Hosted by the SOT Inhalation and Respiratory Specialty Section
Join us to hear exciting new research exploring the impacts of vaping on extrapulmonary tissue systems.
The first presentation will highlight Dr. Alex Carll’s work, “Vaping Cardiotoxicity: Role of the Autonomic Nervous System.”
Electronic cigarettes are widely used amid claims of relative safety, yet their aerosols contain toxic aldehydes, nicotine, and flavorants with uncertain cardiopulmonary risk. In mice, we find e-cigarette aerosols acutely destabilize cardiac autonomic control and precipitate arrhythmias. Exposures also provoke transient hypertension and, weeks after cessation, persistent autonomic dysregulation, conduction abnormalities, and spontaneous arrhythmias. Reports of vaping-associated sudden cardiac arrest, including in healthy young adults, underscore the urgent need to define chemical and biological mechanisms of cardiotoxicity. Our recent murine work implicates nicotine, flavorants, and flavorant-like additives as drivers and amplifiers of a sympathetic dominance that triggers arrhythmias. Pregnancy may heighten susceptibility and prolong post-exposure vulnerability. Collectively, these studies clarify how specific ingredients influence the cardiovascular risks of vaping and point to strategies for harm reduction and mitigation, including limiting pro-arrhythmic constituents and targeting autonomic pathways. Determining ingredient- and exposure-specific mechanisms will better inform regulation, product design, and clinical guidance.
Following Dr. Carll, Dr. Xiaojia He will present his research, “Impacts of Vaping on the Oral Microbiome.”
Electronic nicotine delivery systems (ENDS), or e-cigarettes, are marketed as safer alternatives to tobacco and smoking cessation aids, yet growing evidence links their use to oral disease. We analyzed subgingival plaque and saliva samples from 73 participants using 16S rRNA sequencing, untargeted proteomics, and metabolomics. Male vapers showed disruptions in amino acid and lipid pathways, while females exhibited broader metabolic alterations. Proteomic profiling also demonstrated distinct sex-specific differences. In females, vaping was associated with alterations in platelet activation, cell-cell adhesion, and cellular responses to stress. Male vapers exhibited proteomic changes primarily in protein metabolic process and organelle biogenesis and maintenance. Notably, innate immune-related pathways were differentially modulated between sexes. Proteomic profiling revealed sex-specific immune differences and distinct mechanisms in aldehyde metabolism, including variations in exhaled aldehydes and aldehyde dehydrogenase 3A1 expression. These differences may underlie oral health outcomes: male vapers had higher Community Periodontal Index of Treatment Need (CPITN) scores, potentially linked to sex-based nicotine metabolism. Microbiome analysis further identified sex-specific enrichment of pathogenic taxa, consistent with observed metabolic and proteomic perturbations. Overall, our findings suggest that vaping differentially impacts oral health in males and females through immune, metabolic, and microbial mechanisms.
Alex Carll, PhD, MSPH, Associate Professor, University of Louisville
Xiaojia He, PhD, MS, Senior Research Scientist, Underwriters Laboratories