U.S. scientists join effort to solve mysterious vaping-related illnesses

UNTV News   •   September 20, 2019   •   440

The U.S. investigation into hundreds of cases of life-threatening lung illnesses related to vaping is turning up new clues and helping researchers across the country trying to make sense of the situation.

Robert Tarran, a physiologist and vaping expert at the University of North Carolina School of Medicine, is one of a group of researchers studying collections of lung cell samples, looking for answers about the outbreak.

“In my lab we study real world vapers who vape normally. So we’ve been collecting people who’ve been vaping for six months to a couple of years and then taken their lungs as they are. So I think the people we’ve been studying are representative of people being hospitalized. And I think it’s important to say that in the all the vapers that we’ve studied we’re seeing changes in their lungs,” he told Reuters.

Many of the victims had pockets of oil clogging up cells responsible for removing impurities in the lungs.

The answer to where that oil comes from will help explain whether these cells play a key role in the vaping-related outbreak that has killed atleast seven people and sickened 530 so far.

It may also reveal whether some of these cases have been occurring all along, undetected.

A group of researchers who have been studying the long-term effects of vaping told Reuters they have taken up the challenge. They have begun to re-examine lung cell samples they have collected in recent years for evidence of these oil-filled immune cells in people who vaped but didn’t get sick.

One possibility: The deposits are residue from inhaling vaping oils, such as those containing the marijuana ingredient tetrahydrocannabinol (THC) or vitamin E acetate. Both are considered possible contributors to the current illnesses.

Some researchers suspect the oils are formed inside the lungs as part of the body’s natural response to chemicals found in many commercial vaping devices. One theory is that vaping these chemicals may impair the immune system, and make people who vape more vulnerable to respiratory distress, they say.

“One of the things we found there is a wide variety some liquids are more toxic than others and we found there is a correlation the more flavors in a liquid the more likely it was to be toxic. But there’s also an incredible diversity of flavors. So in 150 e-liquids we found about 200 different chemical constituents. And so really the flavors e-liquid really are all over the map,” Tarrant said.

A study published in the Journal of Clinical Investigation earlier this month has fueled the latter theory.

It found that mice exposed to aerosols of propylene glycol and vegetable glycerin – common solvents used in conventional nicotine vaping devices – developed these same fat-clogged immune cells even though they were never exposed to vaping oils. These mice also had impaired immune systems compared to mice exposed to room air.

The study set off alarm bells for Thomas Eissenberg, co-director of the Center for Tobacco Products at Virginia Commonwealth University. For years, doctors have reported isolated cases of pneumonia-like illnesses in people who vaped. In many cases, patients also had these fat-filled immune cells – called lipid-laden macrophages.

Now, these same abnormalities have been found in mice, and in at least some of the people who have fallen ill recently.

They want to help determine is whether these abnormalities have been present for years, and whether they have made vapers generally more vulnerable to severe disease, possibly triggered by some new vaping substance.

The group’s members say they have been in regular contact with officials at the CDC and the National Institutes of Health on how they can best help with the multistate investigation.

They include Tarran, a physiologist and vaping expert at the University of North Carolina School of Medicine, and Dr. Peter Shields, a lung cancer specialist at The Ohio State University Wexner Medical Center, who has one of the country’s largest sets of lung samples from vapers, smokers and never-smokers.

Investigators at the CDC and the U.S. Food and Drug Administration (FDA) have pointed to THC vaping oils or vitamin E, a substance used in some THC products, as a possible cause of these illnesses. But they have not ruled out anything yet, including conventional nicotine liquids.

“So we’ve been able to break some of our studies down to study just the nicotine or the solvent the propane glycol vegetable glycerin. And we’ve been finding changes due to both of these components. So we can help identify things in any liquids which are having these effects and then potentially we could extend these studies and study cannabinoids or the vitamin E oils,” Tarrant said.

CDC pathologists are examining hundreds of lung cell samples gathered from patients in the outbreak. Meanwhile, forensic chemists at the FDA are testing more than 120 products to determine whether there is a common ingredient that may explain the illnesses. (REUTERS)

(Production: Gershon Peaks, Kevin Fogarty, Andrew Hofstetter, Rollo Ross, Temis Tormo)

Police to still arrest people who vape in public —NCRPO

Maris Federez   •   December 10, 2019

MANILA, Philippines— The National Capital Region Police Office (NCRPO) will still continue arresting people who vape in public places.

NCRPO acting director PBGen. Debold Sinas said that around 98 vapes had been confiscated and 98 had also been arrested.

He added that 812 vape stores have voluntarily closed down and 297 were urged by the NCRPO to stop selling.

Sinas also welcomed the report that the ban on the importation of vapes is now in effect, although he admitted that they have not received any directive on the matter.

“Wala pa kaming natanggap na directive so yung campaign namin ay tuloy tuloy lang po yun. Napansin mo medyo humina na nga ang nahuhuli eh. At tsaka kumukonti na rin kasi parang nasanay na rin. So sana tuloy tuloy na ito,” Sinas said.(from the report of Lea Ylagan) /mbmf

MMDA supports ban on vape

Aileen Cerrudo   •   November 22, 2019

The Metropolitan Manila Development Authority (MMDA) has announced their support for President Rodrigo Duterte’s ban on vaping in public places.

MMDA Chairman Danilo Lim encourages the public to adhere to the President’s order. He also said that the said order aims to protect the public’s health.

“I agree with the statement of the President that vaping poses harmful effects to human health. Hence, I support the regulation of vaping for the sake of the general public,” he said.

Meanwhile, Director of the MMDA Health and Environmental Protection Office (HEPO) Dr. Loida Alzona said the MMDA’s environmental enforcers will strictly monitor the selling, advertising and promotion of cigarettes and other tobacco products within 100-meter perimeter of schools in Metro Manila.

“We will help make sure that no vape shops are established within 100-perimeter of public and private schools in the metropolis,” she said.—AAC

DOH-FDA receives first report of vape-associated lung injury case in Phl

Maris Federez   •   November 15, 2019

MANILA, Philippines – The Department of Health (DOH) on Friday (November 15) announced that it has received an official report on the first case of E-cigarette or Vape-Associated Lung Injury (EVALI) from a private pediatric pulmonologist based in the Visayas.

Based on the DOH information released to the media, the patient is a 16-year old female who had been using e-cigarettes for six months while concurrently consuming combustible cigarettes, referred to as “dual-use.”

It said the patient, who was admitted last October 21, initially presented sudden-onset of severe shortness of breath which required them to administer her with oxygen and be admitted to the ICU.

The report also said the clinical impression was initially considered to be infectious in nature, but after further evaluation, the patient met the case criteria for EVALI based on the guidelines of the US Centers for Disease Control (CDC).

The patient, however, was subsequently discharged after receiving appropriate care from the attending pulmonologist who is now in continuous communication with the DOH regarding the condition of the patient.

Health Undersecretary Rolando Enrique Domingo said, “all e-cigarette users should seek immediate medical help, and ask their doctors for ways to quit these harmful products.”

“No e-cigarette product should be accessible to young children and adolescents, who are uniquely susceptible to the harms of e-cigarettes and nicotine. I urge non-users not to even try e-cigarettes at all,” he added.

The health department urges the public to report suspected EVALI cases to ecigarettesurveillance@doh.gov.ph. /mbmf

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