{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T23:06:25Z","timestamp":1773702385321,"version":"3.50.1"},"reference-count":25,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2021,8,10]],"date-time":"2021-08-10T00:00:00Z","timestamp":1628553600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"national institutes of health","doi-asserted-by":"publisher","award":["P50DA036105"],"award-info":[{"award-number":["P50DA036105"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"American University of Beirut (LB) medical practice plan"},{"DOI":"10.13039\/100000038","name":"u.s. food and drug administration","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000038","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Patients with diabetes are more vulnerable to the detrimental respiratory effects of combustible cigarette smoke (CS) when compared to the general population. Electronic cigarettes (ECIG) and heated tobacco products (HTP) are marketed as less harmful alternatives to CS. In this study, we compared the effects of acute ECIG, HTP and CS exposure on the lungs of type II diabetes versus non-diabetic mice in an animal model.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Type II Diabetic (Diab) and Non-Diabetic (Non-Diab) mice were divided into Control, ECIG, HTP and CS groups. Animals were exposed for 6 hrs.\/day to either air, ECIG, HTP or CS for seven days. Lung injury was determined by a) histopathology, b) wet to dry ratio, c) albumin concentration in bronchoalveolar lavage fluid, d) expression of TNF-\u03b1, IL-6, and IL-1 \u03b2, e) reactive oxygen species production (ROS), and f) assessment of cellular apoptosis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Lung histology revealed increased edema and inflammatory cells in diabetic mice exposed to ECIG, HTP and CS. The expression of Inflammatory mediators was, in general, more significant in the Diabetic groups as well. TNF-\u03b1 expression, for example, was upregulated in Diab + ECIG but not in Non-Diab + ECIG. ROS was significantly increased in Diab + CS, less in Non-Diab + CS and weakly noted in ECIG + Diab. Significant albumin leak was observed in Diab and Non-Diab HTP-exposed animals. CS exposure worsened lung injury in Diab when compared to Non-Diab mice.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Comorbid medical conditions like diabetes may amplify ill effects of CS, ECIG or HTP exposure.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0255876","type":"journal-article","created":{"date-parts":[[2021,8,10]],"date-time":"2021-08-10T17:34:33Z","timestamp":1628616873000},"page":"e0255876","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":10,"title":["Role of diabetes in lung injury from acute exposure to electronic cigarette, heated tobacco product, and combustible cigarette aerosols in an animal model"],"prefix":"10.1371","volume":"16","author":[{"given":"Michella Abi Zeid","family":"Daou","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan","family":"Shihadeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasmine","family":"Hashem","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hala","family":"Bitar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alaa","family":"Kassir","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3014-3937","authenticated-orcid":true,"given":"Mohammad","family":"El-Harakeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nareg","family":"Karaoghlanian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Assaad A.","family":"Eid","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marwan","family":"El-Sabban","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ghazi","family":"Zaatari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2317-1385","authenticated-orcid":true,"given":"Ahmad","family":"Husari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,8,10]]},"reference":[{"issue":"10100","key":"pone.0255876.ref001","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1016\/S0140-6736(17)32366-8","article-title":"Global, regional, and national comparative risk assessment of 84 behavioral, environmental and occupational, and metabolic risks or clusters of risks, 1990\u20132016: a systematic analysis for the Global Burden of Disease Study 2016","volume":"390","author":"GBD 2016 Risk Factors Collaborators","year":"2017","journal-title":"Lancet"},{"issue":"10082","key":"pone.0255876.ref002","doi-asserted-by":"crossref","first-page":"1931","DOI":"10.1016\/S0140-6736(17)31222-9","article-title":"Chronic obstructive pulmonary disease","volume":"389","author":"KF Rabe","year":"2017","journal-title":"Lancet"},{"key":"pone.0255876.ref003","first-page":"Chapter 46","volume-title":"Disease Control Priorities in Developing Countries","author":"P Jha","year":"2006","edition":"2"},{"key":"pone.0255876.ref004","unstructured":"Grana R, Benowitz N, Glantz SA. 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