Electronic nicotine delivery systems exhibit reduced bronchial epithelial cells toxicity compared to cigarette: The Replica Project

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Acknowledging CoEHAR in your work

If CoEHAR training and education, events, resources, equipment or staff have helped your project, we appreciate an acknowledgement in your papers, articles, presentations, posters, blog post with a citation and/ or link. It helps us to spread the word about our services and demonstrate our ongoing value to our Funders.

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We wish to thank the Center of Excellence for the Acceleration of Harm Reduction (CoEHAR, University of Catania, Italy- COE01-05) for assisting our project with the resources provided.

Massimo Caruso, Rosalia Emma, Alfio Distefano, Sonja Rust, Konstantinos Poulas, Fahad Zadjali, Antonio Giordano, Vladislav Volarevic, Konstantinos Mesiakaris, Mohammed Al Tobi, Silvia Boffo, Aleksandar Arsenijevic, Pietro Zuccarello, Cesarina Giallongo, Margherita Ferrante, Riccardo Polosa, Giovanni Li Volti


Cigarette smoking is the leading cause of preventable deaths worldwide. Electronic Nicotine Delivery Systems (ENDS) may reduce health risks associated with chronic exposure to smoke and their potential benefits have been the matter of intense scientific debate. Here we replicated three key published studies from the Tobacco Industry on cytotoxic and inflammatory effects of cigarette smoke and ENDS aerosol in an independent multicentric study. We aimed to establish the reliability of results and the robustness of conclusions by replicating the authors’ experimental protocols and further validating them with different techniques. We exposed human bronchial epithelial cell (NCI-H292) to cigarette smoke and to aerosol from ENDS. All the exposure were conducted at air-liquid interface to assess cytotoxicity effects of smoke and aerosol. Moreover, we aimed to assess different inflammatory mediators release (IL-6, IL-8 and MMP-1) from cells exposed to whole smoke and to smoke without particulate matter (vapor phase). We were able to replicate the results obtained in the original studies on cytotoxicity confirming that almost 80% of the cytotoxic effect of smoke is due to the vapor phase of smoke. Moreover, our results substantiated the reduced cytotoxic effects of ENDS aerosol in respect to cigarette smoke. However, our data are significantly different from the original ones in terms of inflammatory and remodeling activity triggered by smoke. Taken all together, the data obtained independently in different laboratories clearly demonstrate the reduced toxicity of ENDS products compared to cigarettes and thus providing a valuable tool to the harm reduction strategies in smokers.