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Duncan RS, Riordan SM, Gernon MC, Koulen P. Cannabinoids and endocannabinoids as therapeutics for nervous system disorders: preclinical models and clinical studies. Neural Regen Res 2024; 19:788-799. [PMID: 37843213 PMCID: PMC10664133 DOI: 10.4103/1673-5374.382220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 06/08/2023] [Accepted: 07/01/2023] [Indexed: 10/17/2023] Open
Abstract
Cannabinoids are lipophilic substances derived from Cannabis sativa that can exert a variety of effects in the human body. They have been studied in cellular and animal models as well as in human clinical trials for their therapeutic benefits in several human diseases. Some of these include central nervous system (CNS) diseases and dysfunctions such as forms of epilepsy, multiple sclerosis, Parkinson's disease, pain and neuropsychiatric disorders. In addition, the endogenously produced cannabinoid lipids, endocannabinoids, are critical for normal CNS function, and if controlled or modified, may represent an additional therapeutic avenue for CNS diseases. This review discusses in vitro cellular, ex vivo tissue and in vivo animal model studies on cannabinoids and their utility as therapeutics in multiple CNS pathologies. In addition, the review provides an overview on the use of cannabinoids in human clinical trials for a variety of CNS diseases. Cannabinoids and endocannabinoids hold promise for use as disease modifiers and therapeutic agents for the prevention or treatment of neurodegenerative diseases and neurological disorders.
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Affiliation(s)
- R. Scott Duncan
- Department of Ophthalmology, School of Medicine, University of Missouri, Kansas, MO, USA
| | - Sean M. Riordan
- Department of Ophthalmology, School of Medicine, University of Missouri, Kansas, MO, USA
| | - Matthew C. Gernon
- Department of Ophthalmology, School of Medicine, University of Missouri, Kansas, MO, USA
| | - Peter Koulen
- Department of Ophthalmology, School of Medicine, University of Missouri, Kansas, MO, USA
- Department of Biomedical Sciences, School of Medicine, University of Missouri, Kansas, MO, USA
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Haddad NM, De Jesus LP, Serpa M, Van De Bilt M, Talib L, Costa A, Gattaz W, Loch AA. Endocannabinoid system alterations in schizophrenia: association with cannabis use and antipsychotic medication. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01788-x. [PMID: 38502208 DOI: 10.1007/s00406-024-01788-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 02/24/2024] [Indexed: 03/21/2024]
Abstract
Determining peripheral modulation of the endocannabinoid system (ECS) may be important for differentiating individuals with schizophrenia. Such differentiation can also be extended to subgroups of individuals, those who use cannabis and antipsychotic medications, particularly those who are treatment resistant. Patients and controls were recruited from the outpatient clinic of the Psychosis Group of the University of São Paulo, Brazil. A final sample of 93 individuals was divided into 3 groups: patients with schizophrenia using clozapine (treatment-resistant) (n = 29), patients with schizophrenia using another antipsychotic (n = 31), and controls (n = 33). By measuring the proteins and metabolites involved in the ECS pathways in the peripheral blood, AEA (anandamide), 2-AG (2-arachidonoyl ethanolamine), and CB2 receptor (peripheral) were quantified. Individuals reporting lifetime cannabis use had lower 2-AG plasma levels (p = 0.011). Regarding the CB2 receptor, the values of patients with schizophrenia and controls were similar, but those of patients using antipsychotics other than clozapine differed (p = 0.022). In generalized linear models to control for confounders, the use of cannabis remained the only factor that significantly influenced 2-AG levels. The relationship for non-clozapine antipsychotics as the only factor related to CB2 changes was marginally significant. We found for the first time that cannabis use and non-clozapine antipsychotic medication are potentially involved in the modulation of the ECS, specifically influencing 2-AG endocannabinoid and CB2 receptor levels. More studies regarding the ECS are needed since it has been increasingly related to the physiopathology of schizophrenia.
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Affiliation(s)
- Natalia Mansur Haddad
- Laboratório de Neurociências (LIM 27), Instituto de Psiquiatria, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, Rua Dr. Ovidio Pires de Campos 785, 4 Andar Ala Norte Sala 4N60, Sao Paulo, SP, CEP 05403-010, Brazil.
| | - Leonardo Peroni De Jesus
- Laboratório de Neurociências (LIM 27), Instituto de Psiquiatria, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, Rua Dr. Ovidio Pires de Campos 785, 4 Andar Ala Norte Sala 4N60, Sao Paulo, SP, CEP 05403-010, Brazil
| | - Mauricio Serpa
- Laboratório de Neurociências (LIM 27), Instituto de Psiquiatria, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, Rua Dr. Ovidio Pires de Campos 785, 4 Andar Ala Norte Sala 4N60, Sao Paulo, SP, CEP 05403-010, Brazil
- Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBION), Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brasília, Brazil
| | - Martinus Van De Bilt
- Laboratório de Neurociências (LIM 27), Instituto de Psiquiatria, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, Rua Dr. Ovidio Pires de Campos 785, 4 Andar Ala Norte Sala 4N60, Sao Paulo, SP, CEP 05403-010, Brazil
- Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBION), Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brasília, Brazil
| | - Leda Talib
- Laboratório de Neurociências (LIM 27), Instituto de Psiquiatria, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, Rua Dr. Ovidio Pires de Campos 785, 4 Andar Ala Norte Sala 4N60, Sao Paulo, SP, CEP 05403-010, Brazil
- Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBION), Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brasília, Brazil
| | - Alana Costa
- Laboratório de Neurociências (LIM 27), Instituto de Psiquiatria, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, Rua Dr. Ovidio Pires de Campos 785, 4 Andar Ala Norte Sala 4N60, Sao Paulo, SP, CEP 05403-010, Brazil
| | - Wagner Gattaz
- Laboratório de Neurociências (LIM 27), Instituto de Psiquiatria, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, Rua Dr. Ovidio Pires de Campos 785, 4 Andar Ala Norte Sala 4N60, Sao Paulo, SP, CEP 05403-010, Brazil
- Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBION), Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brasília, Brazil
| | - Alexandre Andrade Loch
- Laboratório de Neurociências (LIM 27), Instituto de Psiquiatria, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, Rua Dr. Ovidio Pires de Campos 785, 4 Andar Ala Norte Sala 4N60, Sao Paulo, SP, CEP 05403-010, Brazil
- Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBION), Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brasília, Brazil
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Cherry AL, Wheeler MJ, Mathisova K, Di Miceli M. In silico analyses of the involvement of GPR55, CB1R and TRPV1: response to THC, contribution to temporal lobe epilepsy, structural modeling and updated evolution. Front Neuroinform 2024; 18:1294939. [PMID: 38404644 PMCID: PMC10894036 DOI: 10.3389/fninf.2024.1294939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 01/19/2024] [Indexed: 02/27/2024] Open
Abstract
Introduction The endocannabinoid (eCB) system is named after the discovery that endogenous cannabinoids bind to the same receptors as the phytochemical compounds found in Cannabis. While endogenous cannabinoids include anandamide (AEA) and 2-arachidonoylglycerol (2-AG), exogenous phytocannabinoids include Δ-9 tetrahydrocannabinol (THC) and cannabidiol (CBD). These compounds finely tune neurotransmission following synapse activation, via retrograde signaling that activates cannabinoid receptor 1 (CB1R) and/or transient receptor potential cation channel subfamily V member 1 (TRPV1). Recently, the eCB system has been linked to several neurological diseases, such as neuro-ocular abnormalities, pain insensitivity, migraine, epilepsy, addiction and neurodevelopmental disorders. In the current study, we aim to: (i) highlight a potential link between the eCB system and neurological disorders, (ii) assess if THC exposure alters the expression of eCB-related genes, and (iii) identify evolutionary-conserved residues in CB1R or TRPV1 in light of their function. Methods To address this, we used several bioinformatic approaches, such as transcriptomic (Gene Expression Omnibus), protein-protein (STRING), phylogenic (BLASTP, MEGA) and structural (Phyre2, AutoDock, Vina, PyMol) analyzes. Results Using RNA sequencing datasets, we did not observe any dysregulation of eCB-related transcripts in major depressive disorders, bipolar disorder or schizophrenia in the anterior cingulate cortex, nucleus accumbens or dorsolateral striatum. Following in vivo THC exposure in adolescent mice, GPR55 was significantly upregulated in neurons from the ventral tegmental area, while other transcripts involved in the eCB system were not affected by THC exposure. Our results also suggest that THC likely induces neuroinflammation following in vitro application on mice microglia. Significant downregulation of TPRV1 occurred in the hippocampi of mice in which a model of temporal lobe epilepsy was induced, confirming previous observations. In addition, several transcriptomic dysregulations were observed in neurons of both epileptic mice and humans, which included transcripts involved in neuronal death. When scanning known interactions for transcripts involved in the eCB system (n = 12), we observed branching between the eCB system and neurophysiology, including proteins involved in the dopaminergic system. Our protein phylogenic analyzes revealed that CB1R forms a clade with CB2R, which is distinct from related paralogues such as sphingosine-1-phosphate, receptors, lysophosphatidic acid receptors and melanocortin receptors. As expected, several conserved residues were identified, which are crucial for CB1R receptor function. The anandamide-binding pocket seems to have appeared later in evolution. Similar results were observed for TRPV1, with conserved residues involved in receptor activation. Conclusion The current study found that GPR55 is upregulated in neurons following THC exposure, while TRPV1 is downregulated in temporal lobe epilepsy. Caution is advised when interpreting the present results, as we have employed secondary analyzes. Common ancestors for CB1R and TRPV1 diverged from jawless vertebrates during the late Ordovician, 450 million years ago. Conserved residues are identified, which mediate crucial receptor functions.
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Affiliation(s)
- Amy L. Cherry
- Worcester Biomedical Research Group, School of Science and the Environment, University of Worcester, Worcester, United Kingdom
| | - Michael J. Wheeler
- Sustainable Environments Research Group, School of Science and the Environment University of Worcester, Worcester, United Kingdom
| | - Karolina Mathisova
- School of Science and the Environment University of Worcester, Worcester, United Kingdom
| | - Mathieu Di Miceli
- Worcester Biomedical Research Group, School of Science and the Environment, University of Worcester, Worcester, United Kingdom
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Chester LA, Englund A, Chesney E, Oliver D, Wilson J, Sovi S, Dickens AM, Oresic M, Linderman T, Hodsoll J, Minichino A, Strang J, Murray RM, Freeman TP, McGuire P. Effects of Cannabidiol and Delta-9-Tetrahydrocannabinol on Plasma Endocannabinoid Levels in Healthy Volunteers: A Randomized Double-Blind Four-Arm Crossover Study. Cannabis Cannabinoid Res 2024; 9:188-198. [PMID: 36493386 PMCID: PMC10874814 DOI: 10.1089/can.2022.0174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background: The effects of cannabis are thought to be mediated by interactions between its constituents and the endocannabinoid system. Delta-9-tetrahydrocannabinol (THC) binds to central cannabinoid receptors, while cannabidiol (CBD) may influence endocannabinoid function without directly acting on cannabinoid receptors. We examined the effects of THC coadministered with different doses of CBD on plasma levels of endocannabinoids in healthy volunteers. Methods: In a randomized, double-blind, four-arm crossover study, healthy volunteers (n=46) inhaled cannabis vapor containing 10 mg THC plus either 0, 10, 20, or 30 mg CBD, in four experimental sessions. The median time between sessions was 14 days (IQR=20). Blood samples were taken precannabis inhalation and at 0-, 5-, 15-, and 90-min postinhalation. Plasma concentrations of THC, CBD, anandamide, 2-arachidonoylglycerol (2-AG), and related noncannabinoid lipids were measured using liquid chromatography-mass spectrometry. Results: Administration of cannabis induced acute increases in plasma concentrations of anandamide (+18.0%, 0.042 ng/mL [95%CI: 0.023-0.062]), and the noncannabinoid ethanolamides, docosatetraenylethanolamide (DEA; +35.8%, 0.012 ng/mL [95%CI: 0.008-0.016]), oleoylethanolamide (+16.1%, 0.184 ng/mL [95%CI: 0.076-0.293]), and N-arachidonoyl-L-serine (+25.1%, 0.011 ng/mL [95%CI: 0.004-0.017]) (p<0.05). CBD had no significant effect on the plasma concentration of anandamide, 2-AG or related noncannabinoid lipids at any of three doses used. Over the four sessions, there were progressive decreases in the preinhalation concentrations of anandamide and DEA, from 0.254 ng/mL [95%CI: 0.223-0.286] to 0.194 ng/mL [95%CI: 0.163-0.226], and from 0.039 ng/mL [95%CI: 0.032-0.045] to 0.027 ng/mL [95%CI: 0.020-0.034] (p<0.05), respectively. Discussion: THC induced acute increases in plasma levels of anandamide and noncannabinoid ethanolamides, but there was no evidence that these effects were influenced by the coadministration of CBD. It is possible that such effects may be evident with higher doses of CBD or after chronic administration. The progressive reduction in pretreatment anandamide and DEA levels across sessions may be related to repeated exposure to THC or participants becoming less anxious about the testing procedure and requires further investigation. The study was registered on clinicaltrials.gov (NCT05170217).
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Affiliation(s)
- Lucy A. Chester
- Department of Psychosis Studies and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Amir Englund
- National Addiction Centre (NAC), Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Edward Chesney
- Department of Psychosis Studies and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Dominic Oliver
- Department of Psychosis Studies and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Department of Psychiatry, Oxford University, Warneford Hospital, Oxford, United Kingdom
| | - Jack Wilson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, New South Wales, Australia
| | - Simina Sovi
- Department of Psychosis Studies and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Alex M. Dickens
- Turku Bioscience Center, University of Turku and Åbo Akademi University, Turku, Finland
- Department of Chemistry, University of Turku, Turku, Finland
| | - Matej Oresic
- Turku Bioscience Center, University of Turku and Åbo Akademi University, Turku, Finland
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Tuomas Linderman
- Turku Bioscience Center, University of Turku and Åbo Akademi University, Turku, Finland
| | - John Hodsoll
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Amedeo Minichino
- Department of Psychosis Studies and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Department of Psychiatry, Oxford University, Warneford Hospital, Oxford, United Kingdom
| | - John Strang
- National Addiction Centre (NAC), Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Robin M. Murray
- Department of Psychosis Studies and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Tom P. Freeman
- Department of Psychology, University of Bath, Bath, United Kingdom
| | - Philip McGuire
- Department of Psychosis Studies and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Department of Psychiatry, Oxford University, Warneford Hospital, Oxford, United Kingdom
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Dixon T, Cadenhead KS. Cannabidiol versus placebo as adjunctive treatment in early psychosis: study protocol for randomized controlled trial. Trials 2023; 24:775. [PMID: 38037108 PMCID: PMC10691114 DOI: 10.1186/s13063-023-07789-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 11/07/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Psychotic disorders are a leading cause of disability in young adults. Antipsychotics have been the primary intervention for psychosis for over 60 years, and yet, we have made little progress in treating negative symptoms, neurocognition, and functional disability. There is growing evidence that cannabidiol (CBD) is effective in treating positive psychotic symptoms, possibly also negative and neurocognitive symptoms, and moreover is well tolerated compared to other psychotropic medications. Anecdotally, patients participating in the Cognitive Assessment and Risk Evaluation (CARE) Early Psychosis Treatment Program at the University of California, San Diego, are self-administering CBD and report subjective improvement in stress, anxiety, and ability to cope with symptoms. The overarching aim of the trial is to explore the effectiveness of CBD augmentation on symptoms and neurocognition in early psychosis while also exploring the mechanism of action of CBD and predictors of response to treatment. The mechanism by which cannabidiol has a therapeutic effect on psychosis is poorly understood. Recent evidence has suggested that CBD may reduce stress and pro-inflammatory biomarker levels. Endocannabinoids also have powerful roles in eating behavior, reward, and mood, indicating these neurotransmitters may play a role in reducing hyperphagia and metabolic abnormalities that are present early in the course of psychotic illness and exacerbated by antipsychotic medication. The neurophysiological effects of CBD have been studied in animal models of psychosis that show improvements in information processing in response to CBD, but there are no studies in individuals with early psychosis. METHOD A total of 120 individuals in the early stages of psychosis will be randomized to 1000 mg of CBD versus placebo as an adjunct to existing treatment in a 8-week, double-blind superiority randomized control trial. The primary outcome measures are symptoms and neurocognition. DISCUSSION We hypothesized that CBD will improve symptoms and neurocognition as well as secondary outcome measures of neurohormones, inflammation, eating behaviors, and information processing. Importantly, predictors, moderators, and mediators of the CBD effects will be examined. A better understanding of which individuals are likely to respond to CBD can inform treatment planning and personalize treatment. TRIAL REGISTRATION ClinicalTrials.gov NCT04411225. Registered on June 2, 2020.
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Affiliation(s)
- T Dixon
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive 0810, La Jolla, CA, 92093-0810, USA
| | - K S Cadenhead
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive 0810, La Jolla, CA, 92093-0810, USA.
