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In a controlled study of smokers, nonsmokers, and e-cigarette users, University of North Carolina School of Medicine researchers found that e-cigarette users exhibited significantly altered immune responses to a model of influenza virus infection, suggesting increased susceptibility to disease. The findings, published in the American Journal of Respiratory Cell and Molecular Biology, show that vaping changes the expression of genes and production of proteins in respiratory cells, as well as altering virus-specific antibody production.