Effect of δ-9-tetrahydrocannabinol on altered antioxidative enzyme defense mechanisms and lipid peroxidation in mice testes

Association of cannabis abuse/dependence on risks of erectile dysfunction and testosterone deficiency using a large claims database analysis

BACKGROUND

Cannabis is widely consumed across the United States; however, studies assessing the association between cannabis use and male sexual health, specifically erectile dysfunction (ED) and testosterone deficiency (TD), have mixed results and small sample sizes.

AIM

To evaluate the impact of cannabis abuse/dependence on risks of ED, phosphodiesterase-5 inhibitor (PDE5-i) prescription, TD, and testosterone replacement therapy (TRT) using a population-level analysis.

METHODS

We sampled men ≥18 years old from the large claims database, TriNetX, in 2025. Patients previously diagnosed with or treated for ED or TD and those with prior prostatectomy were excluded. Patients were split into two cohorts: diagnoses of cannabis abuse/dependence or not. Cohorts were propensity score-matched on 49 pertinent factors. Risk of ED, TD, PDE5-i prescription, and TRT were compared at 3 months-1 year (patients from 2005-2024) and 3-5 years (patients from 2005-2020) from cannabis diagnoses. Subgroups of age younger or older than 40 years were also analyzed. Kaplan-Meier survival analysis was performed to assess differences in time to development of ED and TD.

OUTCOMES

Primary outcomes were risk of diagnosis of ED or TD (testosterone level <300 ng/dL). Secondary outcomes were risk of new prescription of PDE5-i or TRT.

RESULTS

Between 2005-2024, 30 964 patients with and 1 473 182 without cannabis diagnoses were identified with 29 442 in each cohort after matching. Between 2005-2020, 17 948 patients with and 839 496 without cannabis abuse/dependence were identified, with 17 211 in each cohort after matching. Cannabis abuse/dependence was significantly associated with ED (0.9% vs. 0.2%, RR = 3.99 [3.05, 5.21]), TD (0.2% vs. 0.1%, RR = 2.19 [1.45, 3.31]), and PDE5-i prescription (0.8% vs. 0.2%, RR = 3.80 [2.86, 5.04]) at 3 months-1 year, and only ED at 3-5 years (1.61% vs. 1.34%, RR = 1.20, 95% CI = [1.01, 1.43]). Kaplan-Meier analysis revealed significantly shorter time to development of ED (HR = 1.65, 95% CI = [1.47, 1.85]) and TD (HR = 1.34, 95% CI = 1.07, 1.69]) associated with cannabis abuse/dependence. No association between cannabis abuse/dependence and TRT was found. In those <40 years old, only ED and PDE5-i were significant at 3 months-1 year, but not at 3-5 years.

CLINICAL IMPLICATIONS

Our findings support an association between cannabis abuse/dependence, ED, and TD, which providers may consider when treating patients with these diagnoses.

STRENGTHS AND LIMITATIONS

Strengths include having a large, national sample of patients. Limitations include inability to assess dose-dependent relationships and using diagnosis codes as proxies for cannabis use.

CONCLUSION

Cannabis abuse/dependence is associated with increased risk of ED, PDE5-i prescription, and TD.

In vitro evaluation of cell viability and expression profile of growth factors in mouse Sertoli cells exposed to Delta-9-tetrahydrocannabinol: a mechanistic insight into the cannabinoid-induced testicular toxicity

The potentially adverse effects of cannabis (marijuana), a common leisure compound, on male reproductive performance are a reason for concern. δ-9-tetrahydrocannabinol (THC), the primary active component of marijuana alters testicular cells' proliferation and function which affects male fertility and causes testicular cells dysfunction and apoptosis. The main objective of this study was to investigate the possible mechanism underlying the toxic effects of THC with a mechanistic insight into Sertoli cell-based reproductive dysfunction. The Mus musculus Sertoli cell line (TM4) was cultured and exposed to different concentrations of THC and, MTT (3-(4, 5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay was then performed for evaluating cell viability. The expression of caspase-3 gene and genes related to growth factors were analyzed by real-time RT-PCR. Western blotting was performed for evaluating protein expression level. THC concentration-dependently decreased the TM4 viability with a significant effect starting at concentration of 1 μM and reaching about 75% of the control level at the concentration of 50 μM (IC25). Moreover, caspase-3 mRNA expression levels significantly increased while growth factors mRNA levels decreased in THC-exposed cells compared to unexposed cells. There was also a significant reduction in related protein levels in THC group. Administration of the THC promotes cytotoxic and apoptotic effects on TM4 cells partly through down-regulation of growth factors expression. Increased apoptosis, over expression of caspase-3, and down-regulation of growth factors expression in Sertoli cells exposed to THC may be a reflection of THC-induced testicular toxicity, which may be partly involved in infertility associated with marijuana smoking or medical cannabis use.

