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In this study we investigated the impact of inhalation of aerosols produced from pod-based, flavored e-cigarettes aerosols three times daily for 3 months on inflammatory markers in the brain, lung, heart, and colon. JUUL aerosol exposure induced upregulation of cytokine and chemokine gene expression and increased HMGB1 and RAGE in the nucleus accumbens in the central nervous system. Inflammatory gene expression increased in the colon, while gene expression was more broadly altered by e-cigarette aerosol inhalation in the lung. Cardiopulmonary inflammatory responses to acute lung injury with lipopolysaccharide were exacerbated in the heart.

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The lead concentrations in most ENDS aerosols, however, were much lower than in mainstream smoke, with the exception of the Vuse Alto® Menthol aerosols. The typical lower delivery of lead in most ENDS likely is due to the lower temperatures in ENDS heating coils compared to a burning cigarette coal temperature during inhalation. We agree with the reviewer, that confirmation with protein levels would yield the strongest data possible. In the original manuscript we did include protein-based quantification data for the brain and lung. However, พอต did not have enough tissue to conduct protein-based studies on colon tissue. Although we were unable to include protein based quantification for all organs, we do feel that our original intention of demonstrating broad reaching effects of e-cigarette aerosols across the body was still achieved.

We do not mean to overstate our findings and have revised the manuscript to avoid that. The authors observed neuroinflammation in brain regions responsible for behavior modification, drug reward and formation of anxious or depressive behaviors after exposure to JUUL. It would help demonstrate the pathogenic role of the neuroinflammation by testing animal behaviors. It is unclear why the authors do not present their gene expression data in the form of a heatmap instead of 24 small individual graphs (e.g., Figures 3 and 6).

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5), with the exception of Vuse Alto® Menthol zinc (867–4,580 ng/10 puffs). Tin and lead concentrations were low in our previous ENDS results as well as in most pod liquid samples used for this study. One exception for tin was observed in myblu™ Tobacco Chill liquid where the concentration was greater than the other pod liquid concentrations. In aerosol, there were detectable tin and lead values among the pods. The highest tin aerosol concentration ranged from 81.2 to 127 ng/10 puffs, and the highest aerosol lead concentration ranged from 96.5 to 463 ng/10 puffs.

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This can lead to lung damage like scarring and narrowing of the tubes that bring air in and out of your lungs. Researchers don’t yet know all the effects vaping can have on your body. We showedthat JUUL exposure affected the expression of pro-inflammatory cytokines in colonic tissue under homeostatic conditions.

Another study assessed whether exposure to JUUL aerosol played a causal role in EVALI patients (Matsumoto et al., 2020). While the study revealed that 15 days of exposure to JUUL aerosol did not cause direct lung injury, the authors cautioned that chronic exposure to nicotine may still have a disruptive effect on lung physiology (Matsumoto et al., 2020). While these studies have laid the groundwork for assessing the acute impact of JUUL use on the respiratory system, much work remains to be done on the effects across the body. Comparing e-cigarettes to nicotine replacement therapy, a 2021 review found “moderate-certainty evidence” that e-cigarettes are more effective than nicotine replacement therapy for quitting smoking. The difference was minor, indicating that compared to NRT, e-cigarettes might lead to an additional four successful quitters per 100.

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