Skip to main content
Top
Published in:

03-01-2024 | Biomarkers

Clinical Biomarkers to Evaluate Next Generation Inhaled Tobacco Products’ Effect in the Oral Cavity: a Narrative Review

Authors: S. Emma Sarles, Edward C. Hensel, Irfan Rahman, Risa J. Robinson

Published in: Current Oral Health Reports | Issue 1/2024

Login to get access

Abstract

Purpose of Review

Biomarkers in the oral cavity of users of next generation tobacco products, such as electronic cigarettes (EC), provide data about effects on oral and systemic health and help predict long-term health effects, such as cardiovascular, respiratory, and periodontal disease. Despite oral cavity health provides, translation of findings to regulatory outcomes around EC is lacking. A review of the current state of the art in use of clinical biomarkers of the oral cavity was conducted. This identified inconsistencies and gaps in tobacco regulatory science to address how to improve clinical studies for screening tobacco products and studying disease.

Recent Findings

The review identified that saliva and buccal biopsies provide dependable biomarkers of oral and systemic health when several parameters of health are standardized and considered. Inflammatory cytokines in oral tissue and biofluids of EC users are conflicting due to differences in sample collection and analysis techniques. Salivary C-reactive protein levels provide information about systemic inflammation and risk of cardiovascular disease, but analysis of this biomarker in the oral cavity does not appear in the current literature. The oral microbiome plays a significant role in human health and may be a useful tool to study systemic effects of tobacco products non-invasively, yet inconsistencies in reporting metrics make studies difficult to compare or translate into tangible outcomes. Effects of tobacco product use on hard dental tissue are not widely investigated despite correlations observed between e-cigarette use and broken teeth.

