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Favretto D, Cirnelli A, Pertile R, Stimamiglio R, Cestonaro C, Cuman O, Pagliaro A, Mattiazzi F, Basso C, Galeazzi M. Infant Death due to Cannabis Ingestion. Drug Test Anal 2025. [PMID: 40399755 DOI: 10.1002/dta.3904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2025] [Revised: 04/17/2025] [Accepted: 05/05/2025] [Indexed: 05/23/2025]
Abstract
A child died in the emergency room of a local hospital a few hours after ingesting a substance the color of cork and the consistency of earth. At home, a modest amount of resinous substance was found. At the hospital, the child exhibited alterations in walking, balance, and consciousness. Intubation was needed for the onset of dyspnea, so fentanyl and ketamine were administered during the procedure. A sample of blood was also collected for clinical investigation. During the autopsy, cadaveric samples were collected. Autopsy evaluation revealed multiorgan congestion in the brain, lung, liver, and kidney. Histological investigations were inconclusive. A thorough toxicological investigation was undertaken by immunochemical technique, gas chromatography-mass spectrometry (GC-MS), and liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) on samples of blood, bile, urine, organs, gastric content, and head hair. Toxicological analysis detected cannabinoids, ketamine, norketamine, and fentanyl in blood drawn from the emergency room. Cannabinoids were also observed in postmortem central blood, peripheral blood, urine, bile, brain, lung, and liver samples. Hair analysis showed tetrahydrocannabinol, cannabidiol, cannabinol, methadone and metabolites, cocaine and metabolites, ketamine, morphine, 6-monoacetylmorphine, and fentanyl. Gastric content revealed traces of cannabis products. Acute cannabis intoxication in the context of chronic exposure to numerous drugs has been considered responsible for the death. An increasing number of intoxication cases are being reported worldwide due to the legalization of cannabis. In most cases, these are adults suffering from preexisting conditions, whereas data on younger individuals are still scarce. In this paper, the case of a child who died from acute intoxication due to ingestion of hashish is presented.
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Affiliation(s)
- Donata Favretto
- Legal Medicine and Toxicology, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | | | - Roberto Pertile
- Legal Medicine and Toxicology, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Raffaella Stimamiglio
- Legal Medicine and Toxicology, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Clara Cestonaro
- Legal Medicine and Toxicology, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Oriana Cuman
- Legal Medicine and Toxicology, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Anna Pagliaro
- Legal Medicine and Toxicology, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | | | - Cristina Basso
- Cardiovascular Pathology, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Maddalena Galeazzi
- Legal Medicine and Toxicology, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
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Schiemer C, Summers MJ, Stefanidis KB. Identifying EEG markers related to acute cannabis consumption: A systematic review. Neurosci Biobehav Rev 2025; 172:106092. [PMID: 40057256 DOI: 10.1016/j.neubiorev.2025.106092] [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] [Received: 09/11/2024] [Revised: 02/26/2025] [Accepted: 03/05/2025] [Indexed: 03/16/2025]
Abstract
BACKGROUND/RATIONALE Electroencephalography (EEG) has potential to provide a sensitive measure of the acute neurophysiological response to cannabis administration. As delta-9-tetrahydrocannabinol (THC; the psychoactive constituent of cannabis) can induce transient neurocognitive impairments that differ as a function of tolerance and dose, understanding the neural profile related to intoxication would be of great benefit in the wake of increasing recreational and medicinal use. Accordingly, the present systematic review examined the current research literature related to acute cannabis administration and EEG measures. METHODS Peer-reviewed articles published from 2000 were assessed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies that administered non-synthetic cannabis, containing THC (orally or inhaled) and reported differences in EEG outcomes within the acute time frame (<6 hours post-administration) as compared to baseline or placebo, were eligible for inclusion. RESULTS/DISCUSSION A total of 16 studies were eligible for inclusion, of which 11 reported differences in the amplitude/latency of event-related potentials (ERPs) and 9 reported changes in frequency band power. Of the ERPs, the P3 was identified as a potential indicator of recent cannabis consumption, as demonstrated by decreased P3 amplitude across various doses (generally exhibiting small-to-moderate magnitude effects where effect sizes were reported). Oscillatory activity in the theta frequency band power range (typically 4-7 Hz) was impacted following cannabis administration, with some support for a dose-dependent change in power. The present results highlight the potential utility of some EEG measures as markers of recent cannabis consumption, although great heterogeneity in participant characteristics and reported data limits conclusions from these results. It is also evident that EEG changes in highly tolerant user groups (such as those who use cannabis medicinally), require further exploration.
