Influence of smoking and vaping on bone-muscle crosstalk

The intricate relationship between the skeletal and muscular systems involves a complex exchange of molecular signals, with muscles and bones functioning as endocrine and paracrine organs that produce bioactive molecules known as myokines and osteokines. These molecules are essential for maintaining the balance between bone and muscle tissue. However, various factors can disrupt this balance and negatively impact bone and muscle health. Cigarette smoking, including the use of electronic cigarettes, is among the factors that affect communication between muscles and bones. While the exact mechanisms through which smoking influences muscle-bone signaling pathways are still being investigated, it is known that substances like nicotine in traditional cigarettes and other compounds in cigarette smoke can hinder fracture healing by decreasing the formation of new bone tissue. These substances also in- fluence the levels of important molecules like RANKL, sclerostin, and osteocalcin, which are crucial for bone and muscle health. Additionally, the use of electronic cigarettes, including various flavored varieties, has been linked to an increase in proinflammatory cytokines that adversely affect the musculoskeletal system. Finally, cigarette smoking has been associated with a higher risk of vitamin D deficiency through multiple pathways, leading to an increased risk of osteoporosis and falls. These findings underscore the importance of educating the public about the risks to musculoskeletal health posed by both traditional smoking and electronic cigarettes. KEY WORDS: Traditional smoking, electronic cigarettes, bone-muscle crosstalk, myokines, osteokines.