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Cropley VL, Kittel M, Heurich M, Föcking M, Leweke FM, Pantelis C. Complement proteins are elevated in blood serum but not CSF in clinical high-risk and antipsychotic-naïve first-episode psychosis. Brain Behav Immun 2023; 113:136-144. [PMID: 37437819 DOI: 10.1016/j.bbi.2023.07.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 06/29/2023] [Accepted: 07/05/2023] [Indexed: 07/14/2023] Open
Abstract
Alterations in the complement system have been reported in some people with psychotic disorder, including in pre-psychotic individuals, suggesting that complement pathway dysregulation may be a feature of the early psychosis phenotype. Measurement of complement protein expression in psychosis has been largely restricted to the blood from patients with established illness who were taking antipsychotic medication. The present study examined a range of complement proteins in blood and cerebrospinal fluid (CSF) derived from individuals at clinical high-risk for psychosis (CHR), antipsychotic-naïve first-episode psychosis (FEP) and healthy controls. A panel of complement proteins (C1q, C3, C3b/iC3b, C4, factor B and factor H) were quantified in serum and matched CSF in 72 participants [n = 23 individuals at CHR, n = 24 antipsychotic-naïve FEP, n = 25 healthy controls] using a multiplex immunoassay. Analysis of covariance was used to assess between-group differences in complement protein levels in serum and CSF. Pearson's correlation was used to assess the relationship between serum and CSF proteins, and between complement proteins and symptom severity. In serum, all proteins, except for C3, were significantly higher in FEP and CHR. While a trend was observed, protein levels in CSF did not statistically differ between groups and appeared to be impacted by BMI and sample storage time. Across the whole sample, serum and CSF protein levels were not correlated. In FEP, higher levels of serum classical and alternative grouped pathway components were correlated with symptom severity. Our exploratory study provides evidence for increased activity of the peripheral complement system in the psychosis spectrum, with such elevations varying with clinical severity. Further study of complement in CSF is warranted. Longitudinal investigations are required to elucidate whether complement proteins change peripherally and/or centrally with progression of psychotic illness.
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Affiliation(s)
- V L Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & NorthWestern Mental Health, Melbourne, Australia.
| | - M Kittel
- Institute for Clinical Chemistry, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - M Heurich
- School of Pharmacy and Pharmaceutical Sciences, College of Biomedical and Life Sciences, Cardiff University, United Kingdom
| | - M Föcking
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - F M Leweke
- Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - C Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & NorthWestern Mental Health, Melbourne, Australia; Florey Institute of Neuroscience and Mental Health, Parkville, Vic, Australia
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7
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Boachie N, Gaudette E, Bazinet RP, Lin L, Tyndale RF, Mansouri E, Huestis MA, Tong J, Le Foll B, Kish SJ, George TP, Boileau I. Circulating Endocannabinoids and N-Acylethanolamines in Individuals with Cannabis Use Disorder-Preliminary Findings. Brain Sci 2023; 13:1375. [PMID: 37891745 PMCID: PMC10605789 DOI: 10.3390/brainsci13101375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/19/2023] [Accepted: 09/21/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Endocannabinoids and related N-acylethanolamines (NAEs) are bioactive lipids with important physiological functions and putative roles in mental health and addictions. Although chronic cannabis use is associated with endocannabinoid system changes, the status of circulating endocannabinoids and related NAEs in people with cannabis use disorder (CUD) is uncertain. METHODS Eleven individuals with CUD and 54 healthy non-cannabis using control participants (HC) provided plasma for measurement by high-performance liquid chromatography-mass spectrometry of endocannabinoids (2-arachidonoylglycerol (2-AG) and N-arachidonoylethanolamine (AEA)) and related NAE fatty acids (N-docosahexaenoylethanolamine (DHEA) and N-oleoylethanolamine (OEA)). Participants were genotyped for the functional gene variant of FAAH (rs324420, C385A) which may affect concentrations of AEA as well as other NAEs (OEA, DHEA). RESULTS In overnight abstinent CUD, AEA, OEA and DHEA concentrations were significantly higher (31-40%; p < 0.05) and concentrations of the endocannabinoid 2-AG were marginally elevated (55%, p = 0.13) relative to HC. There were no significant correlations between endocannabinoids/NAE concentrations and cannabis analytes, self-reported cannabis use frequency or withdrawal symptoms. DHEA concentration was inversely related with marijuana craving (r = -0.86; p = 0.001). Genotype had no significant effect on plasma endocannabinoids/NAE concentrations. CONCLUSIONS Our preliminary findings, requiring replication, might suggest that activity of the endocannabinoid system is elevated in chronic cannabis users. It is unclear whether this elevation is a compensatory response or a predating state. Studies examining endocannabinoids and NAEs during prolonged abstinence as well as the potential role of DHEA in craving are warranted.
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Affiliation(s)
- Nadia Boachie
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON N6B 1Y6, Canada; (N.B.)
- Institute of Medical Science, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Erin Gaudette
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON N6B 1Y6, Canada; (N.B.)
- Institute of Medical Science, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Richard P. Bazinet
- Department of Nutritional Sciences, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Lin Lin
- Department of Nutritional Sciences, University of Toronto, Toronto, ON M5S 1A1, Canada
- Department of Anatomy and Neurobiology, Faculty of Medicine, University of California, Irvine, CA 92697, USA
| | - Rachel F. Tyndale
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON N6B 1Y6, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5S 1A1, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Esmaeil Mansouri
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON N6B 1Y6, Canada; (N.B.)
- Institute of Medical Science, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Marilyn A. Huestis
- Institute of Emerging Health Professions, Thomas Jefferson University, Severna Park, Philadelphia, PA 19144, USA
| | - Junchao Tong
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON N6B 1Y6, Canada; (N.B.)
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON N6B 1Y6, Canada
| | - Bernard Le Foll
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON N6B 1Y6, Canada; (N.B.)
- Institute of Medical Science, University of Toronto, Toronto, ON M5S 1A1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON N6B 1Y6, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5S 1A1, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON M5S 1A1, Canada
- Addictions Division and Institute of Mental Health Policy and Research, Centre for Addiction and Mental Health, Toronto, ON N6B 1Y6, Canada
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, ON N6B 1Y6, Canada
- Departments of Family and Community Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada
- Waypoint Research Institute, Waypoint Centre for Mental Health Care, Penetanguishene, ON L9M 1G3, Canada
| | - Stephen J. Kish
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON N6B 1Y6, Canada; (N.B.)
- Institute of Medical Science, University of Toronto, Toronto, ON M5S 1A1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON N6B 1Y6, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5S 1A1, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Tony P. George
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON N6B 1Y6, Canada; (N.B.)
- Institute of Medical Science, University of Toronto, Toronto, ON M5S 1A1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON N6B 1Y6, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5S 1A1, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON M5S 1A1, Canada
- Addictions Division and Institute of Mental Health Policy and Research, Centre for Addiction and Mental Health, Toronto, ON N6B 1Y6, Canada
| | - Isabelle Boileau
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON N6B 1Y6, Canada; (N.B.)
- Institute of Medical Science, University of Toronto, Toronto, ON M5S 1A1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON N6B 1Y6, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5S 1A1, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON M5S 1A1, Canada
- Addictions Division and Institute of Mental Health Policy and Research, Centre for Addiction and Mental Health, Toronto, ON N6B 1Y6, Canada
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8
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Li F, Pi Y, Zhang M, Ma L, Wu Y, Luo J, Cai Y, Dai Y, Zheng F, Yue H. Urine and serum metabolomics study of wild ginseng in rats with spleen-qi deficiency using rapid resolution liquid chromatography coupled with quadrupole-time-of-flight mass spectrometry. J Sep Sci 2023; 46:e2300344. [PMID: 37438972 DOI: 10.1002/jssc.202300344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/28/2023] [Accepted: 06/30/2023] [Indexed: 07/14/2023]
Abstract
Patients with a spleen-qi deficiency often exhibit dysfunction in the metabolic system. Metabolites are considered the most direct reflection of individual physiological and pathological conditions and represent attractive candidates to provide deep insights into disease phenotypes. This study examines the potential therapeutic mechanism of wild ginseng on spleen-qi deficiency through the analysis of serum and urine metabolomics using rapid-resolution liquid chromatography coupled with quadrupole-time-of-flight mass spectrometry. The reasons for the superiority of wild ginseng treatment over cultivated ginseng were also analyzed in depth. After wild ginseng intervention, anandamide, urobilinogen, aldosterone, and testosterone glucuronide were significantly reduced in serum. Meanwhile, argininosuccinic acid, L-cysteine, and seven other metabolites were significantly elevated in serum. Nine metabolites, including L-acetylcarnitine, and citrulline were elevated in the urine, and trimethylamine N-oxide, adrenic acid, and 10 other metabolites were reduced. Arginine biosynthesis, pantothenate and CoA biosynthesis, thiamin metabolism, taurine, and tryptophan metabolism pathways were mainly improved. Further analysis was conducted on the relationship between Lactobacillus and Akkermansia bacteria with metabolites, and it was found that they are mainly related to amino acid metabolites. This study provides strong theoretical support and direction for further explanation of the immune mechanism of wild ginseng and lays the foundation for future studies.
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Affiliation(s)
- Fangtong Li
- Changchun University of Chinese Medicine, Jilin Ginseng Academy, Changchun, P. R. China
| | - Yijun Pi
- Changchun University of Chinese Medicine, School of Traditional Chinese Medicine, Changchun, P. R. China
| | - Meiyu Zhang
- Changchun University of Chinese Medicine, Jilin Ginseng Academy, Changchun, P. R. China
| | - Liting Ma
- Changchun University of Chinese Medicine, Jilin Ginseng Academy, Changchun, P. R. China
| | - Yongxi Wu
- Changchun University of Chinese Medicine, Jilin Ginseng Academy, Changchun, P. R. China
| | - Jing Luo
- Changchun University of Chinese Medicine, Jilin Ginseng Academy, Changchun, P. R. China
| | - Yongyu Cai
- Changchun University of Chinese Medicine, Jilin Ginseng Academy, Changchun, P. R. China
| | - Yulin Dai
- Changchun University of Chinese Medicine, Jilin Ginseng Academy, Changchun, P. R. China
| | - Fei Zheng
- Changchun University of Chinese Medicine, Jilin Ginseng Academy, Changchun, P. R. China
| | - Hao Yue
- Changchun University of Chinese Medicine, School of health management, Changchun, P. R. China
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9
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Orihuel J, Capellán R, Casquero-Veiga M, Soto-Montenegro ML, Desco M, Oteo-Vives M, Ibáñez-Moragues M, Magro-Calvo N, Luján VM, Morcillo MÁ, Ambrosio E, Higuera-Matas A. The long-term effects of adolescent Δ9-tetrahydrocannabinol on brain structure and function assessed through neuroimaging techniques in male and female rats. Eur Neuropsychopharmacol 2023; 74:47-63. [PMID: 37276836 DOI: 10.1016/j.euroneuro.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 03/24/2023] [Accepted: 05/22/2023] [Indexed: 06/07/2023]
Abstract
Several studies performed on human subjects have examined the effects of adolescent cannabis consumption on brain structure or function using brain imaging techniques. However, the evidence from these studies is usually heterogenous and affected by several confounding variables. Animal models of adolescent cannabinoid exposure may help to overcome these difficulties. In this exploratory study, we aim to increase our understanding of the protracted effects of adolescent Δ9-tetrahydrocannabinol (THC) in rats of both sexes using magnetic resonance (MR) to obtain volumetric data, assess grey and white matter microstructure with diffusion tensor imaging (DTI) and measure brain metabolites with 1H-MR spectroscopy (MRS); in addition, we studied brain function using positron emission tomography (PET) with 2-deoxy-2-[18F]fluoro-d-glucose as the tracer. THC-exposed rats exhibited volumetric and microstructural alterations in the striatum, globus pallidus, lateral ventricles, thalamus, and septal nuclei in a sex-specific manner. THC administration also reduced fractional anisotropy in several white matter tracts, prominently in rostral sections, while in vivo MRS identified lower levels of cortical choline compounds. THC-treated males had increased metabolism in the cerebellum and olfactory bulb and decreased metabolism in the cingulate cortex. By contrast, THC-treated females showed hypermetabolism in a cluster of voxels comprising the entorhinal piriform cortices and in the cingulate cortex. These results indicate that mild THC exposure during adolescence leaves a lingering mark on brain structure and function in a sex-dependant manner. Some of the changes found here resemble those observed in human studies and highlight the importance of studying sex-specific effects in cannabinoid research.
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Affiliation(s)
- Javier Orihuel
- Department of Psychobiology, School of Psychology, National University for Distance Learning (UNED), C/Juan del Rosal 10, Madrid, Spain
| | - Roberto Capellán
- Department of Psychobiology, School of Psychology, National University for Distance Learning (UNED), C/Juan del Rosal 10, Madrid, Spain
| | - Marta Casquero-Veiga
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER de Salud Mental (CIBERSAM), Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain
| | - María Luisa Soto-Montenegro
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER de Salud Mental (CIBERSAM), Madrid, Spain; Grupo de Fisiopatología y Farmacología del Sistema Digestivo de la Universidad Rey Juan Carlos (NEUGUT), Madrid, Spain
| | - Manuel Desco
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER de Salud Mental (CIBERSAM), Madrid, Spain; Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain
| | - Marta Oteo-Vives
- CIEMAT - Research Centre for Energy, Environment and Technology, Medical Applications of Ionizing Radiations Unit, Madrid, Spain
| | - Marta Ibáñez-Moragues
- CIEMAT - Research Centre for Energy, Environment and Technology, Medical Applications of Ionizing Radiations Unit, Madrid, Spain
| | - Natalia Magro-Calvo
- CIEMAT - Research Centre for Energy, Environment and Technology, Medical Applications of Ionizing Radiations Unit, Madrid, Spain
| | - Víctor M Luján
- CIEMAT - Research Centre for Energy, Environment and Technology, Medical Applications of Ionizing Radiations Unit, Madrid, Spain
| | - Miguel Ángel Morcillo
- CIEMAT - Research Centre for Energy, Environment and Technology, Medical Applications of Ionizing Radiations Unit, Madrid, Spain
| | - Emilio Ambrosio
- Department of Psychobiology, School of Psychology, National University for Distance Learning (UNED), C/Juan del Rosal 10, Madrid, Spain
| | - Alejandro Higuera-Matas
- Department of Psychobiology, School of Psychology, National University for Distance Learning (UNED), C/Juan del Rosal 10, Madrid, Spain.
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10
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Couttas TA, Boost C, Pahlisch F, Sykorova EB, Leweke JE, Koethe D, Endepols H, Rohleder C, Leweke FM. Simultaneous Assessment of Serum Levels and Pharmacologic Effects of Cannabinoids on Endocannabinoids and N-Acylethanolamines by Liquid Chromatography-Tandem Mass Spectrometry. Cannabis Cannabinoid Res 2023; 8:657-669. [PMID: 35580134 PMCID: PMC10442685 DOI: 10.1089/can.2021.0181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: The primary compounds of Cannabis sativa, delta-9-tetrahydrocannabinol (Δ9-THC) and cannabidiol (CBD), inflict a direct influence on the endocannabinoid system-a complex lipid signaling network with a central role in neurotransmission and control of inhibitory and excitatory synapses. These phytocannabinoids often interact with endogenously produced endocannabinoids (eCBs), as well as their structurally related N-acylethanolamines (NAEs), to drive neurobiological, nociceptive, and inflammatory responses. Identifying and quantifying changes in these lipid neuromodulators can be challenging owing to their low abundance in complex matrices. Materials and Methods: This article describes a robust liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the extraction and quantification of the eCBs anandamide and 2-arachidonoylglycerol, along with their congener NAEs oleoylethanolamine and palmitoylethanolamine, and phytocannabinoids CBD, Δ9-THC, and 11-Nor-9-carboxy-Δ9-tetrahydrocannabinol, a major metabolite of Δ9-THC. Our method was applied to explore pharmacokinetic and pharmacodynamic effects from intraperitoneal injections of Δ9-THC and CBD on circulating levels of eCBs and NAEs in rodent serum. Results: Detection limits ranged from low nanomolar to picomolar in concentration for eCBs (0.012-0.24 pmol/mL), NAEs (0.059 pmol/mL), and phytocannabinoids (0.24-0.73 pmol/mL). Our method displayed good linearity for calibration curves of all analytes (R2>0.99) as well as acceptable accuracy and precision, with quality controls not deviating >15% from their nominal value. Our LC-MS/MS method reliably identified changes to these endogenous lipid mediators that followed a causal relationship, which was dependent on both the type of phytocannabinoid administered and its pharmaceutical preparation. Conclusion: We present a rapid and reliable method for the simultaneous quantification of phytocannabinoids, eCBs, and NAEs in serum using LC-MS/MS. The accuracy and sensitivity of our assay infer it can routinely monitor endogenous levels of these lipid neuromodulators in serum and their response to external stimuli, including cannabimimetic agents.
