Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 74, 04100, Latina, Italy.
IRCCS NEUROMED, Pozzilli, Italy.
Curr Atheroscler Rep. 2020 Feb 7;22(2):8. doi: 10.1007/s11883-020-0824-4.
Modified risk products (MRP) are promoted as a safer alternative to traditional combustion cigarettes (TCC) in chronic smokers. Evidence for their lower hazardous profile is building, despite several controversies. Yet, it is unclear whether individual responses to MRP differ among consumers. We hypothesized that different clusters of subjects exist in terms of acute effects of MRP.
Pooling data from a total of 60 individuals, cluster analysis identified at least three clusters (labelled 1 to 3) of subjects with different electronic vaping cigarettes (EVC) effects and at least two clusters (labelled 4 to 5) of subjects with different heat-not-burn cigarettes (HNBC) effects. Specifically, oxidative stress, platelet aggregation, and endothelial dysfunction after EVC were significantly different cluster-wise (all p < 0.05), and oxidative stress and platelet aggregation after HNBC were significantly different (all p < 0.05). In particular, subjects belonging to Cluster 1 appeared to have less detrimental responses to EVC usage than subjects in Cluster 2 and 3, as shown by non-significant changes in flow-mediated dilation (FMD) and less marked increase in Nox2-derived peptide (NOX). Conversely, those assigned to Cluster 3 had the worst reaction in terms of changes in FMD, NOX, and P-selectin. Furthermore, individuals belonging to Cluster 4 responded unfavorably to both HNBC and EVC, whereas those in Cluster 5 interestingly showed less adverse results after using HNBC than EVC. Results for main analyses were consistent employing different clusters, tests, and bootstrap. Individual responses to MRP differ and smokers aiming at using EVC or HNBC as a risk reduction strategy should consider trying different MRP aiming at finding the one which is less detrimental, with subjects resembling those in Cluster 1 preferably using EVC and those resembling Cluster 5 preferably using HNBC.
综述目的：改良风险产品 (MRP) 作为传统燃烧香烟 (TCC) 的替代品，在慢性吸烟者中推广。尽管存在一些争议，但越来越多的证据表明它们的危害较小。然而，目前尚不清楚消费者对 MRP 的个体反应是否存在差异。我们假设在 MRP 的急性作用方面，存在不同的个体反应群体。
最新发现：对总共 60 名个体的数据进行汇总分析，聚类分析确定了至少 3 个不同的电子雾化香烟 (EVC) 效应的受试者群体 (标记为 1 至 3) 和至少 2 个不同的加热不燃烧香烟 (HNBC) 效应的受试者群体 (标记为 4 至 5)。具体来说，EVC 使用后氧化应激、血小板聚集和内皮功能障碍在聚类间差异具有统计学意义 (所有 p<0.05)，HNBC 使用后氧化应激和血小板聚集差异具有统计学意义 (所有 p<0.05)。特别是，与聚类 2 和 3 相比，属于聚类 1 的受试者 EVC 使用后的不利反应似乎较小，表现为血流介导的扩张 (FMD) 无显著变化，Nox2 衍生肽 (NOX) 增加不明显。相反，属于聚类 3 的受试者 FMD、NOX 和 P-选择素的变化最严重。此外，属于聚类 4 的个体对 HNBC 和 EVC 的反应均不佳，而属于聚类 5 的个体在使用 HNBC 后，结果与使用 EVC 相比，不良反应较少。使用不同的聚类、检验和自举法进行的主要分析结果一致。MRP 的个体反应不同，试图将 EVC 或 HNBC 作为降低风险策略的吸烟者应考虑尝试不同的 MRP，以找到危害较小的产品，类似于聚类 1 的受试者最好使用 EVC，类似于聚类 5 的受试者最好使用 HNBC。
