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Waterpipe smoking is harmful and dangerous, and it is a growing threat to public health. This study was performed to evaluate the influence of waterpipe smoking on global DNA methylation, DNA fragmentation, and protamine deficiency in spermatozoa compared to cigarette heavy smokers and nonsmokers, and to determine whether the transcription levels of spermatozoa nuclear proteins genes ‘ PRM1 ,  PRM2 , and  H2BFWT ’ in waterpipe smokers are different compared to cigarette heavy smokers and nonsmokers. A total of 900 semen samples were collected from males with a mean age of 32.5 ± 6.3 years (300 waterpipe smokers, 300 cigarette heavy smokers, and 300 nonsmokers). The nucleic acids were isolated from purified spermatozoa, and then the global DNA methylation and transcription levels of the  PRM1 ,  PRM2 , and  H2BFWT  genes were assessed using ELISA and qPCR, respectively. A significant increase was found in the level of global DNA methylation (8.6 ± 0.6 ng/μl vs. 7.1 ± 0.6 ng/μl and 4.7 ± 0.6 ng/μl,  p  &lt; 0.001), protamine deficiency (72.8 ± 15.3 vs. 51.7 ± 19.2 and 15.3 ± 5.9%,  p  &lt; 0.001), and DNA fragmentation (73.4 ± 13.4 vs. 50.5 ± 18.9 and 9.3 ± 4.3%,  p  &lt; 0.001) in waterpipe smokers compared to cigarette heavy smokers and nonsmokers. A significant increase was shown in the transcription levels of  PRM1, PRM2 , and  H2BFWT  genes in waterpipe smokers compared to cigarette heavy smokers and nonsmokers ( p  &lt; 0.001). A down-regulation was found in the transcription level of these genes in different smoker groups compared to nonsmokers (&lt;0.001). This study suggests that waterpipe smoking is more harmful than cigarette smoking on semen parameters, global DNA methylation, and transcription of nuclear protein genes.

inhalation toxicology

Impact of waterpipe and tobacco cigarette smoking on global DNA methylation and nuclear proteins genes transcription in spermatozoa: a comparative investigation