Respiratory Research (Jun 2023)

Alveolar macrophages from EVALI patients and e-cigarette users: a story of shifting phenotype

  • Kristi J. Warren,
  • Emily M. Beck,
  • Sean J. Callahan,
  • My N. Helms,
  • Elizabeth Middleton,
  • Sean Maddock,
  • Jason R. Carr,
  • Dixie Harris,
  • Denitza P. Blagev,
  • Michael J. Lanspa,
  • Samuel M. Brown,
  • Robert Paine

DOI
https://doi.org/10.1186/s12931-023-02455-w
Journal volume & issue
Vol. 24, no. 1
pp. 1 – 10

Abstract

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Abstract Exposure to e-cigarette vapors alters important biologic processes including phagocytosis, lipid metabolism, and cytokine activity in the airways and alveolar spaces. Little is known about the biologic mechanisms underpinning the conversion to e-cigarette, or vaping, product use-associated lung injury (EVALI) from normal e-cigarette use in otherwise healthy individuals. We compared cell populations and inflammatory immune populations from bronchoalveolar lavage fluid in individuals with EVALI to e-cigarette users without respiratory disease and healthy controls and found that e-cigarette users with EVALI demonstrate a neutrophilic inflammation with alveolar macrophages skewed towards inflammatory (M1) phenotype and cytokine profile. Comparatively, e-cigarette users without EVALI demonstrate lower inflammatory cytokine production and express features associated with a reparative (M2) phenotype. These data indicate macrophage-specific changes are occurring in e-cigarette users who develop EVALI.

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