Summary

This review provides a comprehensive update on clinical biomarkers in systemic and oral diseases associated with emerging nicotine products.
Literature
3.
go back to reference • Park-Lee E, Ren C, Sawdey MD, Gentzke AS, Cornelius M, Jamal A, et al. Notes from the field: e-cigarette use among middle and high school students - National Youth Tobacco Survey, United States, 2021. MMWR Morb Mortal Wkly Rep. 2021;70(39):1387–9. https://doi.org/10.15585/mmwr.mm7039a4. This important update on e-cigarette use among adolescents supports the premise of the importance of this review. • Park-Lee E, Ren C, Sawdey MD, Gentzke AS, Cornelius M, Jamal A, et al. Notes from the field: e-cigarette use among middle and high school students - National Youth Tobacco Survey, United States, 2021. MMWR Morb Mortal Wkly Rep. 2021;70(39):1387–9. https://​doi.​org/​10.​15585/​mmwr.​mm7039a4. This important update on e-cigarette use among adolescents supports the premise of the importance of this review.
6.
18.
go back to reference •• Ureña JF, Ebersol LA, Silakov A, Elias RJ, Lambert JD. Impact of atomizer age and flavor on. Chem Res Toxicol. 2020;33(10):2527–37. https://doi.org/10.1021/acs.chemrestox.0c00028. This important study shows that coil age impacts reactive oxygen species in aerosol and reveals that mechanisms other than oxidative stress contribute to the cytotoxicity of e-cigarette aerosol. •• Ureña JF, Ebersol LA, Silakov A, Elias RJ, Lambert JD. Impact of atomizer age and flavor on. Chem Res Toxicol. 2020;33(10):2527–37. https://​doi.​org/​10.​1021/​acs.​chemrestox.​0c00028. This important study shows that coil age impacts reactive oxygen species in aerosol and reveals that mechanisms other than oxidative stress contribute to the cytotoxicity of e-cigarette aerosol.
24.
go back to reference Singh J, Luquet E, Smith DPT, Potgieter HJ, Ragazzon P. Toxicological and analytical assessment of e-cigarette refill components on airway epithelia. Sci Prog. 2016;99(4):351–98.CrossRefPubMedPubMedCentral Singh J, Luquet E, Smith DPT, Potgieter HJ, Ragazzon P. Toxicological and analytical assessment of e-cigarette refill components on airway epithelia. Sci Prog. 2016;99(4):351–98.CrossRefPubMedPubMedCentral
26.
go back to reference D’Aiuto F, Graziani F, Tete S, Gabriele M, Tonetti MS. Periodontitis: from local infection to systemic diseases. Int J Immunopathol Pharmacol. 2005;18(3 Suppl):1–11.PubMed D’Aiuto F, Graziani F, Tete S, Gabriele M, Tonetti MS. Periodontitis: from local infection to systemic diseases. Int J Immunopathol Pharmacol. 2005;18(3 Suppl):1–11.PubMed
27.
go back to reference •• Granger DA, Taylor MK, SpringerLink. Salivary bioscience: foundations of interdisciplinary saliva research and applications. 1st 2020. ed., vol Book, Whole. Cham: Springer International Publishing; 2020. This book provides an updated guide on handling and use of saliva samples for biomarker analysis. •• Granger DA, Taylor MK, SpringerLink. Salivary bioscience: foundations of interdisciplinary saliva research and applications. 1st 2020. ed., vol Book, Whole. Cham: Springer International Publishing; 2020. This book provides an updated guide on handling and use of saliva samples for biomarker analysis.
29.
go back to reference Roushdy MM. Association of dental caries, Streptococcus mutans counts and secretory IgA with tobacco smoking. Aust J Basic Appl Sci. 2009;3(4):3224–9. Roushdy MM. Association of dental caries, Streptococcus mutans counts and secretory IgA with tobacco smoking. Aust J Basic Appl Sci. 2009;3(4):3224–9.
32.
go back to reference Djaldetti M, Bessler H. Nicotine modifies cytokine production by human mononuclears stimulated by colon cancer cells. Colorec Cancer. 2017;3(2):16. Djaldetti M, Bessler H. Nicotine modifies cytokine production by human mononuclears stimulated by colon cancer cells. Colorec Cancer. 2017;3(2):16.
33.
go back to reference Toker H, Akpınar A, Aydın H, Poyraz O. Influence of smoking on interleukin-1beta level, oxidant status and antioxidant status in gingival crevicular fluid from chronic periodontitis patients before and after periodontal treatment. J Periodontal Res. 2012;47(5):572–7.CrossRefPubMed Toker H, Akpınar A, Aydın H, Poyraz O. Influence of smoking on interleukin-1beta level, oxidant status and antioxidant status in gingival crevicular fluid from chronic periodontitis patients before and after periodontal treatment. J Periodontal Res. 2012;47(5):572–7.CrossRefPubMed
