Abstract

Biomarkers of potential harm (BoPH) are indicators of biological perturbations which may contribute to the pathophysiology of disease. In this review, we critically assessed the published data on lung-related BoPH in human lung disease for potential use in evaluating the effects of tobacco and nicotine products. A Scopus literature search was conducted on lung disease biomarkers used in a clinical setting over the last 10 years. We identified 1171 papers which were further screened using commercial software (Sciome SWIFT-Active Screener) giving 68 publications that met our inclusion criteria (data on the association of the biomarker with cigarette smoking, the impact of smoking cessation on the biomarker, and differences between smokers and non-smokers), the majority of which investigated chronic obstructive pulmonary disease. Several physiological and biochemical measures were identified that are potentially relevant for evaluating the impact of tobacco products on lung health. Promising new candidates included blood biomarkers, such as surfactant protein D (SP-D), soluble receptor for advanced glycation end products (sRAGE), skin autofluorescence (SAF), and imaging techniques. These biomarkers may provide insights into lung disease development and progression; however, all require further research and validation to confirm their role in the context of tobacco and nicotine exposure, their time course of development and ability to measure or predict disease progression.