Conclusions and Proposals for future work:
Nicotine has been a part of human culture in some shape or form for hundreds of years, and remains highly present through tobacco consumption in cultures worldwide. While the addictive nature of nicotine is well known, and the health effects of tobacco exposure widely exposed to consumers, it does not appear that there will be a significant reduction in nicotine exposure within the next several years. In light of the novel nicotine delivery systems without tobacco, such as electronic cigarettes, the possibility of increased exposure to nicotine by recreational users is a possibility. With the lack of knowledge regarding potential nicotine toxicity, there exists the possibility for accidental poisonings until proper handling of nicotine products and liquids is more commonly understood within the public sphere. Additionally, the risk of chronic exposure to nicotine beyond that of addiction is less well understood, with the majority of knowledge resting in neuroscience regarding the role of increased dopamine levels.
Possible areas of research going forward include:
- Further examination of binding sites within the nAChR complex, and experimentation seeking to discern whether the presence of terminal groups on neonicotinoids benefits or inhibits binding in all cases. The role of pesticides and wide use of neonicotinoids presents this as both a mechanism to better understand nicotine toxicity as well as manage the public health concerns regarding nicotine-like chemicals in wider dispersal through crops and water supplies. (Fassa 2014)
- Examination of further genetic data which seeks to determine if there is any heritable traits which affect either the short term response to nicotine through the acetylcholine binding mechanisms, or that correlate with propensities for addictive behavior overall. This would hopefully allow for further examination not just directly relevant to acute poisoning, but also serve to examine the genetics of addiction more closely through a well-known model. (Saccone 2007)
- Examining the role of medical treatments to directly counteract or limit the effects of nicotine upon the nAChR complex, including modifying end groups in such a way as to create a less potent neonicotinoid alternative without any additional detrimental effects upon human health. This could allow for a reduction in accidental acute cases of nicotine poisoning, as decreasing the binding affinity for the nicotine molecule would correlate directly with less overstimulation and resulting cascade block of the nAChR complexes. (Schep 2009)