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Affiliation(s)
- C Schiemer
- MAIC/UniSC Road Safety Research Collaboration, University of the Sunshine Coast, 90 Sippy Downs Dr, Sippy Downs, Queensland 4556, Australia.
| | - M J Summers
- Discipline of Psychology, School of Health, University of the Sunshine Coast, 90 Sippy Downs Dr, Sippy Downs, Queensland 4556, Australia
| | - K B Stefanidis
- MAIC/UniSC Road Safety Research Collaboration, University of the Sunshine Coast, 90 Sippy Downs Dr, Sippy Downs, Queensland 4556, Australia
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Jain T, Patriquin M, Sanches M. Associations between big five personality dimensions and lifetime use of cannabis. Am J Addict 2025; 34:322-326. [PMID: 39555836 DOI: 10.1111/ajad.13668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Revised: 10/12/2024] [Accepted: 11/05/2024] [Indexed: 11/19/2024] Open
Abstract
BACKGROUND AND OBJECTIVES With the rise in cannabis use over the last couple of decades and shifting social views around drug use, the characterization of potential predictors for the development of cannabis use disorder (CUD) may be of high relevance for the implementation of preventive measures toward this condition. We conducted a study with the aim of analyzing possible associations between personality traits and CUD. METHODS Our sample consisted of 1335 inpatients admitted to The Menninger Clinic between September 2016 and December 2021. All participants completed the Big Five Inventory for the characterization of their personalities. The presence of a diagnosis of CUD and other substance use disorders was established through the administration of the Structured Clinical Interview for DSM-5 (SCID-5). Patients with and without a lifetime diagnosis of CUD were compared with regard to their scores in the five personality dimensions. We utilized analysis of covariance for the statistical inference, with age, sex, and use of other substances as covariates. RESULTS Our findings revealed that low conscientiousness, low agreeableness, and high open-mindedness were associated with the presence of CUD. The relationships between CUD and the remaining personality dimensions explored (extraversion and neuroticism) were not statistically significant. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE This study indicates that certain personality dimensions are potential predictors for the risk for developing CUD. An inpatient population was sampled for this study, allowing for the comparison with other community-based studies. These findings have important preventative and treatment implications from a clinical and research standpoint.
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Affiliation(s)
- Tanya Jain
- Wiess School of Natural Sciences, Medical Humanities Program, Rice University, Houston, Texas, USA
- Research Division, The Menninger Clinic, Houston, Texas, USA
| | - Michelle Patriquin
- Research Division, The Menninger Clinic, Houston, Texas, USA
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Marsal Sanches
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, Houston, Texas, USA
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Singh A, Alcali O, Hunsaker AR, Hammer MM. Quantitative and qualitative imaging in marijuana users and smokers. Curr Probl Diagn Radiol 2025:S0363-0188(25)00073-8. [PMID: 40318925 DOI: 10.1067/j.cpradiol.2025.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 04/08/2025] [Accepted: 04/16/2025] [Indexed: 05/07/2025]
Abstract
OBJECTIVE To evaluate the effect of marijuana use compared to cigarette smoking on imaging findings in the lungs. METHODS By searching the electronic medical record, we identified patients who were marijuana users who never smoked; current smokers; and non-marijuana never smokers, who underwent chest CT in our healthcare system in 2019. We generated a random sample of 100 marijuana users as well as 100 each age- and sex-matched controls from the current smoker and never-smoker groups. Patients with extensive airspace disease on CT were excluded. Quantitative CT analysis was performed to measure total lung volume (TLV). A thoracic radiologist reviewed chest CTs in a blinded fashion for the presence of emphysema, centrilobular ground glass opacities, mosaic attenuation, bronchial wall thickening, and coronary calcification. RESULTS Our study included 285 participants, comprising 89 non-smokers, 97 smokers, and 99 marijuana users. Despite propensity score matching, the marijuana user group was slightly younger than the smokers and non-smokers (mean age 59 versus 62 and 64 years, respectively, p = 0.04), with similar sex distribution across all groups. TLV was higher in smokers than marijuana users and non-smokers (p<.01 for both). By visual analysis, 62 % of smokers had emphysema versus 4 % of marijuana users (p<.001). Additionally, centrilobular ground glass opacities were more prevalent in smokers (15 %) than in marijuana users (2 %) (p = 0.0008). No significant difference was noted in the occurrence of mosaic attenuation between smokers and marijuana users. In terms of coronary artery calcification, more smokers had moderate to severe coronary artery calcifications compared to marijuana users (43 % versus 25 %, p = 0.01). CONCLUSION While emphysema and hyperinflation were common in smokers, they were rare in marijuana users.
