Background and Aim: The use of conventional cigarettes is a major and preventable health problem and the leading cause of preventable morbidity and mortality. Electronic cigarettes have been shown to yield plasma nicotine levels similar to that seen in traditional cigarette users. E-cigarettes have been touted as a healthier alternative to traditional cigarettes and as a smoking cessation tool with mixed results. The increasing use of e-cigarettes by youth is concerning with 27.5% of high school students and 10.5% of middle school students reporting using e-cigarettes in 2019. Use among young adults (18-24) is increasing with 7.6% reporting use in 2018. Toll-like receptors (TLRs) are key sensors in the activation of innate immunity. In addition to activating antiviral and pro-inflammatory responses, TLR3 in particular has been shown to behave as a death receptor, causing apoptosis in cancer cells. TLR3 expression is reduced in the airway epithelial cells of smokers, leading to a reduction in the downstream expression of type I interferons following viral infection.

Methods: E-cigarette aerosol extracts were prepared from two brands of e-cigarettes, as previously described. Mainstream tobacco smoke extract was used as a positive control. Normal lung epithelial cells were exposed for 2 weeks to e-cigarette aerosol extracts at nicotine doses comparable to those observed in e-cigarette users. Whole-cell RNA was isolated. Gene expression was assessed by RNA-sequencing and validated by western blot.

Results: Exposure of lung epithelial cells to e-cigarette aerosol extracts significantly decreased the mRNA expression levels of TLR3 (p<0.0001). A significant reduction (p<0.0001) in the mRNA expression of downstream innate immune system molecules including RIG1, IRF7 and interferons was also observed. The reduction in gene expression was similar to that observed from traditional cigarette smoke extracts.

Conclusions: Our study suggests that exposure to e-cigarette aerosol can decrease the expression of key genes involved in innate immune response. TLR3 expression has been associated with good prognosis in early stage lung cancer. A decrease in TLR3 expression could allow tumors to evade immune surveillance and apoptosis

Citation Format: Daniel Brobst, Jimmy Manyanga, Constantin Georgescu, Jonathan Wren, Lurdes Queimado. Exposure to E-cigarette aerosol reduces the expression of Toll-like receptor 3 in lung epithelial cells [abstract]. In: Abstracts: AACR Virtual Special Conference: Tumor Immunology and Immunotherapy; 2020 Oct 19-20. Philadelphia (PA): AACR; Cancer Immunol Res 2021;9(2 Suppl):Abstract nr PO033.