Adverse effects of electronic cigarette vapor condensation on oral cells: A scoping review

Autores

DOI:

https://doi.org/10.21527/2176-7114.2026.51.15544

Palavras-chave:

Cigarro eletrônico, Forma celular, Citotoxicidade imunológica, Fator de indução de apoptose

Resumo

Electronic cigarettes (ECs), when internally heated, generate aerosol through e-liquid, with part of it being absorbed into the bloodstream. Consequently, little is known about the potential adverse events of this vapor on oral cells, which may contribute to alterations in their functionality. The present study aims to organize data from the literature on the adverse effects of EC vapor condensation on oral cavity cells. The analysis was conducted following the methodological approach of PRISMA-ScR and the Joanna Briggs Institute (JBI). Thus, two researchers from the team independently searched the PubMed/MEDLINE, Scopus, Web Of Science, and LILACS databases using combinations of descriptors through "and/or," tabulating studies published in English over a 10-year period (January 1, 2013, to October 13, 2023), with the assistance of the EndNote reference manager. With the search, a total of 803 studies were located, of which 15 in vitro studies were included in the final analysis. Among the qualitative results, exposure to EC vapor for up to 72 hours caused damage to deoxyribonucleic acid (DNA), oxidative stress, double-strand DNA breaks, apoptosis, cytotoxicity, and genotoxicity in human gingival fibroblasts (FGH), gingival mesenchymal stem cells (CTMG), primary human gingival epithelial cells (CEGHP), normal human oral keratinocytes (QOHN), and clustered human gingival epithelial progenitors (HGEPp). The evaluated cell cultures also showed a high percentage of apoptotic cells positive for terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL), delaying their migration. Thus, xenobiotic metabolism, oxidative stress response, and processes related to inflammation are influenced by EC vapor in oral cells.

Referências

1. Almeida-da-Silva CLC, Matshik Dakafay H, O’Brien K, Montierth D, Xiao N, Ojcius DM. Effects of electronic cigarette aerosol exposure on oral and systemic health. Biomedical Journal. 2020 Jul;44(3).

2. Krishnan-Sarin S, Morean M, Kong G, Bold KW, Camenga DR, Cavallo DA, et al. E-Cigarettes and “Dripping” Among High-School Youth. Pediatrics [Internet]. 2017 Mar 1; Available from: https://pediatrics.aappublications.org/content/early/2017/02/02/peds.2016-3224

3. Yu V, Rahimy M, Korrapati A, Xuan Y, Zou AE, Krishnan AR, et al. Electronic cigarettes induce DNA strand breaks and cell death independently of nicotine in cell lines. Oral Oncology [Internet]. 2016 Jan;52:58–65. Available from: https://www.sciencedirect.com/science/article/pii/S1368837515003620?via%3Dihub

4. Isik Andrikopoulos G, Farsalinos K, Poulas K. Electronic Nicotine Delivery Systems (ENDS) and Their Relevance in Oral Health. Toxics. 2019 Dec 6;7(4):61.

5. Irusa KF, Vence B, Donovan T. Potential oral health effects of e‐cigarettes and vaping: A review and case reports. Journal of Esthetic and Restorative Dentistry. 2020 Apr;32(3):260–4.

6. Anthérieu S, Garat A, Beauval N, Soyez M, Allorge D, Garçon G, et al. Comparison of cellular and transcriptomic effects between electronic cigarette vapor and cigarette smoke in human bronchial epithelial cells. Toxicology in Vitro. 2017 Dec;45:417–25.

7. Rouabhia M, Park HJ, Semlali A, Zakrzewski A, Chmielewski W, Chakir J. E-Cigarette Vapor Induces an Apoptotic Response in Human Gingival Epithelial Cells Through the Caspase-3 Pathway. Journal of Cellular Physiology. 2016 Nov 30;232(6):1539–47.

8. Wisniewski D, Ma T, Schneider A. Advances in the Chemopreventive Targeting of Oral Carcinogenesis. Current Oral Health Reports. 2015 Apr 2;2(2):63–72.

