Scientists find lung damage in chronic e-cigarette users

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In a study from Massachusetts General Hospital, scientists found chronic use of e-cigarettes, commonly known as vaping, can result in progressive small airway obstruction and asthma-like symptoms such as shortness of breath and chest pains.

They found in a small group of patients, there were fibrosis and damage in the small airways, similar to the chemical inhalation damage to the lungs typically seen in soldiers returning from overseas conflicts who had inhaled mustard or similar types of noxious gases.

A huge increase in vaping, particularly among young adults and adolescents, has occurred in the United States, with studies showing about 9% of the population and nearly 28% of high school students are e-cigarette users.

Unlike cigarette smoking, however, the long-term health risks of chronic vaping are largely unknown.

In the study, the team examined four patients, each with a three-to-eight-year history of e-cigarette use and chronic lung disease.

All patients underwent detailed clinical evaluation, including pulmonary function tests, high resolution chest imaging, and surgical lung biopsy.

Constrictive bronchiolitis, or narrowing of the small airways due to fibrosis within the bronchiolar wall, was found in each patient.

So was significant overexpression of MUC5AC, a gel-forming protein in the mucus layer of the airway that has been seen in airway cell and sputum samples of individuals who vape.

In addition, three of the four patients had evidence of mild emphysema consistent with their former combustible cigarette smoking history.

Because the same type of lung damage was observed in all patients, as well as partial improvement in symptoms after e-cigarette usage was stopped, researchers concluded that vaping was the most likely cause after thorough evaluation and exclusion of other possible causes.

The team says doctors need to be informed by scientific evidence when advising patients about the potential harm of long-term vaping, and this work adds to a growing body of toxicological evidence that nicotine vaping exposures can harm the lung.

A hopeful sign from the study was that three of the four patients showed improvements in their pulmonary function tests and high-resolution computed tomography (HRCT) chest imaging after they ceased vaping.

If you care about lung health, please read studies about how to manage chronic lung disease amid COVID-19, and E-cigarettes change inflammation in brain, heart, lungs and colon.

For more information about health, please see recent studies about why smokers have a lower risk of COVID-19, and results showing scientists find the cause of lung cancer in never smokers.

The study was conducted by Lida Hariri et al and published in the New England Journal of Medicine Evidence.

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