The effect of cannabis toxicity on a model microbiome bacterium epitomized by a panel of bioluminescent E. coli

The world acceptance of medical cannabis slowly widens. Cannabinoids are known as the main therapeutic active compounds in the cannabis plant, yet their bioactive physiological effects are still unknown. In this study, the mode of action of nine selected cannabinoids was examined using a bioluminescent bacterial panel, as well as the extracts of six different cannabis varieties and cannabinoids standards artificial mixtures. The bacterial panel was composed of genetically modified E. coli bacteria that is commonly found in the gut microbiome, to which a lux operon was added to various stress promoters. The panel was exposed to the cannabinoids in order to identify bacterial defense mechanism, via the aforementioned specific stress types response. This enables the understanding of the toxicity mode of action of cannabinoids. From all the tested cannabinoids, only delta-9-tetrahydrocannabinol (THC) and delta-9-tetrahydrocannabinolic acid A (THCA) produced a genotoxic effect, while the other tested cannabinoids, demonstrated cytotoxic or oxidative damages. Unlike pure cannabinoids, cannabis plant extracts exhibited mostly genotoxicity, with minor cytotoxicity or oxidative stress responses. Moreover, cannabinoids standards artificial mixtures produced a different response patterns compared to their individual effects, which may be due to additional synergistic or antagonistic reactions between the mixed chemicals on the bacterial panel. The results showed that despite the lack of cannabigerol (CBG), cannabidivarin (CBDV), cannabinol (CBN), and cannabichromene (CBC) in the artificial solution mimicking the CN6 cannabis variety, a similar response pattern to the cannabinoids standards mixture was obtained. This work contributes to the understanding of such correlations and may provide a realistic view of cannabinoid effects on the human microbiome.

Molecular and hormonal changes caused by long-term use of high dose pregabalin on testicular tissue: the role of p38 MAPK, oxidative stress and apoptosis

In 1990, pregabalin was introduced as a novel antiepileptic drug that acts by binding selectively to the alpha-2-delta subunits of voltage-gated calcium channels resulting in increasing neuronal GABA levels and inhibiting the release of exciting neurotransmitters. The aim of our study is to assess the hazardous effects of prolonged high-dose pregabalin (like that abused by addicts) on testes and to clarify the potential causative mechanisms. The current study was conducted on 70 adult male Wistar albino rats which were divided into 7 groups. In our study we evaluated the effect of pregabalin, at concentrations 150 and 300 mg/kg/day for 90 days, on hormones; FSH, LH, testosterone and prolactin secretion. Our study also evaluated the expression of apoptosis-related genes BAX and BCL2 in testicular tissue in addition to the western blotted analysis of p38 Mitogen activated protein kinases (p38 MAPK). The levels of reduced glutathione, malondialdehyde and superoxide dismutase were also measured. Pregabalin decreased testosterone level while FSH, LH and prolactin showed a significant increase. It also produced genotoxicity through reversal of the BAX/BCL2 ratio; increased p38 MAPK level and induction of oxidative stress markers. The concomitant administration of vitamin E significantly reduced all the previously mentioned biochemical and hormonal adverse effects caused by pregabalin. Pregabalin can adversely affect male fertility particularly in addicts and patients who are being treated with it for long periods as those suffering from neuropathies and seizures. Antioxidants like vitamin E could have a role in amelioration.

Reproductive toxicity in male mice after exposure to high molybdenum and low copper concentrations

To evaluate the effects of dietary high molybdenum (HMo) and low copper (LCu) concentrations on reproductive toxicity of male mice, 80 mice were divided into 4 groups of 20. These groups were fed with the following: (1) normal control (NC) diet (NC group); (2) NC and HMo diets (HMo group); (3) LCu diet (LCu group); and (4) HMo and LCu diets (HMoLCu group). On the 50th and 100th day, superoxide dismutase (SOD), malondialdehyde (MDA), glutathione peroxidase (GSH-Px), and total antioxidant capacity (T-AOC) were analyzed to determine oxidative stress states. Morphological changes in testicular tissue were evaluated with hematoxylin and eosin staining and ultrastructural changes were monitored by transmission electron microscopy. The results showed that administration of HMo, LCu, and HMoLCu not only decreased sperm density and motility but also increased the rate of teratosperm occurrence. A significant increase in MDA content and a decrease in SOD, GSH-Px, and T-AOC contents were observed in LCu, HMo, and HMoLCu groups. Testicular tissues and cells of mice were damaged by HMo and the damages were more serious in the case of Cu deficiency. Exposure to HMo adversely affected the reproductive system of male mice, and dietary LCu plays key roles in HMo-induced reproductive toxicity.

Oxidative and genetic responses induced by Δ-9-tetrahydrocannabinol (Δ-9-THC) to Dreissena polymorpha

Cannabis is the most used illicit substance worldwide and its main psychoactive compound, the Δ-9-tetrahydrocannabinol (Δ-9-THC), is detected in aquatic environments at measurable concentrations. Even though its occurrence is well documented, no information is available on its hazard to aquatic organisms. The aim of this study was to assess the adverse effects induced to zebra mussel (Dreissena polymorpha) specimens by 14 day exposures to environmentally relevant Δ-9-THC concentrations (0.05 μg/L and 0.5 μg/L) by means of the application of a biomarker suite. Catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GPx) and glutathione S-transferase (GST) activities, as well as the lipid peroxidation (LPO) and protein carbonyl content (PCC), were measured as oxidative stress indices. The single cell gel electrophoresis (SCGE) assay, the DNA diffusion assay and the micronucleus test (MN test) were applied to investigate DNA injuries, while the neutral red retention assay (NRRA) was used to assess Δ-9-THC cytotoxicity. The lowest treatment induced negligible adverse effects to bivalves, while 0.5 μg/L Δ-9-THC exposure caused remarkable alterations in D. polymorpha oxidative status, which lead to significant increase of lipid peroxidation, protein carbonylation and DNA damage.

