Electronic cigarettes containing nicotine increase endothelial and platelet derived extracellular vesicles in healthy volunteers

E-cigarette use is increasingly common. Whether e-cigarettes are harmful to human health is an intensely debated subject. In order to investigate whether e-cigarettes with and without nicotine cause different vascular responses, we obtained blood samples from healthy young volunteers who performed brief active e-cigarette inhalations. Extracellular vesicles (EVs) of endothelial and platelet origin were measured to determine vascular changes. Using a randomized, double-blind, crossover design, 17 healthy occasional smokers inhaled 30 puffs of e-cigarette vapor during 30 min. Blood samples were collected at baseline, as well as at 0, 2, 4 and 6 h post-exposure. EVs from platelets and endothelial cells were measured by flow cytometry. Platelet and endothelial derived EVs were significantly increased with peak levels seen at 4 h following exposure to active inhalation of e-cigarette vapor with nicotine. Moreover, platelet derived EVs, expressing platelet activation marker P-selectin and the inflammation marker, CD40 ligand, were also significantly increased following inhalation of e-cigarette vapor with nicotine. In addition, platelet derived EVs expressing CD40 ligand was increased after inhalation of e-cigarette vapor without nicotine. As few as 30 puffs of nicotine-containing e-cigarette vapor caused an increase in levels of circulating EVs of endothelial and platelet origin, which may signify underlying vascular changes. Although e-cigarette vapor without nicotine caused an increase in platelet EVs expressing CD40 ligand, nicotine, as a component in the vapor, seems to have a more compelling effect on extracellular vesicle formation and protein composition. [Display omitted] •The vascular effects of e-cigarettes with and without nicotine were investigated in healthy volunteers.•Circulating extracellular vesicles (EVs) of endothelial and platelet origin were assessed.•Thirty puffs of nicotine-containing e-cigarette vapor caused an increase in EVs of endothelial and platelet origin.•Following exposure to e-cigarettes without nicotine only platelet derived EVs expressing CD40 ligand were increased.•E-cigarettes cause stress to endothelial and platelet cells similar to what has been observed following cigarette smoking.•This effect seems mainly to be driven by the addition of nicotine in the e-cigarette vapor.