Incense Smoke Exposure: An Appraisal of Organ Toxicity

Abstract

Background: This narrative type review aimed to address organ toxicity emanating from incense usage.
Methods: An online search using the following MeSH terms “Incense smoke,”, “adverse effects,”
“organotoxicity”, “oxidative stress” and “inflammation” was done to identify studies directly applicable to
adverse effects of incense smoke exposure.
Findings: Exposure to incense smoke demonstrated various toxicity changes in the kidney, testes, lungs,
liver and heart. Renal effects included a decrease in oxidative stress markers GSH and CAT, increase in
MDA, serum creatinine uric acid and blood urea nitrogen (BUN). Testicular toxicityrevealed significant
disturbances in spermatogenetic patterns, testicular atrophy, germinal aplasia, hypospermia and damage to
the basal seminiferous epithelia tissue. In the cardiac muscle, ultrastructural changes, increased oxidative
stress, inflammation, and altered cardiac hypertrophic gene expression was noted. Thenegative impact
of incense smoke emanating from free radical (ROS), lipid peroxidation and GSH destabilizes vascular
homeostasis and initiates ahyperinflammatory response, warranting the need to understand the conceptual
basis of the mode of action linked to incense exposure.
Conclusion: We highlight that incense generates ROS which initiates lipid peroxidation through ATP energy
depletion and reduction in the natural antioxidants. This subsequently triggers oxidative stress, inflammation
and endothelial dysfunction resulting in organotoxicity