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Vaping has sent nearly 100 people with lung disease to the hospital in the last two weeks, mostly teenagers and young adults.
The Centers for Disease Control and Prevention (CDC) are investigating 94 possible cases of "severe pulmonary disease associated with inhalation of vapors", which were reported in 14 states on August 17. according to a statement from the agency. It is still unclear what causes the diseases or even if there is a link between the symptoms of the patients and the types of products that they use.
But patients reported spraying various substances, including nicotine and marijuana. Some patients said they bought their e-cigarette products on the street, according to a previous Live Science report. What could hurt them?
Related: 4 myths about electronic cigarettes
On the basis of limited information, the "most likely" explanation is that a toxic chemical in electronic cigarettes causes a "reactive and severe inflammatory" response in the lungs of patients, said Dr. Michael Siegel, Professor of Community Health Sciences at School of Public Health, Boston University.
If this is the case, this chemically induced lung injury could lead to several serious lung diseases. A condition, known as acute respiratory distress syndrome (ARDS), has been associated with the inhalation of toxic fumes. Another condition is chemical pneumonitis, or inflammation of the lungs caused by inhalation of irritants, Siegel told Live Science.
But "it is very unlikely that this is solely caused by e-liquids containing nicotine," he added. On the contrary, the reaction is probably caused by a "contaminant present in some formulations of cannabis products" sold for vaping, possibly on the street, he said.
For example, pneumonia has been linked to the practice of "buffering" or inhalation of butane oil, a concentrated form of marijuana that contains a large amount of active compound, THC. According to a report published in the newspaper, heating butane oil at high temperatures can result in the formation of toxic chemicals to the lungs. Case reports on respiratory medicine last January.
But other experts say that cannabis-free electronic cigarettes, those containing nicotine instead of THC, could also provoke such reactions. A group of researchers recently discovered that nicotine releases potentially harmful enzymes – molecules that play a role in the breakdown of proteins in the body – in the lungs. These researchers published their results on August 7 in the American Journal of Respiratory and Critical Care Medicine.
These enzymes are known to cause lung damage, said Robert Tarran, lead author of this study and a professor at the University of North Carolina's School of Medicine. At least in part, "I think … teens take in very large amounts of nicotine, which then affects the immune cells in the lungs," he said.
Previous research on electronic cigarettes has revealed the presence of numerous chemicals in the vapor that can damage cells and cause inflammation of the lungs and blood, said Dr. Laura Crotty Alexander, Associate Professor of Medicine at the University from California to San Diego. "It could be a chemical present in the vapor of the electronic cigarette or several different chemicals resulting in acute lung injury," said Crotty.
Acute lung injury means that the cells of the lungs have been damaged and the immune system has reacted to try to stop the damage and heal the lungs. Due to inflammation and cellular damage, gaseous exchanges in the body are "altered", so that patients are short of breath, deprived of oxygen and often cough, said Alexander. This could be caused by e-cigarettes bought in stores or on the street, she said.
A study published today (August 20) found that, just after vaporizing a nicotine-free e-cigarette, participants had a lot less oxygen flowing in their blood. "We can only assume at this point" whether this discovery could help explain the mysterious vaping-related disease, said Felix Wehrli, lead author of the study and professor of radiology and biophysics at the University of Michigan. 39, University of Pennsylvania, Perelman School of Medicine.
One possibility is that the lungs of these patients can not properly absorb oxygen, he said. If this were the case, the lungs could have used a greater amount of oxygen in the blood. This phenomenon would also explain why Wehrli and his colleagues found a reduction in circulating oxygen in blood vessels after vaping in their study, he said.
In part because e-cigarettes are often considered safer than regular cigarettes because they do not contain tobacco, there has been a significant increase in their use in recent years, especially among adolescents.
Most electronic cigarette fluids contain three main components: propylene glycol, glycerol and nicotine, said Alexander. But when you heat these components into steam, you create completely different chemicals, some of which are toxic, such as formaldehyde and acrolein. "But as new e-cigarettes and e-liquids come on the market at least every month, it's impossible to track all the chemicals sold and inhaled," she said.
In addition, the Food and Drug Administration does not actively regulate these devices, she said. The administration does not require companies to label their products with all the ingredients, and those labeled are often wrong, she said. As for the electronic cigarettes sold in the street, their content is even more vague, she said. She therefore advises teens not to use it if someone gives you one of these devices at a party, she said. "Because you have no idea what's in it."
In any case, according to the CDC statement, there is no conclusive evidence that an infectious disease is the cause of the disease. The investigation is ongoing and the agency has announced that it will share more information as it becomes available.
Originally published on Science live.
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