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
Open accessAbstract
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".
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Blood-brain barrier integrity can be compromised by exposures to certain toxicants and by health conditions through molecular alterations in barrier function.
“Integrity of the BBB can be compromised because of exposures to certain toxicants, such as pesticides, mixed vehicle emissions, and tobacco smoke, as well as certain health conditions including diabetes and neurological disorders reviewed in Neurotoxicity of PFAS in Sensitive Populations, through molecular alterations in barrier function (Gupta et al., 1999; Weiss et al., 2009; Mazzone et al., 201”
From A Critical Review and Meta-Analysis of Impacts of Per- and Polyfluorinated Substances on the Brain and Behavior (2022) · cites this paper as Mazzone et al., 2010
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- Authors
- Mazzone, P., Tierney, W., Hossain, M., Puvenna, V., Janigro, D., & Cucullo, L.
- Affiliations
- Cleveland Clinic (US)
- Case Western Reserve University (US)
- Corresponding author
- Cucullo, Luca
- Venue
- International Journal of Environmental Research and Public Health
- Publisher
- MDPI AG
- Published
- 2010-11-26
- Volume
- 7
- Issue
- 12
- Pages
- 4111-4126
- ISSN
- 1660-4601 (ISSN-L)
- PMC
- PMC3037043
- OpenAlex
- W1970824175
- Cited by
- 183
- References
- 97
- Citations by year
- 2026: 9 · 2025: 8 · 2024: 18 · 2023: 11 · 2022: 14 · 2021: 17 · 2020: 22 · 2019: 9 · 2018: 14 · 2017: 14 · 2016: 7 · 2015: 17 · 2014: 4 · 2013: 10 · 2012: 5
- FWCI
- 0.51
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- Alternatives Research and Development Foundation
- Topics
- Life Sciences › Neuroscience › Neurology › Barrier Structure and Function Studies
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Keywords
- cigarette smoke, blood-brain barrier, cerebrovascular system, endothelial dysfunction, small vessel ischemic disease, silent cerebral infarction, stroke, passive smoking, tobacco smoke toxicity, atherosclerosis, thrombosis
- MeSH terms
- Blood-Brain Barrier, Cerebrovascular Disorders, Endothelium, Vascular, Humans, Smoking, Tobacco Smoke Pollution
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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