Lesão pulmonar induzida pelo uso excessivo de cigarros eletrônicos: toxicantes envolvidos e mecanismos fisiopatológicos

Abstract

Introduction: Electronic cigarettes were introduced to the market for assisting in smoking cessation. However, this alternative is related to the development of Lung Injury Associated with the Use of Electronic Cigarettes and Vaporizers (EVALI), especially in the young population. In this context, it is necessary to understand the mechanisms of lung injury produced by the use of electronic cigarettes in order to establish the true risks of long-term exposure to these vapors. Objective: To elucidate the pathophysiological mechanisms of EVALI. Method: Integrative literature review based on the PRISMA method and search in the LILACs, PubMed, and EMBASE databases, from 2003 to 2023 and free access experimental and epidemiological research in full, with an approach to the pathogenesis of EVALI, were selected. Results: The different constituents present in electronic cigarettes are involved in the development of EVALI as they age through different mechanisms, such as: changes in the structure and functions of the lung surfactant; accumulation of oil droplets in mucus, and alteration of the structure, function, and chemotaxis of cells that make up innate immunity, such as neutrophils and macrophages. Conclusions: Electronic cigarettes induce EVALI through different mechanisms due to the complexity of the composition of substances present in vapors. Clarifying the mechanisms of lung injury is pertinent for regulatory agencies to apply more stringent measures to electronic cigarettes in order to reduce the impact of exposure and cases of morbidity and mortality among young people and adults.