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Affiliation(s)
- Timothy A. Couttas
- Brain and Mind Centre, Translational Research Collective, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Carola Boost
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Franziska Pahlisch
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Eliska B. Sykorova
- Brain and Mind Centre, Translational Research Collective, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Judith E. Leweke
- Brain and Mind Centre, Translational Research Collective, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, Goettingen University, Goettingen, Germany
| | - Dagmar Koethe
- Brain and Mind Centre, Translational Research Collective, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Heike Endepols
- Department of Multimodal Imaging, Max-Planck-Institute for Neurological Research, Cologne, Germany
- Institute of Radiochemistry and Experimental Molecular Imaging, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Forschungszentrum Juelich GmbH, Institute of Neuroscience and Medicine, Nuclear Chemistry (INM-5), Juelich, Germany
| | - Cathrin Rohleder
- Brain and Mind Centre, Translational Research Collective, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, Goettingen University, Goettingen, Germany
- Department of Multimodal Imaging, Max-Planck-Institute for Neurological Research, Cologne, Germany
- Endosane Pharmaceuticals GmbH, Berlin, Germany
| | - F. Markus Leweke
- Brain and Mind Centre, Translational Research Collective, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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11
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Rømer TB, Jeppesen R, Christensen RHB, Benros ME. Biomarkers in the cerebrospinal fluid of patients with psychotic disorders compared to healthy controls: a systematic review and meta-analysis. Mol Psychiatry 2023; 28:2277-2290. [PMID: 37169812 DOI: 10.1038/s41380-023-02059-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 03/24/2023] [Accepted: 03/28/2023] [Indexed: 05/13/2023]
Abstract
Psychotic disorders are severe mental disorders with poorly understood etiology. Biomarkers in the cerebrospinal fluid (CSF) could provide etiological clues and diagnostic tools for psychosis; however, an unbiased overview of CSF alterations in individuals with psychotic disorders is lacking. The objective of this study was to summarize all quantifiable findings in CSF from individuals with psychotic disorders compared to healthy controls (HC). Studies published before January 25th, 2023 were identified searching PubMed, EMBASE, Cochrane Library, Web of Science, ClinicalTrials.gov, and PsycINFO. Screening, full-text review, data extraction, and risk of bias assessments were performed by two independent reviewers following PRISMA guidelines. Findings in patients and healthy controls were compared and summarized using random-effects analyses and assessment of publication bias, subgroup and sensitivity analyses were performed. 145 studies, covering 197 biomarkers, were included, of which 163 biomarkers have not previously been investigated in meta-analyses. All studies showed some degree of bias. 55 biomarkers measured in CSF were associated with psychosis and of these were 15 biomarkers measured in ≥2 studies. Patients showed increased levels of noradrenaline (standardized mean difference/SMD, 0.53; 95% confidence interval/CI, 0.16 to 0.90) and its metabolite 3-methoxy-4-hydroxyphenylglycol (SMD, 0.30; 95% CI: 0.05 to 0.55), the serotonin metabolite 5-hydroxyindoleacetic acid (SMD, 0.11; 95% CI: 0.01 to 0.21), the pro-inflammatory neurotransmitter kynurenic acid (SMD, 1.58; 95% CI: 0.34 to 2.81), its precursor kynurenine (SMD,0.99; 95% CI: 0.60 to 1.38), the cytokines interleukin-6 (SMD, 0.58; 95% CI: 0.39 to 0.77) and interleukin-8 (SMD, 0.43; 95% CI: 0.24 to 0.62), the endocannabinoid anandamide (SMD, 0.78; 95% CI: 0.53 to 1.02), albumin ratio (SMD, 0.40; 95% CI: 0.08 to 0.72), total protein (SMD, 0.29; 95% CI: 0.16 to 0.43), immunoglobulin ratio (SMD, 0.45; 95% CI: 0.06 to 0.85) and glucose (SMD, 0.48; 95% CI: 0.01 to 0.94). Neurotensin (SMD, -0.67; 95% CI: -0.89 to -0.46) and γ-aminobutyric acid (SMD, -0.29; 95% CI: -0.50 to -0.09) were decreased. Most biomarkers showed no significant differences, including the dopamine metabolites homovanillic acid and 3,4-dihydroxyphenylacetic acid. These findings suggest that dysregulation of the immune and adrenergic system as well as blood-brain barrier dysfunction are implicated in the pathophysiology of psychotic disorders.
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Affiliation(s)
- Troels Boldt Rømer
- Biological and Precision Psychiatry, Copenhagen Research Center for Mental Health, Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Cellular and Molecular Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Rose Jeppesen
- Biological and Precision Psychiatry, Copenhagen Research Center for Mental Health, Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Rune Haubo Bojesen Christensen
- Biological and Precision Psychiatry, Copenhagen Research Center for Mental Health, Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Michael Eriksen Benros
- Biological and Precision Psychiatry, Copenhagen Research Center for Mental Health, Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.
- Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark.
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12
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Herrera-Imbroda J, Flores-López M, Requena-Ocaña N, Araos P, Ropero J, García-Marchena N, Bordallo A, Suarez J, Pavón-Morón FJ, Serrano A, Mayoral F, Rodríguez de Fonseca F. Antipsychotic Medication Influences the Discriminative Value of Acylethanolamides as Biomarkers of Substance Use Disorder. Int J Mol Sci 2023; 24:ijms24119371. [PMID: 37298321 DOI: 10.3390/ijms24119371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/01/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023] Open
Abstract
Plasma acylethanolamides (NAEs), including the endocannabinoid anandamide (AEA), have been proposed as circulating biomarkers of substance use disorders. However, the concentration of these lipid transmitters might be influenced by the use of drugs prescribed for either the treatment of addiction or the associated psychiatric co-morbidities such as psychosis. As an example, neuroleptics, used for attenuation of psychotic symptoms and sedation, might theoretically interfere with the monoamine-mediated production of NAEs, obstructing the interpretation of plasma NAEs as clinical biomarkers. To solve the lack of information on the impact of neuroleptics on the concentration of NAEs, we evaluated the concentrations of NAEs in a control group and compared them to those present in (a) substance use disorders (SUD) patients that are not prescribed with neuroleptics, and (b) SUD patients (both alcohol use disorder and cocaine use disorder patients) using neuroleptics. The results demonstrate that SUD patients exhibited greater concentrations of NAEs than the control population, affecting all species with the exception of stearoylethanolamide (SEA) and palmitoleoylethanolamide (POEA). Neuroleptic treatment enhanced the concentrations of NAEs, especially those of AEA, linoleoylethanolamide (LEA), and oleoylethanolamide (OEA). This effect of neuroleptic treatment was observed independently of the drug addiction that motivated the demand for treatment (either alcohol or cocaine). This study remarks the need to control the current use of psychotropic medication as a potential confounding variable when considering the use of NAEs as biomarkers in SUD.
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Affiliation(s)
- Jesús Herrera-Imbroda
- Grupo de Neuropsicofarmacología, IBIMA-Plataforma BIONAND, 29590 Málaga, Spain
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, IBIMA-Plataforma BIONAND, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
- Facultad de Medicina, Universidad de Málaga, Andalucía Tech, Campus de Teatinos s/n, 29071 Málaga, Spain
| | - María Flores-López
- Grupo de Neuropsicofarmacología, IBIMA-Plataforma BIONAND, 29590 Málaga, Spain
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, IBIMA-Plataforma BIONAND, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
| | - Nerea Requena-Ocaña
- Grupo de Neuropsicofarmacología, IBIMA-Plataforma BIONAND, 29590 Málaga, Spain
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, IBIMA-Plataforma BIONAND, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
| | - Pedro Araos
- Grupo de Neuropsicofarmacología, IBIMA-Plataforma BIONAND, 29590 Málaga, Spain
- Departamento de Psicología Básica, Facultad de Psicología, Universidad de Málaga, 29071 Málaga, Spain
| | - Jessica Ropero
- Grupo de Neuropsicofarmacología, IBIMA-Plataforma BIONAND, 29590 Málaga, Spain
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, IBIMA-Plataforma BIONAND, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
| | - Nuria García-Marchena
- Grupo de Neuropsicofarmacología, IBIMA-Plataforma BIONAND, 29590 Málaga, Spain
- Departamento de Psicobiología y Metodología, Facultad de Psicología, Universidad Complutense de Madrid, 28223 Madrid, Spain
| | - Antonio Bordallo
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, IBIMA-Plataforma BIONAND, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
| | - Juan Suarez
- Grupo de Neuropsicofarmacología, IBIMA-Plataforma BIONAND, 29590 Málaga, Spain
- Departamento de Anatomía, Medicina Legal e Historia de la Ciencia, Facultad de Medicina, Universidad de Málaga, 29071 Málaga, Spain
| | - Francisco Javier Pavón-Morón
- Unidad Clínica Área del Corazón, Hospital Universitario Virgen de la Victoria, IBIMA-Plataforma BIONAND, 29010 Málaga, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Antonia Serrano
- Grupo de Neuropsicofarmacología, IBIMA-Plataforma BIONAND, 29590 Málaga, Spain
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, IBIMA-Plataforma BIONAND, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
| | - Fermín Mayoral
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, IBIMA-Plataforma BIONAND, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
| | - Fernando Rodríguez de Fonseca
- Grupo de Neuropsicofarmacología, IBIMA-Plataforma BIONAND, 29590 Málaga, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Unidad Clínica de Neurología, Hospital Regional Universitario de Málaga, IBIMA-Plataforma BIONAND, 29010 Málaga, Spain
- Andalusian Network for Clinical and Translational Research in Neurology [NEURO-RECA], 29001 Málaga, Spain
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13
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Boyacıoğlu Ö, Reçber T, Kır S, Korkusuz P, Nemutlu E. Development and validation of a sensitive assay for the quantification of arachidonoylcyclopropylamide (ACPA) in cell culture by LC–MS/MS. J Anal Sci Technol 2023. [DOI: 10.1186/s40543-023-00381-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
AbstractSynthetic and natural cannabinoid derivatives are highly investigated as drug candidates due to their antinociceptive, antiepileptic and anticancer potential. Arachidonoylcyclopropylamide (ACPA) is a synthetic cannabinoid with antiproliferative and apoptotic effects on non-small cell lung cancer and pancreatic and endometrial carcinoma. Thus, ACPA has a great potential for being used as an anticancer drug for epithelial cancers. Therefore, determining the levels of ACPA in biological fluids, cells, tissues and pharmaceutical dosage forms is crucial in monitoring the effects of various pharmacological, physiological and pathological stimuli on biological systems. However, the challenge in the quantification of ACPA is its short half-life and lack of UV signal. Therefore, we developed a liquid chromatography-tandem mass spectrometric (LC–MS/MS) method for sensitive and selective quantification of ACPA in cell culture medium and intracellular matrix. Multiple reaction monitoring in the positive ionization mode was used for detection with 344 → 203 m/z transitions. The separation of ACPA was performed on C18 column (50 × 3.0 mm, 2.1 μm) with the mobile phase run in the gradient mode with 0.1% formic acid (FA) in water and 0.1% FA in acetonitrile at a flow rate of 0.3 ml/min. The assay was linear in the concentration range of 1.8–1000 ng/mL (r = 0.999). The validation studies revealed that the method was linear, sensitive, accurate, precise, selective, repeatable, robust and rugged. Finally, the developed method was applied to quantify ACPA in cell culture medium and intracellular matrix.
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14
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Herrera-Imbroda J, Flores-López M, Ruiz-Sastre P, Gómez-Sánchez-Lafuente C, Bordallo-Aragón A, Rodríguez de Fonseca F, Mayoral-Cleríes F. The Inflammatory Signals Associated with Psychosis: Impact of Comorbid Drug Abuse. Biomedicines 2023; 11:biomedicines11020454. [PMID: 36830990 PMCID: PMC9953424 DOI: 10.3390/biomedicines11020454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/27/2023] [Accepted: 02/01/2023] [Indexed: 02/08/2023] Open
Abstract
Psychosis and substance use disorders are two diagnostic categories whose association has been studied for decades. In addition, both psychosis spectrum disorders and drug abuse have recently been linked to multiple pro-inflammatory changes in the central nervous system. We have carried out a narrative review of the literature through a holistic approach. We used PubMed as our search engine. We included in the review all relevant studies looking at pro-inflammatory changes in psychotic disorders and substance use disorders. We found that there are multiple studies that relate various pro-inflammatory lipids and proteins with psychosis and substance use disorders, with an overlap between the two. The main findings involve inflammatory mediators such as cytokines, chemokines, endocannabinoids, eicosanoids, lysophospholipds and/or bacterial products. Many of these findings are present in different phases of psychosis and in substance use disorders such as cannabis, cocaine, methamphetamines, alcohol and nicotine. Psychosis and substance use disorders may have a common origin in an abnormal neurodevelopment caused, among other factors, by a neuroinflammatory process. A possible convergent pathway is that which interrelates the transcriptional factors NFκB and PPARγ. This may have future clinical implications.
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Affiliation(s)
- Jesús Herrera-Imbroda
- Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
- Facultad de Medicina, Universidad de Málaga, Andalucía Tech, Campus de Teatinos s/n, 29071 Málaga, Spain
- Departamento de Farmacología y Pediatría, Universidad de Málaga, Andalucía Tech, Campus de Teatinos s/n, 29071 Málaga, Spain
| | - María Flores-López
- Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
- Facultad de Psicología, Universidad de Málaga, Andalucía Tech, Campus de Teatinos s/n, 29071 Málaga, Spain
| | - Paloma Ruiz-Sastre
- Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
- Facultad de Medicina, Universidad de Málaga, Andalucía Tech, Campus de Teatinos s/n, 29071 Málaga, Spain
- Correspondence: (P.R.-S.); (C.G.-S.-L.)
| | - Carlos Gómez-Sánchez-Lafuente
- Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
- Facultad de Psicología, Universidad de Málaga, Andalucía Tech, Campus de Teatinos s/n, 29071 Málaga, Spain
- Correspondence: (P.R.-S.); (C.G.-S.-L.)
| | - Antonio Bordallo-Aragón
- Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
| | - Fernando Rodríguez de Fonseca
- Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
| | - Fermín Mayoral-Cleríes
- Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
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15
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Bassir Nia A, Gibson CL, Spriggs SA, Jankowski SE, DeFrancisco D, Swift A, Perkel C, Galynker I, Honrao C, Makriyannis A, Hurd YL. Cannabis use is associated with low plasma endocannabinoid Anandamide in individuals with psychosis. J Psychopharmacol 2023; 37:484-489. [PMID: 36633290 DOI: 10.1177/02698811221148604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Cannabis use suppresses the endocannabinoid system in healthy individuals. However, the association between cannabis use with the endocannabinoid system is understudied in individuals with psychosis despite the high rate of cannabis use in these individuals. METHODS We enrolled 83 individuals who were admitted to an inpatient psychiatric unit with psychotic presentations, and measured their plasma levels of main endocannabinoids, Anandamide (AEA) and 2-Acylglycerol (2-AG), and endocannabinoid related compounds, Palmitoylethanolamine, and N-oleoylethanolamine. Cannabis use was assessed with urine toxicology and frequency of cannabis use was assessed using self-reported questionnaires. The Positive and Negative Syndrome Scale was used to assess the severity of psychotic symptoms. RESULTS Overall, we had 38 individuals in cannabis positive group (CN+) and 45 individuals in cannabis negative group (CN-). Compared to CN-, CN+ group had lower plasma levels of AEA, which remained significant after controlling for age, gender, race/ethnicity, and use of other drugs. CONCLUSION Cannabis use is associated with low plasma AEA levels in individuals with psychosis, which is in the same line with reported suppressive effects of cannabis on the endocannabinoid system in healthy individuals. Further studies are needed to investigate the clinical significance of this finding.
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Affiliation(s)
- Anahita Bassir Nia
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Claire L Gibson
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Sharron A Spriggs
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Samantha E Jankowski
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Daniel DeFrancisco
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Amy Swift
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Charles Perkel
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Igor Galynker
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | | | | | - Yasmin L Hurd
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.,Addiction Institute at Mount Sinai, New York City, NY, USA
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16
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D'Souza DC, DiForti M, Ganesh S, George TP, Hall W, Hjorthøj C, Howes O, Keshavan M, Murray RM, Nguyen TB, Pearlson GD, Ranganathan M, Selloni A, Solowij N, Spinazzola E. Consensus paper of the WFSBP task force on cannabis, cannabinoids and psychosis. World J Biol Psychiatry 2022; 23:719-742. [PMID: 35315315 DOI: 10.1080/15622975.2022.2038797] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
OBJECTIVES The liberalisation of cannabis laws, the increasing availability and potency of cannabis has renewed concern about the risk of psychosis with cannabis. METHODS The objective of the WFSBP task force was to review the literature about this relationship. RESULTS Converging lines of evidence suggest that exposure to cannabis increases the risk for psychoses ranging from transient psychotic states to chronic recurrent psychosis. The greater the dose, and the earlier the age of exposure, the greater the risk. For some psychosis outcomes, the evidence supports some of the criteria of causality. However, alternate explanations including reverse causality and confounders cannot be conclusively excluded. Furthermore, cannabis is neither necessary nor sufficient to cause psychosis. More likely it is one of the multiple causal components. In those with established psychosis, cannabis has a negative impact on the course and expression of the illness. Emerging evidence also suggests alterations in the endocannabinoid system in psychotic disorders. CONCLUSIONS Given that exposure to cannabis and cannabinoids is modifiable, delaying or eliminating exposure to cannabis or cannabinoids, could potentially impact the rates of psychosis related to cannabis, especially in those who are at high risk for developing the disorder.
