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Researchers at the University of California, Riverside, have completed a cross-sectional human study that compares biomarkers and metal concentrations in the urine of e-cigarette users, nonsmokers, and cigarette smokers.

They found that the biomarkers, which reflect exposure, effect, and potential harm, are both elevated in e-cigarette users compared to the other groups and linked to metal exposure and oxidative DNA damage.

Our study found e-cigarette users are exposed to increased concentrations of potentially harmful levels of metals — especially zinc — that are correlated to elevated oxidative DNA damage.”

Prue Talbot, professor of cell biology, University of California, Riverside

Zinc, a dietary nutrient, plays key roles in growth, immune function, and wound healing. Too little of this essential trace element can cause death; too much of it can cause disease. Its deficiency, as well as its excess, cause cellular oxidative stress, which, if unchecked, can lead to diseases such as atherosclerosis, coronary heart disease, pulmonary fibrosis, acute lymphoblastic leukemia, and lung cancer.

Electronic cigarettes consist of a battery, atomizing unit, and refill fluid. Metals in e-cigarette aerosols come mainly from the metal components in the atomizer– nichrome wire, tin solder joints, brass clamps, insulating sheaths, and wicks — as well as the e-fluids that the atomizers heat.

The study, which appears in BMJ Open Respiratory Research, marks the first time researchers have examined and quantified urinary biomarkers of effect and potential harm in relation to metals in e-cigarette users.

A biomarker is a quantifiable characteristic of a biological process. Biomarkers allow researchers and physicians to measure a biological or chemical substance that is indicative of a person’s physiological state. Previous e-cigarette studies with humans have examined biomarkers of exposure — for example, nicotine or nicotine metabolites — but none have studied biomarkers of potential harm or shown how this harm correlates with metal exposure.

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The biomarkers studied by the UC Riverside researchers were 8-hydroxydeoxyguanosine (8-OHdG), a biomarker of oxidative DNA damage; 8-isoprostane, an indicator of the oxidative degradation of lipids; and metallothionein, a metal response protein. All three biomarkers were significantly elevated in e-cigarette users compared to the concentrations in cigarette smokers.

“Our findings reaffirm that e-cigarette use is not harm free,” said Shane Sakamaki-Ching, a graduate student in the Cell, Molecular and Developmental Biology Graduate Program and the research paper’s first author. “Indeed, prolonged use may lead to disease progression.”

The researchers advise physicians to exercise caution when recommending e-cigarettes to their patients. Electronic cigarette aerosols contain potentially harmful chemicals, cytotoxic flavor chemicals, metals, ultrafine particles, and reaction products. E-cigarette use has been linked to adverse health effects such as respiratory diseases, increased risk for cardiovascular disease, and impaired wound healing following surgery.

“Pregnant women, especially, should not be encouraged to use e-cigarettes,” Talbot said. “Excess of zinc in their bodies can lead to nausea and diarrhea. Given the recent deaths and pulmonary illnesses related to e-cigarette usage, everyone should be made aware of the potential health risks linked to e-cigarette usage.”

Source:

University of California – Riverside

Journal reference:

Sakamaki-Ching, S., et al. (2020) Correlation between biomarkers of exposure, effect and potential harm in the urine of electronic cigarette users. BMJ Open Respiratory Research. doi.org/10.1136/bmjresp-2019-000452.

Back in February 2018, the World Health Organization (WHO) talked about a new virus that will emerge and wreak havoc across the globe. Disease X was the term used for this new unknown pathogen that might cause a future epidemic.

Two years later, the novel COVID-19 coronavirus, has evolved from a mild to deadly virus and is spreading across the globe. This begs the question, is COVID-19 the dreaded Disease X that the WHO predicted back in 2018?

Disease X is a placeholder name adopted by the World Health Organization (WHO) for any new unknown pathogen that may cause disease and potentially an epidemic in the future. Image Credit: Lightspring

What is Disease X?

Disease X is a deadly plague and an outbreak of a flu-like illness, which can result in a pandemic that can kill millions of people worldwide. In 2018, the WHO classified Disease X as more deadly than the Lassa fever and the Ebola virus disease.

