White Ashley M, Craig Ashley J, Richie Daryl L, Corley Christa, Sadek Safiyah M, Barton Heather N, Gipson Cassandra D
Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA.
Beebe Health, Gastroenterology and Internal Medicine, Lewes, Delaware, USA.
J Neuroimmunol. 2024 Dec 15;397:578468. doi: 10.1016/j.jneuroim.2024.578468. Epub 2024 Oct 20.
A plethora of evidence supports that nicotine, the primary alkaloid in tobacco products that is generally accepted for maintaining use, is immunoregulatory and may function as an immunosuppressant. Women have unique experiences with use of nicotine-containing products and also undergo significant reproductive transitions throughout their lifespan which may be impacted by nicotine use. Within the extant literature, there is conflicting evidence that nicotine may confer beneficial health effects in specific disease states (e.g., in ulcerative colitis). Use prevalence of nicotine-containing products is exceptionally high in individuals presenting with some comorbid disease states that impact immune system health and can be a risk factor for the development of diseases which disproportionately impact women; however, the mechanisms underlying these relationships are largely unclear. Further, little is known regarding the impacts of nicotine's immunosuppressive effects on women's health during the menopausal transition, which is arguably an inflammatory event characterized by a pro-inflammatory peri-menopause period. Given that post-menopausal women are at a higher risk than men for the development of neurodegenerative diseases such as Alzheimer's disease and are also more vulnerable to negative health effects associated with diseases such as HIV-1 infection, it is important to understand how use of nicotine-containing products may impact the immune milieu in women. In this review, we define instances in which nicotine use confers immunosuppressive, anti-inflammatory, or pro-inflammatory effects in the context of comorbid disease states, and focus on how nicotine impacts neuroimmune signaling to maintain use. We posit that regardless of potential health benefits, nicotine use cessation should be a priority in the clinical care of women. The synthesis of this review demonstrates the importance of systematically defining the relationships between volitional nicotine use, immune system function, and comorbid disease states in women to better understand how nicotine impacts women's health and disease.
大量证据表明，尼古丁作为烟草制品中的主要生物碱，通常被认为是维持烟草使用的原因，具有免疫调节作用，可能起到免疫抑制剂的功能。女性在使用含尼古丁产品方面有独特经历，并且在其一生中会经历重大的生殖转变，而这些转变可能会受到尼古丁使用的影响。在现有文献中，关于尼古丁在特定疾病状态（如溃疡性结肠炎）中可能带来有益健康影响的证据相互矛盾。在一些影响免疫系统健康且可能是对女性影响尤为严重的疾病发展风险因素的合并疾病状态个体中，含尼古丁产品的使用 prevalence 异常高；然而，这些关系背后的机制在很大程度上尚不清楚。此外，关于尼古丁免疫抑制作用在绝经过渡期间对女性健康的影响知之甚少，而绝经过渡可以说是一个以围绝经期促炎期为特征的炎症事件。鉴于绝经后女性患阿尔茨海默病等神经退行性疾病的风险高于男性，并且也更容易受到与 HIV - 1 感染等疾病相关的负面健康影响，了解含尼古丁产品的使用如何影响女性的免疫环境很重要。在本综述中，我们定义了尼古丁使用在合并疾病状态背景下产生免疫抑制、抗炎或促炎作用的情况，并关注尼古丁如何影响神经免疫信号传导以维持使用。我们认为，无论潜在的健康益处如何，戒烟都应是女性临床护理中的优先事项。本综述的综合阐述表明，系统地定义女性中自愿使用尼古丁、免疫系统功能和合并疾病状态之间的关系对于更好地理解尼古丁如何影响女性健康和疾病至关重要。
