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Pathophysiological Impact of Cigarette Smoke Exposure on the Cerebrovascular System with a Focus on the Blood-brain Barrier: Expanding the Awareness of Smoking Toxicity in an Underappreciated Area

1
Department of Pulmonary Medicine, Cleveland Clinic Lerner College of Medicine, E 100th St, Cleveland, OH 44106, USA
2
Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106, USA
3
Cerebrovascular Research, Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH 44195 USA
4
Department of Cell Biology, Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH 44195, USA
5
Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, E 100th St, Cleveland, OH 441065, USA
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2010, 7(12), 4111-4126; https://doi.org/10.3390/ijerph7124111
Received: 2 November 2010 / Revised: 18 November 2010 / Accepted: 19 November 2010 / Published: 26 November 2010
(This article belongs to the Special Issue Tobacco Smoking: Public Health, Science and Policy)
Recent evidence has indicated that active and passive cigarette smoking are associated, in a dose-dependent manner, with dysfunction of normal endothelial physiology. Tobacco smoke (TS) may predispose individuals to atherogenic and thrombotic problems, significantly increasing the risk for ischemic manifestations such as acute coronary syndrome and stroke. Despite the strong evidence for an association between smoking and vascular impairment, the impact of TS exposure on the blood-brain barrier (BBB) has only been marginally addressed. This is a major problem given that the BBB is crucial in the maintenance of brain homeostasis. Recent data have also shown that chronic smokers have a higher incidence of small vessel ischemic disease (SVID), a pathological condition characterized by leaky brain microvessels and loss of BBB integrity. In the brain TS increases the risk of silent cerebral infarction (SCI) and stroke owing to the pro-coagulant and atherogenic effects of smoking. In this article we provide a detailed review and analysis of current knowledge of the pathophysiology of tobacco smoke toxicity at the cerebrovascular levels. We also discuss the potential toxicity of recently marketed “potential-reduced exposure products”. View Full-Text
Keywords: tobacco smoke; alternative; blood-brain barrier; central nervous system; inflammation; endothelial cells; white blood cells tobacco smoke; alternative; blood-brain barrier; central nervous system; inflammation; endothelial cells; white blood cells
MDPI and ACS Style

Mazzone, P.; Tierney, W.; Hossain, M.; Puvenna, V.; Janigro, D.; Cucullo, L. Pathophysiological Impact of Cigarette Smoke Exposure on the Cerebrovascular System with a Focus on the Blood-brain Barrier: Expanding the Awareness of Smoking Toxicity in an Underappreciated Area. Int. J. Environ. Res. Public Health 2010, 7, 4111-4126.

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