Electronic cigarettes increase endothelial progenitor cells in the blood of healthy volunteers.
The use of electronic cigarettes is increasing dramatically on a global scale and its effects on human health remain uncertain. In the present study, we measured endothelial progenitor cells (EPCs) and microvesicles (MVs) in healthy young volunteers following short-term exposure to inhalation of e-cigarette vapor (ECV) to determine vascular changes.



Sixteen healthy seldom smokers were randomized into two groups either exposed or not exposed to 10 puffs of ECV for 10 min, in a crossover design. Blood samples were obtained at baseline and 1, 4 and 24 h following exposure. EPCs (CD34 + CD309) and MVs were analyzed by flow cytometry. MVs were phenotyped according to origin (platelet (CD41), endothelial (CD144), leukocytes (CD45), monocytes (CD14)) and nuclear content (SYTO 13 dye). In addition, expression of inflammation markers such P-selectin (CD62P), E-selectin (CD62E), CD40-ligand (CD154) and HMGB1 was investigated. Fractional exhaled nitric oxide (FeNO) was also measured at baseline and after 24 h.



EPC levels in blood were significantly increased 1 h following exposure to ECV and returned to baseline values after 24 h. Only E-selectin positive MVs (endothelial origin) were slightly elevated (p < 0.038). FeNO was unaffected by exposure to ECV.



In healthy volunteers, ten puffs of e-cigarette vapor inhalation caused an increase in EPCs. This increase was of the same magnitude as following smoking of one traditional cigarette, as we previously demonstrated. Taken together, these results may represent signs of possible vascular changes after short e-cigarette inhalation. Further studies analyzing potential cardiovascular health effects are critical as the e-cigarette market continues to burgeon.
Karolinska Institutet, Department of Clinical Sciences, Division of Internal Medicine, Danderyd University Hospital, Stockholm, Sweden. Electronic address: lukasz.antoniewicz@ki.se.
Lukasz
L
Antoniewicz
Umeå University, Department of Public Health and Clinical Medicine, Division of Medicine/Respiratory Medicine, Umeå, Sweden.
Jenny A
JA
Bosson
Karolinska Institutet, Department of Clinical Sciences, Division of Cardiovascular Medicine, Danderyd University Hospital, Stockholm, Sweden.
Jeanette
J
Kuhl
Karolinska Institutet, Department of Clinical Sciences, Division of Internal Medicine, Danderyd University Hospital, Stockholm, Sweden.
Samy M
SM
Abdel-Halim
Karolinska Institutet, Department of Clinical Sciences, Division of Cardiovascular Medicine, Danderyd University Hospital, Stockholm, Sweden.
Anna
A
Kiessling
Karolinska Institutet, Department of Medicine, Solna, Stockholm, Sweden.
Fariborz
F
Mobarrez
Karolinska Institutet, Department of Clinical Sciences, Division of Cardiovascular Medicine, Danderyd University Hospital, Stockholm, Sweden.
Magnus
M
Lundbäck
D000280:Administration, Inhalation; D000328:Adult; D015415:Biomarkers / Q000097:blood; D055252:Cell-Derived Microparticles / Q000187:drug effects / Q000378:metabolism / Q000473:pathology; D003257:Consumer Product Safety; D003367:Cotinine / Q000097:blood; D018592:Cross-Over Studies; D066300:Electronic Nicotine Delivery Systems / Q000009:adverse effects*; D066026:Endothelial Progenitor Cells / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D045853:Exhalation; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D008297:Male; D009538:Nicotine / Q000008:administration & dosage / Q000009:adverse effects* / Q000097:blood; D018722:Nicotinic Agonists / Q000008:administration & dosage / Q000009:adverse effects* / Q000097:blood; D009569:Nitric Oxide / Q000378:metabolism; D010641:Phenotype; D018570:Risk Assessment; D013548:Sweden; D013997:Time Factors; D055815:Young Adult
D015415:Biomarkers; D018836:Inflammation Mediators; D018722:Nicotinic Agonists; D009569:Nitric Oxide; D009538:Nicotine; D003367:Cotinine
E-cigarette; Electronic cigarette; Endothelial progenitor cells; Microvesicles