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Wandji SR, Abshire DA, Davis JE, Tavakoli AS, Pope R. Substance use disorders among African-American men in the rural south: A scoping review. J Ethn Subst Abuse 2025; 24:327-352. [PMID: 37655703 DOI: 10.1080/15332640.2023.2248029] [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: 09/02/2023]
Abstract
African American (AA) men in the rural South may be at high risk for experiencing adverse health outcomes from substance use (SU). We conducted a scoping review to explore the research on SU among rural AA men in the rural South of the United States (US). Ten articles addressed the following thematic areas pertaining to SU: factors associated with SU (n = 6), associations between substance use and health outcomes (n = 2), and the influence of impulsivity on SU (n = 2). Additional research on SU among AA men in the rural South is needed, particularly pertaining to treatment-related considerations.
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Affiliation(s)
| | | | - Jean E Davis
- University of South Carolina, Columbia, South Carolina
| | | | - Robert Pope
- Dominican University of California, San Rafael, California
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Zhao S, Liu S, Gong Y, Ma Z. The effect of cannabinoid type Ⅱ receptor on the excitability of substantia nigra dopaminergic neurons. Front Pharmacol 2025; 16:1522210. [PMID: 40028168 PMCID: PMC11867961 DOI: 10.3389/fphar.2025.1522210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2024] [Accepted: 01/28/2025] [Indexed: 03/05/2025] Open
Abstract
The biological effects of cannabinoids are mainly mediated by two members of the G-protein-coupled-receptor family: cannabinoid type 1 receptor (CB1R) and cannabinoid type 2 receptor (CB2R). Unlike CB1R, CB2R is considered a "peripheral" cannabinoid receptor. However, recent studies have found that CB2R is widely expressed in the central nervous system and is involved in dopamine related behavioral regulation, including dietary behavior, weight regulation, anxiety, and schizophrenia like behavior. Our previous laboratory research demonstrated that activating CB2R on dopaminergic neurons in the ventral tegmental area can regulate addictive behavior in animals by inhibiting neuronal excitability. However, it is currently unclear whether CB2R on dopaminergic neurons in the substantia nigra compacta (SNc) has similar therapeutic potential. Brain patch clamp results have shown that the CB2R agonist JWH133 significantly inhibits the discharge of SNc dopamine neurons in a concentration dependent manner. The pharmacological blocker AM630 of CB2R can reverse this inhibitory effect, indicating that the expression of CB2R in SNc dopaminergic neurons is functional. After treatment with JWH133, the number of induced action potentials decreased, and the peak potential interval time, action potential start time, and potential amplitude after hyperpolarization amplitude all increased. In addition, synaptic current results showed that JWH133 can significantly reduce the frequency of miniature excitatory postsynaptic currents, indicating that activating CB2R to some extent inhibits the release of presynaptic glutamate and indirectly excites postsynaptic neurons.