9. Wisniewski DJ, Ma T, Schneider A. Nicotine induces oral dysplastic keratinocyte migration via fatty acid synthase-dependent epidermal growth factor receptor activation. Experimental Cell Research [Internet]. 2018 Sep 15 [cited 2022 Aug 2];370(2):343–52. Available from: https://pubmed.ncbi.nlm.nih.gov/29966661/

10. Flach S, Maniam P, Manickavasagam J. E-cigarettes and head and neck cancers: A systematic review of the current literature. Clinical otolaryngology: official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery [Internet]. 2019 Sep 1 [cited 2020 Oct 5];44(5):749–56. Available from: https://pubmed.ncbi.nlm.nih.gov/31148389/

11. Khalil C, Chahine JB, Haykal T, Al Hageh C, Rizk S, Khnayzer RS. E-cigarette aerosol induced cytotoxicity, DNA damages and late apoptosis in dynamically exposed A549 cells. Chemosphere [Internet]. 2021 Jan 1 [cited 2023 Apr 24];263:127874. Available from: https://www.sciencedirect.com/science/article/pii/S0045653520320695

12. Auschwitz E, Almeda J, Andl CD. Mechanisms of E-Cigarette Vape-Induced Epithelial Cell Damage. Cells [Internet]. 2023 Jan 1 [cited 2023 Nov 7];12(21):2552. Available from: https://www.mdpi.com/2073-4409/12/21/2552

13. Mohammadi L, Han DD, Xu F, Huang A, Derakhshandeh R, Rao P, et al. Chronic E-Cigarette Use Impairs Endothelial Function on the Physiological and Cellular Levels. Arteriosclerosis, Thrombosis, and Vascular Biology [Internet]. 2022 Nov 1;42(11):1333–50. Available from: https://pubmed.ncbi.nlm.nih.gov/36288290/

14. Wilson C, Tellez Freitas CM, Awan KH, Ajdaharian J, Geiler J, Thirucenthilvelan P. Adverse effects of E‐cigarettes on head, neck, and oral cells: A systematic review. Journal of Oral Pathology & Medicine. 2022 Feb;51(2):113–25.

15. Alanazi H, Rouabhia M. Effect of e-cigarette aerosol on gingival mucosa structure and proinflammatory cytokine response. Toxicology Reports. 2022;9:1624–31.

16. Peters M, Godfrey C, McInerney P, Munn Z, Trico A, Khalil H. Chapter 11: Scoping Reviews. JBI Manual for Evidence Synthesis [Internet]. 2020; Available from: https://jbi-global-wiki.refined.site/space/MANUAL/4687342/Chapter+11%3A+Scoping+reviews

17. Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Annals of Internal Medicine. 2018 Sep 4;169(7):467–73.

18. El‐Mouelhy ATM, Nasry SA, Abou El‐Dahab O, Sabry D, Fawzy El‐Sayed K. In vitro evaluation of the effect of the electronic cigarette aerosol, Cannabis smoke, and conventional cigarette smoke on the properties of gingival fibroblasts/gingival mesenchymal stem cells. Journal of Periodontal Research. 2021 Nov 8;57(1):104–14.

19. Tellez CS, Juri DE, Phillips LM, Do K, Yingling CM, Cindy Parks Thomas, et al. Cytotoxicity and Genotoxicity of E-Cigarette Generated Aerosols Containing Diverse Flavoring Products and Nicotine in Oral Epithelial Cell Lines. 2021 Jan 28;179(2):220–8.

20. Ramenzoni LL, Schneider A, Fox SC, Meyer M, Meboldt M, Attin T, et al. Cytotoxic and Inflammatory Effects of Electronic and Traditional Cigarettes on Oral Gingival Cells Using a Novel Automated Smoking Instrument: An In Vitro Study. Toxics [Internet]. 2022 Apr 6 [cited 2022 Nov 15];10(4):179. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9032316/

21. Urena J, Ebersol L, Alexey Silakov, Elias RJ, Lambert JD. Impact of Atomizer Age and Flavor on In Vitro Toxicity of Aerosols from a Third-Generation Electronic Cigarette against Human Oral Cells. Chemical Research in Toxicology. 2020 Sep 10;33(10):2527–37.

22. Vermehren MF, Wiesmann N, Deschner J, Brieger J, Al-Nawas B, Kämmerer PW. Comparative analysis of the impact of e-cigarette vapor and cigarette smoke on human gingival fibroblasts. Toxicology in Vitro. 2020 Dec;69:105005.

23. Alanazi H, Park HJ, Chakir J, Semlali A, Rouabhia M. Comparative study of the effects of cigarette smoke and electronic cigarettes on human gingival fibroblast proliferation, migration and apoptosis. Food and Chemical Toxicology. 2018 Aug;118:390–8.

24. Ganapathy V, Manyanga J, Brame L, McGuire D, Sadhasivam B, Floyd E, et al. Electronic cigarette aerosols suppress cellular antioxidant defenses and induce significant oxidative DNA damage. Chellappan S, editor. PLOS ONE. 2017 May 18;12(5):e0177780.

