Major constituents |
Nicotine |
Nicotine |
Carbon monoxide |
Propylene glycol |
Nitrosamines |
Glycerol |
Aromatic hydrocarbons |
Flavoring |
Aldehydes |
|
>4,000 Chemical compounds |
|
Effects on inflammatory cells |
Increase in inflammatory cytokines, such as IL-1 and TNF-alpha |
No increase in WBC |
Increase number and reactivity of neutrophils in the blood stream |
Decreased density and viability of Kupffer cells |
Decrease in neutrophil and monocyte chemotaxis |
Increase complement protein activation and deposition onto liver Kupffer cells |
Decrease in neutrophil and macrophage migration into wounded issue |
Enhanced C1q receptor expression on Kupffer cells |
Decrease in neutrophil and macrophage oxidative burst and phagocytic activity, resulting in decreased ability to clear wounds of bacteria |
Increase Kupffer cell cytokine release |
Increase in proteolytic enzymes (specifically MMP-8 and MMP-9) leading to increased collagen degradation and weaker wound strength |
Enhanced hydrogen peroxide production due to increased xanthine oxidase and peroxidase activity |
ROS inhibit anti-proteases |
Decreased epithelial cell, alveolar macrophage and neutrophil anti-microbial activity against staph aureus |
Upregulation of certain inflammatory markers and acute phase reactants |
Some vapor extracts promote ROS formation |
Effects on cellular proliferation and wound healing process |
Reduced fibroblast proliferation |
Enhanced epithelial cell death with exposure to vapor extract |
Reduced pro-collagen (I and III) and collagen (I and III) synthesis |
Decreased endothelial cell proliferation |
Reduced hydroxyproline accumulation |
Increased DNA strand breaks in epithelial and squamous cell lines exposed to e-cigarette vapor, with or without nicotine |
Likely reduced endothelial angiogenesis |
Reduced epidermal regeneration with thinner epidermis and stratum corneum and reduced epidermal barrier |
Reduced levels of Vitamin C and E, with reduced ability to clear ROS and increased defective collagen synthesis |
ROS contribute to increased destruction of cell membranes, endothelial dysfunction and cellular apoptosis |
Effects on clotting cascade |
Increase in platelet activation |
Largely unknown |
Increase circulating fibronectin |
Overall increased propensity to form blood clots |
Effects on blood vessels |
Oxidative stress on endothelial cells |
Cytotoxic to endothelial cells, whether or not vapor contains nicotine |
Induces vasoconstriction |
Morphologic alterations to endothelial cells, including disruptions to endothelial cell barrier and cell-to-cell contacts |
Inhibits endothelial-dependent vasodilation |
Stimulates catecholamine release and adrenergic stimulation contributing to vasoconstriction |
Effects on tissue oxygenation |
Vasoconstriction induces hypoxia |
Reduced cutaneous blood flow |
Decreased subcutaneous blood flow |
Decreased tissue oxygen tension |
Increased lactate levels and anaerobic metabolism in tissue |
Carbon monoxide shifts oxygen dissocation curve to the left and has 200 times higher affinity for hemoglobin, decreasing oxygen delivery to peripheral tissues |
Cardiovascular effects |
Accelerated atherosclerotic disease |
Smokers switching to e-cigarettes with elevated systolic blood pressure at baseline demonstrate a decrease in systolic blood pressure after 1 year of smoking cessation with e-cigarette use |
Increased risk of CAD and MI |
Pulmonary effects |
Increased risk of lung cancer |
Increased dynamic airway resistance |
Increased risk of COPD and other lung disorders |
Increased expired NO |
Airway colonizer staph aureus demonstrates increased virulence, biofilm formation and enhanced invasion of host epithelial cells when exposed to vapor extract |
Associated surgical complications |
SSI |
Increased distal skin flap necrosis in rats |
Delayed wound healing |
Largely unknown in humans |
Wound dehiscence |
Incisional hernia |
Skin flap necrosis |
Tissue flap necrosis |