New Study Published in AJCP Among the First to Examine Lung Biopsies From Patients With Vaping-Related Lung Illness

Study suggests illnesses may be caused by toxic chemicals rather than the inhalation of oily substances

The findings of a new study on lung injury associated with e-cigarette usage (vaping) indicate that lung illness in the individuals studied could be caused by toxic chemicals rather than the inhalation of oily substances.

The study, “Lung Biopsy Findings in Severe Pulmonary Illness Associated With E-Cigarette Use (Vaping): A Report of Eight Cases,” by Sanjay Mukhopadhyay, MD, FASCP, et al., was published October 17 in the American Journal of Clinical Pathology (AJCP). It is among the first papers to examine a series of lung biopsies from patients who experienced lung illnesses after the use of e-cigarettes.

Recent reports of vaping-associated pulmonary illness have focused primarily on epidemiology and clinical features. The aim of this study is to describe the lung biopsy findings in this emerging area.

“People have been wondering what the underlying biology of these illnesses is,” explains Dr. Mukhopadhyay. “That’s where pathology comes in; you want someone with expertise in looking at lung tissue to figure out if these patients are getting some kind of pneumonia.”

Lung biopsies from eight men, ages 19 to 61, with vaping-associated pulmonary illnesses form the basis of the paper. Common symptoms were cough, shortness of breath and fever. Lung biopsies showed acute lung injury patterns. However, lung biopsies showed no evidence of infection or exogenous lipoid pneumonia, which is typically seen in patients who aspirate oily substances, such as mineral oil, into their lungs.

“This is a new and exciting finding,” Dr. Mukhopadhyay says. “We have evidence this is not caused by infection. We know that the pathology of vaping is the pathology of acute lung injury, which happens from any toxin or noxious stimulus that will cause severe damage. And, we have evidence there is no oil-related injury.”

At present, there is only one other similar article, a Letter to the Editor recently published in the New England Journal of Medicine, that examines the pathology of lung injury associated with vaping-related illnesses. “Our findings are very similar to that paper,” Dr. Mukhopadhyay says.

“Our findings indicate there is severe lung damage, but they don’t identify the cause,” he adds. “The only thing we know is that the patients had a history of vaping before the damage occurred, and we were able to exclude the other possible causes.”  

Vaping-related lung illnesses have been rising steadily and are clearly garnering much discussion. Although vaping has been around for some time, Dr. Mukhopadhyay wonders whether a recent “batch” of vaping materials, especially those containing THC (tetrahydrocannabinol), might contain some sort of chemical contaminant that is causing the illnesses. Read the entire AJCP study here.