Page 1 of 4 123 ... LastLast
Results 1 to 10 of 37

Thread: An Inadequate "Sensationalist" Study

  1. #1
    PSU Member plugugly's Avatar
    Join Date
    Oct 2013
    Location
    Scotland
    Real Name
    Chris
    Pipe smoker since
    2001
    Posts
    10,801


    9 members Liked or found this post helpful.

    An Inadequate "Sensationalist" Study

    For reasons that I will explain below, this seems a trivial study, but of course, it has been picked up and sensationalised by the media, notably by the BBC this morning:


    https://www.bbc.co.uk/news/health-45170756



    But not as harmful as inhaling cigarette smoke! You can bet your boots on that.

    In my practice, and in that of many other pulmonary physicians, nicotine-containing e-cigarettes have been a godsend in weaning patients off cigarettes. I'm not saying that they have no effects on the lungs, but I am saying these will be trivial compared to inhaled cigarette smoke; which IMO is why cigarette-smoke condensate was excluded from this study.


    I have pasted the abstract of the actual article below. It took only two minutes for me to have binned it, had I been asked to review (it is in my field). I don't know those that put it together, "Thorax" is not particularly impressive, but nonetheless it is the "British" respiratory journal.

    My knee-jerk critique to the abstract (all most people read):

    1. In addition, crucially, there should have been a proper negative control - phosphate-buffered saline - from my past studies I know that even this innocuous fluid can cause mild inflammation in the lung.

    2. Are they being disingenuous by deliberately not including real cigarette smoke condensate in the study - pound to a penny says this would have comparatively massive effects.

    3. No actual data are included in the abstract.

    4. A 'small' study? What does this mean? A couple of goes? Where are the "n=" values in the abstract?

    5. "Significant"? What does this mean, significant to them? Or statistically significant, in which case we need numbers, standard errors and "P values". Not seen in the abstract.

    I hate seeing this sort of stuff in the medical literature and I am unimpressed by "Thorax", a recognised British journal, for what seems an attempt to attract media attention.



    Smoking

    Original article

    Pro-inflammatory effects of e-cigarette vapour condensate on human alveolar macrophages

    Aaron Scott1, Sebastian T Lugg1, Kerrie Aldridge1, Keir E Lewis2, Allen Bowden3, Rahul Y Mahida1, Frances Susanna Grudzinska1, Davinder Dosanjh1, Dhruv Parekh1, Robert Foronjy4, Elizabeth Sapey1, Babu Naidu1, David R Thickett1

    Author affiliations
    Birmingham Acute Care Research Group Institute of Inflammation and Ageing (IIA), University of Birmingham, Birmingham, UK
    College of Medicine, Swansea University, Swansea, UK
    Analytical Facility, School of Chemistry, University of Birmingham, Birmingham, UK
    Division of Pulmonary and Critical Care Medicine,Department of Medicine, SUNY Downstate Medical Center, Brooklyn, New York, USA
    Correspondence to
    Dr David R Thickett, Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TH, UK; d.thickett@bham.ac.uk

    Abstract

    Objective Vaping may increase the cytotoxic effects of e-cigarette liquid (ECL). We compared the effect of unvaped ECL to e-cigarette vapour condensate (ECVC) on alveolar macrophage (AM) function.

    Methods
    AMs were treated with ECVC and nicotine-free ECVC (nfECVC). AM viability, apoptosis, necrosis, cytokine, chemokine and protease release, reactive oxygen species (ROS) release and bacterial phagocytosis were assessed.

    Results
    Macrophage culture with ECL or ECVC resulted in a dose-dependent reduction in cell viability. ECVC was cytotoxic at lower concentrations than ECL and resulted in increased apoptosis and necrosis. nfECVC resulted in less cytotoxicity and apoptosis. Exposure of AMs to a sub-lethal 0.5% ECVC/nfECVC increased ROS production approximately 50-fold and significantly inhibited phagocytosis. Pan and class one isoform phosphoinositide 3 kinase inhibitors partially inhibited the effects of ECVC/nfECVC on macrophage viability and apoptosis. Secretion of interleukin 6, tumour necrosis factor α, CXCL-8, monocyte chemoattractant protein 1 and matrix metalloproteinase 9 was significantly increased following ECVC challenge. Treatment with the anti-oxidant N-acetyl-cysteine (NAC) ameliorated the cytotoxic effects of ECVC/nfECVC to levels not significantly different from baseline and restored phagocytic function.

    Conclusions
    ECVC is significantly more toxic to AMs than non-vaped ECL. Excessive production of ROS, inflammatory cytokines and chemokines induced by e-cigarette vapour may induce an inflammatory state in AMs within the lung that is partly dependent on nicotine. Inhibition of phagocytosis also suggests users may suffer from impaired bacterial clearance. While further research is needed to fully understand the effects of e-cigarette exposure in humans in vivo, we caution against the widely held opinion that e-cigarettes are safe.

    This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:http://creativecommons.org/licenses/by-nc/4.0/.


    http://dx.doi.org/10.1136/thoraxjnl-2018-211663
    Last edited by plugugly; 08-14-2018 at 09:28.

  2. #2
    Moderator jimbo44's Avatar
    Join Date
    Sep 2013
    Location
    North Yorkshire, UK
    Pipe smoker since
    1960
    Posts
    10,618


    5 members Liked or found this post helpful.

    "In my practice, and in that of many other pulmonary physicians, nicotine-containing e-cigarettes have been a godsend in weaning patients off cigarettes. I'm not saying that they have no effects on the lungs, but I am saying these will be trivial compared to inhaled cigarette smoke"...

