Multisystem Toxicity of E-Cigarettes in Preclinical and Clinical Studies: Pathophysiologic Effects of E-Cigarette Aerosol Exposures from Head to Toe

Abstract

The global population breathes unsafe levels of pollutants. In recent years, electronic cigarettes (e-cigs) have become a significant source of particulate matter (PM), which causes injurious effects across organ systems. E-cig users and bystanders are exposed to concentrated aerosols, commonly called vapor, that we now know can have harmful long-term consequences due to PM and chemicals contained within. E-cigs are diverse in design, and e-liquids vary dramatically, making it difficult to draw broad conclusions from studies of different devices, brands, and flavors. With the rise in popularity of e-cigs, it is important to define the health effects across the body. In this comprehensive review, we dissect and summarize the known organ-specific effects of e-cigs, including underlying molecular mechanisms. Notably, e-cig aerosols broadly cause increased cytokine release and oxidative stress, which are associated with a heightened risk of organ dysfunction. We also highlight ways to minimize harmful e-cig constituents to develop safer products.