Correlation of testicular toxicity and oxidative stress induced by chlorpyrifos in rats

Effect of chlorpyrifos pesticide on testicular oxidative damage was studied in Sprague-Dawley rats at varying doses. At lower doses (5 and 10 mg/kg body weight/30 days), reduction in plasma levels of testosterone and follicular stimulating hormone (FSH) and luteinizing hormone (LH) along with significant shrinkage of seminiferous tubules and drastic changes in germ cells were seen. But these adverse changes of testes were restored with the revival of serum testosterone and FSH and LH at higher doses (20 and 30 mg/kg body weight/30 days). Similarly, levels of testicular lipid peroxidation and diene conjugates were elevated whereas activities of antioxidant enzymes (superoxide dismutase, catalase and glutathione peroxidase), steroidogenic (Δ5, 3β-HSD and Δ5, 17β-HSD) enzymes and angiotensinogen-converting enzyme and glutathione content including lipid–protein content of testes were decreased at low doses. But at higher doses, reductions in level of lipid peroxidation (as revealed by malondialdehyde [MDA] value) and conjugated dienes were found and on the contrary, revivals of testicular antiperoxidative/antioxidant enzymes defense systems, angiotensinogen-converting enzyme (ACE), steroidogenic enzymes, lipid–protein and antioxidant glutathione content were observed. Therefore, the present study indicated from the results that chlorpyrifos had a dual effect at both doses on oxidative stress changes, but at higher doses, the cells were triggering its natural defense mechanism to combat the insult of lower doses of chlorpyrifos and became operative possibly through corrective measure of antioxidant enzymes defense system and pituitary gonadotropins hormones feedback mechanisms on testes.

Green tea extracts attenuate doxorubicin-induced spermatogenic disorders in conjunction with higher telomerase activity in mice

PURPOSE

The aim of this study was to investigate the protective effect of green tea extracts against doxorubicin-induced damage in the mouse testes correlating with telomerase activity.

METHODS

Green tea extracts were administered orally. Doxorubicin was coadministered intraperitoneally. These testes were evaluated histologically and the telomerase activity was analyzed. Additional immunostaining was carried out.

RESULTS

Both the sperm density and sperm motility were significantly increased in green tea extracts coadministration groups as compared to the doxorubicin-treated groups. By histological analysis, germ cell damage was greatly attenuated by green tea extracts coadministration. Telomerase activity significantly increased in association with the coadministration of green tea extracts as compared to that of doxorubicin-only groups. In all groups, human telomerase reverse transcriptase signals were mainly observed in the spermatocytes and spermatids.

CONCLUSIONS

These findings suggest that green tea extracts exert protective effects against doxorubicin-induced spermatogenic disorders in conjunction with higher telomerase activity levels.

Effect of (-)-Delta(9)-tetrahydrocannabinoid on the hepatic redox state of mice

(-)-Delta(9)-Tetrahydrocannabinol (Delta(9)-THC), a psychoactive component of marijuana, has been reported to induce oxidative damage in vivo and in vitro. In this study, we administered Delta(9)-THC to healthy C57BL/6J mice aged 15 weeks in order to determine its effect on hepatic redox state. Mice were divided into 3 groups: Delta(9)-THC (N = 10), treated with 10 mg/kg body weight Delta(9)-THC daily; VCtrl (N = 10), treated with vehicle [1:1:18, cremophor EL (polyoxyl 35 castor oil)/ethanol/saline]; Ctrl (N = 10), treated with saline. Animals were injected ip twice a day with 5 mg/kg body weight for 10 days. Lipid peroxidation, protein carbonylation and DNA oxidation were used as biomarkers of oxidative stress. The endogenous antioxidant defenses analyzed were glutathione (GSH) levels as well as enzyme activities of superoxide dismutase, catalase, glutathione S-transferase, glutathione reductase, and glutathione peroxidase (GPx) in liver homogenates. The levels of mRNA of the cannabinoid receptors CB1 and CB2 were also monitored. Treatment with Delta(9)-THC did not produce significant changes in oxidative stress markers or in mRNA levels of CB1 and CB2 receptors in the liver of mice, but attenuated the increase in the selenium-dependent GPx activity (Delta(9)-THC: 8%; VCtrl: 23% increase) and the GSH/oxidized GSH ratio (Delta(9)-THC: 61%; VCtrl: 96% increase), caused by treatment with the vehicle. Delta(9)-THC administration did not show any harmful effects on lipid peroxidation, protein carboxylation or DNA oxidation in the healthy liver of mice but attenuated unexpected effects produced by the vehicle containing ethanol/cremophor EL.