Kelesidis Theodoros, Fotooh Abadi Leila, Ruedisueli Isabelle, D'Costa Zoee U, Middlekauff Holly R
Department of Medicine, Division of Infectious Disease University of Texas-Southwestern Dallas TX USA.
Department of Medicine, Division of Cardiology UCLA David Geffen School of Medicine Los Angeles CA USA.
J Am Heart Assoc. 2025 Apr;14(7):e038258. doi: 10.1161/JAHA.124.038258. Epub 2025 Mar 19.
People living with HIV (PLWH) are disproportionately affected by tobacco-related health disparities. Concurrent recreational drug use is also more prevalent. Switching to electronic cigarettes (ECs) has been proposed as a harm reduction strategy. However, it remains unproven whether ECs are less atherogenic than tobacco cigarettes (TCs).
PLWH who smoke TCs and met eligibility criteria were invited to enroll in our acute crossover trial (NCT04568395) comparing the effects of using an EC, a TC, and a straw control on different days on monocyte transendothelial migration and monocyte-derived foam cell formation in our novel ex vivo atherogenesis assay. Twenty-eight PLWH (aged 41.8±9.8 years; 27 men and 1 woman, 18 with a positive urine toxicology screen) completed all 3 sessions. The acute rise in plasma nicotine was similar after acute TC and EC use (7.32±0.86 ng/mL versus 6.30±0.92 ng/mL, =0.69). The monocyte transendothelial migration after acutely smoking a TC increased by a mean of 0.65-fold difference compared with the straw control (<0.01). The monocyte transendothelial migration after using an EC was not significantly increased compared with the straw control. The monocyte-derived foam cell formation after acutely smoking a TC was increased by a mean of 0.65-fold difference compared with the straw control (<0.001). The monocyte-derived foam cell formation after acutely using an EC was not significantly increased compared with the straw control. These findings were present in PLWH with and without concurrent recreational drug use.
These data suggest smaller proatherogenic effects following EC versus TC use in PLWH and justify a larger study looking at cardiovascular risks of ECs in PLWH who smoke, including those who use recreational drugs, populations disproportionately affected by tobacco-related health disparities.
感染艾滋病毒的人（PLWH）受烟草相关健康差距的影响尤为严重。同时，娱乐性药物的使用也更为普遍。改用电子烟（EC）已被提议作为一种减少危害的策略。然而，电子烟是否比香烟（TC）的致动脉粥样硬化性更低仍未得到证实。
邀请吸烟且符合入选标准的PLWH参加我们的急性交叉试验（NCT04568395），该试验比较在不同日期使用电子烟、香烟和吸管对照对我们新的体外动脉粥样硬化试验中单核细胞跨内皮迁移和单核细胞衍生泡沫细胞形成的影响。28名PLWH（年龄41.8±9.8岁；27名男性和1名女性，18名尿液毒理学筛查呈阳性）完成了所有3个阶段。急性使用香烟和电子烟后血浆尼古丁的急性升高相似（7.32±0.86 ng/mL对6.30±0.92 ng/mL，P=0.69）。与吸管对照相比，急性吸烟后单核细胞跨内皮迁移平均增加0.65倍差异（P<0.01）。与吸管对照相比，使用电子烟后单核细胞跨内皮迁移没有显著增加。与吸管对照相比，急性吸烟后单核细胞衍生泡沫细胞形成平均增加0.65倍差异（P<0.001）。急性使用电子烟后单核细胞衍生泡沫细胞形成与吸管对照相比没有显著增加。这些发现在有或没有同时使用娱乐性药物 的PLWH中均存在。
这些数据表明，PLWH使用电子烟比使用香烟产生的促动脉粥样硬化作用更小，这为开展一项更大规模的研究提供了依据，该研究旨在探讨吸烟的PLWH（包括使用娱乐性药物的人群，这些人群受烟草相关健康差距的影响尤为严重）使用电子烟的心血管风险。
