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E-cigarette exposure triggers distal lung cell injury, persistent lung stress response, and antiviral immune suppression
Tanner C. Rivera, Kelly S. Schweitzer, Christina Cornell, Jordan Nall, Nicholas Egersdorf, Courtney Moeder, Riley A. Cooney, Eszter K. Vladar, Steve D. Groshong, Gregory P. Downey, James P. Bridges, Richard Bowen, Hong Wei Chu, Irina Petrache
Tanner C. Rivera, Kelly S. Schweitzer, Christina Cornell, Jordan Nall, Nicholas Egersdorf, Courtney Moeder, Riley A. Cooney, Eszter K. Vladar, Steve D. Groshong, Gregory P. Downey, James P. Bridges, Richard Bowen, Hong Wei Chu, Irina Petrache
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Research Article Pulmonology Vascular biology

E-cigarette exposure triggers distal lung cell injury, persistent lung stress response, and antiviral immune suppression

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Abstract

The mechanisms by which e-cigarette vaping (EV) affects lung health remain unclear. Clusters of EV-associated lung injury indicate that EV damages distal lung parenchyma and increases vulnerability to second-hit injury, including respiratory viral infections. Using human lung endothelial and epithelial cells and precision-cut lung slices, we investigated the mechanisms underlying distal lung cell injury and repair triggered by brief (24-hour) EV exposure. RNA-seq of lung tissue from golden Syrian hamsters evaluated the persistence of lung stress responses (10 days after 5 days of EV exposure) and the effect of EV on host defense against influenza A virus and SARS-CoV-2. EV disrupted the barrier function of human distal lung cells through JNK stress response signaling, triggered autophagy with impaired flux, suppressed mTOR signaling and cell proliferation, and culminated in apoptosis. Transcriptional responses in EV-exposed hamster lungs revealed persistent activation of JNK signaling, autophagy, barrier dysfunction, tissue remodeling, and impaired Th1 immunity. EV increased SARS-CoV-2 viral burden, downregulated antiviral genes (Ifit1, Isg15, Nfkbia), and amplified oxidative stress and IL-12 signaling. Short-term EV exposure triggered stress-induced distal lung cell injury with persistent changes in antiviral immunity and molecular pathways associated with tissue remodeling. That may increase susceptibility to viral infections and contribute to lung disease.

Authors

Tanner C. Rivera, Kelly S. Schweitzer, Christina Cornell, Jordan Nall, Nicholas Egersdorf, Courtney Moeder, Riley A. Cooney, Eszter K. Vladar, Steve D. Groshong, Gregory P. Downey, James P. Bridges, Richard Bowen, Hong Wei Chu, Irina Petrache

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Figure 8

Effects of brief prior EV exposure on inflammatory responses to respiratory viral infections in hamsters.

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Effects of brief prior EV exposure on inflammatory responses to respirat...
(A) Experimental timeline: Exposure to EV for 5 days prior to intranasal administration of influenza A virus (IAV), followed 3 days later by intranasal administration of SARS-CoV-2 (COV2). Viral titers were measured at days 1, 2, and 3 after infection with SARS-CoV-2; lung tissues and bronchoalveolar lavage fluid (BALF) were collected at 7 days after infection with SARS-CoV-2 (10 days after cessation of EV exposure). (B) Upper respiratory viral titers obtained by nasal swabs at the indicated times (days) after SARS-CoV-2 infection. Mean ± SEM; 3-way ANOVA with a P value for the EV of 0.04. (C) Change in body weight in female and male hamsters from pre-infection weight. Mean ± SEM; 2-way ANOVA with Fisher’s least significant difference (LSD). (D–I) Quantification of indicated inflammatory cell population abundance in cytospins of BALF. Mean ± SEM; 2-way ANOVA with Fisher’s LSD. (J) Representative H&E-stained lung tissue sections from uninfected, SARS-CoV-2–infected, and coinfected (IAV+COV-2) hamsters show exuberant inflammatory infiltrate in SARS-CoV-2–infected lungs. Scale bars: 100 μm. (K) Unbiased histological scoring of inflammatory lung injury (based on epithelial thickening and inflammatory cell infiltration). Mean ± SEM; 2-way ANOVA with Fisher’s LSD. For all graphs, *P < 0.05, **P < 0.01, **P < 0.001, ****P < 0.0001; dots are individual animals. UT, untreated.

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