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Affiliation(s)
- Deepak Cyril D'Souza
- Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA.,Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, CT, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Marta DiForti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK.,South London and Maudsley NHS Mental Health Foundation Trust, London, UK
| | - Suhas Ganesh
- Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA.,Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, CT, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Tony P George
- Addictions Division and Centre for Complex Interventions, Centre for Addiction and Mental Health (CAMH), Toronto, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Wayne Hall
- The National Centre for Youth Substance Use Research, University of Queensland, Brisbane, Australia
| | - Carsten Hjorthøj
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University, Copenhagen, Denmark.,Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
| | - Oliver Howes
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Institute for Clinical Sciences, Imperial College London, London, UK
| | - Matcheri Keshavan
- Beth Israel Deaconess Medical Center, Massachusetts Mental Health Center, Harvard Medical School, Boston, MA, USA
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Timothy B Nguyen
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK.,Institute for Clinical Sciences, Imperial College London, London, UK
| | - Godfrey D Pearlson
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.,Olin Neuropsychiatry Ctr. Institute of Living, Hartford, CT, USA
| | - Mohini Ranganathan
- Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA.,Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, CT, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Alex Selloni
- Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, CT, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Nadia Solowij
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia.,Australian Centre for Cannabinoid Clinical and Research Excellence (ACRE), New Lambton Heights, NSW, Australia
| | - Edoardo Spinazzola
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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17
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Ibarra‐Lecue I, Unzueta‐Larrinaga P, Barrena‐Barbadillo R, Villate A, Horrillo I, Mendivil B, Landabaso MA, Meana JJ, Etxebarria N, Callado LF, Urigüen L. Cannabis use selectively modulates circulating biomarkers in the blood of schizophrenia patients. Addict Biol 2022; 27:e13233. [PMID: 36301212 PMCID: PMC9539611 DOI: 10.1111/adb.13233] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/05/2022] [Accepted: 08/30/2022] [Indexed: 01/24/2023]
Abstract
Cannabis use disorder is frequent in schizophrenia patients, and it is associated with an earlier age of onset and poor schizophrenia prognosis. Serotonin 2A receptors (5-HT2AR) have been involved in psychosis and, like Akt kinase, are known to be modulated by THC. Likewise, endocannabinoid system dysregulation has been suggested in schizophrenia. The presence of these molecules in blood makes them interesting targets, as they can be evaluated in patients by a minimally invasive technique. The aim of the present study was to evaluate 5-HT2AR protein expression and the Akt functional status in platelet homogenates of subjects diagnosed with schizophrenia, cannabis use disorder, or both conditions, compared with age- and sex-matched control subjects. Additionally, endocannabinoids and pro-inflammatory interleukin-6 (IL-6) levels were also measured in the plasma of these subjects. Results showed that both platelet 5-HT2AR and the active phospho (Ser473)Akt protein expression were significantly increased in schizophrenia subjects, whereas patients with a dual diagnosis of schizophrenia and cannabis use disorder did not show significant changes. Similarly, plasma concentrations of anandamide and other lipid mediators such as PEA and DEA, as well as the pro-inflammatory IL-6, were significantly increased in schizophrenia, but not in dual subjects. Results demonstrate that schizophrenia subjects show different circulating markers pattern depending on the associated diagnosis of cannabis use disorder, supporting the hypothesis that there could be different underlying mechanisms that may explain clinical differences among these groups. Moreover, they provide the first preliminary evidence of peripherally measurable molecules of interest for bigger prospective studies in these subpopulations.
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Affiliation(s)
- Inés Ibarra‐Lecue
- Department of PharmacologyUniversity of the Basque Country UPV/EHULeioaBizkaiaSpain,Present address:
Department of Psychiatry, College of Physicians and Surgeons, Columbia UniversityNew York and New York State Psychiatric InstituteNew YorkNew YorkUSA,New York State Psychiatric InstituteNew YorkNew YorkUSA
| | - Paula Unzueta‐Larrinaga
- Department of PharmacologyUniversity of the Basque Country UPV/EHULeioaBizkaiaSpain,Biocruces Bizkaia Health Research InstituteBarakaldoBizkaiaSpain
| | | | - Aitor Villate
- Department of Analytical ChemistryUniversity of the Basque Country UPV/EHULeioaBizkaiaSpain,PiE‐UPV/EHU, Plentzia Itsas EstazioaAreatza PasealekuaPlentziaBizkaia48620Spain
| | - Igor Horrillo
- Department of PharmacologyUniversity of the Basque Country UPV/EHULeioaBizkaiaSpain,Biocruces Bizkaia Health Research InstituteBarakaldoBizkaiaSpain,Centro de Investigación Biomédica en Red de Salud MentalInstituto de Salud Carlos IIIMadridSpain
| | | | | | - J. Javier Meana
- Department of PharmacologyUniversity of the Basque Country UPV/EHULeioaBizkaiaSpain,Biocruces Bizkaia Health Research InstituteBarakaldoBizkaiaSpain,Centro de Investigación Biomédica en Red de Salud MentalInstituto de Salud Carlos IIIMadridSpain
| | - Nestor Etxebarria
- Department of Analytical ChemistryUniversity of the Basque Country UPV/EHULeioaBizkaiaSpain,PiE‐UPV/EHU, Plentzia Itsas EstazioaAreatza PasealekuaPlentziaBizkaia48620Spain
| | - Luis F. Callado
- Department of PharmacologyUniversity of the Basque Country UPV/EHULeioaBizkaiaSpain,Biocruces Bizkaia Health Research InstituteBarakaldoBizkaiaSpain,Centro de Investigación Biomédica en Red de Salud MentalInstituto de Salud Carlos IIIMadridSpain
| | - Leyre Urigüen
- Department of PharmacologyUniversity of the Basque Country UPV/EHULeioaBizkaiaSpain,Biocruces Bizkaia Health Research InstituteBarakaldoBizkaiaSpain,Centro de Investigación Biomédica en Red de Salud MentalInstituto de Salud Carlos IIIMadridSpain
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18
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Quantification of endocannabinoids in human cerebrospinal fluid using a novel micro-flow liquid chromatography-mass spectrometry method. Anal Chim Acta 2022; 1210:339888. [DOI: 10.1016/j.aca.2022.339888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/13/2022] [Accepted: 04/28/2022] [Indexed: 11/19/2022]
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19
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Molecular Alterations of the Endocannabinoid System in Psychiatric Disorders. Int J Mol Sci 2022; 23:ijms23094764. [PMID: 35563156 PMCID: PMC9104141 DOI: 10.3390/ijms23094764] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/22/2022] [Accepted: 04/23/2022] [Indexed: 02/07/2023] Open
Abstract
The therapeutic benefits of the current medications for patients with psychiatric disorders contrast with a great variety of adverse effects. The endocannabinoid system (ECS) components have gained high interest as potential new targets for treating psychiatry diseases because of their neuromodulator role, which is essential to understanding the regulation of many brain functions. This article reviewed the molecular alterations in ECS occurring in different psychiatric conditions. The methods used to identify alterations in the ECS were also described. We used a translational approach. The animal models reproducing some behavioral and/or neurochemical aspects of psychiatric disorders and the molecular alterations in clinical studies in post-mortem brain tissue or peripheral tissues were analyzed. This article reviewed the most relevant ECS changes in prevalent psychiatric diseases such as mood disorders, schizophrenia, autism, attentional deficit, eating disorders (ED), and addiction. The review concludes that clinical research studies are urgently needed for two different purposes: (1) To identify alterations of the ECS components potentially useful as new biomarkers relating to a specific disease or condition, and (2) to design new therapeutic targets based on the specific alterations found to improve the pharmacological treatment in psychiatry.
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20
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Parksepp M, Haring L, Kilk K, Koch K, Uppin K, Kangro R, Zilmer M, Vasar E. The Expanded Endocannabinoid System Contributes to Metabolic and Body Mass Shifts in First-Episode Schizophrenia: A 5-Year Follow-Up Study. Biomedicines 2022; 10:biomedicines10020243. [PMID: 35203453 PMCID: PMC8869544 DOI: 10.3390/biomedicines10020243] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 01/16/2022] [Accepted: 01/18/2022] [Indexed: 02/07/2023] Open
Abstract
Alterations in the expanded endocannabinoid system (eECS) and cell membrane composition have been implicated in the pathophysiology of schizophrenia spectrum disorders. We enrolled 54 antipsychotic (AP)-naïve first-episode psychosis (FEP) patients and 58 controls and applied a targeted metabolomics approach followed by multivariate data analysis to investigate the profile changes in the serum levels of endocannabinoids: 2-arachidonoylglycerol (2-AG) and anandamide, endocannabinoids-like N-acylethanolamines (NAEs: linoleoylethanolamide, oleoylethanolamide, and palmitoylethanolamide), and their dominating lipid precursor’s phosphatidylcholines. Biomolecule profiles were measured at the onset of first-episode psychosis (FEP) and 0.6 years and 5.1 years after the initiation of AP treatment. The results indicated that FEP might be characterized by elevated concentrations of NAEs and by decreased 2-AG levels. At this stage of the disease, the NAE-mediated upregulation of peroxisome proliferator-activated receptors (PPARs) manifested themselves in energy expenditure. A 5-year disease progression and AP treatment adverse effects led to a robust increase in 2-AG levels, which contributed to strengthened cannabinoid (CB1) receptor-mediated effects, which manifested in obesity. Dynamic 2-AG, NAEs, and their precursors in terms of phosphatidylcholines are relevant to the description of the metabolic shifts resulting from the altered eECS function during and after FEP.
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Affiliation(s)
- Madis Parksepp
- Institute of Clinical Medicine, University of Tartu, 50406 Tartu, Estonia;
- Psychiatry Clinic of Viljandi Hospital, 71024 Viljandi, Estonia
| | - Liina Haring
- Institute of Clinical Medicine, University of Tartu, 50406 Tartu, Estonia;
- Psychiatry Clinic of Tartu University Hospital, 50406 Tartu, Estonia; (K.K.); (K.U.)
- Centre of Excellence for Genomics and Translational Medicine, Institute of Biomedicine and Translational Medicine, Univesignallingrsity of Tartu, 50090 Tartu, Estonia; (K.K.); (M.Z.); (E.V.)
- Correspondence: ; Tel.: +372-7318-767
| | - Kalle Kilk
- Centre of Excellence for Genomics and Translational Medicine, Institute of Biomedicine and Translational Medicine, Univesignallingrsity of Tartu, 50090 Tartu, Estonia; (K.K.); (M.Z.); (E.V.)
| | - Kadri Koch
- Psychiatry Clinic of Tartu University Hospital, 50406 Tartu, Estonia; (K.K.); (K.U.)
| | - Kärt Uppin
- Psychiatry Clinic of Tartu University Hospital, 50406 Tartu, Estonia; (K.K.); (K.U.)
| | - Raul Kangro
- Institute of Mathematics and Statistics, University of Tartu, 50090 Tartu, Estonia;
| | - Mihkel Zilmer
- Centre of Excellence for Genomics and Translational Medicine, Institute of Biomedicine and Translational Medicine, Univesignallingrsity of Tartu, 50090 Tartu, Estonia; (K.K.); (M.Z.); (E.V.)
| | - Eero Vasar
- Centre of Excellence for Genomics and Translational Medicine, Institute of Biomedicine and Translational Medicine, Univesignallingrsity of Tartu, 50090 Tartu, Estonia; (K.K.); (M.Z.); (E.V.)
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21
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Abstract
BACKGROUND Evidence suggests that an overlap exists between the neurobiology of psychotic disorders and the effects of cannabinoids on neurocognitive and neurochemical substrates involved in reward processing. AIMS We investigate whether the psychotomimetic effects of delta-9-tetrahydrocannabinol (THC) and the antipsychotic potential of cannabidiol (CBD) are underpinned by their effects on the reward system and dopamine. METHODS This narrative review focuses on the overlap between altered dopamine signalling and reward processing induced by cannabinoids, pre-clinically and in humans. A systematic search was conducted of acute cannabinoid drug-challenge studies using neuroimaging in healthy subjects and those with psychosis RESULTS: There is evidence of increased striatal presynaptic dopamine synthesis and release in psychosis, as well as abnormal engagement of the striatum during reward processing. Although, acute THC challenges have elicited a modest effect on striatal dopamine, cannabis users generally indicate impaired presynaptic dopaminergic function. Functional MRI studies have identified that a single dose of THC may modulate regions involved in reward and salience processing such as the striatum, midbrain, insular, and anterior cingulate, with some effects correlating with the severity of THC-induced psychotic symptoms. CBD may modulate brain regions involved in reward/salience processing in an opposite direction to that of THC. CONCLUSIONS There is evidence to suggest modulation of reward processing and its neural substrates by THC and CBD. Whether such effects underlie the psychotomimetic/antipsychotic effects of these cannabinoids remains unclear. Future research should address these unanswered questions to understand the relationship between endocannabinoid dysfunction, reward processing abnormalities, and psychosis.
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22
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Kratz D, Thomas D, Gurke R. Endocannabinoids as potential biomarkers: It's all about pre-analytics. J Mass Spectrom Adv Clin Lab 2021; 22:56-63. [PMID: 34939056 DOI: 10.1016/j.jmsacl.2021.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 11/01/2021] [Accepted: 11/05/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction Arachidonoyl ethanolamide (AEA) and 2-arachidonoyl glycerol (2-AG) are central lipid mediators of the endocannabinoid system. They are highly relevant due to their involvement in a wide variety of inflammatory, metabolic or malign diseases. Further elucidation of their modes of action and use as biomarkers in an easily accessible matrix, like blood, is restricted by their susceptibility to deviations during blood sampling and physiological co-dependences, which results in high variability of reported concentrations in low ng/mL ranges. Objectives The objective of this review is the identification of critical parameters during the pre-analytical phase and proposal of minimum requirements for reliable determination of endocannabinoids (ECs) in blood samples. Methods Reported physiological processes influencing the EC concentrations were put into context with published pre-analytical research and stability data from bioanalytical method validation. Results The cause for variability in EC concentrations is versatile. In part, they are caused by inter-individual factors like sex, metabolic status and/or diurnal changes. Nevertheless, enzymatic activity in freshly drawn blood samples is the main reason for changing concentrations of AEA and 2-AG, besides additional non-enzymatic isomerization of the latter. Conclusion Blood samples for EC analyses require immediate processing at low temperatures (>0 °C) to maintain sample integrity. Standardization of the respective blood tube or anti-coagulant, sampling time point, applied centrifugal force and complete processing time can further decrease variability caused by sample handling. Nevertheless, extensive characterization of study participants is needed to reduce distortion of clinical data caused by co-variables and facilitate research on the endocannabinoid system.
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Key Words
- (U)HPLC, (ultra) high performance liquid chromatography
- 1-AG, 1-arachidonoyl glycerol
- 2-AG, 2-arachidonoyl glycerol
- 2-Arachidonoyl glycerol
- AEA, arachidonoyl ethanolamide
- Anandamide
- BMI, body mass index
- Blood sampling
- CBR, cannabinoid receptor
- EC-like, endocannabinoid-like
- ECS, endocannabinoid system
- ECs, endocannabinoids
- EDTA, ethylenediaminetetraacetic acid
- Endocannabinoid
- FAAH, fatty acid amide hydrolase
- FT, freezing temperature
- FTC, freeze–thaw cycles
- HDL, high density lipo protein
- KSCN, potassium thiocyanate
- LLE, liquid–liquid extraction
- MAGL, monoacylglycerol lipase
- MS/MS, tandem mass spectrometry
- O-AEA, virodhamine
- OEA, oleoyl ethanolamide
- PAF, platelet-activating factor
- PEA, palmitoyl ethanolamide
- PMSF, phenylmethylsulfonyl fluoride
- Pre-analytics
- RT, room temperature
- SPE, solid-phase extraction
- WB, whole blood
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Affiliation(s)
- Daniel Kratz
- Institute of Clinical Pharmacology, pharmazentrum frankfurt/ZAFES, University Hospital of Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Dominique Thomas
- Institute of Clinical Pharmacology, pharmazentrum frankfurt/ZAFES, University Hospital of Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology (ITMP), and Fraunhofer Cluster of Excellence for Immune Mediated Diseases (CIMD), Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
| | - Robert Gurke
- Institute of Clinical Pharmacology, pharmazentrum frankfurt/ZAFES, University Hospital of Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology (ITMP), and Fraunhofer Cluster of Excellence for Immune Mediated Diseases (CIMD), Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
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23
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Xiao MF, Roh SE, Zhou J, Chien CC, Lucey BP, Craig MT, Hayes LN, Coughlin JM, Leweke FM, Jia M, Xu D, Zhou W, Conover Talbot C, Arnold DB, Staley M, Jiang C, Reti IM, Sawa A, Pelkey KA, McBain CJ, Savonenko A, Worley PF. A biomarker-authenticated model of schizophrenia implicating NPTX2 loss of function. SCIENCE ADVANCES 2021; 7:eabf6935. [PMID: 34818031 PMCID: PMC8612534 DOI: 10.1126/sciadv.abf6935] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 10/05/2021] [Indexed: 05/27/2023]
Abstract
Schizophrenia is a polygenetic disorder whose clinical onset is often associated with behavioral stress. Here, we present a model of disease pathogenesis that builds on our observation that the synaptic immediate early gene NPTX2 is reduced in cerebrospinal fluid of individuals with recent onset schizophrenia. NPTX2 plays an essential role in maintaining excitatory homeostasis by adaptively enhancing circuit inhibition. NPTX2 function requires activity-dependent exocytosis and dynamic shedding at synapses and is coupled to circadian behavior. Behavior-linked NPTX2 trafficking is abolished by mutations that disrupt select activity-dependent plasticity mechanisms of excitatory neurons. Modeling NPTX2 loss of function results in failure of parvalbumin interneurons in their adaptive contribution to behavioral stress, and animals exhibit multiple neuropsychiatric domains. Because the genetics of schizophrenia encompasses diverse proteins that contribute to excitatory synapse plasticity, the identified vulnerability of NPTX2 function can provide a framework for assessing the impact of genetics and the intersection with stress.
