Smoking Cessation Clinical Trial
Official title:
The Effects of Electronic Cigarette Smoking on the Arterial Wall and Endothelial Glycocalyx Properties of Smokers
Electronic cigarette is proposed as a bridge to smoking cessation. In this study we examine its effects on aortic elasticity, glycocalyx integrity, and exhaled carbon monoxide (CO) concentration and platelet function, both acutely and after 1 month of use.
Two smoker groups matched for age and sex will be assessed:
1. a group of 30 current smokers with no diagnosed cardiovascular disease as the control
group for chronic phase
2. a group of 30 current smokers with no diagnosed cardiovascular disease who will be using
the electronic cigarette with nicotine for 1 month
In the acute phase all 60 smokers will undergo a "sham" smoking for 7 minutes. Afterwards 30
out of 60 smokers will be randomized to smoke either a normal cigarette or an electronic
cigarette with nicotine and after a 60 minute washout period these subjects will be crossed
over to the alternate mode of smoking (electronic with nicotine or normal cigarette
respectively).
The remaining 30 smokers will be randomized to smoke either a normal cigarette or an
electronic cigarette without nicotine and after a 60 minute washout period these subjects
will be crossed over to the alternate mode of smoking (electronic without nicotine or normal
cigarette respectively.
After the completion of the acute phase all 60 smokers will start the use of an electronic
cigarette for one month.
In the acute phase, measurements will be performed at baseline, after sham smoking and after
smoking of the normal or electronic cigarette (with or without nicotine). The chronic phase
measurements will be performed 1 month after use electronic cigarette with nicotine. Thirty
current smokers of similar age and sex will serve as controls and will have measurements at
baseline and 1 month after baseline assessment. The nicotine concentration of the electronic
cigarette fluid used during both phases will be 12 mg/dL, while the participants will be
allowed to use their cigarette of preference in the acute phase. In both phases we will
assess a) the aortic pulse wave velocity (PWV) and augmentation index (AIx) by Arteriograph
and Complior; b) the perfusion boundary region of the sublingual arterial microvessels using
Sideview, Darkfield imaging (Microscan, Glycocheck); c) the exhaled carbon monoxide (CO)
level (parts per million -ppm) as a smoking status marker; d) the vital signs; e) an
electrocardiogram; and f) plasma levels of C- reactive protein (CRP), transforming growth
factor-b (TGF-b), lipoprotein associated phospholipase A2 (LP- LPA2), tumor necrosis factor-
α (TNF-α), interleukins 6 and 10 (IL-6 and -10), procollagen propeptide type III (PIIINP),
matrix metalloproteinase 2 and 9 (MMP-2 and -9), and macrophage-colony stimulating factor
(MCSF), malondialdehyde (MDA) and protein carbonyls (PC) and platelet function tests using
the novel Platelet Function Analyzer PFA-100 and the traditional Light Transmission
Aggregometry (LTA)
;
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