25. Sancilio S, Gallorini M, Cataldi A, di Giacomo V. Cytotoxicity and apoptosis induction by e-cigarette fluids in human gingival fibroblasts. Clinical Oral Investigations. 2015 Aug 4;20(3):477–83.

26. Sundar IK, Javed F, Romanos GE, Rahman I. E-cigarettes and flavorings induce inflammatory and pro-senescence responses in oral epithelial cells and periodontal fibroblasts. Oncotarget. 2016 Oct 24;7(47).

27. Welz C, Canis M, Schwenk-Zieger S, Becker S, Stucke V, Ihler F, et al. Cytotoxic and Genotoxic Effects of Electronic Cigarette Liquids on Human Mucosal Tissue Cultures of the Oropharynx. Journal of Environmental Pathology, Toxicology and Oncology: Official Organ of the International Society for Environmental Toxicology and Cancer [Internet]. 2016 [cited 2023 Apr 24];35(4):343–54. Available from: https://pubmed.ncbi.nlm.nih.gov/27992314/

28. Ji EH, Sun B, Zhao T, Shu S, Chang CH, Messadi D, et al. Characterization of Electronic Cigarette Aerosol and Its Induction of Oxidative Stress Response in Oral Keratinocytes. Teh MT, editor. PLOS ONE. 2016 May 25;11(5):e0154447.

29. Willershausen I, Wolf T, Weyer V, Sader R, Ghanaati S, Willershausen B. Influence of E-smoking liquids on human periodontal ligament fibroblasts. Head & Face Medicine. 2014 Sep 15;10(1).

30. Rouabhia M, Alanazi H, Park HJ, Gonçalves RB. Cigarette Smoke and E-Cigarette Vapor Dysregulate Osteoblast Interaction With Titanium Dental Implant Surface. The Journal of Oral Implantology [Internet]. 2019 Feb 1 [cited 2021 Apr 17];45(1):2–11. Available from: https://pubmed.ncbi.nlm.nih.gov/30160606/

31. Lerner CA, Rutagarama P, Ahmad T, Sundar IK, Elder A, Rahman I. Electronic cigarette aerosols and copper nanoparticles induce mitochondrial stress and promote DNA fragmentation in lung fibroblasts. Biochemical and Biophysical Research Communications [Internet]. 2016 Sep 2 [cited 2021 Jan 26];477(4):620–5. Available from: https://pubmed.ncbi.nlm.nih.gov/27343559/

32. Al Amri MD, Kellesarian SV, Abduljabbar TS, Al Rifaiy MQ, Al Baker AM, Al-Kheraif AA. Comparison of Peri-Implant Soft Tissue Parameters and Crestal Bone Loss Around Immediately Loaded and Delayed Loaded Implants in Smokers and Non-Smokers: 5-Year Follow-Up Results. Journal of Periodontology. 2017 Jan;88(1):3–9.

33. Costa V, Kowalski LP, Coutinho-Camillo CM, Begnami MD, Calsavara VF, Neves JI, et al. EGFR amplification and expression in oral squamous cell carcinoma in young adults. International journal of oral and maxillofacial surgery [Internet]. 2018 [cited 2019 Dec 4];47(7):817–23. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29395668

34. Bollu LR, Katreddy RR, Blessing AM, Pham N, Zheng B, Wu X, et al. Intracellular activation of EGFR by fatty acid synthase dependent palmitoylation. Oncotarget. 2015 Sep 12;6(33).

35. Platel A, Dusautoir R, Kervoaze G, Dourdin G, Gateau E, Talahari S, et al. Comparison of the in vivo genotoxicity of electronic and conventional cigarettes aerosols after subacute, subchronic and chronic exposures. Journal of Hazardous Materials [Internet]. 2022 Feb 5 [cited 2023 Apr 20];423(Pt B):127246. Available from: https://pubmed.ncbi.nlm.nih.gov/34844363/

36. Raes S, Rocci A, Raes F, Cooper L, De Bruyn H, Cosyn J. A prospective cohort study on the impact of smoking on soft tissue alterations around single implants. Clinical Oral Implants Research. 2014 May 5;26(9):1086–90.

Downloads

Publicado

2026-01-02

Como Citar

Sousa, Z. da S., Oliveira, R. C. da S., Florêncio, C. M. G. D., Duarte, A. V. M., Mateus, M. M., Moreira, S. L. S., … Moraes, R. P. (2026). Adverse effects of electronic cigarette vapor condensation on oral cells: A scoping review. Revista Contexto & Saúde, 26(51), e15544. https://doi.org/10.21527/2176-7114.2026.51.15544

Edição

Seção

Artigo de Revisão