    This sentence alone seems to justify ignoring the "study"!
    Work is the curse of the smoking classes

  3. #3


    5 members Liked or found this post helpful.

    Quote Originally Posted by jimbo44 View Post
    "In my practice, and in that of many other pulmonary physicians, nicotine-containing e-cigarettes have been a godsend in weaning patients off cigarettes. I'm not saying that they have no effects on the lungs, but I am saying these will be trivial compared to inhaled cigarette smoke"...

    This sentence alone seems to justify ignoring the "study"!
    Beat me to the punch Jimbo.
    Last edited by craigmilllar; 08-14-2018 at 14:54. Reason: glaswegian accent

  4. #4
    PSU Member Rockbass's Avatar
    Join Date
    Feb 2014
    Location
    Cleveland, OH
    Real Name
    Thomas
    Posts
    7,033


    7 members Liked or found this post helpful.

    Too many big words. I fell asleep.
    Anyway I only read studies by Dr. Pugnacious.
    I can resist anything but temptation--Oscar Wilde

  5. #5
    PSU Member plugugly's Avatar
    Join Date
    Oct 2013
    Location
    Scotland
    Real Name
    Chris
    Pipe smoker since
    2001
    Posts
    10,801


    4 members Liked or found this post helpful.

    Quote Originally Posted by jimbo44 View Post
    "In my practice, and in that of many other pulmonary physicians, nicotine-containing e-cigarettes have been a godsend in weaning patients off cigarettes. I'm not saying that they have no effects on the lungs, but I am saying these will be trivial compared to inhaled cigarette smoke"...

    This sentence alone seems to justify ignoring the "study"!
    That is true, Jim, but it represents an opinion based on experience.

    My firm scientific view is that if this 'study' was to represent an important contribution to the literature, there should have been four groups , all done with a range of concentrations (except the saline one) and with an appropriate number of repeats:

    1. The full vaping solution

    2. The vaping solution without nicotine

    3. Cigarette smoke condensate

    4. Control buffered saline.

    Then, a repeat of each group, again at a range of concentrations, but with added anti-oxidant/ other anti-inflammatory agent.

    A pretty piss-poor effort, in my personal opinion.

    For all we know, there might have been very little/no difference between the vaping solution and control saline (which, as I said above, does itself induce a mild inflammatory response in the lung)
    Last edited by plugugly; 08-14-2018 at 15:19.

  6. #6
    PSU Member plugugly's Avatar
    Join Date
    Oct 2013
    Location
    Scotland
    Real Name
    Chris
    Pipe smoker since
    2001
    Posts
    10,801


    5 members Liked or found this post helpful.

    Quote Originally Posted by Rockbass View Post
    Too many big words. I fell asleep.
    Anyway I only read studies by Dr. Pugnacious.
    You'd better get them gloves on again, li'l froggie!!


    boxer.jpg
    Last edited by plugugly; 08-14-2018 at 15:32.

  7. #7
    Moderator jimbo44's Avatar
    Join Date
    Sep 2013
    Location
    North Yorkshire, UK
    Pipe smoker since
    1960
    Posts
    10,618


    3 members Liked or found this post helpful.

    Quote Originally Posted by Rockbass View Post
    Anyway I only read studies by Dr. Pugnacious.
    Who you gonna call? Mythbuster
    Work is the curse of the smoking classes

  8. #8
    Moderator jimbo44's Avatar
    Join Date
    Sep 2013
    Location
    North Yorkshire, UK
    Pipe smoker since
    1960
    Posts
    10,618


    5 members Liked or found this post helpful.

    Quote Originally Posted by plugugly View Post
    That is true, Jim, but it represents an opinion based on experience.

    My firm scientific view is that if this 'study' was to represent an important contribution to the literature, there should have been four groups , all done with a range of concentrations (except the saline one) and with an appropriate number of repeats:

    1. The full vaping solution

    2. The vaping solution without nicotine

    3. Cigarette smoke condensate

    4. Control buffered saline.

    Then, a repeat of each group, again at a range of concentrations, but with added anti-oxidant/ other anti-inflammatory agent.

    A pretty piss-poor effort, in my personal opinion.

    For all we know, there might have been very little/no difference between the vaping solution and control saline (which, as I said above, does itself induce a mild inflammatory response in the lung)
    Accepted - but the empirical evidence gained from a lifetime of experience by an expert clinician ranks as pretty good science for me.
    Work is the curse of the smoking classes

  9. #9
    PSU Member Rockbass's Avatar
    Join Date
    Feb 2014
    Location
    Cleveland, OH
    Real Name
    Thomas
    Posts
    7,033


    4 members Liked or found this post helpful.

    Quote Originally Posted by plugugly View Post
    You'd better get them gloves on again, li'l froggie!!


    boxer.jpg
    Pugilistic humour is the realm of an undisciplined mind.
    I can resist anything but temptation--Oscar Wilde

  10. #10
    PSU Member plugugly's Avatar
    Join Date
    Oct 2013
    Location
    Scotland
    Real Name
    Chris
    Pipe smoker since
    2001
    Posts
    10,801


    5 members Liked or found this post helpful.

    Quote Originally Posted by jimbo44 View Post
    Accepted - but the empirical evidence gained from a lifetime of experience by an expert clinician ranks as pretty good science for me.
    Bottom line here - for anyone trying to get off cigs, do not hesitate to use e-cigarettes - ideally those with just/mainly nicotine, rather than with fancy added flavours. Pure nicotine is not known to be a carcinogen.

    In England, there is pressure to introduce them on the NHS. Of course the cigarette lobby do not like the idea, which is part of the reason we are seeing anti-e-cigarette 'shroud-waving'.

Page 1 of 4 123 ... LastLast

Bookmarks

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •