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Effects of electronic cigarettes on the liver (literature review)

https://doi.org/10.36604/1998-5029-2025-96-154-163

Abstract

   At present, the impact of electronic cigarettes on human health is being actively investigated. The liver is a vital multifunctional organ whose function can be impaired by various toxic factors such as alcohol or traditional cigarette smoking. In this review, we examine and synthesize current scientific literature on the effects of electronic cigarettes on the liver, drawing on publications retrieved through Google Scholar, Elsevier, and PubMed. The review discusses how certain chemicals found in e-cigarette liquids and their derivatives act on the liver, the relationship between e-cigarette use and oxidative-stress parameters, their influence on mitochondria, and changes in organ-specific enzymes that serve as biomarkers of liver injury. Histopathological alterations detected in liver tissue after exposure to electronic cigarettes are described, and differences between nicotine-containing and nicotine-free e-liquids are considered. The possible role of vaping in the development of liver diseases in humans including acute non-infectious toxic hepatitis and non-alcoholic fatty liver disease is explored. On the basis of available scientific evidence, we conclude that electronic cigarettes are not harmless and exert a significant negative effect. At the same time, further studies on the impact of electronic cigarettes on the liver and other organs and systems are warranted.

About the Authors

O. G. Androsova
Amur State Medical Academy
Russian Federation

Olga G. Androsova, PhD (Med.), Associate Professor

Department of Physiology and Pathophysiology

675000; 95 Gor'kogo Str.; Blagoveshchensk



D. R. Allazov
Amur State Medical Academy
Russian Federation

Dmitriy R. Allazov, 3rd year Student

Medical Faculty

675000; 95 Gor'kogo Str.; Blagoveshchensk



M. S. Zinin
Amur State Medical Academy
Russian Federation

Maxim S. Zinin, 3rd year Student

Medical Faculty

675000; 95 Gor'kogo Str.; Blagoveshchensk



References

1. Perera S.D., Dulmini A.D.T. Overview of e-cigarettes and e-liquids. Rajarata University Journal 2022; 7(1):30–35.

2. Ali N., Xavier J., Engur M., Mohanah P.V., Bernardino de la Serna J. The impact of e-cigarette exposure on different organ systems: a review of recent evidence and future perspectives. J. Hazard. Mater. 2023; 457:131828. doi: 10.1016/j.jhazmat.2023.131828

3. Marques P., Piqueras L., Sanz M.J. An updated overview of e-cigarette impact on human health. Respir. Res. 2021; 22(1):151. doi: 10.1186/s12931-021-01737-5

4. Gotts J.E., Jordt S.E., McConnell R., Tarran R. What are the respiratory effects of e-cigarettes? BMJ 2019; 366:l5275. Erratum in: BMJ. 2019; 367:l5980. doi: 10.1136/bmj.l5275

5. Miyashita L., Foley G. E‐cigarettes and respiratory health: the latest evidence. J. Physiol. 2020; 598(22):5027–5038. doi: 10.1113/JP279526

6. Wang L., Wang Y., Chen J., Liu P., Li M. A review of toxicity mechanism studies of electronic cigarettes on respiratory system. Int. J. Mol. Sci. 2022; 23(9):5030. doi: 10.3390/ijms23095030

7. Benowitz N.L., Fraiman J.B. Cardiovascular effects of electronic cigarettes. Nat. Rev. Cardiol. 2017; 14(8):447–456. doi: 10.1038/nrcardio.2017.36

8. Qasim H., Karim Z.A., Rivera J.O., Khasawneh F.T., Alshbool F.Z. Impact of electronic cigarettes on the cardiovascular system. J. Am. Heart Assoc. 2017; 6(9):e006353. doi: 10.1161/JAHA.117.006353

9. Kennedy C.D., van Schalkwyk M.C., McKee M., Pisinger C. The cardiovascular effects of electronic cigarettes : a systematic review of experimental studies. Prev. Med. 2019; 127:105770. doi: 10.1016/j.ypmed.2019.105770

10. Khadka S., Awasthi M., Lamichhane R.R., Ojha C., Mamudu H.M., Lavie C.J., Daggubati R., Paul T.K. The cardiovascular effects of electronic cigarettes. Curr. Cardiol. Rep. 2021; 23(5):40. doi: ?10.1007/s11886-021-01469-4

11. Corless J.K., Middleton H.M. Normal liver function: a basis for understanding hepatic disease. Arch. Intern. Med. 1983; 143(12):2291–2294. doi: 10.1001/archinte.1983.00350120085018

12. Herrington J.S., Myers C. Electronic cigarette solutions and resultant aerosol profiles. J. Chromatogr. A 2015; 1418:192–199. doi: 10.1016/j.chroma.2015.09.034

