Acute effects of vaping one E-cigarette in airway inflammation of asthmatic patients

Introduction: E-cigarettes (ECs) are devices that are marketed for tobacco replacement. ECs safety has not been scientifically demonstrated especially in asthma patients. Aims and Objectives: To investigate the acute changes in airway inflammatory mediators in asthma patients after the use of EC. Methods: We randomly selected 25 smokers suffering from stable asthma receiving 'step 3' treatment according to GINA guidelines with no other co-morbidities, and 25 healthy smokers matched with the baseline characteristics of the asthmatic patients. The participants were subjected to FENO measurement and Exhaled Breathe Condensate (EBC) gathering, before and 30 minutes after the use of one EC with nicotine for 5 minutes. From EBC, pH and the concentrations of Interleukins (IL) 1b, 4, 5, 6, 8, 10, 13, 17A, Tumor Necrosis Factor-alpha (TNF-a), 8-Isoprostane (ISO8) and Leukotriene B4 (LTB4) were measured. Results: FENO and EBC's pH increased in asthmatics after EC by 3.60 ppb (P = 0.001) and 0.15 (P = 0.014), while they decreased in the control group by 3.28 ppb (P < 0.001) and 0.12 (P = 0.064) respectively. In asthma group, the concentrations of IL-10, TNF-a and ISO8 in EBC increased significantly and the concentrations of IL-1b, IL-8, IL-13 and IL-17A increased at the limit of significance after EC, something that did not apply in control group. The changes in concentrations of IL-1b and IL-4 after EC differed significantly between the two groups. Conclusion: FENO and the concentrations of inflammatory mediators of multiple inflammatory pathways were altered after EC use in the EBC of asthmatic patients, while in control group no such outcome was observed.