Part Three: Biomarker Changes in Cigarette Smokers Switched to Vuse Solo or Abstinence: A Randomized, Controlled Study

Biomarkers of exposure (BoE) can help evaluate exposure to combustion-related, tobacco-specific toxicants after smokers switch from cigarettes to potentially less-harmful products like electronic nicotine delivery systems (ENDS). This paper reports data for one (Vuse Solo Original) of three products evaluated in a randomized, controlled confinement study of BoE in smokers switched to ENDS. Subjects smoked their usual brand cigarette ad libitum for two days, then were randomized to one of three ENDS for a 7-day ad libitum use period, or to smoking abstinence. Thirteen BoE were assessed at baseline and Day 5, and percent change in mean values for each BoE was calculated. Biomarkers of potential harm (BoPH) linked to oxidative stress, platelet activation, and inflammation were also assessed. Levels decreased among subjects randomized to Vuse Solo versus Abstinence, respectively, for the following BoE: 42–96% vs. 52–97% (non-nicotine constituents); 51% vs. 55% (blood carboxyhemoglobin); and 29% vs. 96% (nicotine exposure). Significant decreases were observed in three BoPH: leukotriene E4, 11-dehydro-thromboxane B2, and 2,3-dinor thromboxane B2 on Day 7 in the Vuse Solo and Abstinence groups. These findings show that ENDS use results in substantially reduced exposure to toxicants compared to smoking, which may lead to reduced biological effects.

First Experience Addressing the Prognostic Utility of Novel Urinary Biomarkers in Patients with COVID-19

Urine 11-dehydro-thromboxane B2 (u11-dh-TxB2), 8-hydroxy-2'-deoxyguanosine, and liver-type fatty acid binding protein levels (L-FABP) at the time of hospitalization were higher in COVID-19 patients with adverse events versus without events. Higher u11-dh-TxB2 and L-FABP levels were associated with longer hospitalization, more thrombotic events, and greater mortality, providing evidence for potential utility as early prognostic biomarkers for COVID-19.

The prevalence and associated factors of aspirin resistance among prophylactic aspirin users

Background. Aspirin is an antiplatelet used for the secondary prevention after vascular events. It is also suggested for the primary prevention of vascular events in high risk people, however, despite using standard prophylactic doses, aspirin resistance may result in therapeutic failure and arterial thrombosis. Since the prevalence of aspirin resistance and its associated factors were heterogeneous in different studies, this study was conducted to determine the prevalence and associated factors of aspirin resistance in an Iranian population under aspirin for primary prevention of vascular events. Methods. 264 patients without documented vascular disease with 80 mg daily aspirin consumption for at least one month enrolled in this cross-sectional study. Aspirin resistance was assessed by the measurement of thromboxane B2 in the urine samples using the enzyme-linked immunosorbent assay method. Aspirin resistance was defined as a urine level of thromboxane B2 ≥ 1700 ng/dl. Results. The prevalence of aspirin resistance in this study was 9.8%. Age (OR = 0.935, 95% CI: 0.880-0.993, P = 0.028) and geographical regions (OR = 0.117, 95% CI: 0.014-0.958, P = 0.045) showed independent correlation with aspirin resistance. No significant association observed between aspirin resistance and gender, diabetes mellitus, hypertension, hyperlipidemia, smoking, duration of aspirin use, body mass index, and drug history. Conclusions. Despite the standard daily dose of aspirin for primary prevention of vascular events, some of our patients exhibited aspirin resistance that was directly related to a higher age and geographical region. More studies are required to clarify the beneficial role of aspirin resistance test before planning a preventive strategy in high risk individuals.

Twenty‐Four‐Hour Cardiovascular Effects of Electronic Cigarettes Compared With Cigarette Smoking in Dual Users

Background Cardiovascular safety is an important consideration regarding the benefits versus risks of electronic cigarette use (EC) for public health. The single‐use cardiovascular effects of EC have been well studied but may not reflect effects of ad libitum use throughout the day. We aimed to compare the circadian hemodynamic effects as well as 24‐hour biomarkers of oxidative stress, and platelet aggregation and inflammation, with ad libitum cigarette smoking (CS) versus EC versus no tobacco product use. Methods and Results Thirty‐six healthy dual CS and EC users participated in a crossover study in a confined research setting. Circadian heart rate, blood pressure and plasma nicotine levels, 24‐hour urinary catecholamines, 8‐isoprostane and 11‐dehydro‐thromboxane B2, and plasma interleukin‐6 and interleukin‐8 were compared in CS, EC, and no nicotine conditions. Over 24 hours, and during daytime, heart rate and blood pressure were higher in CS and EC compared with no tobacco product conditions ( P <0.01). Heart rate on average was higher with CS versus EC. Urinary catecholamines, 8‐isoprostane, and 11‐dehydro‐thromboxane B2 were not significantly different, but plasma IL‐6 and IL‐8 were higher with both CS and EC compared with no tobacco product ( P <0.01). Conclusions CS and EC had similar 24‐hour patterns of hemodynamic effects compared with no tobacco product, with a higher average heart rate with CS versus EC, and similar effects on biomarkers of inflammation. EC may pose some cardiovascular risk, particularly to smokers with underlying cardiovascular disease, but may also provide a harm reduction opportunity for smokers willing to switch entirely to EC. Registration URL: https://www.clinicaltrials.gov ; Unique Identifier: NCT02470754.