The role of nonspecific proteolysis in the development of alterative changes in lung tissue when using electronic cigarettes
https://doi.org/10.18093/0869-0189-2023-33-3-342-349
Abstract
In recent years, the number of electronic cigarettes (ES) users has been growing steadily around the world. ES heat and vaporize components of a mixture of propylene glycol, vegetable glycerin, nicotine, and flavors. Reports of severe forms of lung injury caused by the use of ES, some of which have resulted in death, urge studying the pathogenetic mechanisms of such complications. One of the mechanisms is the activation of nonspecific proteolysis accompanied by the destruction of connective tissue components of the blood-air barrier.
Aim of the study. To study the dynamics of the proteinase-inhibitor system indicators and its role in the morphological changes of lung tissue in experimental modeling of the effects of ES.
Methods. Experimental studies were performed in 24 white male Wistar rats weighing 160 – 180 g. ES use of was simulated by intermittent exposure to smoke mixture vapors using a POD system connected to a two-channel compressor.
Results. Analysis of the state of the nonspecific proteinase inhibitory system in rat broncho-alveolar lavage and blood serum and the results of morphological studies indicate activation of trypsin-like proteinases and depletion of the local antitryptic potential, leading to biochemical changes with subsequent structural changes in lung tissue. The latter are characterized by congestion, leukocyte infiltration, and stromal proliferation. In addition, exposure to nicotine-containing mixtures has been shown to affect the proteinase inhibitory system and blood serum composition, which is associated with a compensatory increase in antitrypsin activity.
Conclusion. The results of the study indicate the activation of trypsin-like proteinases in broncho-alveolar lavage, which have a damaging effect on lung tissue, leading to disturbances in tissue hemodynamics, extravasation of leukocytes, remodeling and thickening of the blood-air barrier.
About the Authors
L. L. AliyevRussian Federation
Leonid L. Aliyev - Candidate of Medicine, Associate Professor, Department of General and Clinical Pathophysiology, Institute “Medical Academy named after S.I.Georgievsky”, V.I.Vernadsky Crimean Federal University, Ministry of Science and Higher Education of the Russian Federation
Bulv. Lenina 5/7, Simferopol, 295051, Crimea Republic; tel.: (3652) 554-940
Competing Interests:
The authors have no conflicts of interest to declare
M. A. Aliyev
Russian Federation
Mukhamed A. Aliyev - 6th year student, Institute “Medical Academy named after S.I.Georgievsky”.
Bulv. Lenina 5/7, Simferopol, 295051, Crimea Republic; tel.: (3652) 554-940
Competing Interests:
The authors have no conflicts of interest to declare
P. E. Maximova
Russian Federation
Polina E. Maximova - 6th year student, Institute “Medical Academy named after S.I.Georgievsky”.
Bulv. Lenina 5/7, Simferopol, 295051, Crimea Republic; tel.: (3652) 554-940
Competing Interests:
The authors have no conflicts of interest to declare
T. P. Makalish
Russian Federation
Tatiana P. Makalish - Candidate of Biology, Leading Researcher, Central Research Laboratory, Institute “Medical Academy named after S.I.Georgievsky”.
Bulv. Lenina 5/7, Simferopol, 295051, Crimea Republic; tel.: (3652) 554-896
Competing Interests:
The authors have no conflicts of interest to declare
A. V. Kubyshkin
Russian Federation
Anatoly V. Kubyshkin, Doctor of Medicine, Professor, Department of General and Clinical Pathophysiology, Institute “Medical Academy named after S.I.Georgievsky”.
Bulv. Lenina 5/7, Simferopol, 295051, Crimea Republic; tel.: (3652) 554-968
Competing Interests:
The authors have no conflicts of interest to declare
E. Yu. Zyablitskaya
Russian Federation
Evgeniya Yu. Zyablitskaya, Doctor of Medicine, Leading Researcher, Head of the Central Research Laboratory, Institute “Medical Academy named after S.I.Georgievsky.
Bulv. Lenina 5/7, Simferopol, 295051, Crimea Republic; tel.: (3652) 554-896
Competing Interests:
The authors have no conflicts of interest to declare
A. V. Grigoryants
Russian Federation
Armen V. Grigoryants - Candidate of Medicine, Associate Professor, Department of Pathological Anatomy with a sectional course, Institute “Medical Academy named after S.I.Georgievsky”.
Bulv. Lenina 5/7, Simferopol, 295051, Crimea Republic; tel.: (3652) 554-707
Competing Interests:
The authors have no conflicts of interest to declare
Ya. Karyophyllidis
Russian Federation
Yannis Karyophyllidis - Laboratory Assistant, Central Research Laboratory, Institute “Medical Academy named after S.I.Georgievsky”.
Bulv. Lenina 5/7, Simferopol, 295051, Crimea Republic; tel.: (3652) 554-896
Competing Interests:
The authors have no conflicts of interest to declare
D. I. Mitrushkin
Russian Federation
Dmitry I. Mitrushkin - Candidate of Medicine, Assistant, Department of Internal Medicine No.1, Institute “Medical Academy named after S.I.Georgievsky”.
