Choriocapillaris and blood flow alterations in smokers naïve to heated tobacco products: a cross-sectional study.

PURPOSE: Heated tobacco products (HTPs) are devices that heat tobacco to high temperatures, rather than combusting it to generate smoke. The potential impact of HTPs on the body is not yet fully understood, as they are relatively recent products. The aim of this multidisciplinary study was to evaluate potential associations between the use of HTPs and both general and system-specific vital parameters in the enrolled subjects in order to determine whether these devices may be harmful and capable of inducing clinical, biochemical, or functional alterations compared to nonsmokers (non-SMs).

MATERIALS AND

METHODS

In this pilot study, the population consisted of 18 exclusive HTP users and 10 non-SMs. Spirometry was performed to assess respiratory function and blood sampling was used to evaluate the presence of oxidative stress (OS) biomarkers. Hemostatic variations and platelet aggregation were assessed using the total thrombus formation analysis system (T-TAS). Finally, ophthalmological examinations and optical coherence tomography angiography (OCTA) were performed to analyze the structural characteristics and chorioretinal vascular flow parameters.

RESULTS

Hemorheological parameters revealed accelerated thrombus formation and prolonged thrombus stability on T-TAS, along with increased nicotinamide adenine dinucleotide phosphate (NADPH) oxidase 2 (NOX2), or NADPH oxidase 2, levels. OCTA also revealed a statistically significant reduction in choriocapillaris flow (Ch-Flow) in HTP users.

CONCLUSIONS

Alterations in primary hemostasis, OS, and chorioretinal microvascular perfusion highlight the need for further research in a larger cohort with higher mean age and longer cumulative exposure to HTPs to confirm these preliminary findings.