E-cigarette aerosol exposure of pulmonary surfactant impairs its surface tension reducing function

Abstract

E-cigarette (EC) and vaping use continue to remain popular amongst teenage and young adult populations, despite several reports of vaping associated lung injury. This popularity is due in part to the vast variety of appealing flavours and nicotine concentrations easily accessible on the market. One of the first compounds that EC aerosols comes into contact within the lungs during a deep inhalation is pulmonary surfactant. This lipid protein mixture lines the alveoli, reducing surface tension and preventing alveolar collapse. Impairment of surfactants critical surface tension reducing activity can contribute to lung dysfunction. Currently, information on how EC aerosols impacts pulmonary surfactant remains limited. We hypothesized that exposure to EC aerosol impairs the surface tension reducing ability of surfactant. Bovine Lipid Extract Surfactant (BLES) was used as a model surfactant in a direct exposure syringe system. BLES (2ml) was placed in a syringe (30ml) attached to an EC. The generated aerosol was drawn into the syringe and then expelled, repeated 30 times. Biophysical analysis after exposure was completed using a constrained drop surfactometer (CDS). Minimum surface tensions increased after exposure to the EC aerosol. Variation in device used, addition of nicotine, or temperature of the aerosol had no additional effect. Two e-liquid flavours, menthol and red wedding, had further detrimental effects, resulting in higher surface tension than the vehicle exposed BLES. Alteration of surfactant properties through interaction with the produced aerosol was observed with a basic e-liquid vehicle, however additional compounds produced by added flavourings appeared to be able to increase inhibition. In conclusion, EC aerosols alter surfactant function through increases in minimum surface tension. This impairment may contribute to lung dysfunction and susceptibility to further injury.