People who vape e-cigarettes might have an increased risk of developing pneumonia because the vapor could help bacteria stick to cells lining the airways, a small experiment suggests.

Traditional cigarettes have long been linked to an increased risk of pneumonia, but it’s been less clear whether e-cigarettes might have the same effect.

To find out, researchers did a series of laboratory experiments to see whether exposure to e-cigarette vapor might increase levels of a molecule produced by airway lining cells, called platelet-activating factor receptor (PAFR). Pneumococcal bacteria use PAFR to help them adhere to airway cells.

First, the researchers exposed some human airway epithelial cells in culture dishes to e-cigarette vapor. Compared to cells that weren’t exposed, those that were had PAFR levels three times higher.

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