PET images show greater lung inflammation in e-cigarette users than in cigarette smokers

Electronic cigarette (e-cigarette) users have greater lung inflammation than cigarette smokers and non-smokers, according to a new study published online in The Journal of Nuclear Medicine. This study is the first to provide evidence that vaping e-liquids with e-cigarettes creates a unique inflammatory response in the lungs that is different from cigarette smoking.

E-cigarette use has increased dramatically in recent years, particularly among adolescents and young adults. While many people assume that e-cigarettes are safer than conventional cigarettes, e-cigarettes can cause lung inflammation and increase the risk of lung disease. Furthermore, its long-term safety has not been rigorously evaluated.

This is the first PET study using a new radiotracer, ¹⁸F-NOS, to compare lung inflammation between cigarette and e-cigarette users in vivo. Although the PET image with ¹⁸F-FDG has been used in the past to investigate inflammation in smokers and vapers, but its conclusions were limited.

“iNOS is an enzyme that is overexpressed in e-cigarette users and cigarette smokers and is associated with acute and chronic inflammatory diseases,” said Reagan Wetherill, Ph.D., lead study author and faculty member at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia. “This makes it a relevant target for molecular imaging of lung inflammation and inflammatory lung disease.”

Study participants were divided into three groups matched for age and sex: five e-cigarette users, five cigarette smokers, and five controls who never smoked/vaped. ¹⁸F-NOS PET was performed to quantify and compare lung inflammation.

E-cigarette users showed greater lung inflammation than cigarette smokers and controls who never smoked or vaped. A positive association was also found between measures of lung and peripheral inflammation, suggesting that e-cigarette use may increase lung inflammation.

“Having these findings provides patients with additional evidence about the potentially harmful effects of e-cigarette use on the lungs,” says Wetherill. “Our work advances what is currently known about the impacts of e-cigarette use on respiratory health and provides a better understanding of the harm and harm reduction associated with e-cigarette use in relation to smoking.”

Lead author and Perelman School of Medicine Department of Radiology faculty member Jacob Dubroff, MD, Ph.D., sees an increasing role for the use of molecular imaging to understand the effects of e-cigarettes. He notes: “These findings suggest that molecular imaging may be uniquely poised to detect and measure potential pathophysiological harm associated with e-cigarettes, which have been promoted as a safer vehicle for nicotine compared to traditional combustible cigarettes.” “.

Provided by the Society for Nuclear Medicine and Molecular Imaging