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Affiliation(s)
- Mei-Fang Xiao
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Seung-Eon Roh
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jiechao Zhou
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Chun-Che Chien
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Brendan P. Lucey
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Michael T. Craig
- Institute of Biomedical & Clinical Science, University of Exeter Medical School, Exeter, UK
| | - Lindsay N. Hayes
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jennifer M. Coughlin
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - F. Markus Leweke
- Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Youth Mental Health Team, Brain and Mind Centre, Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Min Jia
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Desheng Xu
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Weiqiang Zhou
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - C. Conover Talbot
- Transcriptomics and Deep Sequencing Core Facility, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Don B. Arnold
- Department of Biology, Section of Molecular and Computational Biology, University of Southern California, Los Angeles, CA, USA
| | - Melissa Staley
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Cindy Jiang
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Irving M. Reti
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Akira Sawa
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kenneth A. Pelkey
- Program in Developmental Neurobiology, Eunice Kennedy-Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA
| | - Chris J. McBain
- Program in Developmental Neurobiology, Eunice Kennedy-Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA
| | - Alena Savonenko
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Paul F. Worley
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Exploring the relationship between recency and frequency of cannabis use and diminished expression and apathy as two dimensions of negative symptoms in first episode psychosis. A one-year follow-up study. Schizophr Res 2021; 236:89-96. [PMID: 34454305 DOI: 10.1016/j.schres.2021.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/18/2021] [Accepted: 08/04/2021] [Indexed: 11/20/2022]
Abstract
The association between cannabis use and negative symptoms remains unclear because of inconsistent results in existing studies. In this study we aimed to investigate the association between different aspects of cannabis use and 1) diminished expression and 2) apathy as a two-dimensional model of negative symptoms in a sample of 460 participants with first-episode psychosis. Data were collected on relevant clinical and demographic factors including diagnostics and habits of drug use at baseline, with a follow-up assessment after 12-months. We found an association between the frequency of cannabis use two years prior to baseline and the severity of diminished expression and apathy at baseline, while only the association to diminished expression held after controlling for potential clinical and demographic confounders. Frequency of cannabis use at baseline also had a significant effect on the development of diminished expression over the 12-month follow-up period. In conclusion, this study suggests that the frequency of cannabis use contributes to the severity of diminished expression at baseline, and to the progression of diminished expression after 12-months follow-up. Our findings also imply a dose-response relationship between frequency of use and severity of symptoms and add evidence to an association between cannabis use and negative symptoms.
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Borgan F, O'Daly O, Veronese M, Reis Marques T, Laurikainen H, Hietala J, Howes O. The neural and molecular basis of working memory function in psychosis: a multimodal PET-fMRI study. Mol Psychiatry 2021; 26:4464-4474. [PMID: 31801965 PMCID: PMC8550949 DOI: 10.1038/s41380-019-0619-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 11/13/2019] [Accepted: 11/21/2019] [Indexed: 01/10/2023]
Abstract
Working memory (WM) deficits predict clinical and functional outcomes in schizophrenia but are poorly understood and unaddressed by existing treatments. WM encoding and WM retrieval have not been investigated in schizophrenia without the confounds of illness chronicity or the use of antipsychotics and illicit substances. Moreover, it is unclear if WM deficits may be linked to cannabinoid 1 receptor dysfunction in schizophrenia. Sixty-six volunteers (35 controls, 31 drug-free patients with diagnoses of schizophrenia or schizoaffective disorder) completed the Sternberg Item-Recognition paradigm during an fMRI scan. Neural activation during WM encoding and WM retrieval was indexed using the blood-oxygen-level-dependent hemodynamic response. A subset of volunteers (20 controls, 20 drug-free patients) underwent a dynamic PET scan to measure [11C] MePPEP distribution volume (ml/cm3) to index CB1R availability. In a whole-brain analysis, there was a significant main effect of group on task-related BOLD responses in the superior parietal lobule during WM encoding, and the bilateral hippocampus during WM retrieval. Region of interest analyses in volunteers who had PET/fMRI indicated that there was a significant main effect of group on task-related BOLD responses in the right hippocampus, left DLPFC, left ACC during encoding; and in the bilateral hippocampus, striatum, ACC and right DLPFC during retrieval. Striatal CB1R availability was positively associated with mean striatal activation during WM retrieval in male patients (R = 0.5, p = 0.02) but not male controls (R = -0.20, p = 0.53), and this was significantly different between groups, Z = -2.20, p = 0.02. Striatal CB1R may contribute to the pathophysiology of WM deficits in male patients and have implications for drug development in schizophrenia.
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Affiliation(s)
- Faith Borgan
- Psychosis Studies Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England.
- Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, Hammersmith Hospital, London, England.
| | - Owen O'Daly
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
| | - Mattia Veronese
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
| | - Tiago Reis Marques
- Psychosis Studies Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
- Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, Hammersmith Hospital, London, England
| | - Heikki Laurikainen
- Turku PET Centre, Turku University Hospital, Turku, Finland
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Jarmo Hietala
- Turku PET Centre, Turku University Hospital, Turku, Finland
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Oliver Howes
- Psychosis Studies Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
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Shared Biological Pathways between Antipsychotics and Omega-3 Fatty Acids: A Key Feature for Schizophrenia Preventive Treatment? Int J Mol Sci 2021; 22:ijms22136881. [PMID: 34206945 PMCID: PMC8269187 DOI: 10.3390/ijms22136881] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/18/2021] [Accepted: 06/23/2021] [Indexed: 12/25/2022] Open
Abstract
Schizophrenia typically emerges during adolescence, with progression from an ultra-high risk state (UHR) to the first episode of psychosis (FEP) followed by a chronic phase. The detailed pathophysiology of schizophrenia and the factors leading to progression across these stages remain relatively unknown. The current treatment relies on antipsychotics, which are effective for FEP and chronic schizophrenia but ineffective for UHR patients. Antipsychotics modulate dopaminergic and glutamatergic neurotransmission, inflammation, oxidative stress, and membrane lipids pathways. Many of these biological pathways intercommunicate and play a role in schizophrenia pathophysiology. In this context, research of preventive treatment in early stages has explored the antipsychotic effects of omega-3 supplementation in UHR and FEP patients. This review summarizes the action of omega-3 in various biological systems involved in schizophrenia. Similar to antipsychotics, omega-3 supplementation reduces inflammation and oxidative stress, improves myelination, modifies the properties of cell membranes, and influences dopamine and glutamate pathways. Omega-3 supplementation also modulates one-carbon metabolism, the endocannabinoid system, and appears to present neuroprotective properties. Omega-3 has little side effects compared to antipsychotics and may be safely prescribed for UHR patients and as an add-on for FEP patients. This could to lead to more efficacious individualised treatments, thus contributing to precision medicine in psychiatry.
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Bartoli F, Riboldi I, Bachi B, Calabrese A, Moretti F, Crocamo C, Carrà G. Efficacy of Cannabidiol for Δ-9-Tetrahydrocannabinol-Induced Psychotic Symptoms, Schizophrenia, and Cannabis Use Disorders: A Narrative Review. J Clin Med 2021; 10:jcm10061303. [PMID: 33810033 PMCID: PMC8005219 DOI: 10.3390/jcm10061303] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/16/2021] [Accepted: 03/17/2021] [Indexed: 01/17/2023] Open
Abstract
Although cannabis’ major psychoactive component, Δ-9-tetrahydrocannabinol (THC), has been linked to both earlier onset and poorer outcomes of psychotic disorders, Cannabidiol (CBD) seems to have different pharmacological mechanisms and potential therapeutic properties. However, no clinical study has investigated CBD for the treatment of co-occurring psychotic and cannabis use disorders so far, even though its utility seems grounded in a plausible biological basis. The aim of this work is thus to provide an overview of available clinical studies evaluating the efficacy of CBD for psychotic symptoms induced by THC, schizophrenia, and cannabis use disorders. After searching for relevant studies in PubMed, Cochrane Library, and ClinicalTrials.gov, we included 10 clinical studies. Available evidence suggests that CBD may attenuate both psychotic-like symptoms induced by THC in healthy volunteers and positive symptoms in individuals with schizophrenia. In addition, preliminary data on the efficacy of CBD for cannabis use disorders show mixed findings. Evidence from ongoing clinical studies will provide insight into the possible role of CBD for treating psychotic and cannabis use disorders.
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Affiliation(s)
- Francesco Bartoli
- Department of Medicine and Surgery, University of Milano Bicocca, via Cadore 48, 20900 Monza, Italy; (I.R.); (B.B.); (A.C.); (F.M.); (C.C.)
- Correspondence: (F.B.); (G.C.); Tel.: +39-025-799-8644 (F.B.); +39-025-799-8645 (G.C.)
| | - Ilaria Riboldi
- Department of Medicine and Surgery, University of Milano Bicocca, via Cadore 48, 20900 Monza, Italy; (I.R.); (B.B.); (A.C.); (F.M.); (C.C.)
| | - Bianca Bachi
- Department of Medicine and Surgery, University of Milano Bicocca, via Cadore 48, 20900 Monza, Italy; (I.R.); (B.B.); (A.C.); (F.M.); (C.C.)
| | - Angela Calabrese
- Department of Medicine and Surgery, University of Milano Bicocca, via Cadore 48, 20900 Monza, Italy; (I.R.); (B.B.); (A.C.); (F.M.); (C.C.)
| | - Federico Moretti
- Department of Medicine and Surgery, University of Milano Bicocca, via Cadore 48, 20900 Monza, Italy; (I.R.); (B.B.); (A.C.); (F.M.); (C.C.)
| | - Cristina Crocamo
- Department of Medicine and Surgery, University of Milano Bicocca, via Cadore 48, 20900 Monza, Italy; (I.R.); (B.B.); (A.C.); (F.M.); (C.C.)
| | - Giuseppe Carrà
- Department of Medicine and Surgery, University of Milano Bicocca, via Cadore 48, 20900 Monza, Italy; (I.R.); (B.B.); (A.C.); (F.M.); (C.C.)
- Division of Psychiatry, University College London, Maple House 149, London W1T 7BN, UK
- Correspondence: (F.B.); (G.C.); Tel.: +39-025-799-8644 (F.B.); +39-025-799-8645 (G.C.)
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Endocannabinoid system in psychotic and mood disorders, a review of human studies. Prog Neuropsychopharmacol Biol Psychiatry 2021; 106:110096. [PMID: 32898588 PMCID: PMC8582009 DOI: 10.1016/j.pnpbp.2020.110096] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/13/2020] [Accepted: 09/01/2020] [Indexed: 12/21/2022]
Abstract
Despite widespread evidence of endocannabinoid system involvement in the pathophysiology of psychiatric disorders, our understanding remains rudimentary. Here we review studies of the endocannabinoid system in humans with psychotic and mood disorders. Postmortem, peripheral, cerebrospinal fluid and in vivo imaging studies provide evidence for the involvement of the endocannabinoid system in psychotic and mood disorders. Psychotic disorders and major depressive disorder exhibit alterations of brain cannabinoid CB1 receptors and peripheral blood endocannabinoids. Further, these changes may be sensitive to treatment status, disease state, and symptom severity. Evidence from psychotic disorder extend to endocannabinoid metabolizing enzymes in the brain and periphery, whereas these lines of evidence remain poorly developed in mood disorders. A paucity of studies examining this system in bipolar disorder represents a notable gap in the literature. Despite a growing body of productive work in this field of research, there is a clear need for investigation beyond the CB1 receptor in order to more fully elucidate the role of the endocannabinoid system in psychotic and mood disorders.
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Colangeli R, Teskey GC, Di Giovanni G. Endocannabinoid-serotonin systems interaction in health and disease. PROGRESS IN BRAIN RESEARCH 2021; 259:83-134. [PMID: 33541682 DOI: 10.1016/bs.pbr.2021.01.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Endocannabinoid (eCB) and serotonin (5-HT) neuromodulatory systems work both independently and together to finely orchestrate neuronal activity throughout the brain to strongly sculpt behavioral functions. Surprising parallelism between the behavioral effects of 5-HT and eCB activity has been widely reported, including the regulation of emotional states, stress homeostasis, cognitive functions, food intake and sleep. The distribution pattern of the 5-HT system and the eCB molecular elements in the brain display a strong overlap and several studies report a functional interplay and even a tight interdependence between eCB/5-HT signaling. In this review, we examine the available evidence of the interaction between the eCB and 5-HT systems. We first introduce the eCB system, then we describe the eCB/5-HT crosstalk at the neuronal and synaptic levels. Finally, we explore the potential eCB/5-HT interaction at the behavioral level with the implication for psychiatric and neurological disorders. The precise elucidation of how this neuromodulatory interaction dynamically regulates biological functions may lead to the development of more targeted therapeutic strategies for the treatment of depressive and anxiety disorders, psychosis and epilepsy.
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Affiliation(s)
- Roberto Colangeli
- Section of Neuroscience and Cell Biology, Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy; Department of Cell Biology and Anatomy, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.
| | - G Campbell Teskey
- Department of Cell Biology and Anatomy, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Giuseppe Di Giovanni
- Laboratory of Neurophysiology, Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, University of Malta, Msida, Malta; Neuroscience Division, School of Biosciences, Cardiff University, Cardiff, United Kingdom
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Batalla A, Bos J, Postma A, Bossong MG. The Impact of Cannabidiol on Human Brain Function: A Systematic Review. Front Pharmacol 2021; 11:618184. [PMID: 33551817 PMCID: PMC7858248 DOI: 10.3389/fphar.2020.618184] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 12/17/2020] [Indexed: 12/16/2022] Open
Abstract
Background: Accumulating evidence suggests that the non-intoxicating cannabinoid compound cannabidiol (CBD) may have antipsychotic and anxiolytic properties, and thus may be a promising new agent in the treatment of psychotic and anxiety disorders. However, the neurobiological substrates underlying the potential therapeutic effects of CBD are still unclear. The aim of this systematic review is to provide a detailed and up-to-date systematic literature overview of neuroimaging studies that investigated the acute impact of CBD on human brain function. Methods: Papers published until May 2020 were included from PubMed following a comprehensive search strategy and pre-determined set of criteria for article selection. We included studies that examined the effects of CBD on brain function of healthy volunteers and individuals diagnosed with a psychiatric disorder, comprising both the effects of CBD alone as well as in direct comparison to those induced by ∆9-tetrahydrocannabinol (THC), the main psychoactive component of Cannabis. Results: One-ninety four studies were identified, of which 17 met inclusion criteria. All studies investigated the acute effects of CBD on brain function during resting state or in the context of cognitive tasks. In healthy volunteers, acute CBD enhanced fronto-striatal resting state connectivity, both compared to placebo and THC. Furthermore, CBD modulated brain activity and had opposite effects when compared to THC following task-specific patterns during various cognitive paradigms, such as emotional processing (fronto-temporal), verbal memory (fronto-striatal), response inhibition (fronto-limbic-striatal), and auditory/visual processing (temporo-occipital). In individuals at clinical high risk for psychosis and patients with established psychosis, acute CBD showed intermediate brain activity compared to placebo and healthy controls during cognitive task performance. CBD modulated resting limbic activity in subjects with anxiety and metabolite levels in patients with autism spectrum disorders. Conclusion: Neuroimaging studies have shown that acute CBD induces significant alterations in brain activity and connectivity patterns during resting state and performance of cognitive tasks in both healthy volunteers and patients with a psychiatric disorder. This included modulation of functional networks relevant for psychiatric disorders, possibly reflecting CBD’s therapeutic effects. Future studies should consider replication of findings and enlarge the inclusion of psychiatric patients, combining longer-term CBD treatment with neuroimaging assessments.
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Affiliation(s)
- Albert Batalla
- Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University, Utrecht, Netherlands
| | - Julian Bos
- Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University, Utrecht, Netherlands
| | - Amber Postma
- Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University, Utrecht, Netherlands
| | - Matthijs G Bossong
- Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University, Utrecht, Netherlands
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Jacobson MR, Watts JJ, Da Silva T, Tyndale RF, Rusjan PM, Houle S, Wilson AA, Ross RA, Boileau I, Mizrahi R. Fatty acid amide hydrolase is lower in young cannabis users. Addict Biol 2021; 26:e12872. [PMID: 31960544 DOI: 10.1111/adb.12872] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 11/03/2019] [Accepted: 12/21/2019] [Indexed: 12/31/2022]
Abstract
We have recently shown that levels of fatty acid amide hydrolase (FAAH), the enzyme that metabolizes the endocannabinoid anandamide, are lower in the brains of adult cannabis users (CUs) (34 ± 11 years of age), tested during early abstinence. Here, we examine replication of the lower FAAH levels in a separate, younger cohort (23 ± 5 years of age). Eighteen healthy volunteers (HVs) and fourteen CUs underwent a positron emission tomography scan using the FAAH radioligand [11 C]CURB. Regional [11 C]CURB binding was calculated using an irreversible two-tissue compartment model with a metabolite-corrected arterial plasma input function. The FAAH C385A genetic polymorphism (rs324420) was included as a covariate. All CUs underwent a urine screen to confirm recent cannabis use and had serum cannabinoids measured. One CU screened negative for cannabinoids via serum and was removed from analysis. All HVs reported less than five lifetime cannabis exposures more than a month prior to study initiation. There was a significant effect of group (F1,26 = 4.31; P = .048) when two A/A (rs324420) HVs were removed from analysis to match the genotype of the CU group (n = 16 HVs, n = 13 CUs). Overall, [11 C]CURB λk3 was 12% lower in CU compared with HV. Exploratory correlations showed that lower brain [11 C]CURB binding was related to greater use of cannabis throughout the past year. We confirmed our previous report and extended these findings by detecting lower [11 C]CURB binding in a younger cohort with less cumulative cannabis exposure.
