{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T12:29:26Z","timestamp":1786969766748,"version":"build-2736575974"},"reference-count":54,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antioxidants"],"abstract":"<jats:p>Pediatric allergic and obstructive respiratory diseases are a leading cause of chronic childhood morbidity. Passive tobacco smoke exposure (TSE) is one of the most prevalent and preventable indoor pollutants affecting children, while oxidative stress is increasingly recognized as a key mechanism linking tobacco smoke exposure to airway inflammation. This systematic review critically evaluated the evidence connecting passive TSE to oxidative stress pathways in pediatric airway disease and integrated it into a \u201csecond oxidative hit\u201d hypothesis. Following PRISMA 2020 guidelines, PubMed and MEDLINE were searched to identify studies assessing passive TSE, oxidative or antioxidant biomarkers, and respiratory outcomes in children. Of the 77 records identified, four studies met the inclusion criteria. Across the available evidence, passive TSE was associated with increased lipid peroxidation, NOX2 activation, oxidative\u2013inflammatory signaling, depletion of antioxidant defenses, oxidative DNA damage, and impairment of redox-sensitive corticosteroid-response pathways, although findings were not uniform across studies. Clinically, passive TSE children showed persistent allergic rhinitis, greater wheezing severity, poorer asthma control and reduced corticosteroid responsiveness. Despite limited and heterogeneous evidence, the findings provide a biological rationale for a testable \u201csecond oxidative hit\u201d hypothesis, whereby passive TSE, combined with a pre-existing inflammatory environment in the airways associated with the underlying disease, could produce an additional oxidative burden. Further prospective studies integrating standardized oxidative biomarkers and objective exposure assessment are needed to validate this hypothesis, and establish temporal and causal relationships, potentially supporting more targeted preventive and personalized strategies.<\/jats:p>","DOI":"10.3390\/antiox15081024","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T12:01:26Z","timestamp":1786968086000},"page":"1024","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Passive Tobacco Smoke Exposure, Oxidative Stress and Pediatric Allergic and Obstructive Respiratory Diseases: A Systematic Review and a \u201cSecond Oxidative Hit\u201d Hypothesis"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1268-5038","authenticated-orcid":false,"given":"Bianca Laura","family":"Cinicola","sequence":"first","affiliation":[{"name":"Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, 00185 Rome, Italy"},{"name":"Department of Radiological, Oncological and Anatomical Pathology Sciences, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9211-6829","authenticated-orcid":false,"given":"Alessandra","family":"Gori","sequence":"additional","affiliation":[{"name":"Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Leone","sequence":"additional","affiliation":[{"name":"Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, 00185 Rome, Italy"},{"name":"Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0865-3149","authenticated-orcid":false,"given":"Elia","family":"Pignataro","sequence":"additional","affiliation":[{"name":"Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, 00185 Rome, Italy"},{"name":"Department of Experimental Medicine, La Sapienza University, 00198 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Aloisio","sequence":"additional","affiliation":[{"name":"Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6289-2249","authenticated-orcid":false,"given":"Alessandra","family":"Salvatori","sequence":"additional","affiliation":[{"name":"Pediatrics Clinical Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9496-6630","authenticated-orcid":false,"given":"Laura","family":"Tudini","sequence":"additional","affiliation":[{"name":"Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9607-8632","authenticated-orcid":false,"given":"Caterina","family":"Anania","sequence":"additional","affiliation":[{"name":"Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Spalice","sequence":"additional","affiliation":[{"name":"Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Maria","family":"Zicari","sequence":"additional","affiliation":[{"name":"Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1111\/j.1749-6632.2010.05562.x","article-title":"The Role of Oxidative Stress in the Pathogenesis and Treatment of Asthma","volume":"1203","author":"Dozor","year":"2010","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Han, Y., Zhang, M., Yu, S., and Jia, L. (2025). Oxidative Stress in Pediatric Asthma: Sources, Mechanisms, and Therapeutic Potential of Antioxidants. Front. Biosci., 30.","DOI":"10.31083\/FBL22688"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/j.jpeds.2018.06.053","article-title":"Passive Smoking Exacerbates Nicotinamide-Adenine Dinucleotide Phosphate Oxidase Isoform 2\u2013Induced Oxidative Stress and Arterial Dysfunction in Children with Persistent Allergic Rhinitis","volume":"202","author":"Loffredo","year":"2018","journal-title":"J. Pediatr."