeNO and EBC biomarkers, with the changes in PFTs and impulse oscillometry after vaping one nicotine-containing EC.
Research methods
The protocol of this 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 and all participants gave their written informed consent. The protocol of the study was also registered in ISRCTN-registry (ISRCTN89151172).
Research results
There were no significant correlations between the changes in FeNO and the changes in respiratory mechanics before and after EC in the control group. On the other hand, the difference in FeNO before and after EC in the asthmatics was significantly correlated with the corresponding differences in residual volume, total lung capacity and respiratory impedance at 5 Hz. Furthermore, the difference in FeNO before and after EC in the asthmatics was correlated with the corresponding differences in respiratory resistance at 5 and 20 Hz (R5Hz and R20Hz) at the limit of significance, where the number 0.000 was the lowest limit of the 95% of the confidence intervals. However no significant correlations were found between the changes in the EBC biomarkers and the changes in respiratory mechanics before and after EC neither in the asthmatic nor in the control group.
Research conclusions
In conclusion, this study demonstrates that there is a direct association between airway inflammation and respiratory mechanics in patients with asthma after the use of EC, even in patients receiving inhaled corticosteroids.
Research perspectives
As EC becomes more popular, there is an urgent need for studies which will assess its effects in human health, especially in certain group of respiratory patients as those with asthma.