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Affiliation(s)
- Maya R. Jacobson
- Research Imaging Centre Centre for Addiction and Mental Health Toronto Ontario Canada
- Department of Pharmacology and Toxicology University of Toronto Toronto Ontario Canada
- Campbell Family Mental Health Research Institute Centre for Addiction and Mental Health Toronto Ontario Canada
| | - Jeremy J. Watts
- Research Imaging Centre Centre for Addiction and Mental Health Toronto Ontario Canada
- Department of Pharmacology and Toxicology University of Toronto Toronto Ontario Canada
- Campbell Family Mental Health Research Institute Centre for Addiction and Mental Health Toronto Ontario Canada
| | - Tania Da Silva
- Research Imaging Centre Centre for Addiction and Mental Health Toronto Ontario Canada
- Campbell Family Mental Health Research Institute Centre for Addiction and Mental Health Toronto Ontario Canada
| | - Rachel F. Tyndale
- Department of Pharmacology and Toxicology University of Toronto Toronto Ontario Canada
- Department of Psychiatry University of Toronto Toronto Ontario Canada
- Campbell Family Mental Health Research Institute Centre for Addiction and Mental Health Toronto Ontario Canada
| | - Pablo M. Rusjan
- Research Imaging Centre Centre for Addiction and Mental Health Toronto Ontario Canada
- Department of Psychiatry University of Toronto Toronto Ontario Canada
- Campbell Family Mental Health Research Institute Centre for Addiction and Mental Health Toronto Ontario Canada
| | - Sylvain Houle
- Research Imaging Centre Centre for Addiction and Mental Health Toronto Ontario Canada
- Department of Psychiatry University of Toronto Toronto Ontario Canada
- Campbell Family Mental Health Research Institute Centre for Addiction and Mental Health Toronto Ontario Canada
| | - Alan A. Wilson
- Research Imaging Centre Centre for Addiction and Mental Health Toronto Ontario Canada
- Department of Psychiatry University of Toronto Toronto Ontario Canada
| | - Ruth A. Ross
- Department of Pharmacology and Toxicology University of Toronto Toronto Ontario Canada
| | - Isabelle Boileau
- Research Imaging Centre Centre for Addiction and Mental Health Toronto Ontario Canada
- Department of Psychiatry University of Toronto Toronto Ontario Canada
- Campbell Family Mental Health Research Institute Centre for Addiction and Mental Health Toronto Ontario Canada
| | - Romina Mizrahi
- Research Imaging Centre Centre for Addiction and Mental Health Toronto Ontario Canada
- Department of Pharmacology and Toxicology University of Toronto Toronto Ontario Canada
- Department of Psychiatry University of Toronto Toronto Ontario Canada
- Campbell Family Mental Health Research Institute Centre for Addiction and Mental Health Toronto Ontario Canada
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Alves MA, Lamichhane S, Dickens A, McGlinchey A, Ribeiro HC, Sen P, Wei F, Hyötyläinen T, Orešič M. Systems biology approaches to study lipidomes in health and disease. Biochim Biophys Acta Mol Cell Biol Lipids 2020; 1866:158857. [PMID: 33278596 DOI: 10.1016/j.bbalip.2020.158857] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/13/2020] [Accepted: 11/27/2020] [Indexed: 12/15/2022]
Abstract
Lipids have many important biological roles, such as energy storage sources, structural components of plasma membranes and as intermediates in metabolic and signaling pathways. Lipid metabolism is under tight homeostatic control, exhibiting spatial and dynamic complexity at multiple levels. Consequently, lipid-related disturbances play important roles in the pathogenesis of most of the common diseases. Lipidomics, defined as the study of lipidomes in biological systems, has emerged as a rapidly-growing field. Due to the chemical and functional diversity of lipids, the application of a systems biology approach is essential if one is to address lipid functionality at different physiological levels. In parallel with analytical advances to measure lipids in biological matrices, the field of computational lipidomics has been rapidly advancing, enabling modeling of lipidomes in their pathway, spatial and dynamic contexts. This review focuses on recent progress in systems biology approaches to study lipids in health and disease, with specific emphasis on methodological advances and biomedical applications.
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Affiliation(s)
- Marina Amaral Alves
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku 20520, Finland
| | - Santosh Lamichhane
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku 20520, Finland
| | - Alex Dickens
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku 20520, Finland
| | - Aidan McGlinchey
- School of Medical Sciences, Örebro University, 702 81 Örebro, Sweden
| | | | - Partho Sen
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku 20520, Finland; School of Medical Sciences, Örebro University, 702 81 Örebro, Sweden
| | - Fang Wei
- Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan, PR China
| | | | - Matej Orešič
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku 20520, Finland; School of Medical Sciences, Örebro University, 702 81 Örebro, Sweden.
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Watts JJ, Jacobson MR, Lalang N, Boileau I, Tyndale RF, Kiang M, Ross RA, Houle S, Wilson AA, Rusjan P, Mizrahi R. Imaging Brain Fatty Acid Amide Hydrolase in Untreated Patients With Psychosis. Biol Psychiatry 2020; 88:727-735. [PMID: 32387132 PMCID: PMC8240477 DOI: 10.1016/j.biopsych.2020.03.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 03/01/2020] [Accepted: 03/04/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND The brain's endocannabinoid system, the primary target of cannabis, has been implicated in psychosis. The endocannabinoid anandamide is elevated in cerebrospinal fluid of patients with schizophrenia. Fatty acid amide hydrolase (FAAH) controls brain anandamide levels; however, it is unknown if FAAH is altered in vivo in psychosis or related to positive psychotic symptoms. METHODS Twenty-seven patients with schizophrenia spectrum disorders and 36 healthy control subjects completed high-resolution positron emission tomography scans with the novel FAAH radioligand [11C]CURB and structural magnetic resonance imaging. Data were analyzed using the validated irreversible 2-tissue compartment model with a metabolite-corrected arterial input function. RESULTS FAAH did not differ significantly between patients with psychotic disorders and healthy control subjects (F1,62.85 = 0.48, p = .49). In contrast, lower FAAH predicted greater positive psychotic symptom severity, with the strongest effect observed for the positive symptom dimension, which includes suspiciousness, delusions, unusual thought content, and hallucinations (F1,26.69 = 12.42, p = .002; Cohen's f = 0.42, large effect). Shorter duration of illness (F1,26.95 = 13.78, p = .001; Cohen's f = 0.39, medium to large effect) and duration of untreated psychosis predicted lower FAAH (F1,26.95 = 6.03, p = .021, Cohen's f = 0.27, medium effect). These results were not explained by past cannabis exposure or current intake of antipsychotic medications. FAAH exhibited marked differences across brain regions (F7,112.62 = 175.85, p < 1 × 10-56; Cohen's f > 1). Overall, FAAH was higher in female subjects than in male subjects (F1,62.84 = 10.05, p = .002; Cohen's f = 0.37). CONCLUSIONS This first study of brain FAAH in psychosis indicates that FAAH may represent a biomarker of disease state of potential utility for clinical studies targeting psychotic symptoms or as a novel target for interventions to treat psychotic symptoms.
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Affiliation(s)
- Jeremy J Watts
- Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada,Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Maya R Jacobson
- Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada,Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Nittha Lalang
- Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada,Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Isabelle Boileau
- Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada,Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Rachel F Tyndale
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Michael Kiang
- Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Ruth A Ross
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Sylvain Houle
- Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Alan A Wilson
- Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Pablo Rusjan
- Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada,Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Romina Mizrahi
- Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
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Scherma M, Muntoni AL, Riedel G, Fratta W, Fadda P. Cannabinoids and their therapeutic applications in mental disorders
. DIALOGUES IN CLINICAL NEUROSCIENCE 2020; 22:271-279. [PMID: 33162770 PMCID: PMC7605020 DOI: 10.31887/dcns.2020.22.3/pfadda] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Mental disorders represent a significant public health burden worldwide due to their high prevalence, chronically disabling nature, and substantial impact on quality of life. Despite growing knowledge of the pathological mechanisms that underlie the development of these disorders, a high percentage of patients do not respond to first-line clinical treatments; thus, there is a strong need for alternative therapeutic approaches. During the past half-century, after the identification of the endocannabinoid system and its role in multiple physiological processes, both natural and synthetic cannabinoids have attracted considerable interest as putative medications in pathological conditions such as, but not exclusive to, mental disorders. Here, we provide a summary of cannabinoid effects in support of possible therapeutic applications for major depression, bipolar disorder, anxiety, posttraumatic stress disorder, and schizophrenia. Considering this evidence, highlighted benefits and risks of cannabinoid use in the management of these illnesses require further experimental study.
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Affiliation(s)
- Maria Scherma
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Italy
| | - Anna Lisa Muntoni
- Neuroscience Institute, National Research Council of Italy (CNR), Cagliari, Italy
| | - Gernot Riedel
- Institute of Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen, Scotland, United Kingdom
| | - Walter Fratta
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Italy
| | - Paola Fadda
- Author affiliations: Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Italy; Neuroscience Institute, National Research Council of Italy (CNR), Cagliari, Italy; Institute of Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen, Scotland, United Kingdom (Gernot Riedel); National Neuroscience Institute, Pisa, Italy
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Links between central CB1-receptor availability and peripheral endocannabinoids in patients with first episode psychosis. NPJ SCHIZOPHRENIA 2020; 6:21. [PMID: 32848142 PMCID: PMC7450081 DOI: 10.1038/s41537-020-00110-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 07/07/2020] [Indexed: 01/23/2023]
Abstract
There is an established, link between psychosis and metabolic abnormalities, such as altered glucose metabolism and dyslipidemia, which often precede the initiation of antipsychotic treatment. It is known that obesity-associated metabolic disorders are promoted by activation of specific cannabinoid targets (endocannabinoid system (ECS)). Our recent data suggest that there is a change in the circulating lipidome at the onset of first episode psychosis (FEP). With the aim of characterizing the involvement of the central and peripheral ECSs, and their mutual associations; here, we performed a combined neuroimaging and metabolomic study in patients with FEP and healthy controls (HC). Regional brain cannabinoid receptor type 1 (CB1R) availability was quantified in two, independent samples of patients with FEP (n = 20 and n = 8) and HC (n = 20 and n = 10), by applying three-dimensional positron emission tomography, using two radiotracers, [11C]MePPEP and [18F]FMPEP-d2. Ten endogenous cannabinoids or related metabolites were quantified in serum, drawn from these individuals during the same imaging session. Circulating levels of arachidonic acid and oleoylethanolamide (OEA) were reduced in FEP individuals, but not in those who were predominantly medication free. In HC, there was an inverse association between levels of circulating arachidonoyl glycerol, anandamide, OEA, and palmitoyl ethanolamide, and CB1R availability in the posterior cingulate cortex. This phenomenon was, however, not observed in FEP patients. Our data thus provide evidence of cross talk, and dysregulation between peripheral endocannabinoids and central CB1R availability in FEP.
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Endocannabinoid levels in patients with Parkinson's disease with and without levodopa-induced dyskinesias. J Neural Transm (Vienna) 2020; 127:1359-1367. [PMID: 32797288 DOI: 10.1007/s00702-020-02240-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 08/05/2020] [Indexed: 12/20/2022]
Abstract
Levodopa-induced dyskinesias (LID) in Parkinson's disease (PD) are frequent complications, and the endocannabinoid system has a role on its pathophysiology. To test the hypothesis that the functioning of the endocannabinoid system would be altered in PD and in LID by measuring plasma and CSF levels of α-N-arachidonoylethanolamine (AEA) and 2-arachidonoyl-glycerol (2-AG) in patients with PD with and without LID and in healthy controls. Blood and CSF samples were collected from 20 healthy controls, 23 patients with PD without LID, and 24 patients with PD with LID. The levels of AEA and 2-AG were measured using a highly sensitive column switching ultrahigh-performance liquid chromatography-tandem mass spectrometry method. When pooled together, patients with PD had lower plasma and CSF levels of 2-AG and higher CSF levels of AEA compared to healthy controls (Mann-Whitney statistics = 303.0, p = 0.02). Patients with PD without LID had lower CSF levels of 2-AG (Kruskal-Wallis statistics = 7.76, p = 0.02) and higher CSF levels of AEA levels than healthy controls (Kruskal-Wallis statistics = 8.81, p = 0.01). The findings suggest that the endocannabinoid system participates in the pathophysiology of PD symptoms, but its role in the pathophysiology of LID is still unclear.
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Appiah-Kusi E, Wilson R, Colizzi M, Foglia E, Klamerus E, Caldwell A, Bossong MG, McGuire P, Bhattacharyya S. Childhood trauma and being at-risk for psychosis are associated with higher peripheral endocannabinoids. Psychol Med 2020; 50:1862-1871. [PMID: 31422779 DOI: 10.1017/s0033291719001946] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Evidence has been accumulating regarding alterations in components of the endocannabinoid system in patients with psychosis. Of all the putative risk factors associated with psychosis, being at clinical high-risk for psychosis (CHR) has the strongest association with the onset of psychosis, and exposure to childhood trauma has been linked to an increased risk of development of psychotic disorder. We aimed to investigate whether being at-risk for psychosis and exposure to childhood trauma were associated with altered endocannabinoid levels. METHOD We compared 33 CHR participants with 58 healthy controls (HC) and collected information about previous exposure to childhood trauma as well as plasma samples to analyse endocannabinoid levels. RESULTS Individuals with both CHR and experience of childhood trauma had higher N-palmitoylethanolamine (p < 0.001) and anandamide (p < 0.001) levels in peripheral blood compared to HC and those with no childhood trauma. There was also a significant correlation between N-palmitoylethanolamine levels and symptoms as well as childhood trauma. CONCLUSIONS Our results suggest an association between CHR and/or childhood maltreatment and elevated endocannabinoid levels in peripheral blood, with a greater alteration in those with both CHR status and history of childhood maltreatment compared to those with either of those risks alone. Furthermore, endocannabinoid levels increased linearly with the number of risk factors and elevated endocannabinoid levels correlated with the severity of CHR symptoms and extent of childhood maltreatment. Further studies in larger cohorts, employing longitudinal designs are needed to confirm these findings and delineate the precise role of endocannabinoid alterations in the pathophysiology of psychosis.
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Affiliation(s)
- E Appiah-Kusi
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), Box PO 63, De Crespigny Park, Denmark Hill, LondonSE5 8AF, UK
| | - R Wilson
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), Box PO 63, De Crespigny Park, Denmark Hill, LondonSE5 8AF, UK
| | - M Colizzi
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), Box PO 63, De Crespigny Park, Denmark Hill, LondonSE5 8AF, UK
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Policlinico 'G. B. Rossi', P.le L.A. Scuro 10, 37134, Verona, Italy
| | - E Foglia
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), Box PO 63, De Crespigny Park, Denmark Hill, LondonSE5 8AF, UK
| | - E Klamerus
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), Box PO 63, De Crespigny Park, Denmark Hill, LondonSE5 8AF, UK
| | - A Caldwell
- King's College London, Mass Spectometry Facility, Franklin Wilkins Building, 150 Stamford Street, London, SE1 9NH, UK
| | - M G Bossong
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), Box PO 63, De Crespigny Park, Denmark Hill, LondonSE5 8AF, UK
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - P McGuire
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), Box PO 63, De Crespigny Park, Denmark Hill, LondonSE5 8AF, UK
| | - S Bhattacharyya
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), Box PO 63, De Crespigny Park, Denmark Hill, LondonSE5 8AF, UK
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The Cannabinoid CB 1 Receptor in Schizophrenia. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 6:646-659. [PMID: 33077399 DOI: 10.1016/j.bpsc.2020.06.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/28/2020] [Accepted: 06/25/2020] [Indexed: 02/07/2023]
Abstract
Converging lines of evidence from epidemiological, preclinical, and experimental studies indicate that the endocannabinoid system may be involved in the pathophysiology of schizophrenia and suggest that the cannabinoid CB1 receptor may be a potential therapeutic target. In view of this, we first provide an overview of the endocannabinoid system and systematically review the evidence for CB1 receptor alterations in animal models of schizophrenia and clinical studies in schizophrenia. MEDLINE, EMBASE, PsycArticles, and PsycINFO were systematically searched from inception until January 7, 2020. Of 1187 articles, 24 were included in the systematic review, including 8 preclinical studies measuring the CB1 receptor in the context of an established animal model of schizophrenia and 16 clinical studies investigating the CB1 receptor in schizophrenia. The majority of preclinical studies (6 of 8) have shown that the CB1 receptor is reduced in the context of animal models of schizophrenia. Moreover, the majority of in vivo clinical imaging studies that used arterial blood sampling to quantify the radiotracer kinetics (3 of 4) have shown reduced CB1 receptor availability in schizophrenia. However, mixed findings have been reported in ex vivo literature, including reports of no change in receptor levels (5 of 11), increased receptor levels (4 of 11), and decreased receptor levels (2 of 11). We review methodological reasons for these discrepancies and review how CB1 receptor dysfunction may contribute to the pathophysiology of schizophrenia, drawing on the role of the receptor in regulating synaptic transmission and synaptic plasticity. We also discuss how the CB1 receptor may be a potential therapeutic target.