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Koumpagioti, D., Dimitroglou, M., Mpoutopoulou, B., Moriki, D., and Douros, K. (2025). The Role of Oxidative Stress in the Pathogenesis of Childhood Asthma: A Comprehensive Review. Children, 12.","DOI":"10.3390\/children12091110"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/j.atherosclerosis.2015.03.024","article-title":"Endothelial Dysfunction and Oxidative Stress in Children with Sleep Disordered Breathing: Role of NADPH Oxidase","volume":"240","author":"Loffredo","year":"2015","journal-title":"Atherosclerosis"},{"key":"ref_6","unstructured":"(2026, July 01). Global Strategy for Asthma Management and Prevention, 2025. Global Initiative for Asthma. Available online: www.ginasthma.org."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Di Vincenzo, S., Ferrante, G., Ferraro, M., Cascio, C., Malizia, V., Licari, A., La Grutta, S., and Pace, E. (2023). Oxidative Stress, Environmental Pollution, and Lifestyle as Determinants of Asthma in Children. Biology, 12.","DOI":"10.3390\/biology12010133"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"123304","DOI":"10.1016\/j.envpol.2024.123304","article-title":"Impact of Heat-Not-Burn Cigarette Passive Smoking on Children\u2019s Oxidative Stress, Endothelial and Platelet Function","volume":"345","author":"Loffredo","year":"2024","journal-title":"Environ. Pollut."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"673","DOI":"10.3109\/02770903.2012.701363","article-title":"Relationship between Exhaled Nitric Oxide and Exposure to Low-Level Environmental Tobacco Smoke in Children with Asthma on Inhaled Corticosteroids","volume":"49","author":"Krishnan","year":"2012","journal-title":"J. Asthma"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Braun, M., Klingelh\u00f6fer, D., Oremek, G.M., Quarcoo, D., and Groneberg, D.A. (2020). Influence of Second-Hand Smoke and Prenatal Tobacco Smoke Exposure on Biomarkers, Genetics and Physiological Processes in Children\u2014An Overview in Research Insights of the Last Few Years. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17093212"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"608","DOI":"10.4414\/smw.2007.11870","article-title":"Association between environmental tobacco smoke exposure and wheezing disorders in Austrian preschool children","volume":"137","author":"Ly","year":"2007","journal-title":"Swiss Med. Wkly."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2100453","DOI":"10.1183\/13993003.00453-2021","article-title":"Prenatal Tobacco Exposure and Risk of Asthma and Allergy Outcomes in Childhood","volume":"59","author":"Sunde","year":"2022","journal-title":"Eur. Respir. J."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Loffredo, L., Maggio, E., Bartimoccia, S., Magna, A., Tot\u00e8, C.M., Bagnato, C., Cinicola, B.L., Armeli, F., Leonardo, A., and D\u2019Amico, A. (2025). Tobacco Smoke Exposure and Oxidative Stress: The Role of Circulating Lipopolysaccharides in Heated and Conventional Products. Antioxidants, 14.","DOI":"10.3390\/antiox14111316"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Li, C., and Guan, T. (2025). Pulmonary Function and Physical Performance in Adolescent E-Cigarette Users: A Narrative Review. Front. Public Health, 13.","DOI":"10.3389\/fpubh.2025.1703712"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Magna, A., Polisena, N., Polisena, L., Bagnato, C., Pacella, E., Carnevale, R., Nocella, C., and Loffredo, L. (2024). The Hidden Dangers: E-Cigarettes, Heated Tobacco, and Their Impact on Oxidative Stress and Atherosclerosis\u2014A Systematic Review and Narrative Synthesis of the Evidence. Antioxidants, 13.","DOI":"10.3390\/antiox13111395"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1901815","DOI":"10.1183\/13993003.01815-2019","article-title":"E-Cigarette Use and Respiratory Disorders: An Integrative Review of Converging Evidence from Epidemiological and Laboratory Studies","volume":"57","author":"Wills","year":"2021","journal-title":"Eur. Respir. J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1136\/thoraxjnl-2017-211293","article-title":"Role of NADPH Oxidase-2 and Oxidative Stress in Children Exposed to Passive Smoking","volume":"73","author":"Loffredo","year":"2018","journal-title":"Thorax"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 Statement: An Updated Guideline for Reporting Systematic Reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1378\/chest.13-0835","article-title":"Passive Smoking Impairs Histone Deacetylase-2 in Children with Severe Asthma","volume":"145","author":"Kobayashi","year":"2014","journal-title":"Chest"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1080\/02770903.2017.1350970","article-title":"Secondhand Tobacco Smoke and Severity in Wheezing Children: Nasal Oxidant Stress and Inflammation","volume":"55","author":"Yilmaz","year":"2018","journal-title":"J. Asthma"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1080\/15513815.2017.1315199","article-title":"The Role of Oxidative Stress in the Clinical Manifestations of