13. Alshareef H.Z., Omaye S.T. Toxicology of commonly found ingredients in e-cigarettes: a brief review. Health 2021; 13(11):1396–1409. doi: 10.4236/health.2021.1311100

14. Hopstock K.S., Perraud V., Dalton A.B., Barletta B., Meinardi S., Weltman R.M., Mirkhanian M.A., Rakosi K.J., Blake D.R., Edwards R.D., Nizkorodov S.A. Chemical analysis of exhaled vape emissions: unraveling the complexities of humectant fragmentation in a human trial study. Chem. Res. Toxicol. 2024; 37(6):1000–1010. doi: 10.1021/acs.chemrestox.4c00088

15. Sun L., Luo C., Long J., Wei D., Liu J. Acrolein is a mitochondrial toxin: effects on respiratory function and enzyme activities in isolated rat liver mitochondria. Mitochondrion 2006; 6(3):136–142. doi: 10.1016/j.mito.2006.04.003

16. Mohammad M.K., Avila D., Zhang J., Barve S., Arteel G., McClain C., Joshi-Barve S. Acrolein cytotoxicity in hepatocytes involves endoplasmic reticulum stress, mitochondrial dysfunction and oxidative stress. Toxicol. Appl. Pharmacol. 2012; 265(1):73–82. doi: 10.1016/j.taap.2012.09.021

17. Mello T., Ceni E., Surrenti C., Galli A. Alcohol induced hepatic fibrosis: role of acetaldehyde. Mol. Aspects Med. 2008; 29(1-2):17–21. doi: 10.1016/j.mam.2007.10.001

18. Setshedi M., Wands J.R., de la Monte S.M. Acetaldehyde adducts in alcoholic liver disease. Oxid. Med. Cell. Longev. 2010; 3(3):178–185. doi: 10.4161/oxim.3.3.12288

19. Chen W.Y., Zhang J., Ghare S., Barve S., McClain C., Joshi-Barve S. Acrolein is a pathogenic mediator of alcoholic liver disease and the scavenger hydralazine is protective in mice. Cell. Mol. Gastroenterol. Hepatol. 2016; 2(5):685–700. doi: 10.1016/j.jcmgh.2016.05.010

20. Cikmaz S., Kutoglu T., Kanter M., Mesut R. Effect of formaldehyde inhalation on rat livers: a light and electron microscopic study. Toxicol. Ind. Health 2010; 26(2):113–119. doi: 10.1177/0748233710362384

21. Zhang S., Chen H., Wang A., Liu Y., Hou H., Hu Q. Combined effects of co-exposure to formaldehyde and acrolein mixtures on cytotoxicity and genotoxicity in vitro. Environ. Sci. Pollut. Res. 2018; 25:25306–25314. doi: 10.1007/s11356-018-2584-z

22. Hernandez A., Sonavane M., Smith K.R., Seiger J., Migaud M.E., Gassman N.R. Dihydroxyacetone suppresses mTOR nutrient signaling and induces mitochondrial stress in liver cells. PLoS One 2022; 17(12):e0278516. doi: 10.1371/journal.pone.0278516

23. Rickard B.P., Ho H., Tiley J.B., Jaspers I., Brouwer K.L. E-cigarette flavoring chemicals induce cytotoxicity in HepG2 cells. ACS Omega 2021; 6(10):6708–6713. doi: 10.1021/acsomega.0c05639

24. Timkin P.D., Timofeev E.A., Borodin E.A. [TRPM8 ligand modification]. Bûlleten' fiziologii i patologii dyhaniâ = Bulletin of Physiology and Pathology of Respiration 2022; 84:32–36 (in Russian). doi: 10.36604/1998-5029-2022-84-32-36

25. El Golli N., Jrad-Lamine A., Neffati H., Rahali D., Dallagi Y., Dkhili H., Ba N., El May M.V., El Fazaa S. Impact of e-cigarette refill liquid with or without nicotine on liver function in adult rats. Toxicol. Mech. Methods. 2016; 26(6):433–440. doi: 10.3109/15376516.2016.1160963

26. Nima R.S., Aziz D.Z. The oxidative stress induced by the vapours of electronic-hookah on mice liver tissues. Sys. Rev. Pharm. 2020; 11(9):420–423. doi: 10.31838/srp.2020.9.59

27. Granata S., Canistro D., Vivarelli F., Morosini C., Rullo L., Mercatante D., Rodriguez-Estrada M.T., Baracca A., Sgarbi G., Solaini G., Ghini S., Fagiolino I., Sangiorgi S., Paolini M. Potential harm of IQOS smoke to rat liver. Int. J. Mol. Sci. 2023; 24(15):12462. doi: 10.3390/ijms241512462

