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New research appearing in the journal Scientific Reports unpacks the list of chemicals that comprise flavored e-liquids and pods used in vaping and details their harmful effects to lung tissue, including inflammation and genetic damage that could indicate long-term risk for respiratory disease and even cancer.

"While names like mango, cucumber, and mint give the impression that the flavors in e-juices are benign, the reality is that these sensations are derived from chemicals," said Irfan Rahman, Ph.D., a professor in the University of Rochester Medical Center's (URMC) Department of Environmental Medicine and lead author of the study. "These findings indicate that exposure to these chemicals triggers damage and dysfunction in the lungs that are a precursor to long-term health consequences."

Other than propylene glycol and vegetable glycerin, which form the base of vaping liquids, and nicotine, most manufacturers do not disclose the chemical compounds used to create the flavors in vaping products.

Employing mass spectrometry, the researchers identified almost 40 different chemicals present in various combinations in seven flavors manufactured by JUUL. These include hydrocarbons and volatile organic compounds, many of which have industrial uses and are known to be harmful if inhaled.

JUUL -- which accounts for more than 70 percent of all vaping product sales in the U.S. -- has recently halted sales of most of its flavored pods and several states, including New York, are in the process of banning these products. However, many other companies and independent vape shops continue to manufacture and sell an estimated 8,000 different flavored e-juices and pods.

In the study, researchers exposed human lung tissue -- including bronchial epithelial cells, which play an important role in the exchange of gases, and monocytes, an infection-fighting cell in the immune system -- to aerosolized vapor from the flavor pods. They observed that the chemicals provoked inflammation and degraded the integrity of the epithelial cells, a condition that could eventually lead to acute lung injury and respiratory illness. Exposure also damaged DNA in the cells, a potential precursor to cancer. The study showed that menthol flavor, which JUUL continues to sell, is equally as harmful as other flavors.

"Vaping technology has only existed for a short period of time and its use, particularly among younger people, has only recently exploded," said Rahman. "This study gives further evidence that vaping -- while less harmful than combustible tobacco in the short run -- is placing chronic users on the path to significant health problems later in life."

Rahman helps lead the WNY Center for Research on Flavored Tobacco Products (CRoFT), a partnership between researchers at URMC and Roswell Park Comprehensive Cancer Center in Buffalo to study the health effects of one of the fastest-growing trends in tobacco use. The Center is supported by a $19 million grant from the federal Food and Drug Administration's Tobacco Centers of Regulatory Science program.

Additional co-authors of the Scientific Reports study include Thivanka Muthumalage and Thomas Lamb with URMC, and Michelle Friedman the College of Brockport, State University of New York. The study was funded with support from the National Cancer Institute and CRoFT.

Irfan Rahman might be area smoke shops' best customer.

In the last few years, Rahman has haunted local smoke shops, amassing what might the largest collection of vaping devices and supplies in the state. It could conceivably be a contender for the country's largest collection.

In a recent visit to Elite, a Henrietta vape shop and cigar store, Rahman barked rapid-fire orders directing store co-owner Gibran Mehta to add scores of oils to a mounting pile of vaping products as Mehta described the various flavorings and nicotine content of oils, taking occasional hits off an e-cigarette as he worked.

Despite his loyal patronage, Irfan laments, a couple of the smoke shops he frequents temporarily banned him.

"It was when they noticed this," says Rahman, holding out a tag dangling from a lanyard he wears around his neck. The tag identifies him as a URMC research scientist. Putting two and two together, he explains, some shop owners began to suspect that Rahman, a non-smoker and no fan of vaping, might be using his trove of vaping supplies to make a case against vaping.

Shop owners who banned him have now relented, but their fears are far from unfounded.

Vaping involves inhalation of nicotine or the cannabis-derived substances THC and CBD in a cloud of vapor rather than in smoke produced by "combustibles" like cigarettes, cigars or pipes. In vaping, a handheld, battery-operated device heats an oil emulsion containing nicotine, THC or CBD.

At URMC, Rahman heads a laboratory that is delving into vaping's possible ill effects. He also is part of a joint URMC-Roswell Park team working under a 2018 $19 million National Institutes of Health grant to study the effects of flavored tobacco. He is working with New York's Department of Health too.

Projects Rahman is currently leading include an investigation into the toxicology of flavored e-cigarettes and toxicity of nicotine delivered by e-cigarettes.

University of Rochester Environmental Health Sciences Center members Daniel Croft, M.D., M.P.H., and Irfan Rahman, Ph.D., were featured on a Today Show segment about vaping-related lung injury. In the segment, Rahman is shown working in his lab while Croft discussed the symptoms associated with this condition.

Rahman uses cell, mouse, and human studies to investigate how flavoring chemicals used in vaping devices affect lung health. He also analyzes vaping liquid collected from patients and hospitals around the world to better understand its chemical makeup. Croft, a clinician researcher who focuses on inhalation toxicology, helps interpret the clinical relevance of findings from the lab and collaborates on a study to better understand respiratory effects in people who vape.

New research shows that maternal exposure to a common and ubiquitous form of industrial pollution can harm the immune system of offspring and that this injury is passed along to subsequent generations, weakening the body's defenses against infections such as the influenza virus.

The study was led by Paige Lawrence, Ph.D., with the University of Rochester Medical Center's (URMC) Department of Environmental Medicine and appears in the Cell Press journal iScience. The research was conducted in mice, whose immune system function is similar to humans.