Disease X also represents the knowledge that a serious international epidemic could be caused by an unknown pathogen to cause morbidity and mortality. During that time, the diseases being studied by the WHO include the Crimean-Congo hemorrhagic fever (CCHF), Lassa fever, Ebola virus disease, Marburg virus disease, Nipa and henipaviral diseases, Middle East Respiratory Syndrome coronavirus (MERS-Cov), Severe Acute Respiratory Syndrome (SARS), Rift Valley fever (RVF), and the Zika virus.

Coronavirus infection magnitude

The coronavirus disease (COVID-19) is thought to have emerged in late December 2019 in a seafood market in Wuhan City, Hubei Province, China. Since then, the virus has spread to 30 countries across the globe.

As of writing, there are 79,152 confirmed cases of the deadly virus, and it has killed 2,470 people, most of whom in the epicenter of the outbreak in Hubei Province. The majority of the cases were in mainland China, while outside the country, South Korea reported the greatest number of infections, with 763 cases, followed by Italy with 155 cases.

The WHO has declared the coronavirus a global health emergency on Jan. 30 due to the rapid spread of the virus. Many countries have already closed their borders from countries with many confirmed cases.

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South Korea has seen the rapid spread of the disease in the country, prompting officials to declare the highest alert advisory. The number of cases increased from 31 on Feb. 18 to a staggering 763 six days after. The sudden spike in infections can be traced to the city of Daegu. Officials have identified a religious group, the Shincheonji Church of Jesus, as a coronavirus hotbed, where an infected woman attended masses for several occasions.

The virus has spread to 30 countries, including South Korea, Italy, Japan, Singapore, Hong Kong, Iran, Thailand, United States, Taiwan, Australia, Malaysia, Germany, Vietnam, the United Arab Emirates, France, Macau, Canada, the United Kingdom, Philippines, India, Russia, Spain, Lebanon, Nepal, Cambodia, Israel, Belgium, Finland, Sweden, Egypt, and Sri Lanka.

Is the coronavirus the Disease X?

The coronavirus is fast spreading, and if it is not contained, it can become catastrophic. The WHO director-general Tedros Adhanom Ghebreyesus raises concern about the increasing number of the coronavirus without a clear epidemiologic link.

He added that what they fear is if the virus spreads to a country without a sound and strong healthcare system. He fears that if the virus reaches these countries, which have weak healthcare systems, it can be devastating.

Now, scientists caution that the virus’s way of infection is still unclear. During the first weeks of its spread, the incubation period was estimated to be a couple of days to 14 days, but new cases have emerged with longer incubation periods. Further, the disease can be transmitted from human to human, with aerosol and droplets as a possible mode of transmissions.

With several things still unclear about the virus and how it spreads, scientists say that the novel coronavirus fits the disease X category.

“Whether it will be contained or not, this outbreak is rapidly becoming the first true pandemic challenge that fits the disease X category, listed to the WHO’s priority list of diseases for which we need to prepare in our current globalized society,” Marion Koopmans, head of viroscience at Erasmus University Medical Center in Rotterdam, and a member of the WHO’s emergency committee wrote in the journal Cell.

“Time will tell whether the consolidated efforts of the Chinese authorities and the international public health and research community will succeed. But we also need to understand how we make this model of preparedness future-proof,” she added.

Sources:

World Health Organization (WHO). (2018). Prioritizing diseases for research and development in emergency contexts. https://www.who.int/activities/prioritizing-diseases-for-research-and-development-in-emergency-contexts

World Health Organization (WHO). (2020). Coronavirus disease 2019 (COVID-19) Situation Report – 33. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200222-sitrep-33-covid-19.pdf?sfvrsn=c9585c8f_2

Zhang, Y., Koopmans, M., Yuen, K., Andersen, K., Perlman, S., Hogue, B., and Eckerle, I. (2020). The Novel Coronavirus Outbreak: What We Know and What We Don’t. Cell. https://www.cell.com/cell/pdf/S0092-8674(20)30171-9.pdf

The coronavirus may have emerged from a Wuhan laboratory leak, which studies deadly pathogens such as the SARS virus, scientists suggest.

Health officials believe that the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes the coronavirus disease (COVID-19), originated from wild animals sold in the Huanan Seafood Wholesale Market in Wuhan City, which is home to 11 million residents.