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Affiliation(s)
- Sha Zhao
- Department of Physiology, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Shunfeng Liu
- Department of Physiology, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Yongxin Gong
- Department of Physiology, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Zegang Ma
- Department of Physiology, School of Basic Medicine, Qingdao University, Qingdao, China
- Institute of Brain Science and Disorders, Qingdao University, Qingdao, China
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Bobitt J, Berryman K, Weaver FM. VA Providers' Perceptions of Cannabis Use Policies in a Legalized and Nonlegalized State. Cannabis Cannabinoid Res 2025; 10:e176-e183. [PMID: 38597903 DOI: 10.1089/can.2023.0276] [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: 04/11/2024] Open
Abstract
Background: Providers in the Department of Veterans Affairs (VA) system are caught between two opposing sets of laws regarding cannabis and cannabidiol (CBD) use by their patients. As VA is a federal agency, it must abide by federal regulations, including that the Food and Drug Administration classifies cannabis as a Schedule 1 drug and therefore cannot recommend or help Veterans obtain it. Meanwhile, 38 states have passed legislation, legalizing medical use of cannabis. Objective: The goal of this project is to examine how VA providers understand state and federal laws, and VA policies about cannabis and CBD use, and to learn more about providers' experiences with patients who use cannabis and CBD within a legalized and nonlegalized state. Materials and Methods: We identified 432 health care providers from two VA facilities in northern Illinois (IL) where medical and recreational cannabis is legal, and two VA facilities in southern Wisconsin (WI) where medical and recreational cannabis is illegal. Participants were invited via e-mail to complete an anonymous online survey, including 31 closed- and open-ended questions about knowledge of state and federal laws and VA policies regarding cannabis and CBD oil, thoughts about the value of cannabis or CBD for treating medical conditions, and behaviors regarding cannabis use by their patients. Results: We received 50 responses (IL N=20, WI N=30). Providers in both states were knowledgeable about cannabis laws in their state but unsure whether they could recommend cannabis. There were more providers who were unclear if they could have a conversation about cannabis with their VA patients in WI compared with IL. Providers were more likely to agree than disagree that cannabis can be beneficial, χ2 (1, 49)=4.74, p=0.030. Providers in both states (81.6%) believe cannabis use is acceptable for end-of-life care, but responses varied for other conditions and symptoms. Discussion: Findings suggest that VA providers could use more guidance on what is allowable within their VA facilities and how state laws affect their practice. Education about safety related to cannabis and other drug interactions would be helpful. There is limited information about possible interactions, warranting future research.
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Affiliation(s)
- Julie Bobitt
- Department of Medicine, Center for Dissemination and Implementation Science, College of Medicine, University of Illinois Chicago, Chicago, Illinois, USA
- Center of Innovation for Complex Chronic Healthcare, Edward J. Hines, Jr. Veterans Affairs Hospital, Hines, Illinois, USA
| | - Kelsey Berryman
- Center of Innovation for Complex Chronic Healthcare, Edward J. Hines, Jr. Veterans Affairs Hospital, Hines, Illinois, USA
- Department of Public Health, Parkinson School of Health Sciences and Public Health, Loyola University, Maywood, Illinois, USA
| | - Frances M Weaver
- Center of Innovation for Complex Chronic Healthcare, Edward J. Hines, Jr. Veterans Affairs Hospital, Hines, Illinois, USA
- Department of Public Health, Parkinson School of Health Sciences and Public Health, Loyola University, Maywood, Illinois, USA
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Teixeira HM. Phytocanabinoids and synthetic cannabinoids: from recreational consumption to potential therapeutic use - a review. FRONTIERS IN TOXICOLOGY 2025; 6:1495547. [PMID: 39936019 PMCID: PMC11810933 DOI: 10.3389/ftox.2024.1495547] [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: 09/12/2024] [Accepted: 12/27/2024] [Indexed: 02/13/2025] Open
Abstract
Cannabinoids are part of the most popular group of illicit substances in the Western world. The word "cannabinoid" refers to any chemical substance, regardless of structure or origin, that binds to the body's cannabinoid receptors and that has effects similar to those produced by the Cannabis plant. Regarding their origin, cannabinoids can be classified into endocannabinoids, phytocannabinoids and synthetic cannabinoids. The behavioral and physiological effects of cannabinoids have received particular attention over the last few decades, including sensations of euphoria, relaxation and loss of concentration, with their repeated use being associated with short and long-term side effects, including respiratory and cardiovascular disorders, cognitive changes, psychoses, schizophrenia and mood disorders. On the other hand, recent investigations have proposed a promising therapeutic potential of cannabinoid-based drugs for a wide range of medical situations, including neurological and psychiatric disorders, among other indications. The growing popularity in the use of cannabinoid-based compounds, both for recreational and therapeutic purposes, has been accompanied by an equally continuous and growing evolution of knowledge regarding their potential harmful and beneficial effects. However, there are several open questions and challenges to be answered, which require more and better investigations. This article's main objectives are: i) to understand the importance of the action of cannabinoids in humans; ii) identify the different types of cannabinoids that exist and understand the differences in their action; iii) distinguish the legislative framework for cannabinoid consumption; iv) identify the possible adverse effects of cannabinoid consumption, as well as their potential benefits; v) know the existing medical-scientific evidence in terms of therapeutic potential, particularly in relation to aspects of safety and efficacy; vi) encourage critical thinking about the recreational consumption and therapeutic use of cannabinoids, based both on currently available evidence and gaps in knowledge.
