Electronic cigarettes increase endothelial progenitor cells in the blood of healthy volunteers

Atherosclerosis. 2016 Dec:255:179-185. doi: 10.1016/j.atherosclerosis.2016.09.064. Epub 2016 Sep 22.


Background and aims: The use of electronic cigarettes is increasing dramatically on a global scale and its effects on human health remain uncertain. In the present study, we measured endothelial progenitor cells (EPCs) and microvesicles (MVs) in healthy young volunteers following short-term exposure to inhalation of e-cigarette vapor (ECV) to determine vascular changes.

Methods: Sixteen healthy seldom smokers were randomized into two groups either exposed or not exposed to 10 puffs of ECV for 10 min, in a crossover design. Blood samples were obtained at baseline and 1, 4 and 24 h following exposure. EPCs (CD34 + CD309) and MVs were analyzed by flow cytometry. MVs were phenotyped according to origin (platelet (CD41), endothelial (CD144), leukocytes (CD45), monocytes (CD14)) and nuclear content (SYTO 13 dye). In addition, expression of inflammation markers such P-selectin (CD62P), E-selectin (CD62E), CD40-ligand (CD154) and HMGB1 was investigated. Fractional exhaled nitric oxide (FeNO) was also measured at baseline and after 24 h.

Results: EPC levels in blood were significantly increased 1 h following exposure to ECV and returned to baseline values after 24 h. Only E-selectin positive MVs (endothelial origin) were slightly elevated (p < 0.038). FeNO was unaffected by exposure to ECV.

Conclusions: In healthy volunteers, ten puffs of e-cigarette vapor inhalation caused an increase in EPCs. This increase was of the same magnitude as following smoking of one traditional cigarette, as we previously demonstrated. Taken together, these results may represent signs of possible vascular changes after short e-cigarette inhalation. Further studies analyzing potential cardiovascular health effects are critical as the e-cigarette market continues to burgeon.

Keywords: E-cigarette; Electronic cigarette; Endothelial progenitor cells; Microvesicles.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Inhalation
  • Adult
  • Biomarkers / blood
  • Cell-Derived Microparticles / drug effects
  • Cell-Derived Microparticles / metabolism
  • Cell-Derived Microparticles / pathology
  • Consumer Product Safety
  • Cotinine / blood
  • Cross-Over Studies
  • Electronic Nicotine Delivery Systems / adverse effects*
  • Endothelial Progenitor Cells / drug effects*
  • Endothelial Progenitor Cells / metabolism
  • Endothelial Progenitor Cells / pathology
  • Exhalation
  • Female
  • Healthy Volunteers
  • Humans
  • Inflammation Mediators / blood
  • Male
  • Nicotine / administration & dosage
  • Nicotine / adverse effects*
  • Nicotine / blood
  • Nicotinic Agonists / administration & dosage
  • Nicotinic Agonists / adverse effects*
  • Nicotinic Agonists / blood
  • Nitric Oxide / metabolism
  • Phenotype
  • Risk Assessment
  • Sweden
  • Time Factors
  • Young Adult


  • Biomarkers
  • Inflammation Mediators
  • Nicotinic Agonists
  • Nitric Oxide
  • Nicotine
  • Cotinine