Center for Environmental and Smoking Induced Disease and the Division of Cardiovascular Medicine, Department of Internal Medicine, Davis Heart & Lung Research Institute, College of Medicine, The Ohio State University, Columbus, Ohio.
Department of Pharmacology and Toxicology, College of Pharmacy, Al-Azhar University, Cairo, Egypt.
Am J Physiol Heart Circ Physiol. 2022 Apr 1;322(4):H549-H567. doi: 10.1152/ajpheart.00460.2021. Epub 2022 Jan 28.
We recently reported a mouse model of chronic electronic cigarette (e-cig) exposure-induced cardiovascular pathology, where long-term exposure to e-cig vape (ECV) induces cardiac abnormalities, impairment of endothelial function, and systemic hypertension. Here, we delineate the underlying mechanisms of ECV-induced vascular endothelial dysfunction (VED), a central trigger of cardiovascular disease. C57/BL6 male mice were exposed to ECV generated from e-cig liquid containing 0, 6, or 24 mg/mL nicotine for 16 and 60 wk. Time-dependent elevation in blood pressure and systemic vascular resistance were observed, along with an impairment of acetylcholine-induced aortic relaxation in ECV-exposed mice, compared with air-exposed control. Decreased intravascular nitric oxide (NO) levels and increased superoxide generation with elevated 3-nitrotyrosine levels in the aorta of ECV-exposed mice were observed, indicating that ECV-induced superoxide reacts with NO to generate cytotoxic peroxynitrite. Exposure increased NADPH oxidase expression, supporting its role in ECV-induced superoxide generation. Downregulation of endothelial nitric oxide synthase (eNOS) expression and Akt-dependent eNOS phosphorylation occurred in the aorta of ECV-exposed mice, indicating that exposure inhibited de novo NO synthesis. Following ECV exposure, the critical NOS cofactor tetrahydrobiopterin was decreased, with a concomitant loss of its salvage enzyme, dihydrofolate reductase. NADPH oxidase and NOS inhibitors abrogated ECV-induced superoxide generation in the aorta of ECV-exposed mice. Together, our data demonstrate that ECV exposure activates NADPH oxidase and uncouples eNOS, causing a vicious cycle of superoxide generation and vascular oxidant stress that triggers VED and hypertension with predisposition to other cardiovascular disease. Underlying mechanisms of e-cig-induced vascular endothelial dysfunction are delineated. e-cig exposure activates and increases expression of NADPH oxidase and disrupts activation and coupling of eNOS, leading to a vicious cycle of superoxide generation and peroxynitrite formation, with tetrahydrobiopterin depletion, causing loss of NO that triggers vascular endothelial dysfunction. This process is progressive, increasing with the duration of e-cig exposure, and is more severe in the presence of nicotine, but observed even with nicotine-free vaping.
我们最近报道了一种慢性电子烟(e-cigarette,e-cig)暴露诱导心血管病变的小鼠模型,其中长期暴露于电子烟蒸汽(e-cigarette vape,ECV)会导致心脏异常、内皮功能障碍和系统性高血压。在这里,我们阐述了 ECV 诱导的血管内皮功能障碍(vascular endothelial dysfunction,VED)的潜在机制,VED 是心血管疾病的一个核心触发因素。C57/BL6 雄性小鼠暴露于含有 0、6 或 24mg/mL 尼古丁的电子烟液体生成的 ECV 中 16 或 60 周。与空气暴露的对照组相比,在 ECV 暴露的小鼠中观察到血压和全身血管阻力的时间依赖性升高,以及乙酰胆碱诱导的主动脉松弛受损。在 ECV 暴露的小鼠的主动脉中观察到血管内一氧化氮(nitric oxide,NO)水平降低,超氧化物生成增加,3-硝基酪氨酸水平升高,表明 ECV 诱导的超氧化物与 NO 反应生成细胞毒性过氧亚硝酸盐。实验发现烟酰胺腺嘌呤二核苷酸磷酸(nicotinamide adenine dinucleotide phosphate,NADPH)氧化酶表达增加,支持其在 ECV 诱导的超氧化物生成中的作用。在 ECV 暴露的小鼠的主动脉中,内皮型一氧化氮合酶(endothelial nitric oxide synthase,eNOS)表达和 Akt 依赖性 eNOS 磷酸化下调,表明暴露抑制了新的 NO 合成。在 ECV 暴露后,关键的 NOS 辅助因子四氢生物蝶呤(tetrahydrobiopterin,BH4)减少,同时其补救酶二氢叶酸还原酶(dihydrofolate reductase)丢失。NADPH 氧化酶和 NOS 抑制剂消除了 ECV 暴露的小鼠主动脉中 ECV 诱导的超氧化物生成。总之,我们的数据表明,ECV 暴露激活 NADPH 氧化酶并使 eNOS 解偶联,导致超氧化物生成和血管氧化应激的恶性循环,从而引发 VED 和高血压,并易发生其他心血管疾病。阐述了电子烟引起的血管内皮功能障碍的潜在机制。ECV 暴露激活并增加 NADPH 氧化酶的表达,并破坏 eNOS 的激活和偶联,导致超氧化物生成和过氧亚硝酸盐形成的恶性循环,四氢生物蝶呤耗竭,导致触发血管内皮功能障碍的 NO 丢失。这个过程是渐进的,随着电子烟暴露时间的增加而增加,并且在存在尼古丁时更为严重,但即使在无尼古丁蒸气的情况下也会观察到。