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Affiliation(s)
- Helena M. Teixeira
- Department of Research, Training and Documentation, National Institute of Legal Medicine and Forensic Sciences, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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Köck P, Badek A, Meyer M, Klaassen AL, Walter M, Kindler J. Cannabinoids for treating psychiatric disorders in youth: a systematic review of randomized controlled trials. Child Adolesc Psychiatry Ment Health 2024; 18:158. [PMID: 39696457 DOI: 10.1186/s13034-024-00846-5] [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] [Received: 08/27/2024] [Accepted: 11/27/2024] [Indexed: 12/20/2024] Open
Abstract
BACKGROUND Cannabinoids have been of increasing interest mainly due to their putative efficacy in a wide array of psychiatric, psychosomatic, and neurological conditions. AIMS This systematic review aims to synthesize results from randomized placebo-controlled trials regarding the efficacy and the dosage of cannabinoids as therapeutics in psychiatric disorders in children, adolescents, and young adults. METHODS All publications up to June 30th, 2024, were included from PubMed and Embase. Eligibility criteria in accordance with the PRISMA-guidelines was applied. RCTs providing pre- and post-treatment parameters on cannabinoid therapies for mental disorders in comparison to controls in an age range from 0 to 25 years were included. Effect sizes were calculated as Hedges' g for primary outcomes, and a multilevel random-effects meta-analysis was conducted to account for dependent outcomes from same study populations. RESULTS We identified 7603 records, of which 8 independent clinical trials (reported in 9 publications) met the pre-established eligibility criteria, comprising 474 unique participants (245 treatment, 229 control). Analysis of 13 primary outcomes (of 7 clinical trials) revealed a modest positive overall effect for symptom improvement or normalization of brain physiology (Hedges' g = 0.308, 95% CI: 0.167, 0.448). Autism spectrum disorder studies showed the most consistent evidence (g = 0.264, 95% CI: 0.107, 0.421), while other conditions showed wider confidence intervals. Age-stratified analysis showed that adult populations (mean age 23.3 years, n = 5 outcomes) demonstrated higher effect sizes (g = 0.463, SD = 0.402) compared to pediatric populations (mean age 11.8 years, n = 8 outcomes; g = 0.318, SD = 0.212). Whole plant preparations (g = 0.328, 95% CI: 0.083, 0.573) and pharmaceutical cannabinoids (g = 0.292, 95% CI: 0.069, 0.515) showed comparable effects. CBD dosages ranged from 17.5 mg to 600 mg per day, with no significant correlation between dosage and effect size (ρ = -0.014, p = 0.963). Mild to moderate side effects were reported, but no serious adverse events. Risk of bias assessment ranged from low (n = 3) to high (n = 5). CONCLUSION While meta-analysis of effect sizes for primary outcomes revealed modest positive effects, particularly for autism spectrum disorders, the current evidence remains insufficient to broadly recommend cannabinoids for treating mental disorders in youth populations. Larger, controlled studies with standardized outcomes are needed to establish definitive clinical recommendations.
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Affiliation(s)
- Patrick Köck
- Department of Psychosomatics and Psychotherapy, Clinic Barmelweid, Barmelweid, Switzerland
| | - Andrzej Badek
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Maximilian Meyer
- Department of Psychiatry, University Clinics of Psychiatry Basel, University of Basel, Basel, Switzerland
| | - Arndt-Lukas Klaassen
- Department of Anesthesiology & Pain Medicine, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | - Marc Walter
- Clinic of Psychiatry and Psychotherapy, Psychiatric Services Aargau, Windisch, Switzerland
| | - Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
- Child and Adolescent Psychiatry, Psychiatry Baselland, Liestal, Switzerland.