41.
44.
go back to reference Sundar IK, Gerloff J, Freter R, Sekera ER, Friedman AE, Pagano T, et al. Inflammatory response by different e-cigarette flavoring chemicals identified by GC-MS in e-liquids on human lung epithelial cells and fibroblasts. C73 NEW MECHANISMS AND THERAPIES IN COPD. American Thoracic Society International Conference Abstracts: American Thoracic Society; 2017. p. A6286-A. Sundar IK, Gerloff J, Freter R, Sekera ER, Friedman AE, Pagano T, et al. Inflammatory response by different e-cigarette flavoring chemicals identified by GC-MS in e-liquids on human lung epithelial cells and fibroblasts. C73 NEW MECHANISMS AND THERAPIES IN COPD. American Thoracic Society International Conference Abstracts: American Thoracic Society; 2017. p. A6286-A.
46.
go back to reference Chen S, Chen H, Du Q, Shen J. Targeting myeloperoxidase (MPO) mediated oxidative stress and inflammation for reducing brain ischemia injury: potential application of natural compounds. Front Physiol. 2020;11:433.CrossRefPubMedPubMedCentral Chen S, Chen H, Du Q, Shen J. Targeting myeloperoxidase (MPO) mediated oxidative stress and inflammation for reducing brain ischemia injury: potential application of natural compounds. Front Physiol. 2020;11:433.CrossRefPubMedPubMedCentral
47.
go back to reference Ye D, Gajendra S, Lawyer G, Jadeja N, Pishey D, Pathagunti S, et al. Inflammatory biomarkers and growth factors in saliva and gingival crevicular fluid of e-cigarette users, cigarette smokers, and dual smokers: A pilot study. J Periodontol. 2020;91(10):1274–83.CrossRefPubMedPubMedCentral Ye D, Gajendra S, Lawyer G, Jadeja N, Pishey D, Pathagunti S, et al. Inflammatory biomarkers and growth factors in saliva and gingival crevicular fluid of e-cigarette users, cigarette smokers, and dual smokers: A pilot study. J Periodontol. 2020;91(10):1274–83.CrossRefPubMedPubMedCentral
48.
go back to reference • Shaikh S, Tung WC, Pang C, Lucas J, Li D, Rahman I. Classification/categorization and differential toxicity of oral nicotine pouches (ONPs) in lung epithelial cells. Toxics. 2022. https://doi.org/10.3390/toxics10110660. An early investigation into the affects of a product that has recently gained popularity. • Shaikh S, Tung WC, Pang C, Lucas J, Li D, Rahman I. Classification/categorization and differential toxicity of oral nicotine pouches (ONPs) in lung epithelial cells. Toxics. 2022. https://​doi.​org/​10.​3390/​toxics10110660. An early investigation into the affects of a product that has recently gained popularity.
49.
go back to reference •• Michelogiannakis D, Rahman I. Influence of e-cigarette and cannabis vaping on orthodontically induced tooth movement and periodontal health in patients undergoing orthodontic therapy. MDPI; 2022. p. 6518. This important work demonstrates the lack of published literature on the effect vaping has on orthodontic therapy. •• Michelogiannakis D, Rahman I. Influence of e-cigarette and cannabis vaping on orthodontically induced tooth movement and periodontal health in patients undergoing orthodontic therapy. MDPI; 2022. p. 6518. This important work demonstrates the lack of published literature on the effect vaping has on orthodontic therapy.
50.
go back to reference St. John MAR, Li Y, Zhou X, Denny P, Ho C-M, Montemagno C, et al. Interleukin 6 and interleukin 8 as potential biomarkers for oral cavity and oropharyngeal squamous cell carcinoma. Arch Otolaryngol–Head Neck Surg. 2004;130(8):929–35. St. John MAR, Li Y, Zhou X, Denny P, Ho C-M, Montemagno C, et al. Interleukin 6 and interleukin 8 as potential biomarkers for oral cavity and oropharyngeal squamous cell carcinoma. Arch Otolaryngol–Head Neck Surg. 2004;130(8):929–35.
52.
go back to reference Cavaillon J-M. Pro-versus anti-inflammatory cytokines: myth or reality. Cell Mol Biol-PARIS-WEGMANN-. 2001;47(4):695–702. Cavaillon J-M. Pro-versus anti-inflammatory cytokines: myth or reality. Cell Mol Biol-PARIS-WEGMANN-. 2001;47(4):695–702.
54.
go back to reference BinShabaib M, Alharthi SS, Akram Z, Khan J, Rahman I, Romanos GE, et al. Clinical periodontal status and gingival crevicular fluid cytokine profile among cigarette-smokers, electronic-cigarette users and never-smokers. Arch Oral Biol. 2019;102:212–7.CrossRefPubMed BinShabaib M, Alharthi SS, Akram Z, Khan J, Rahman I, Romanos GE, et al. Clinical periodontal status and gingival crevicular fluid cytokine profile among cigarette-smokers, electronic-cigarette users and never-smokers. Arch Oral Biol. 2019;102:212–7.CrossRefPubMed