Childhood Asthma","volume":"36","author":"Topic","year":"2017","journal-title":"Fetal Pediatr. Pathol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1067\/mai.2002.126780","article-title":"Oxidative Stress in Allergic Respiratory Diseases","volume":"110","author":"Bowler","year":"2002","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"370","DOI":"10.2500\/ajra.2009.23.3340","article-title":"Overexpression of the Superoxide Anion and NADPH Oxidase Isoforms1 and 4 (NOX1 and NOX4) Inallergic Nasal Mucosa","volume":"23","author":"Moon","year":"2009","journal-title":"Am. J. Rhinol. Allergy"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1002\/alr.21133","article-title":"Expression of Dual Oxidases and Secreted Cytokines in Chronic Rhinosinusitis","volume":"3","author":"Cho","year":"2013","journal-title":"Int. Forum Allergy Rhinol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1152\/physrev.00044.2005","article-title":"The NOX Family of ROS-Generating NADPH Oxidases: Physiology and Pathophysiology","volume":"87","author":"Bedard","year":"2007","journal-title":"Physiol. Rev."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1016\/j.freeradbiomed.2010.04.030","article-title":"NADPH Oxidases in Cardiovascular Disease","volume":"49","author":"Brandes","year":"2010","journal-title":"Free Radic. Biol. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1089\/ars.2012.4987","article-title":"Does NADPH Oxidase Deficiency Cause Artery Dilatation in Humans?","volume":"18","author":"Loffredo","year":"2013","journal-title":"Antioxid. Redox Signal."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.jaci.2008.03.035","article-title":"A Comprehensive Evaluation of the Enzymatic and Nonenzymatic Antioxidant Systems in Childhood Asthma","volume":"122","author":"Sackesen","year":"2008","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Lin, W., Lin, J., Lai, F., and Shi, J. (2024). Effect of Dietary Antioxidant Quality Score on Tobacco Smoke Exposure and Asthma in Children and Adolescents: A Cross-Sectional Study from the NHANES Database. BMC Pediatr., 24.","DOI":"10.1186\/s12887-024-05009-1"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1093\/ajcn\/77.1.167","article-title":"Influence of environmental tobacco smoke on vitamin C status in children","volume":"77","author":"Preston","year":"2003","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1093\/ntr\/ntr076","article-title":"Micronutrient levels in children exposed to secondhand tobacco smoke","volume":"13","author":"Wilson","year":"2011","journal-title":"Nicotine Tob. Res."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Lee, H., Lee, J., Hong, S.H., Rahman, I., and Yang, S.R. (2018). Inhibition of RAGE Attenuates Cigarette Smoke-Induced Lung Epithelial Cell Damage via RAGE-Mediated Nrf2\/DAMP Signaling. Front Pharmacol., 9.","DOI":"10.3389\/fphar.2018.00684"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1016\/j.freeradbiomed.2009.10.047","article-title":"Induction of COX-2\/PGE(2)\/IL-6 is crucial for cigarette smoke extract-induced airway inflammation: Role of TLR4-dependent NADPH oxidase activation","volume":"48","author":"Lin","year":"2010","journal-title":"Free Radic. Biol. Med."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Strzelak, A., Ratajczak, A., Adamiec, A., and Feleszko, W. (2018). Tobacco Smoke Induces and Alters Immune Responses in the Lung Triggering Inflammation, Allergy, Asthma and Other Lung Diseases: A Mechanistic Review. Int. J. Environ. Res. Public Health, 15.","DOI":"10.3390\/ijerph15051033"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"355","DOI":"10.3109\/02770903.2013.823446","article-title":"Low-Level Environmental Tobacco Smoke Exposure and Inflammatory Biomarkers in Children with Asthma","volume":"51","author":"Gill","year":"2014","journal-title":"J. Asthma"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1016\/j.jaci.2008.03.016","article-title":"Exposure to Tobacco Smoke Increases Leukotriene E4-Related Albuterol Usage and Response to Montelukast","volume":"121","author":"Rabinovitch","year":"2008","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1016\/j.jaci.2011.05.035","article-title":"Urinary Leukotriene E4 Levels Identify Children with Tobacco Smoke Exposure at Risk for Asthma Exacerbation","volume":"128","author":"Rabinovitch","year":"2011","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1136\/thx.2003.016667","article-title":"Glutathione S Transferase Deficiency and Passive Smoking Increase Childhood Asthma","volume":"59","author":"Kabesch","year":"2004","journal-title":"Thorax"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1542\/peds.2005-3030","article-title":"Glutathione S-Transferase M1 and P1 Genotype, Passive Smoking, and Peak Expiratory Flow in Asthma","volume":"118","author":"Palmer","year":"2006","journal-title":"Pediatrics"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1721","DOI":"10.1111\/j.1365-2222.2009.03372.x","article-title":"The Interaction of Glutathione S-Transferase M1-Null Variants with Tobacco Smoke Exposure and the Development of Childhood Asthma","volume":"39","author":"Rogers","year":"2009","journal-title":"Clin. Exp. Allergy"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/j.jpeds.2008.08.040","article-title":"Associations between Multiple Environmental Exposures and Glutathione S-Transferase P1 on Persistent Wheezing in a Birth Cohort","volume":"154","author":"Schroer","year":"2009","journal-title":"J. Pediatr."