"The old adage 'you are what you eat' is a touchstone for many aspects of human health," said Lawrence. "But in terms of the body's ability to fights off infections, this study suggests that, to a certain extent, you may also be what your great-grandmother ate."

While other studies have shown that environmental exposure to pollutants can have effects on the reproductive, respiratory, and nervous system function across multiple generations, the new research shows for the first time that the immune system is impacted as well.

This multigenerational weakening of the immune system could help explain variations that are observed during seasonal and pandemic flu episodes. Annual flu vaccines provide some people more protection than others, and during pandemic flu outbreaks some people get severely ill, while others are able to fight off the infection. While age, virus mutations, and other factors can explain some of this variation, they do not fully account for the diversity of responses to flu infection found in the general population.

"When you are infected or receive a flu vaccine, the immune system ramps up the production of specific kinds of white blood cells in response," said Lawrence. "The larger the response, the larger the army of white blood cells, enhancing the ability of the body to successfully fight off an infection. Having a smaller size army — which we see across multiple generations of mice in this study — means that you're at risk for not fighting the infection as effectively."

In the study, researchers exposed pregnant mice to environmentally relevant levels of a chemical called dioxin, which, like polychlorinated biphenyls (PCBs), is a common by-product of industrial production and waste incineration, and is also found in some consumer products. These chemicals find their way into the food system where they are eventually consumed by humans. Dioxins and PCBs bio-accumulate as they move up the food chain and are found in greater concentrations in animal-based food products. The scientists observed the production and function of cytotoxic T cells — white blood cells that defend the body against foreign pathogens, such as viruses and bacteria, and seek out and destroy cells with mutations that could lead to cancer — was impaired when the mice were infected with influenza A virus.

Michael O'Reilly, professor of Pediatrics—Neonatology, has been named the director of the Lung Biology and Disease Program, administered by the Department of Environmental Medicine. O'Reilly has a secondary appointment as professor of Environmental Medicine and is a member of the Environmental Health Sciences Center.

O'Reilly's research focuses on how neonatal hyperoxia causes pulmonary and vascular diseases, heart failure, and other adverse health outcomes, and how the DNA damage responsive ataxia telangiectasia mutated gene controls lung epithelial regeneration. His research was the first to demonstrate that oxygen-induced DNA damage signaling stimulates expression of the cyclin-dependent kinase inhibitor p21 that promotes survival by maintaining expression of anti-apoptotic proteins independent of its ability to inhibit proliferation. He also found that neonatal hyperoxia enhances the pathogenesis of influenza A virus by depleting alveolar epithelial cells required for alveolar regeneration. Funding from the National Institutes of Health, the American Lung Association, the American Heart Association, and the March of Dimes has supported O'Reilly's research for more than 20 years.

O'Reilly has authored over 100 peer-reviewed research articles, reviews, and book chapters. He has trained two junior faculty, three post-doctoral fellows, ten graduate students and has served on nearly 30 PhD thesis committees. He has served on a number of NIH study sections and special emphasis panels. From 2012-2014, he served on the Board of Directors for the Genesee Valley-Finger Lakes Chapter of the March of Dimes.

After completing two post-doctoral fellowships at the NIH, O'Reilly joined the faculty of URMC in 1995. He earned his PhD in developmental biology from the University of Cincinnati under the mentorship of Dr. Jeffrey Whitsett. His post-doctoral training was completed with Drs. Michael Sporn and Anita Roberts at the National Cancer Institute and with Dr. Heiner Westphal at the National Institute of Child Health and Human Development.

Did you know that your great-grandmother's exposure to industrial pollution may affect how you respond to respiratory viral infections? A recent paper published in iScience, by Christina Post, a graduate student in Toxicology and Dr. Paige Lawrence, the Chair of Environmental Medicine shows how a common industrial pollutant called dioxin weakens how immune cells respond to influenza A virus infections when given to pregnant mice. Surprisingly, the changes in how the offspring respond to infection were passed on for two more generations! The findings are important because they suggest ancestral environmental exposures may contribute to the efficacy of annual flu vaccinations (maybe place the Futurity link here or not use it at all?).

Irfan Rahman's laboratory sits at the end of a long hallway on the third floor of the University of Rochester's School of Medicine and Dentistry.

Inside, Rahman and a team of researchers take apart e-cigarettes. They analyze the liquid that the devices turn into an inhalable vapor in an effort to figure out exactly what it's made of.

The lab's work has taken on growing importance as the number of deaths and injuries attributed to e-cigarettes across the country continues to rise.

"We are the national leaders in this research," Rahman said. "We are doing work here that can save lives. These are very, very grave health problems."

But New York state's action to ban flavored e-cigarettes last week threw their ability to do that research into question.

The state's emergency regulations ban possession of flavored e-cigarette liquids, with no exemption for research.

URMC shares a $19 million federal grant with the Roswell Park Comprehensive Cancer Center in Buffalo that funds the institutions' research into e-cigarettes. It's an emerging field that investigators said is designed around questions of how flavored tobacco products affect the body and mind.

The realization that the rules did not carve out an exception for researchers led the CEOs of Roswell Park and URMC to send a joint letter to Howard Zucker, the commissioner of the state health department, urging him to allow their research to continue.