U.S. Vaping-Related Lung Disease Linked to Vitamin E Oil and Lipid-Laden Macrophages
September 10 news: According to foreign media reports, three deaths were confirmed last Friday in Indiana, Minnesota, and California, bringing the number of reported cases to 450 after cases reported in Illinois and Oregon. Although the investigation is o
On September 10, reports from foreign media indicated that last Friday, three deaths were confirmed in Indiana, Minnesota, and California, bringing the total number of reported cases to 450 following the cases reported in Illinois and Oregon.
"While this investigation is ongoing, people should consider not using electronic cigarette products," said Dr. Dana Meaney-Delman, the CDC's manager for responding to lung injury incidents.
"Those using electronic cigarette products should monitor their symptoms, such as cough, shortness of breath, chest pain, nausea, and vomiting - and seek medical attention immediately for any health issues."
After advising users to stop using electronic cigarettes for several weeks, the CDC, FDA, and HHS ultimately recommended that consumers avoid using unlicensed products and refrain from purchasing untested, unregulated, and potentially unsafe e-liquids on the street.
Most cases have occurred among youth or young adults, and the acute illnesses appear to be lipid pneumonia, acute respiratory distress syndrome, and/or chemical pneumonia.
Vitamin E Oil (Tocopheryl Acetate)
Although close to an answer, the cause remains unknown. However, New York health authorities have confirmed that most of the seized electronic cigarette products in the state contained vitamin E oil (tocopheryl acetate). Additionally, the FDA has received about 120 samples for testing, with 10 out of 18 THC samples containing vitamin E oil.
Contaminated products include brands such as Chronic Carts, Dank Vapes, and West Coast Carts, but this disease is associated with multiple other illegal market brands across several states.
Last week, an article on Leafly reported that a new diluent called Honey Cut entered the illegal electronic cigarette market at the end of 2018. This product dilutes THC oil without thinning it and is known to be used by pen manufacturers because it is a cheap thickening agent. When officials from terpene manufacturer True Terpenes tested Honey Cut earlier this year, they found it contained vitamin E oil.
Lipid-Laden Macrophages in the Lungs
Meanwhile, a study published last week in the "New England Journal of Medicine" identified a previously unrecognized feature of e-cigarette-related respiratory disease. In the lungs of these patients, doctors found a significant number of immune cells containing large oily droplets, known as lipid-laden macrophages.
"The significant and consistent feature we reported in BAL samples was the presence of lipid-laden macrophages observed with Oil Red O staining, which is not attributable to the inhalation of exogenous lipid material. Furthermore, the diffuse parenchymal opacities seen on CT scans did not show low attenuation (in Hounsfield units), consistent with classic lipid pneumonia. While the pathophysiological significance of these lipid-laden macrophages and their relationship to the etiology of this syndrome remains unclear, we believe they may be useful markers for this disease," the study abstract reads.
This finding may help doctors diagnose the condition more quickly and provide clues to the cause. "While it is not yet certain, these lipid-laden macrophages may help confirm or exclude this disease," said the lead author of the study, a medical doctor and pulmonary disease specialist at U of U. "They may also help understand the causes leading to this disease," he added.
"While this investigation is ongoing, people should consider not using electronic cigarette products," said Dr. Dana Meaney-Delman, the CDC's manager for responding to lung injury incidents.
"Those using electronic cigarette products should monitor their symptoms, such as cough, shortness of breath, chest pain, nausea, and vomiting - and seek medical attention immediately for any health issues."
After advising users to stop using electronic cigarettes for several weeks, the CDC, FDA, and HHS ultimately recommended that consumers avoid using unlicensed products and refrain from purchasing untested, unregulated, and potentially unsafe e-liquids on the street.
Most cases have occurred among youth or young adults, and the acute illnesses appear to be lipid pneumonia, acute respiratory distress syndrome, and/or chemical pneumonia.
Vitamin E Oil (Tocopheryl Acetate)
Although close to an answer, the cause remains unknown. However, New York health authorities have confirmed that most of the seized electronic cigarette products in the state contained vitamin E oil (tocopheryl acetate). Additionally, the FDA has received about 120 samples for testing, with 10 out of 18 THC samples containing vitamin E oil.
Contaminated products include brands such as Chronic Carts, Dank Vapes, and West Coast Carts, but this disease is associated with multiple other illegal market brands across several states.
Last week, an article on Leafly reported that a new diluent called Honey Cut entered the illegal electronic cigarette market at the end of 2018. This product dilutes THC oil without thinning it and is known to be used by pen manufacturers because it is a cheap thickening agent. When officials from terpene manufacturer True Terpenes tested Honey Cut earlier this year, they found it contained vitamin E oil.
Lipid-Laden Macrophages in the Lungs
Meanwhile, a study published last week in the "New England Journal of Medicine" identified a previously unrecognized feature of e-cigarette-related respiratory disease. In the lungs of these patients, doctors found a significant number of immune cells containing large oily droplets, known as lipid-laden macrophages.
"The significant and consistent feature we reported in BAL samples was the presence of lipid-laden macrophages observed with Oil Red O staining, which is not attributable to the inhalation of exogenous lipid material. Furthermore, the diffuse parenchymal opacities seen on CT scans did not show low attenuation (in Hounsfield units), consistent with classic lipid pneumonia. While the pathophysiological significance of these lipid-laden macrophages and their relationship to the etiology of this syndrome remains unclear, we believe they may be useful markers for this disease," the study abstract reads.
This finding may help doctors diagnose the condition more quickly and provide clues to the cause. "While it is not yet certain, these lipid-laden macrophages may help confirm or exclude this disease," said the lead author of the study, a medical doctor and pulmonary disease specialist at U of U. "They may also help understand the causes leading to this disease," he added.