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Fernández-Ruiz J, Galve-Roperh I, Sagredo O, Guzmán M. Possible therapeutic applications of cannabis in the neuropsychopharmacology field. Eur Neuropsychopharmacol 2020; 36:217-234. [PMID: 32057592 DOI: 10.1016/j.euroneuro.2020.01.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 01/08/2020] [Accepted: 01/22/2020] [Indexed: 12/18/2022]
Abstract
Cannabis use induces a plethora of actions on the CNS via its active chemical ingredients, the so-called phytocannabinoids. These compounds have been frequently associated with the intoxicating properties of cannabis preparations. However, not all phytocannabinoids are psychotropic, and, irrespective of whether they are psychotropic or not, they have also shown numerous therapeutic properties. These properties are mostly associated with their ability to modulate the activity of an intercellular communication system, the so-called endocannabinoid system, which is highly active in the CNS and has been found altered in many neurological disorders. Specifically, this includes the neuropsychopharmacology field, with diseases such as schizophrenia and related psychoses, anxiety-related disorders, mood disorders, addiction, sleep disorders, post-traumatic stress disorder, anorexia nervosa and other feeding-related disorders, dementia, epileptic syndromes, as well as autism, fragile X syndrome and other neurodevelopment-related disorders. Here, we gather, from a pharmacological and biochemical standpoint, the recent advances in the study of the therapeutic relevance of the endocannabinoid system in the CNS, with especial emphasis on the neuropsychopharmacology field. We also illustrate the efforts that are currently being made to investigate at the clinical level the potential therapeutic benefits derived from elevating or inhibiting endocannabinoid signaling in animal models of neuropsychiatric disorders.
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Affiliation(s)
- Javier Fernández-Ruiz
- Instituto Universitario de Investigación en Neuroquímica, Departamento de Bioquímica y Biología Molecular, Universidad Complutense, Ciudad Universitaria s/n, 28040 Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.
| | - Ismael Galve-Roperh
- Instituto Universitario de Investigación en Neuroquímica, Departamento de Bioquímica y Biología Molecular, Universidad Complutense, Ciudad Universitaria s/n, 28040 Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Onintza Sagredo
- Instituto Universitario de Investigación en Neuroquímica, Departamento de Bioquímica y Biología Molecular, Universidad Complutense, Ciudad Universitaria s/n, 28040 Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Manuel Guzmán
- Instituto Universitario de Investigación en Neuroquímica, Departamento de Bioquímica y Biología Molecular, Universidad Complutense, Ciudad Universitaria s/n, 28040 Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.
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Potvin S, Mahrouche L, Assaf R, Chicoine M, Giguère CÉ, Furtos A, Godbout R. Peripheral Endogenous Cannabinoid Levels Are Increased in Schizophrenia Patients Evaluated in a Psychiatric Emergency Setting. Front Psychiatry 2020; 11:628. [PMID: 32695035 PMCID: PMC7338686 DOI: 10.3389/fpsyt.2020.00628] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 06/16/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The endogenous cannabinoid system mediates the psychoactive effects of cannabis in the brain. It has been argued that this system may play a key role in the pathophysiology of schizophrenia. While some studies have consistently shown that the levels of anandamide, an endogenous cannabinoid ligand, are increased in the cerebrospinal fluid of schizophrenia patients, inconsistent results have been observed in studies measuring anandamide levels in the periphery. Here, we sought to determine if the assessment of peripheral anandamide levels in patients evaluated in a psychiatric emergency setting would show robust increases. METHODS One hundred seven patients with a schizophrenia-spectrum disorder from the psychiatric emergency settings of the Institut Universitaire en Santé Mentale de Montréal and 36 healthy volunteers were included in the study. A subsample of thirty patients were assessed at two time points: at the emergency and at their discharge from the hospital. Anxious and depressive symptoms, sleep and substance use were assessed using self-report questionnaires. In addition to anandamide, the levels of oleoylethanolamide (OEA), an anorexigenic fatty-acid ethanolamide, were also measured, since the prevalence of the metabolic syndrome is increased in schizophrenia. Plasma levels of anandamide and OEA were measured using liquid chromatography and mass spectrometry. RESULTS Plasma anandamide and OEA levels were significantly increased in schizophrenia patients, relative to controls (Cohen's d=1.0 and 0.5, respectively). Between-group differences remained significant after controlling for metabolic measures. No differences were observed between schizophrenia patients with and without a comorbid substance use disorder at baseline. Importantly, the levels of both endocannabinoids significantly decreased after discharge from the emergency setting. CONCLUSION The current results add to the growing body of evidence of endocannabinoid alterations in schizophrenia. The strong elevation of plasma anandamide levels in schizophrenia patients assessed in the psychiatric emergency setting suggests that anandamide and OEA area potential biomarkers of the psychological turmoil associated with this context.
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Affiliation(s)
- Stéphane Potvin
- Department of Psychiatry, Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
- Department of Psychiatry, University of Montreal, Montreal, QC, Canada
| | - Louiza Mahrouche
- Department of Chemistry, University of Montreal, Montreal, QC, Canada
| | - Roxane Assaf
- Department of Psychiatry, Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
- Department of Psychiatry, University of Montreal, Montreal, QC, Canada
| | - Marjolaine Chicoine
- Sleep Laboratory and Clinic, CIUSSS du Nord-de-l'Île-de-Montréal, Hôpital en santé mentale Rivière-des-Prairies, Montréal, QC, Canada
| | - Charles-Édouard Giguère
- Department of Psychiatry, Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
| | - Alexandra Furtos
- Department of Chemistry, University of Montreal, Montreal, QC, Canada
| | - Roger Godbout
- Department of Psychiatry, University of Montreal, Montreal, QC, Canada
- Sleep Laboratory and Clinic, CIUSSS du Nord-de-l'Île-de-Montréal, Hôpital en santé mentale Rivière-des-Prairies, Montréal, QC, Canada
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Banaszkiewicz I, Biala G, Kruk-Slomka M. Contribution of CB2 receptors in schizophrenia-related symptoms in various animal models: Short review. Neurosci Biobehav Rev 2020; 114:158-171. [PMID: 32437746 DOI: 10.1016/j.neubiorev.2020.04.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 04/16/2020] [Accepted: 04/20/2020] [Indexed: 12/28/2022]
Abstract
Schizophrenia is a severe and chronic mental disease with a high prevalence and a variety of symptoms. Data from behavioural studies suggest that it is rational to investigate the endocannabinoid system (ECS) and its cannabinoid receptor (CBr) because they seem to underlie susceptibility to schizophrenia, and these findings have pointed to several lines of future research. Currently, most available studies address the role of CBr type 1 in schizophrenia-like responses. Here, we present for the first time, a review that demonstrates the pivotal role of CBr type 2 in the regulation of neurobiological processes underlying cognition, psychosis- and mood-related (anxiety, depression) behaviours, all of which may be included in schizophrenia symptoms. This review is based on available evidence from the PubMed database regarding schizophrenia-like symptoms induced via CB2r modulation in various animal models. The data presented in this manuscript indicate that CB2r could be a promising new key target in the treatment of different central nervous system (CNS) disorders, which manifest as psychosis, mood-related disturbances and/or memory impairment.
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Affiliation(s)
- Izabela Banaszkiewicz
- Department of Pharmacology and Pharmacodynamics, Medical University of Lublin, Chodzki 4a Street, 20-093 Lublin, Poland
| | - Grazyna Biala
- Department of Pharmacology and Pharmacodynamics, Medical University of Lublin, Chodzki 4a Street, 20-093 Lublin, Poland
| | - Marta Kruk-Slomka
- Department of Pharmacology and Pharmacodynamics, Medical University of Lublin, Chodzki 4a Street, 20-093 Lublin, Poland.
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Sami M, Worker A, Colizzi M, Annibale L, Das D, Kelbrick M, Eranti S, Collier T, Onyejiaka C, O'Neill A, Lythgoe D, McGuire P, Williams SCR, Kempton MJ, Bhattacharyya S. Association of cannabis with glutamatergic levels in patients with early psychosis: Evidence for altered volume striatal glutamate relationships in patients with a history of cannabis use in early psychosis. Transl Psychiatry 2020; 10:111. [PMID: 32317625 PMCID: PMC7174331 DOI: 10.1038/s41398-020-0790-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 02/03/2020] [Accepted: 02/17/2020] [Indexed: 01/01/2023] Open
Abstract
The associative striatum, an established substrate in psychosis, receives widespread glutamatergic projections. We sought to see if glutamatergic indices are altered between early psychosis patients with and without a history of cannabis use and characterise the relationship to grey matter. 92 participants were scanned: Early Psychosis with a history of cannabis use (EPC = 29); Early Psychosis with minimal cannabis use (EPMC = 25); Controls with a history of cannabis use (HCC = 16) and Controls with minimal use (HCMC = 22). Whole brain T1 weighted MR images and localised proton MR spectra were acquired from head of caudate, anterior cingulate and hippocampus. We examined relationships in regions with known high cannabinoid 1 receptor (CB1R) expression (grey matter, cortex, hippocampus, amygdala) and low expression (white matter, ventricles, brainstem) to caudate Glutamine+Glutamate (Glx). Patients were well matched in symptoms, function and medication. There was no significant group difference in Glx in any region. In EPC grey matter volume explained 31.9% of the variance of caudate Glx (p = 0.003) and amygdala volume explained 36.9% (p = 0.001) of caudate Glx. There was no significant relationship in EPMC. The EPC vs EPMC interaction was significant (p = 0.042). There was no such relationship in control regions. These results are the first to demonstrate association of grey matter volume and striatal glutamate in the EPC group. This may suggest a history of cannabis use leads to a conformational change in distal CB1 rich grey matter regions to influence striatal glutamatergic levels or that such connectivity predisposes to heavy cannabis use.
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Affiliation(s)
- Musa Sami
- Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK.
- Institute of Mental Health, Nottingham University, Nottingham, UK.
| | - Amanda Worker
- Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
| | - Marco Colizzi
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Luciano Annibale
- Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
| | - Debasis Das
- Leicestershire Partnership NHS Trust, Thurmaston, UK
| | | | | | - Tracy Collier
- Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
| | - Chidimma Onyejiaka
- Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
| | - Aisling O'Neill
- Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
| | - David Lythgoe
- Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
| | - Philip McGuire
- Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
| | - Steve C R Williams
- Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
| | - Matthew J Kempton
- Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
| | - Sagnik Bhattacharyya
- Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
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Seillier A, Martinez AA, Giuffrida A. Differential effects of Δ9-tetrahydrocannabinol dosing on correlates of schizophrenia in the sub-chronic PCP rat model. PLoS One 2020; 15:e0230238. [PMID: 32163506 PMCID: PMC7067407 DOI: 10.1371/journal.pone.0230238] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 02/25/2020] [Indexed: 01/01/2023] Open
Abstract
Social withdrawal in the sub-chronic phencyclidine (PCP) rat model, a behavioral correlate of the negative symptoms of schizophrenia, results from deficits in brain endocannabinoid transmission. As cannabis intake has been shown to affect negatively the course and expression of psychosis, we tested whether the beneficial effects of endocannabinoid-mediated CB1 activation on social withdrawal in PCP-treated rats (5 mg/kg, twice daily for 7 days)also occurred after administration of Δ9-tetrahydrocannabinol (THC; 0.1, 0.3, 1.0 mg/kg, i.p.). In addition, we assessed whether THC affected two correlates of positive symptoms: 1) motor activity induced by d-amphetamine (0.5 mg/kg, i.p.), and 2) dopamine neuron population activity in the ventral tegmental area (VTA). After the motor activity test, the brains from d-amphetamine-treated animals were collected and processed for measurements of endocannabinoids and activation of Akt/GSK3β, two molecular markers involved in the pathophysiology of schizophrenia. In control rats, THC dose-dependently produced social interaction deficits and aberrant VTA dopamine neuron population activity similar to those observed in PCP-treated animals. In PCP-treated rats, only the lowest dose of THC reversed PCP-induced deficits, as well as PCP-induced elevation of the endocannabinoid anandamide (AEA) in the nucleus accumbens. Last, THC activated the Akt/GSK3β pathway dose-dependently in both control and PCP-treated animals. Taken together, these data suggest that only low doses of THC have beneficial effects on behavioral, neurochemical and electrophysiological correlates of schizophrenia symptoms. This observation may shed some light on the controversial hypothesis of marijuana use as self-medication in schizophrenic patients.
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Affiliation(s)
- Alexandre Seillier
- Department of Pharmacology, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States of America
- * E-mail:
| | - Alex A. Martinez
- Department of Pharmacology, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States of America
| | - Andrea Giuffrida
- Department of Pharmacology, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States of America
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Factors Moderating the Association Between Cannabis Use and Psychosis Risk: A Systematic Review. Brain Sci 2020; 10:brainsci10020097. [PMID: 32059350 PMCID: PMC7071602 DOI: 10.3390/brainsci10020097] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 02/07/2020] [Accepted: 02/10/2020] [Indexed: 12/11/2022] Open
Abstract
Increasing evidence indicates a relationship between cannabis use and psychosis risk. Specific factors, such as determinants of cannabis use or the genetic profile of cannabis users, appear to moderate this association. The present systematic review presents a detailed and up-to-date literature overview on factors that influence the relationship between cannabis use and psychosis risk. A systematic search was performed according to the PRISMA guidelines in MEDLINE and Embase, and 56 studies were included. The results show that, in particular, frequent cannabis use, especially daily use, and the consumption of high-potency cannabis are associated with a higher risk of developing psychosis. Moreover, several genotypes moderate the impact of cannabis use on psychosis risk, particularly those involved in the dopamine function, such as AKT1. Finally, cannabis use is associated with an earlier psychosis onset and increased risk of transition in individuals at a clinical high risk of psychosis. These findings indicate that changing cannabis use behavior could be a harm reduction strategy employed to lower the risk of developing psychosis. Future research should aim to further develop specific biomarkers and genetic profiles for psychosis, thereby contributing to the identification of individuals at the highest risk of developing a psychotic disorder.
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Navarrete F, García-Gutiérrez MS, Jurado-Barba R, Rubio G, Gasparyan A, Austrich-Olivares A, Manzanares J. Endocannabinoid System Components as Potential Biomarkers in Psychiatry. Front Psychiatry 2020; 11:315. [PMID: 32395111 PMCID: PMC7197485 DOI: 10.3389/fpsyt.2020.00315] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 03/30/2020] [Indexed: 12/19/2022] Open
Abstract
The high heterogeneity of psychiatric disorders leads to a lack of diagnostic precision. Therefore, the search of biomarkers is a fundamental aspect in psychiatry to reach a more personalized medicine. The endocannabinoid system (ECS) has gained increasing interest due to its involvement in many different functional processes in the brain, including the regulation of emotions, motivation, and cognition. This article reviews the role of the main components of the ECS as biomarkers in certain psychiatric disorders. Studies carried out in rodents evaluating the effects of pharmacological and genetic manipulation of cannabinoid receptors or endocannabinoids (eCBs) degrading enzymes were included. Likewise, the ECS-related alterations occurring at the molecular level in animal models reproducing some behavioral and/or neuropathological aspects of psychiatric disorders were reviewed. Furthermore, clinical studies evaluating gene or protein alterations in post-mortem brain tissue or in vivo blood, plasma, and cerebrospinal fluid (CSF) samples were analyzed. Also, the results from neuroimaging studies using positron emission tomography (PET) or functional magnetic resonance (fMRI) were included. This review shows the close involvement of cannabinoid receptor 1 (CB1r) in stress regulation and the development of mood disorders [anxiety, depression, bipolar disorder (BD)], in post-traumatic stress disorder (PTSD), as well as in the etiopathogenesis of schizophrenia, attention deficit hyperactivity disorder (ADHD), or eating disorders (i.e. anorexia and bulimia nervosa). On the other hand, recent results reveal the potential therapeutic action of the endocannabinoid tone manipulation by inhibition of eCBs degrading enzymes, as well as by the modulation of cannabinoid receptor 2 (CB2r) activity on anxiolytic, antidepressive, or antipsychotic associated effects. Further clinical research studies are needed; however, current evidence suggests that the components of the ECS may become promising biomarkers in psychiatry to improve, at least in part, the diagnosis and pharmacological treatment of psychiatric disorders.
