E-cigarette aerosols as systemic metabolic disruptors: integrated mitochondrial, circadian, and neurobehavioral mechanisms

E-cigarette exposure is associated with mitochondrial impairment and oxidative stress.

• E-cigarette aerosols contain metals, aldehydes, and solvents that can disrupt metabolic regulation.
• Exposure affects mitochondrial function, leading to oxidative stress and metabolic inflexibility.
• Changes observed include AMPK suppression, disrupted lipid oxidation, adipose inflammation, and reduced thermogenic capacity.
• Disruption of circadian clock signaling and modulation of reward and appetite circuits may bias energy balance.
• These findings suggest that e-cigarettes could act as multi-system metabolic disruptors affecting both peripheral organs and central pathways.
• Uncertainties remain regarding dose-response relationships, exposure patterns, device variability, and long-term human risk.

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