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EClinicalMedicine

Title:		Acrolein and other toxicant exposures in relation to cardiovascular disease among marijuana and tobacco smokers in a longitudinal cohort of HIV-positive and negative adults
Author(s):		Lorenz DR; Misra V; Chettimada S; Uno H; Wang L; Blount BC; De Jesus VR; Gelman BB; Morgello S; Wolinsky SM; Gabuzda D;
Address:		"Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Center for Life Science 1010, 450 Brookline Avenue, Boston, MA 02215, USA. Department of Data Sciences, Dana-Farber Cancer Institute, Boston, MA, USA. Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA. Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA. Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA"
Journal Title:		EClinicalMedicine
Year:		2021
Volume:		20210111
Issue:
Page Number:		100697 -
DOI:		10.1016/j.eclinm.2020.100697
ISSN/ISBN:		2589-5370 (Electronic) 2589-5370 (Linking)
Abstract:		"BACKGROUND: Marijuana smoke contains some of the same toxicants present in tobacco smoke. Marijuana smoking is prevalent among HIV+ individuals, but few studies have characterized smoke-related toxicants or associated health outcomes in exclusive marijuana users. METHODS: This longitudinal study included 245 participants over age 40 (76% HIV+). 33 plasma and 28 urine metabolites of nicotine, ?Os-9-trans-tetrahydrocannabinol, polycyclic aromatic hydrocarbons, and volatile organic compounds were assayed by liquid or gas chromatography/mass spectrometry. Exposures and health outcomes were assessed from surveys and medical records. FINDINGS: At baseline, 18% of participants were marijuana-only smokers, 20% tobacco-only smokers, and 24% dual marijuana-tobacco smokers (median (IQR) age 53 (47-60) years, 78% male, 54% white race). Marijuana smoking was independently associated with elevated plasma naphthalenes, 2-hydroxyfluorene sulfate, 4-vinylphenol sulfate, and o-cresol sulfate (p<0.05) and urine acrylonitrile and acrylamide metabolites (p<0.05), but levels were lower than those associated with tobacco smoking. Acrolein metabolite N-Acetyl-S-(3-hydroxypropyl)-l-cysteine (3HPMA) was significantly elevated in plasma and urine in tobacco-only and dual but not marijuana-only smokers, and correlated with nicotine metabolites (p<0.05). The highest tertile of 3HPMA was associated with increased cardiovascular disease diagnoses independent of tobacco smoking, traditional risk factors, and HIV status (odds ratio [95% CI] 3.34 [1.31-8.57]; p = 0.012). INTERPRETATION: Smoke-related toxicants, including acrylonitrile and acrylamide metabolites, are detectable in exclusive marijuana smokers, but exposures are lower compared with tobacco or dual smokers. Acrolein exposure is increased by tobacco smoking but not exclusive marijuana smoking in HIV+ and HIV- adults, and contributes to cardiovascular disease in tobacco smokers. FUNDING: U.S. NIH"
Keywords:		Acrolein Cardiovascular disease Marijuana Smoke Tobacco Toxicants;
Notes:		"PubMed-not-MEDLINELorenz, David R Misra, Vikas Chettimada, Sukrutha Uno, Hajime Wang, Lanqing Blount, Benjamin C De Jesus, Victor R Gelman, Benjamin B Morgello, Susan Wolinsky, Steven M Gabuzda, Dana eng U24 MH100929/MH/NIMH NIH HHS/ U24 MH100925/MH/NIMH NIH HHS/ U24 MH100928/MH/NIMH NIH HHS/ U01 AI035041/AI/NIAID NIH HHS/ UM1 AI035043/AI/NIAID NIH HHS/ UL1 TR000424/TR/NCATS NIH HHS/ P30 MH062512/MH/NIMH NIH HHS/ U01 AI035039/AI/NIAID NIH HHS/ UL1 TR003098/TR/NCATS NIH HHS/ R01 DA046203/DA/NIDA NIH HHS/ U01 AI035042/AI/NIAID NIH HHS/ HHSN271201000030C/MH/NIMH NIH HHS/ U24 MH100931/MH/NIMH NIH HHS/ U01 AI035043/AI/NIAID NIH HHS/ R01 DA040391/DA/NIDA NIH HHS/ U24 MH100930/MH/NIMH NIH HHS/ U01 AI035040/AI/NIAID NIH HHS/ England 2021/02/09 EClinicalMedicine. 2021 Jan 11; 31:100697. doi: 10.1016/j.eclinm.2020.100697. eCollection 2021 Jan"