Bulv. Lenina 5/7, Simferopol, 295051, Crimea Republic; tel.: (3652) 554-930
Competing Interests:
The authors have no conflicts of interest to declare
References
1. Kasza K.A., Ambrose B.K., Conway K.P. et al. Tobacco-product use by adults and youths in the United States in 2013 and 2014. N. Engl. J. Med. 2017; 376 (4): 342–353. DOI: 10.1056/NEJMsa1607538.
2. Gentzke A.S., Wang T.W., Jamal A. et al. Tobacco product use among middle and high school students – United States, 2020. MMWR Morb. Mortal. Wkly Rep. 2020; 69 (50): 1881–1888. DOI: 10.15585/mmwr.mm6950a1.
3. World Health Organization. WHO report on the global tobacco epidemic 2021: addressing new and emerging products. Geneva; 2021. Available at: https://www.who.int/publications/i/item/9789240032095
4. Cao D.J., Aldy K., Hsu S. et al. Review of health consequences of electronic cigarettes and the outbreak of electronic cigarette, or vaping, product use-associated lung injury. J. Med. Toxicol. 2020; 16 (3): 295–310. DOI: 10.1007/s13181-020-00772-w.
5. Seitz C.M., Kabir Z. Burn injuries caused by e-cigarette explosions: a systematic review of published cases. Tob. Prev. Cessat. 2018; 4: 32. DOI: 10.18332/tpc/94664.
6. Wang L., Wang Y., Chen J. et al. A review of toxicity mechanism studies of electronic cigarettes on respiratory system. Int. J. Mol. Sci. 2022; 23 (9): 5030. DOI: 10.3390/ijms23095030.
7. Schier J.G., Meiman J.G., Layden J. et al. Severe pulmonary disease associated with electronic-cigarette-product use – interim guidance. MMWR Morb. Mortal. Wkly Rep. 2019; 68 (36): 787–790. DOI: 10.15585/mmwr.mm6836e2.
8. Perrine C.G., Pickens C.M., Boehmer T.K. et al. Characteristics of a multistate outbreak of lung injury associated with E-cigarette use, or vaping – United States, 2019. MMWR Morb. Mortal. Wkly Rep. 2019; 68 (39): 860–864. DOI: 10.15585/mmwr.mm6839e1.
9. Cherian S.V., Kumar A., Estrada-Y-Martin R.M. E-cigarette or vaping product-associated lung injury: a review. Am. J. Med. 2020; 133 (6): 657–663. DOI: 10.1016/j.amjmed.2020.02.004.
10. Halpin D.M.G. Precision medicine in chronic obstructive pulmonary disease. Chin. Med. J. (Engl.). 2022; 135 (10): 1156–1162. DOI: 10.1097/CM9.0000000000002042.
11. Hachem A., Gartenhaus R.B. Oncogenes as molecular targets in lymphoma. Blood. 2005; 106 (6): 1911–1923. DOI: 10.1182/blood-2004-12-4621.
12. Meyer N.J., Gattinoni L., Calfee C.S. Acute respiratory distress syndrome. Lancet. 2021; 398 (10300): 622–637. DOI: 10.1016/S0140-6736(21)00439-6.
13. Corriden R., Moshensky A., Bojanowski C.M. et al. E-cigarette use increases susceptibility to bacterial infection by impairment of human neutrophil chemotaxis, phagocytosis, and NET formation. Am. J. Physiol. Cell Physiol. 2019; 318 (1): C205–214. DOI: 10.1152/ajpcell.00045.2019.
14. Wills T.A., Pagano I., Williams R.J., Tam E.K. E-cigarette use and respiratory disorder in an adult sample. Drug Alcohol Depend. 2019; 194: 363–370. DOI: 10.1016/j.drugalcdep.2018.10.004.
15. Osei A.D., Mirbolouk M., Orimoloye O.A. et al. Association between e-cigarette use and cardiovascular disease among never and current combustible-cigarette smokers. Am. J. Med. 2019; 132 (8): 949–954.e2. DOI: 10.1016/j.amjmed.2019.02.016.
16. Polosa R., Cibella F., Caponnetto P. et al. Health impact of E-cigarettes: a prospective 3.5-year study of regular daily users who have never smoked. Sci. Rep. 2017; 7 (1): 13825. DOI: 10.1038/s41598-017-14043-2.
Supplementary files
Review
For citations:
Aliyev L.L., Aliyev M.A., Maximova P.E., Makalish T.P., Kubyshkin A.V., Zyablitskaya E.Yu., Grigoryants A.V., Karyophyllidis Ya., Mitrushkin D.I. The role of nonspecific proteolysis in the development of alterative changes in lung tissue when using electronic cigarettes. PULMONOLOGIYA. 2023;33(3):342-349. (In Russ.) https://doi.org/10.18093/0869-0189-2023-33-3-342-349