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Nebulized Menthol Impairs Mucociliary Clearance via TRPM8 and MUC5AC/MUC5B in Primary Airway Epithelial Cells
Nathalie Baumlin1, Neerupma Silswal1, John S Dennis1
1Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA.
Abstract:
Flavorings enhance the palatability of e-cigarettes (e-cigs), with menthol remaining a popular choice among e-cig users. Menthol flavor remains one of the only flavors approved by the United States FDA for use in commercially available, pod-based e-cigs. However, the safety of inhaled menthol at the high concentrations used in e-cigs remains unclear. Here, we tested the effects of menthol on parameters of mucociliary clearance (MCC) in air-liquid interface (ALI) cultures of primary airway epithelial cells. ALI cultures treated with basolateral menthol (1 mM) showed a significant decrease in ciliary beat frequency (CBF) and airway surface liquid (ASL) volumes after 24 h. Menthol nebulized onto the surface of ALI cultures similarly reduced CBF and increased mucus concentrations, resulting in decreased rates of mucociliary transport. Nebulized menthol further increased the expression of mucin 5AC (MUC5AC) and mRNA expression of the inflammatory cytokines IL1B and TNFA. Menthol activated TRPM8, and the effects of menthol on MCC and inflammation could be blocked by a specific TRPM8 antagonist. These data provide further evidence that menthol at the concentrations used in e-cigs could cause harm to the airways.
Insights
Inhaled menthol in e-cigarettes significantly impairs airway clearance mechanisms, reducing ciliary beat frequency and increasing mucus. This suggests menthol poses risks to respiratory health at typical e-cigarette concentrations.
Area of Science:
- Respiratory Physiology
- Toxicology
- Cell Biology
Background:
- Menthol is a popular flavoring in e-cigarettes, approved by the FDA for some products.
- The safety of high menthol concentrations inhaled from e-cigarettes is not well understood.
Purpose of the Study:
- To investigate the effects of menthol on mucociliary clearance (MCC) in airway epithelial cells.
- To determine the impact of menthol on ciliary function, mucus production, and inflammation.
Main Methods:
- Utilized air-liquid interface (ALI) cultures of primary human airway epithelial cells.
- Applied menthol via basolateral treatment and nebulization.
- Measured ciliary beat frequency (CBF), airway surface liquid (ASL) volume, mucin production, and inflammatory cytokine expression (IL1B, TNFA).
- Investigated the role of the TRPM8 channel.
Main Results:
- Menthol significantly decreased CBF and ASL volume.
- Nebulized menthol reduced mucociliary transport by increasing mucus concentration.
- Menthol increased MUC5AC expression and inflammatory cytokine mRNA levels (IL1B, TNFA).
- Menthol activated TRPM8, and TRPM8 antagonism blocked menthol's adverse effects.
Conclusions:
- Menthol, at concentrations relevant to e-cigarette use, impairs crucial airway clearance functions.
- Menthol exposure can lead to increased mucus production and airway inflammation.
- The TRPM8 channel mediates menthol's detrimental effects on airway epithelium.
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