Impaired respiratory health induced by cannabis smoking is associated with a sparse airway epithelium and elevated MUC5AC expression

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Introduction: Cannabis is used by 147 million people globally, with smoking as the main method consumption. However, the impact of cannabis smoking on the lungs is not fully understood. Objective: Investigate how cannabis smoking affects airway epithelial morphology and association with respiratory health outcomes. Methods: 11 non-smoking controls (NS) and 20 cannabis smokers (CS) completed St. George’s Respiratory Questionnaires (SGRQ) and underwent bronchoscopy. Epithelial cells from bronchial brushings were cultured as air-liquid interface to establish a pseudostratified epithelium which was stained for epithelial morphometry and mucin quantification. Results: Total SGRQ scores were higher in CS than NS (P<0.01). Compared with NS (Fig. 1A), epithelial cell number was lower in CS (Fig. 1B; P=0.01). Lower epithelial cell number was correlated with increased cough (P<0.01) and worse SGRQ symptom scores (P=0.02). Relative to NS (Fig. 1C), CS (Fig. 1D) had 86% greater MUC5AC expression (P=0.01), with worse SGRQ symptom scores associated with higher MUC5AC expression (P<0.05) across the cohort. Epithelial thickness, cilia length, and MUC5B expression did not differ between groups. Conclusion: Cannabis smoking impairs respiratory health, underpinned by a sparse airway epithelium and greater MUC5AC expression; epithelial disruption may contribute to obstructive airway disease pathology. erj;66/suppl_69/PA3500/F1 F1 F1

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