56.
go back to reference Zutshi DV, Gupta MD, Girish MP, Bansal A, Batra V, Saijpaul R, et al. Evaluation of systemic inflammatory and thrombotic markers of cardiovascular risk among young Indian oral tobacco users. Indian Heart J. 2020;72(5):389–93.CrossRefPubMedPubMedCentral Zutshi DV, Gupta MD, Girish MP, Bansal A, Batra V, Saijpaul R, et al. Evaluation of systemic inflammatory and thrombotic markers of cardiovascular risk among young Indian oral tobacco users. Indian Heart J. 2020;72(5):389–93.CrossRefPubMedPubMedCentral
57.
go back to reference Li Y, John MARS, Zhou X, Kim Y, Sinha U, Jordan RCK, et al. Salivary transcriptome diagnostics for oral cancer detection. Clin Cancer Res. 2004;10(24):8442–50.CrossRefPubMed Li Y, John MARS, Zhou X, Kim Y, Sinha U, Jordan RCK, et al. Salivary transcriptome diagnostics for oral cancer detection. Clin Cancer Res. 2004;10(24):8442–50.CrossRefPubMed
58.
go back to reference Katakura A, Kamiyama I, Takano N, Shibahara T, Muramatsu T, Ishihara K, et al. Comparison of salivary cytokine levels in oral cancer patients and healthy subjects. Bull Tokyo Dent Coll. 2007;48(4):199–203.CrossRefPubMed Katakura A, Kamiyama I, Takano N, Shibahara T, Muramatsu T, Ishihara K, et al. Comparison of salivary cytokine levels in oral cancer patients and healthy subjects. Bull Tokyo Dent Coll. 2007;48(4):199–203.CrossRefPubMed
59.
go back to reference Mainous Iii AG, Yadav S, Hong Y-R, Huo J. e-Cigarette and conventional tobacco cigarette use, dual use, and C-reactive protein. J Am Coll Cardiol. 2020;75(17):2271–3.CrossRef Mainous Iii AG, Yadav S, Hong Y-R, Huo J. e-Cigarette and conventional tobacco cigarette use, dual use, and C-reactive protein. J Am Coll Cardiol. 2020;75(17):2271–3.CrossRef
60.
go back to reference Moon J, Lee H, Kong M, Kim H, Oh Y. Association between electronic cigarette use and levels of high-sensitivity C-reactive protein and uric acid. Asia Pac J Public Health. 2020;32(1):35–41.CrossRefPubMed Moon J, Lee H, Kong M, Kim H, Oh Y. Association between electronic cigarette use and levels of high-sensitivity C-reactive protein and uric acid. Asia Pac J Public Health. 2020;32(1):35–41.CrossRefPubMed
62.
go back to reference Kang J-H, Lee Y-H, Kho H-S. Clinical factors affecting salivary transferrin level, a marker of blood contamination in salivary analysis. BMC Oral Health. 2018;18(1):1–5.CrossRef Kang J-H, Lee Y-H, Kho H-S. Clinical factors affecting salivary transferrin level, a marker of blood contamination in salivary analysis. BMC Oral Health. 2018;18(1):1–5.CrossRef
65.
go back to reference Suh K-I, Kim Y-K, Kho H-S. Salivary levels of IL-1β, IL-6, IL-8, and TNF-α in patients with burning mouth syndrome. Arch Oral Biol. 2009;54(9):797–802.CrossRefPubMed Suh K-I, Kim Y-K, Kho H-S. Salivary levels of IL-1β, IL-6, IL-8, and TNF-α in patients with burning mouth syndrome. Arch Oral Biol. 2009;54(9):797–802.CrossRefPubMed
73.
go back to reference Kumar S, Prasad RS, Atulya, Kumar K, Kedia G, Kedia NB. Assessment of effect of cigarette smoking effects on the surface roughness of different denture base materials. Journal of Advanced Medical and Dental Sciences Research. 2020;8(7):12–5. https://doi.org/10.21276/jamdsr. Kumar S, Prasad RS, Atulya, Kumar K, Kedia G, Kedia NB. Assessment of effect of cigarette smoking effects on the surface roughness of different denture base materials. Journal of Advanced Medical and Dental Sciences Research. 2020;8(7):12–5. https://​doi.​org/​10.​21276/​jamdsr.
76.
go back to reference Javed F, Kellesarian SV, Sundar IK, Romanos GE, Rahman I. Recent updates on electronic cigarette aerosol and inhaled nicotine effects on periodontal and pulmonary tissues. Oral Dis. 2017;23(8):1052–7.CrossRefPubMedPubMedCentral Javed F, Kellesarian SV, Sundar IK, Romanos GE, Rahman I. Recent updates on electronic cigarette aerosol and inhaled nicotine effects on periodontal and pulmonary tissues. Oral Dis. 2017;23(8):1052–7.CrossRefPubMedPubMedCentral
Metadata
Title
Clinical Biomarkers to Evaluate Next Generation Inhaled Tobacco Products’ Effect in the Oral Cavity: a Narrative Review
Authors
S. Emma Sarles
Edward C. Hensel
Irfan Rahman
Risa J. Robinson
Publication date
03-01-2024
Publisher
Springer International Publishing
Published in
Current Oral Health Reports / Issue 1/2024
Electronic ISSN: 2196-3002
DOI
https://doi.org/10.1007/s40496-023-00357-w