Unveiling Oral Health Impacts of Vaping in African Americans through Untargeted Metabolomics and Proteomics

Electronic nicotine delivery systems (ENDSs), commonly termed e-cigarettes, have been advertised as a safer alternative to traditional tobacco cigarettes and promoted for smoking cessation. However, emerging evidence suggests a connection between e-cigarette use or vaping and an increased risk of oral disease, particularly among minoritized populations such as Black and African Americans (AAs). AA communities have historically experienced disproportionate harm from tobacco use, which could extend to vaping. In this study, we recruited 20 AAs and 28 individuals of other races, oversampled for vapers, with no statistical differences in age, sex, sugar intake, income, or education across groups. Whole saliva samples collected at the time of the visit were processed for untargeted UHPLC-ESI-MS/MS proteomics and HPLC-MS/MS metabolomics. Our results revealed vaping preferentially impaired redox pathways and amino acid metabolism among AAs, with elevated malondialdehyde levels and an oxidized glutathione to glutathione ratio and lowered levels of glucose-6-phosphate dehydrogenase and ascorbate. Salivary proteomics demonstrated salivary secretion was upregulated in AAs while Fc gamma R-mediated phagocytosis, bacterial invasion defense, natural killer cell function, leukocyte migration, and phagosome function were downregulated, suggesting dysregulated innate immune function in AA vapers. Additionally, focal adhesion, cell-substrate junction, and actin cytoskeleton regulation were downregulated in AA vapers, indicating that mucous epithelium barrier integrity may be disrupted. Lastly, the Community Periodontal Index of Treatment Need (CPITN), a dental assessment tool developed by the World Health Organization (WHO) to evaluate periodontal health and determine the need for treatment, revealed that a significantly higher proportion of AA vapers had CPITN scores of 3 or higher, suggesting the need for further clinical assessment of periodontal disease. Collectively, our results suggest that AAs may be more susceptible to oral health effects of vaping than individuals of other racial groups, with elevated levels of oxidative stress, dysregulated innate immune function, mucous epithelium barrier integrity disruption, and varying nicotine metabolism.