title: Changes in markers of epithelial permeability and inflammation in chronic smokers switching to a nonburning tobacco device (Eclipse).
abstract: Eclipse, produced by R. J. Reynolds Tobacco Company, is a potential reduced exposure product (PREP) that heats rather than burns tobacco. We hypothesized that switching to Eclipse would result in relative normalization of pulmonary epithelial permeability, airway inflammation, and blood leukocyte activation in current smokers. We assessed 10 healthy smokers (aged 21-50 years, 19+/-8 pack-years) at baseline and after 2 and 4 weeks of switching to Eclipse, for symptoms, pulmonary function, airway inflammation, lung clearance of (99m)technicium-diethylenetriaminepentaacetic acid, and blood leukocyte activation and production of reactive oxygen species. Values were compared before and after Eclipse use and with those of healthy, lifetime nonsmokers (aged 18-53 years). Compared with baseline values before switching to Eclipse, lung permeability half-time increased from 33+/-3 to 43+/-6 min (p = .017) after 2 weeks and to 44+/-7 min (p = .10) after 4 weeks of Eclipse use. Carboxyhemoglobin levels increased from 5%+/-2% to 7%+/-2% (p<.01) at 4 weeks. Compared with smoking the usual brand of cigarettes, after smoking Eclipse the percentage of natural killer cells, the expression of intercellular adhesion molecule-1 on monocytes, and the expression of CD45RO on T cells showed significant improvement. However, expression of other surface markers, notably CD23 on monocytes, became more abnormal. Production of reactive oxygen species by smokers' neutrophils and monocytes increased further with Eclipse use. We found no significant effects on pulmonary function, cells in induced sputum, or exhaled nitric oxide. Switching to Eclipse reduces alveolar epithelial injury in some smokers but may increase carboxyhemoglobin levels and oxidative stress.
authors.affiliation: Department of Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA.
authors.forename: Judith C
authors.initials: JC
authors.lastname: Stewart
authors.forename: Richard W
authors.initials: RW
authors.lastname: Hyde
authors.forename: Joseph
authors.initials: J
authors.lastname: Boscia
authors.forename: Ming-Yan
authors.initials: MY
authors.lastname: Chow
authors.forename: Robert E
authors.initials: RE
authors.lastname: O'Mara
authors.forename: Irene
authors.initials: I
authors.lastname: Perillo
authors.forename: Anthony
authors.initials: A
authors.lastname: Pietropaoli
authors.forename: Carr J
authors.initials: CJ
authors.lastname: Smith
authors.forename: Alfonso
authors.initials: A
authors.lastname: Torres
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Utell
authors.forename: Mark W
authors.initials: MW
authors.lastname: Frampton
mesh_terms: D000328:Adult; D002463:Cell Membrane Permeability / Q000187:drug effects; D004847:Epithelial Cells / Q000187:drug effects / Q000378:metabolism*; D005260:Female; D006801:Humans; D007962:Leukocytes / Q000187:drug effects / Q000378:metabolism*; D015227:Lipid Peroxidation / Q000187:drug effects; D008168:Lung / Q000378:metabolism; D008213:Lymphocyte Activation / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000008:administration & dosage*; D018384:Oxidative Stress; D017382:Reactive Oxygen Species; D012907:Smoking / Q000378:metabolism*; D016540:Smoking Cessation / Q000379:methods*
chemical_list: D017382:Reactive Oxygen Species; D009538:Nicotine