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1136\/thx.2009.125856","article-title":"Maternal Nrf2 and Gluthathione-S-Transferase Polymorphisms Do Not Modify Associations of Prenatal Tobacco Smoke Exposure with Asthma and Lung Function in School-Aged Children","volume":"65","author":"Henderson","year":"2010","journal-title":"Thorax"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Lee, S.Y., Kim, B.S., Kwon, S.O., Oh, S.Y., Shin, H.L., Jung, Y.H., Lee, E., Yang, S.I., Kim, H.Y., and Seo, J.H. (2015). Modification of Additive Effect between Vitamins and ETS on Childhood Asthma Risk According to GSTP1 Polymorphism: A Cross -Sectional Study. BMC Pulm. Med., 15.","DOI":"10.1186\/s12890-015-0093-0"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.chest.2018.08.1079","article-title":"Interaction of Glutathione S-Transferase M1, T1, and P1 Genes with Early Life Tobacco Smoke Exposure on Lung Function in Adolescents","volume":"155","author":"Dai","year":"2019","journal-title":"Chest"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1111\/cea.13815","article-title":"Second-Hand Smoke and NFE2L2 Genotype Interaction Increases Paediatric Asthma Risk and Severity","volume":"51","author":"Johansson","year":"2021","journal-title":"Clin. Exp. Allergy"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1186\/s13148-021-01161-y","article-title":"Impact of Vitamin C Supplementation on Placental DNA Methylation Changes Related to Maternal Smoking: Association with Gene Expression and Respiratory Outcomes","volume":"13","author":"McEvoy","year":"2021","journal-title":"Clin. Epigenet."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Rosenberg, L., Liu, C., Sharma, R., Wood, C., Vyhlidal, C.A., Gaedigk, R., Kho, A.T., Ziniti, J.P., Celed\u00f3n, J.C., and Tantisira, K.G. (2023). Intrauterine Smoke Exposure, MicroRNA Expression during Human Lung Development, and Childhood Asthma. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24097727"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Ward, A.M., Yaman, R., and Ebbert, J.O. (2020). Electronic nicotine delivery system design and aerosol toxicants: A systematic review. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0234189"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"L957","DOI":"10.1152\/ajplung.00123.2020","article-title":"E-cigarette constituents propylene glycol and vegetable glycerin decrease glucose uptake and its metabolism in airway epithelial cells in vitro","volume":"319","author":"Woodall","year":"2020","journal-title":"Am. J. Physiol. Lung Cell Mol. Physiol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1942","DOI":"10.1038\/s41598-024-52317-8","article-title":"The combination of propylene glycol and vegetable glycerin e-cigarette aerosols induces airway inflammation and mucus hyperconcentration","volume":"14","author":"Kim","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Lerner, C.A., Sundar, I.K., Yao, H., Gerloff, J., Ossip, D.J., McIntosh, S., Robinson, R., and Rahman, I. (2015). Vapors produced by electronic cigarettes and e-juices with flavorings induce toxicity, oxidative stress, and inflammatory response in lung epithelial cells and in mouse lung. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0116732"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1089\/aivt.2016.0030","article-title":"Inflammatory Response and Barrier Dysfunction by Different e-Cigarette Flavoring Chemicals Identified by Gas Chromatography-Mass Spectrometry in e-Liquids and e-Vapors on Human Lung Epithelial Cells and Fibroblasts","volume":"3","author":"Gerloff","year":"2017","journal-title":"Appl. Vitr. Toxicol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1093\/toxsci\/kfu233","article-title":"Molecular mechanisms of acrolein toxicity: Relevance to human disease","volume":"143","author":"Moghe","year":"2015","journal-title":"Toxicol. Sci."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Minet, E., Errington, G., Scherer, G., Newland, K., Sharifi, M., Bailey, B., McEwan, M., and Cheung, F. (2011). An inter-laboratory comparison of urinary 3-hydroxypropylmercapturic acid measurement demonstrates good reproducibility between laboratories. BMC Res. Notes, 4.","DOI":"10.1186\/1756-0500-4-391"}],"container-title":["Antioxidants"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3921\/15\/8\/1024\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T12:17:37Z","timestamp":1786969057000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3921\/15\/8\/1024"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,17]]},"references-count":54,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["antiox15081024"],"URL":"https:\/\/doi.org\/10.3390\/antiox15081024","relation":{},"ISSN":["2076-3921"],"issn-type":[{"value":"2076-3921","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,17]]}}}