28. Hasan K.M., Friedman T.C., Shao X., Parveen M., Sims C., Lee D.L., Espinoza-Derout J., Sinha-Hikim I., Sinha-Hikim A.P. E‐cigarettes and western diet: important metabolic risk factors for hepatic diseases. Hepatology 2019; 69(6):2442–2454. doi: 10.1002/hep.30512

29. Bekyarova G., Tzaneva M., Bratoeva K., Ivanova I., Kotzev A., Hristova M., Krastev D., Kindekov I., Mileva M. 4-Hydroxynonenal (HNE) and hepatic injury related to chronic oxidative stress. Biotechnol. Biotechnol. Equip. 2019; 33(1):1544–1552. doi: 10.1080/13102818.2019.1674690

30. Kanithi M., Junapudi S., Shah S.I., Reddy A.M., Ullah G., Chidipi B. Alterations of mitochondrial network by cigarette smoking and e-cigarette vaping. Cells 2022; 11(10):1688. doi: 10.3390/cells11101688

31. Espinoza-Derout J., Shao X.M., Bankole E., Hasan K.M., Mtume N., Liu Y., Sinha-Hikim A.P., Friedman T.C. Hepatic DNA damage induced by electronic cigarette exposure is associated with the modulation of NAD+/PARP1/SIRT1 axis. Front. Endocrinol. 2019; 10:320. doi: 10.3389/fendo.2019.00320

32. Li G., Chan Y.L., Wang B., Saad S., George J., Oliver B.G., Chen H. E‐cigarettes damage the liver and alter nutrient metabolism in pregnant mice and their offspring. Ann. N.Y. Acad. Sci. 2020; 1475(1):64–77. doi: 10.1111/nyas.14411

33. Wang Q., Ji X., Rahman I. Dysregulated metabolites serve as novel biomarkers for metabolic diseases caused by e-cigarette vaping and cigarette smoking. Metabolites 2021; 11(6):345. doi: 10.3390/metabo11060345

34. Aubrecht J., Schomaker S.J., Amacher D.E. Emerging hepatotoxicity biomarkers and their potential to improve understanding and management of drug-induced liver injury. Genome Med. 2013; 5:85. doi: 10.1186/gm489

35. Salman R.J., Alyodawi K. Biochemical and histopathological study of the toxic effects of electronic and conventional cigarette smoke on the liver of rats. IJST 2023; 2(5):7–15.

36. Abd Z.S., Mehdi W.T. Effects of vaping and water pipe on lipid profiles, glucose and liver enzymes. Central Asian Journal of Medical and Natural Science 2023; 4(3):582–591.

37. Mumtaz H., Hameed M., Sangah A.B., Zubair A., Hasan M. Association between smoking and non-alcoholic fatty liver disease in Southeast Asia. Front. Public Health 2022; 10:1008878. doi: 10.3389/fpubh.2022.1008878

38. Sinyakin I.A., Shestakova M.A., Byshlyaga O.Yu., Batalova T.A. [Main pathologic effects of exposure to highly dispersed e-cigarette aerosol on lung cells and respiratory epithelium : literature review]. Meditsina = Medicina 2024; 12(1):72–87 (in Russian). doi: 10.29234/2308-9113-2024-12-1-1-10

39. Chakinala R.C., Dawoodi S., Fabara S.P., Asad M., Khayyat A., Chandramohan S., Aslam A., Unachukwu N., Nasyrlaeva B., Jaiswal R., Chowdary S.B., Malik P., Rabbani R. Association of smoking and e-cigarette in chronic liver disease: an NHANES study. Gastroenterol. Res. 2022; 15(3):113– 119. doi: 10.14740/gr1490

40. Editorial Office. Retraction notice to "Association of smoking and e-cigarette in chronic liver disease: an NHANES study". Gastroenterol. Res. 2023; 16(3):201. doi: 10.14740/gr1490r

41. Fan T., DuBose L., Wayne C., Sisniega C. E-cigarette, or vaping, associated lung and hepatic injury. J. Pediatr. Gastroenterol. Nutr. 2020; 71(3):e98–e100. doi: 10.1097/MPG.0000000000002744

42. Godbee M., Jakate S., Eswaran S. A case of electronic nicotine delivery systems (ENDS) liver injury. Hepatology 2021; 73(3):1230–1232. doi: %10.1002/hep.31475

43. Van Roey G., Goos W., Claessens C., Hoorens A., Verlinden W., Schouten J. Acute grade IV toxic hepatitis due to the e-cigarette. Acta Gastroenterol. Belg. 2024; 87(1):44–47. doi: 10.51821/87.1.11378


Review

For citations:


Androsova O.G., Allazov D.R., Zinin M.S. Effects of electronic cigarettes on the liver (literature review). Bulletin Physiology and Pathology of Respiration. 2025;(96):154-163. (In Russ.) https://doi.org/10.36604/1998-5029-2025-96-154-163

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ISSN 1998-5029 (Print)