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Affiliation(s)
- Francisco Navarrete
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Alicante, Spain.,Red Temática de Investigación Cooperativa en Salud (RETICS), Red de Trastornos Adictivos, Instituto de Salud Carlos III, MICINN and FEDER, Madrid, Spain
| | - María Salud García-Gutiérrez
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Alicante, Spain.,Red Temática de Investigación Cooperativa en Salud (RETICS), Red de Trastornos Adictivos, Instituto de Salud Carlos III, MICINN and FEDER, Madrid, Spain
| | - Rosa Jurado-Barba
- Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain.,Servicio de Psiquiatría, Hospital Universitario 12 de Octubre, Madrid, Spain.,Departamento de Psicología, Facultad de Educación y Salud, Universidad Camilo José Cela, Madrid, Spain
| | - Gabriel Rubio
- Red Temática de Investigación Cooperativa en Salud (RETICS), Red de Trastornos Adictivos, Instituto de Salud Carlos III, MICINN and FEDER, Madrid, Spain.,Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain.,Servicio de Psiquiatría, Hospital Universitario 12 de Octubre, Madrid, Spain.,Department of Psychiatry, Complutense University of Madrid, Madrid, Spain
| | - Ani Gasparyan
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Alicante, Spain.,Red Temática de Investigación Cooperativa en Salud (RETICS), Red de Trastornos Adictivos, Instituto de Salud Carlos III, MICINN and FEDER, Madrid, Spain
| | | | - Jorge Manzanares
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Alicante, Spain.,Red Temática de Investigación Cooperativa en Salud (RETICS), Red de Trastornos Adictivos, Instituto de Salud Carlos III, MICINN and FEDER, Madrid, Spain
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Determination of anandamide in cerebrospinal fluid samples by disposable pipette extraction and ultra-high performance liquid chromatography tandem mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 2019; 1130-1131:121809. [PMID: 31669634 DOI: 10.1016/j.jchromb.2019.121809] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 09/13/2019] [Accepted: 09/14/2019] [Indexed: 11/21/2022]
Abstract
This work describes the development and validation of an ultra-high performance liquid chromatography tandem mass spectrometry method that uses disposable pipette extraction (DPX-UHPLC-MS/MS) to determine the endocannabinoid anandamide (AEA) in cerebrospinal fluid samples (CSF). The DPX parameters sorption equilibrium time, sample volume, number of draw-eject cycles, washing solvent volume, and elution solvent volume were optimized by design of experiments (DOE) techniques. The simple DPX protocol proposed herein required a reduced amount of CSF sample and organic solvent. The DPX-UHPLC-MS/MS method presented linear range from 0.10 ng mL-1 (LLOQ) to 3.0 ng mL-1, inter- and intra-assay accuracy with EPR values varying from -8.2% to 9.6%, inter- and intra-assay precision with CV values ranging from 1.3% to 14.8% (except for the LLOQ), and no significant matrix effect. The innovative DPX-UHPLC-MS/MS method was successfully applied to determine AEA in CSF samples from Parkinson's disease (PD) patients and should therefore be used in clinical studies.
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Osborne AL, Solowij N, Babic I, Lum JS, Huang XF, Newell KA, Weston-Green K. Cannabidiol improves behavioural and neurochemical deficits in adult female offspring of the maternal immune activation (poly I:C) model of neurodevelopmental disorders. Brain Behav Immun 2019; 81:574-587. [PMID: 31326506 DOI: 10.1016/j.bbi.2019.07.018] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 07/03/2019] [Accepted: 07/15/2019] [Indexed: 11/18/2022] Open
Abstract
Cognitive impairment is a major source of disability in schizophrenia and current antipsychotic drugs (APDs) have minimal efficacy for this symptom domain. Cannabidiol (CBD), the major non-intoxicating component of Cannabis sativa L., exhibits antipsychotic and neuroprotective properties. We recently reported the effects of CBD on cognition in male offspring of a maternal immune activation (polyinosinic-polycytidilic acid (poly I:C)) model relevant to the aetiology of schizophrenia; however, the effects of CBD treatment in females are unknown. Sex differences are observed in the onset of schizophrenia symptoms and response to APD treatment. Furthermore, the endogenous cannabinoid system, a direct target of CBD, is sexually dimorphic in humans and rodents. Therefore, the present work aimed to assess the therapeutic impact of CBD treatment on behaviour and neurochemical signalling markers in female poly I:C offspring. Time-mated pregnant Sprague-Dawley rats (n = 16) were administered poly I:C (4 mg/kg; i.v.) or saline (control) on gestational day 15. From postnatal day 56, female offspring received CBD (10 mg/kg, i.p.) or vehicle treatment for approximately 3 weeks. Following 2 weeks of CBD treatment, offspring underwent behavioural testing, including the novel object recognition, rewarded alternation T-maze and social interaction tests to assess recognition memory, working memory and sociability, respectively. After 3 weeks of CBD treatment, the prefrontal cortex (PFC) and hippocampus (HPC) were collected to assess effects on endocannabinoid, glutamatergic and gamma-aminobutyric acid (GABA) signalling markers. CBD attenuated poly I:C-induced deficits in recognition memory, social interaction and glutamatergic N-methyl-d-aspartate receptor (NMDAR) binding in the PFC of poly I:C offspring. Working memory performance was similar between treatment groups. CBD also increased glutamate decarboxylase 67, the rate-limiting enzyme that converts glutamate to GABA, and parvalbumin protein levels in the HPC. In contrast to the CBD treatment effects observed in poly I:C offspring, CBD administration to control rats reduced social interaction, cannabinoid CB1 receptor and NMDAR binding density in the PFC, suggesting that CBD administration to healthy rats may have negative consequences on social behaviour and brain maturation in adulthood. Overall, the findings of this study support the therapeutic benefits of CBD on recognition memory and sociability in female poly I:C offspring, and provide insight into the neurochemical changes that may underlie the therapeutic benefits of CBD in the poly I:C model.
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Affiliation(s)
- Ashleigh L Osborne
- Neuropharmacology and Molecular Psychiatry Laboratory, School of Medicine, University of Wollongong, Wollongong, NSW 2522, Australia; Centre for Translational Neuroscience, Illawarra Health and Medical Research Institute, Wollongong, NSW 2522, Australia; Molecular Horizons, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Nadia Solowij
- School of Psychology, Faculty of Social Sciences, University of Wollongong, and Illawarra Health and Medical Research Institute, Wollongong, NSW 2522, Australia; Australian Centre for Cannabinoid Clinical and Research Excellence, New Lambton Heights, NSW 2305, Australia
| | - Ilijana Babic
- Neuropharmacology and Molecular Psychiatry Laboratory, School of Medicine, University of Wollongong, Wollongong, NSW 2522, Australia; Centre for Translational Neuroscience, Illawarra Health and Medical Research Institute, Wollongong, NSW 2522, Australia; Molecular Horizons, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW 2522, Australia; Illawarra and Shoalhaven Local Health District, Wollongong, NSW 2500, Australia
| | - Jeremy S Lum
- Neuropharmacology and Molecular Psychiatry Laboratory, School of Medicine, University of Wollongong, Wollongong, NSW 2522, Australia; Centre for Translational Neuroscience, Illawarra Health and Medical Research Institute, Wollongong, NSW 2522, Australia; Molecular Horizons, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Xu-Feng Huang
- Centre for Translational Neuroscience, Illawarra Health and Medical Research Institute, Wollongong, NSW 2522, Australia; Molecular Horizons, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW 2522, Australia; Australian Centre for Cannabinoid Clinical and Research Excellence, New Lambton Heights, NSW 2305, Australia
| | - Kelly A Newell
- Neuropharmacology and Molecular Psychiatry Laboratory, School of Medicine, University of Wollongong, Wollongong, NSW 2522, Australia; Centre for Translational Neuroscience, Illawarra Health and Medical Research Institute, Wollongong, NSW 2522, Australia; Molecular Horizons, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Katrina Weston-Green
- Neuropharmacology and Molecular Psychiatry Laboratory, School of Medicine, University of Wollongong, Wollongong, NSW 2522, Australia; Centre for Translational Neuroscience, Illawarra Health and Medical Research Institute, Wollongong, NSW 2522, Australia; Molecular Horizons, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW 2522, Australia; Australian Centre for Cannabinoid Clinical and Research Excellence, New Lambton Heights, NSW 2305, Australia.
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Borgan F, Laurikainen H, Veronese M, Marques TR, Haaparanta-Solin M, Solin O, Dahoun T, Rogdaki M, Salokangas RKR, Karukivi M, Di Forti M, Turkheimer F, Hietala J, Howes O. In Vivo Availability of Cannabinoid 1 Receptor Levels in Patients With First-Episode Psychosis. JAMA Psychiatry 2019; 76:1074-1084. [PMID: 31268519 PMCID: PMC6613300 DOI: 10.1001/jamapsychiatry.2019.1427] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
IMPORTANCE Experimental and epidemiological studies implicate the cannabinoid 1 receptor (CB1R) in the pathophysiology of psychosis. However, whether CB1R levels are altered in the early stages of psychosis and whether they are linked to cognitive function or symptom severity remain unknown. OBJECTIVE To investigate CB1R availability in first-episode psychosis (FEP) without the confounds of illness chronicity or the use of illicit substances or antipsychotics. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional, case-control study of 2 independent samples included participants receiving psychiatric early intervention services at 2 independent centers in Turku, Finland (study 1) and London, United Kingdom (study 2). Study 1 consisted of 18 volunteers, including 7 patients with affective or nonaffective psychoses taking antipsychotic medication and 11 matched controls; study 2, 40 volunteers, including 20 antipsychotic-naive or antipsychotic-free patients with schizophrenia or schizoaffective disorder and 20 matched controls. Data were collected from January 5, 2015, through September 26, 2018, and analyzed from June 20, 2016, through February 12, 2019. MAIN OUTCOMES AND MEASURES The availability of CB1R was indexed using the distribution volume (VT, in milliliters per cubic centimeter) of 2 CB1R-selective positron emission tomography radiotracers: fluoride 18-labeled FMPEP-d2 (study 1) and carbon 11-labeled MePPEP (study 2). Cognitive function was measured using the Wechsler Digit Symbol Coding Test. Symptom severity was measured using the Brief Psychiatric Rating Scale for study 1 and the Positive and Negative Syndrome Scale for study 2. RESULTS A total of 58 male individuals were included in the analyses (mean [SD] age of controls, 27.16 [5.93] years; mean [SD] age of patients, 26.96 [4.55] years). In study 1, 7 male patients with FEP (mean [SD] age, 26.80 [5.40] years) were compared with 11 matched controls (mean [SD] age, 27.18 [5.86] years); in study 2, 20 male patients with FEP (mean [SD] age, 27.00 [5.06] years) were compared with 20 matched controls (mean [SD] age, 27.15 [6.12] years). In study 1, a significant main effect of group on [18F]FMPEP-d2 VT was found in the anterior cingulate cortex (ACC) (t16 = -4.48; P < .001; Hedges g = 1.2), hippocampus (t16 = -2.98; P = .006; Hedges g = 1.4), striatum (t16 = -4.08; P = .001; Hedges g = 1.9), and thalamus (t16 = -4.67; P < .001; Hedges g = 1.4). In study 2, a significant main effect of group on [11C]MePPEP VT was found in the ACC (Hedges g = 0.8), hippocampus (Hedges g = 0.5), striatum (Hedges g = 0.4), and thalamus (Hedges g = 0.7). In patients, [11C]MePPEP VT in the ACC was positively associated with cognitive functioning (R = 0.60; P = .01), and [11C]MePPEP VT in the hippocampus was inversely associated with Positive and Negative Syndrome Scale total symptom severity (R = -0.50; P = .02). CONCLUSIONS AND RELEVANCE The availability of CB1R was lower in antipsychotic-treated and untreated cohorts relative to matched controls. Exploratory analyses indicated that greater reductions in CB1R levels were associated with greater symptom severity and poorer cognitive functioning in male patients. These findings suggest that CB1R may be a potential target for the treatment of psychotic disorders.
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Affiliation(s)
- Faith Borgan
- Psychosis Studies Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom,MRC London Institute of Medical Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Heikki Laurikainen
- Turku PET (Positron Emission Tomography) Centre, University of Turku and Turku University Hospital, Turku, Finland.,Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Mattia Veronese
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Tiago Reis Marques
- Psychosis Studies Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom,MRC London Institute of Medical Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Merja Haaparanta-Solin
- Turku PET (Positron Emission Tomography) Centre, University of Turku and Turku University Hospital, Turku, Finland
| | - Olof Solin
- Turku PET (Positron Emission Tomography) Centre, University of Turku and Turku University Hospital, Turku, Finland
| | - Tarik Dahoun
- MRC London Institute of Medical Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom,Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, Hammersmith Hospital, London, United Kingdom,Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, United Kingdom
| | - Maria Rogdaki
- MRC London Institute of Medical Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Raimo KR Salokangas
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Max Karukivi
- Department of Psychiatry, Turku University, Satakunta Hospital District, Turku, Finland
| | - Marta Di Forti
- Psychosis Studies Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Federico Turkheimer
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Jarmo Hietala
- Turku PET (Positron Emission Tomography) Centre, University of Turku and Turku University Hospital, Turku, Finland.,Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Oliver Howes
- Psychosis Studies Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom,MRC London Institute of Medical Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom,Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, Hammersmith Hospital, London, United Kingdom
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Minichino A, Senior M, Brondino N, Zhang SH, Godwlewska BR, Burnet PW, Cipriani A, Lennox BR. Measuring Disturbance of the Endocannabinoid System in Psychosis: A Systematic Review and Meta-analysis. JAMA Psychiatry 2019; 76:914-923. [PMID: 31166595 PMCID: PMC6552109 DOI: 10.1001/jamapsychiatry.2019.0970] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
IMPORTANCE The endocannabinoid system (ECS) is a lipid-based endogenous signaling system. Its relevance to psychosis is through the association between cannabis use and the onset and course of illness and through the antipsychotic properties of cannabidiol, a potential ECS enhancer. OBJECTIVE To conduct a systematic review and meta-analysis of the blood and cerebrospinal fluid (CSF) measures of the ECS in psychotic disorders. DATA SOURCES Web of Science and PubMed were searched from inception through June 13, 2018. The articles identified were reviewed, as were citations to previous publications and the reference lists of retrieved articles. STUDY SELECTION Original articles were included that reported blood or CSF measures of ECS activity in patients with psychotic illnesses and in healthy controls. DATA EXTRACTION AND SYNTHESIS PRISMA guidelines, independent extraction by multiple observers, and random-effects meta-analysis were used. Heterogeneity was assessed with the I2 index. Sensitivity analyses tested the robustness of the results. MAIN OUTCOMES AND MEASURES The clinical relevance of ECS modifications in psychotic disorders was investigated by (1) a quantitative synthesis of the differences in blood and CSF markers of the ECS between patients and healthy controls, and (2) a qualitative synthesis of the association of these markers with symptom severity, stage of illness, and response to treatment. RESULTS A total of 18 studies were included. Three individual meta-analyses were performed to identify the differences in ECS markers between people with schizophrenia and healthy controls. Five studies, including 226 patients and 385 controls, reported significantly higher concentrations of anandamide in the CSF of patients than controls (standardized mean difference [SMD], 0.97; 95% CI, 0.67-1.26; P < .001; I2 = 54.8%). In 9 studies, with 344 patients and 411 controls, significantly higher anandamide levels in blood were found in patients, compared with controls (SMD, 0.55; 95% CI, 0.05-1.04; P = .03; I2 = 89.6%). In 3 studies, involving 88 patients and 179 controls, a significantly higher expression of type 1 cannabinoid receptors on peripheral immune cells was reported in patients compared with controls (SMD, 0.57; 95% CI, 0.31-0.84; P < .001; I2 = 0%). Higher ECS tone was found at an early stage of illness in individuals who were antipsychotic naïve or free, and it had an inverse association with symptom severity and was normalized after successful treatment. Moderate to high level of heterogeneity in methods was found between studies. CONCLUSIONS AND RELEVANCE Testing clinically relevant markers of the ECS in the blood and CSF of people with psychotic illness appears possible, and these markers provide useful biomarkers for the psychotic disorder; however, not all studies accounted for important variables, such as cannabis use. TRIAL REGISTRATION PROSPERO identifier: CRD42018099863.
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Affiliation(s)
- Amedeo Minichino
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Morwenna Senior
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Natascia Brondino
- Section of Psychiatry, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Sam H Zhang
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | | | - Philip W.J Burnet
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Andrea Cipriani
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom,Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, United Kingdom
| | - Belinda R. Lennox
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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Magrone T, Jirillo E. Drugs of Abuse Induced-Subversion of the Peripheral Immune Response and Central Glial Activity: Focus on Novel Therapeutic Approaches. Endocr Metab Immune Disord Drug Targets 2019; 19:281-291. [PMID: 30488804 DOI: 10.2174/1871530319666181129104329] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 04/11/2018] [Accepted: 04/12/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Drugs of abuse affect both central nervous system (CNS) and peripheral immune function. Besides the involvement of dopamine and glutamate systems, chronic exposure to drugs of abuse alters immune homeostasis, promoting a pro-inflammatory status. At the same time, impaired peripheral immunity leads to an increased susceptibility to infections in drug abusers. DISCUSSION There is evidence that certain drugs, such as opioids, activate microglial cells and astrocytes which, in turn, provoke central neuroinflammation. Particularly, opioids bind the Toll-like receptor (TLR)-4 with increased expression of nuclear factor kappa-light-chain-enhancer of activated B cells and release of pro-inflammatory cytokines. Peripheral mediators released by immune cells also contribute to aggravate central neuroinflammation. CONCLUSION These are based either on the inhibition of TLR-4 activation by drugs of abuse or on the correction of dopamine and glutamate pathways. Finally, a hypothetic nutraceutical intervention with polyphenols in view of their anti-inflammatory and anti-oxidant properties will be outlined as an adjuvant treatment for drugs of abuse-related disorders.
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Affiliation(s)
- Thea Magrone
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University of Bari, School of Medicine, Bari, Italy
| | - Emilio Jirillo
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University of Bari, School of Medicine, Bari, Italy
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