Cardiopulmonary Disease

Cardiopulmonary disease is the medical term used to describe a range of serious disorders that affect the heart (“cardio-”) and lungs (“-pulmonary”). The two primary tobacco-related cardiopulmonary diseases are Cardiovascular Disease (CVD) and Chronic Obstructive Pulmonary Disorder (COPD).

Exposure to tobacco smoke has long been recognized as a prominent risk factor for CVD. Similarly minimizing exposure to tobacco smoke is the only effective way to prevent COPD. However, the mechanisms by which tobacco toxicants increase the risk of CVD and lead to the onset of COPD are still unclear. Despite reductions in smoking over the past decade, CVD and COPD remain the first and second leading causes of death among smokers. It is important to remember also that for every person who dies because of smoking, at least 30 people live with a serious smoking-related illness.

The emergence of e-cigarettes and other new tobacco products that deliver nicotine aerosolized in various solvents raises new critical questions regarding the potential risk for cardiopulmonary disease among users. The use of these new tobacco products has soared over the last few years, particularly among adolescents, and is expected to overtake the conventional cigarette market within the next decade. These new products deliver nicotine and chemical flavorings aerosolized in a base of propylene glycol and/or glycerin via inhalation. Studies have shown that they produce ultra-fine particulate matter and cytotoxic chemicals, which are known to negatively impact heart and lung function, respectively. Nicotine itself is known to impair lung function, particularly in adolescents. Due to the rapid uptake of these products among young people and the lack of existing regulation of these products, research is critically needed to understand more about the toxicity profile and potential for harm from the use of these products.

TRDRP research support under this priority focuses on understanding the etiology and mechanisms of action of tobacco product-induced cardiopulmonary disease. Of interest are projects studying the effects of nicotine and e-cigarette aerosol on the development and function of the heart and lungs. A new category of tobacco products called ‘heat-not-burn’ is being introduced as a reduced risk product in the global markets. Such products will need to be examined for their claimed characteristics and effects on humans.

Examples of relevant research topics include:

• The effect of nicotine, sub-micro particles, and other constituents of tobacco products, and  aerosols on:
  • endothelial function
  • vascular function/vasoconstriction
  • inflammatory response
• The effects and mechanism of action of tobacco toxicants and oxidative stress on endothelial function
• The identification of toxicants responsible for platelet activation
• The mechanism by which tobacco toxicants contribute to the development of insulin resistance
• The effect of nicotine, nanoparticles, and other constituents of tobacco product aerosols on:
  • pulmonary function
  • lung development
  • inflammatory response
• The role of inflammation and oxidative stress in COPD pathogenesis
• Biomarkers of COPD susceptibility and progression
• Basic studies aimed at the development of therapeutics to remedy nicotine’s effects in the heart and lungs