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Lung Model Developed to Test E-Cigarettes, Hookah

Juul e-cigarette

Juul e-cigarette device (Mylesclark96, Wikimedia Commons)

12 April 2019. A three-dimensional model of a human lung is being developed to test health effects of new trends in smoking, such as electronic cigarettes and hookahs. The model lung is a project of the University of Colorado medical school in Denver, funded by a $3.4 million grant from Food and Drug Administration.

Electronic cigarettes, or e-cigarettes, are battery-powered nicotine delivery devices, that heat a liquid containing nicotine, moisturizing and flavoring agents, as well as preservatives and artificial coloring. Makers of e-cigarettes often market the devices as safer alternatives to tobacco-burning cigarettes and sometimes as a technique to help tobacco smokers quit conventional cigarettes. Hookahs are water pipes, used for centuries in the Middle East, but becoming popular in cafes in the West, including the U.S. Hookahs are smoked through a water bowl and flexible tube, often with flavored tobacco, much like e-cigarettes.

Data from a Centers for Disease Control and Prevention survey in reported in November 2018 show large increases in electronic cigarette use in high school and middle school children in just the past year. The results show the number of e-cigarette users in high school rose 78 percent to more than 3 million, or about 21 percent of all high school students, since the last survey in 2017. Even among middle school students, e-cigarette smoking jumped by 48 percent in the past year to 570,000 or about 5 percent of all middle school students. At the same time, tobacco use of any kind among high-school students rose in the past year by 38 percent to 4 million, and among middle-schoolers, tobacco use increased by 29 percent to 840,000.

As reported by Science & Enterprise last month, Scott Gottlieb, the recently-departed commissioner of the FDA, described the sharp rise in youth e-cigarette use “an epidemic,” adding that, “All the gains made against youth tobacco use over the years will be reversed by these products.” Gottlieb added that some evidence shows e-cigarettes can help current smokers quit their conventional cigarettes, but that’s far outweighed by the marked increases in teen use of e-cigarettes and upticks in combustible tobacco.

The 3-D lung project is led by Kambez Benam, a biomedical engineering professor at Colorado, whose lab is developing tissue engineered models of lungs to better understand effects of smoking and other pathologies. In this project, Benam and colleagues are creating an engineered airways, the passage through which air reaches the lungs and respiratory tract, with living cells that line the airways. The airway tissue cells will be seeded on an extracellurlar matrix, the framework or scaffold for the airways, as well as stromal, or connective tissue cells surrounding the lung.

The model lung is expected to provide realistic effects of e-cigarette and hookah smoking on lung tissue and cells, as well as related impacts on on genes, proteins, and functions of organs and the immune system. Researchers in the past used animals for these kinds of tests, but results from animal tests are not always transferable to humans.

“Providing the next generation of a human lung model to compare the toxicity of emerging products,” says Benam in a university statement, “particularly hookah and e-cigarettes, will help identify dangerous and carcinogenic formulations. This study has an unprecedented potential to advance the available tool kits for FDA to better protect and promote public health concerns around tobacco products.”

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