Now, a team of scientists from Xishuangbanna Tropical Botanical Garden of Chinese Academy of Sciences, South China Agricultural University, and Chinese Institute for Brain Research wrote in a paper published on ChinaXiv, about an alternative source of the coronavirus that is currently spreading across the globe.

The scientists say they have found genomic evidence that the seafood market is not the actual source of the outbreak. Instead, they point the source of the virus outbreak to a laboratory that studies potent viruses.

The Wuhan Virology Institute researches some of the world's most dangerous pathogens. It is China's first Biosafety Level 4 laboratory, the highest security level needed to isolate dangerous biological agents in an enclosed facility.

Image Credit: Connect World / Shutterstock

The spread of the virus

The scientists in the study speculated that the outbreak of the virus has started before December 2019, probably beginning in late November. Further, the busy seafood market may have facilitated the transmission of the virus to buyers, and from buyers to residents across the city.

In the study, the researchers collected genome-wide information from 93 new coronavirus samples shared on the GISAID EpiFlu, which is an international database storing information about the influenza virus. The team studied the evolution and human-to-human transmission of the coronavirus over the past two months.

The samples were taken from 12 countries, wherein 54 came from China before Jan. 22 and the other 39 samples were from France, Australia, Japan, and the United States after Jan. 22.

The team also found that while the virus had spread in the seafood market in Wuhan, there had also been two major population expansions, dated Dec. 8 and Jan. 6. Further, scientists believe that the virus originated outside the market, but the crowded market had boosted the circulation of the coronavirus, spreading it to the whole city by December 2019.

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The first case manifesting symptoms emerged on Dec. 8, and most of the following cases were linked to the seafood market. On Jan. 1, the seafood market was closed, but the virus had already spread in the city, suggesting that the outbreak has started through human-to-human transmission by late November.

Warning about the new virus

“The study concerning whether the Huanan market is the only birthplace of SARS-CoV-2 is of great significance for finding its source and determining the intermediate host to control the epidemic and prevent it from spreading again,” the researchers said.

The researchers also said that while at the beginning of the outbreak in Hubei province and neighboring areas, China’s National Center for Disease Control and Prevention issued a level 2 emergency warning about the new outbreak on Jan. 6, the information was not widely shared. The team said if warning received more attention, the number of cases in China, and across the globe would have been reduced.

The government has locked down Wuhan city on Jan. 23, which is weeks after the outbreak has been reported. Before the residents were barred from leaving the city in fear of spreading the virus, millions have already left.

The Wuhan Institute of Virology, which is the only laboratory in China that is equipped to study with such deadly infectious diseases, released a statement saying that the rumors had caused great harm to the researchers of the laboratory.

The origin of the new coronavirus is still unknown, but scientists and the World Health Organization (WHO) said it is most likely an animal reservoir.

Coronavirus by the numbers

The coronavirus disease (COVID-19) has already spread to 30 countries, with South Korea reporting the greatest number of infections after China. As of writing, there are 763 people in South Korea testing positive for the deadly virus.

The coronavirus has infected nearly 80,000 people, most of whom in mainland China and the death toll has reached 2,670, which is more than twice the number of deaths linked to SARS in 2003.

Countries across the globe, particularly those fearing the rapid spread of the virus, have imposed travel bans from countries who have confirmed cases of the coronavirus. Meanwhile, Italy has also reported a spike in cases, with 155 people testing positive while three patients have succumbed to the disease.

The World Health Organization (WHO) reported that no new countries had reported confirmed cases in the past 24 hours.

Sources:

  • Decoding evolution and transmissions of novel pneumonia coronavirus using the whole genomic data, Yu, Wen-Bin, Tang, Guang-Da, Zhang, Li, Corlett, Richard, http://www.chinaxiv.org/abs/202002.00033
  • World Health Organization (WHO). (2020). Coronavirus disease 2019 (COVID-19) Situation Report – 34. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200223-sitrep-34-covid-19.pdf?sfvrsn=44ff8fd3_2
  • http://www.ecns.cn/news/sci-tech/2020-02-23/detail-ifztvsqr0576579.shtml
  • https://www.globaltimes.cn/content/1180429.shtml
  • https://news.cgtn.com/news/2020-02-23/New-study-shows-Wuhan-seafood-market-not-the-source-of-COVID-19-OjhaHnwdnG/index.html