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Udomuksorn W, Saowaneepitak N, Dolthammasiri P, Ruanglertboon W, Limsuwanchote S, Wiriyapongsukit S, Tungsukruthai S. Unveiling the impact of water-boiled cannabis on warfarin: A case report of atrial fibrillation patients after cannabis legalization in Thailand. Toxicol Rep 2024; 13:101838. [PMID: 39703766 PMCID: PMC11655687 DOI: 10.1016/j.toxrep.2024.101838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2024] [Revised: 11/19/2024] [Accepted: 11/25/2024] [Indexed: 12/21/2024] Open
Abstract
Warfarin, a commonly prescribed anticoagulant, is utilized to prevent thrombotic issues and requires careful dose adjustment due to its narrow therapeutic range. As warfarin is metabolized by essential drug-metabolizing enzymes (DMEs), it is prone to interactions with a wide range of therapeutic agents, including herbal medicines. In June 2022, Thailand became the first country in Asia to remove cannabis plants from its narcotics control list, allowing individuals to cultivate them for personal use. Consequently, this report aimed to examine the interaction between cannabis and warfarin in Thai patients following the legalization of cannabis from 2021 to 2023. These three case reports elucidated the potential for drug interactions arising from the concurrent use of warfarin and water-boiled cannabis. This process involved placing cannabis flowers into a boiling kettle and subsequently consuming the resulting cannabis-infused water instead of regular drinking water. Our findings revealed that each atrial fibrillation patient had supratherapeutic international normalized ratio (INR) levels ranging from 3.49 to 4.92, with no bleeding complications. Following the cessation of cannabis use, the INR levels decreased and returned to the therapeutic range for warfarin therapy. In summary, the current report indicates that water-boiled cannabis may influence the outcomes of warfarin therapy, as evidenced by the changes in INR levels.
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Affiliation(s)
- Wandee Udomuksorn
- Division of Health and Applied Sciences, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
| | | | | | - Warit Ruanglertboon
- Division of Health and Applied Sciences, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
| | - Supattra Limsuwanchote
- Division of Health and Applied Sciences, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
| | | | - Sucharat Tungsukruthai
- Division of Health and Applied Sciences, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
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Leclerc L, Fakra E, Pignon B, Benyamina A, Gaillard R, Rolland B. Opinions of French psychiatrists on the regulatory status of cannabis: Results from the "PsyCan - Encéphale" national online survey. L'ENCEPHALE 2024; 50:597-602. [PMID: 38311481 DOI: 10.1016/j.encep.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 09/30/2023] [Accepted: 11/02/2023] [Indexed: 02/06/2024]
Abstract
OBJECTIVE To explore the opinions of French psychiatrists toward the legalization of medical or recreational use of cannabis in France. METHODS Psycan was an anonymous Internet survey conducted between September 28, 2021 and March 29, 2022, among subscribers of the Encéphale Online community, i.e., approximately 4000 French psychiatrists. Participants were asked to complete a structured questionnaire, collecting their socio-demographic features, clinical experience, opinions toward cannabis legalization, and perceived impact of cannabis derivatives for psychiatric disorders. Logistic regression models were used to identify factors associated with being for or against cannabis legalization. RESULTS In total, 413 psychiatrists answered the survey, of whom 253 (61.3%) declared being in favour of recreational cannabis, and 349 (84.4%) of medical cannabis. Being in favour of legalization of recreational cannabis was negatively associated with being female (odd ratio [OR]=0.61; 95% confidence interval [CI]=0.41-0.93), and with the frequency of meeting patients with cannabis use disorder (OR=0.60; 95%CI=0.43-0.83). Most respondents were concerned about the development of psychotic disorders. The most frequent pro-legalization arguments were improved prevention, better control of product content, and better protection of youth, respectively. Arguments against legalization were increased societal damages, increased impact on health, including mental health. CONCLUSIONS A majority of French psychiatrists were in favour of the marketing of medical cannabis, and, to a lesser extent, the legalization of recreational cannabis. For recreational cannabis, the proportion of pro-legalization psychiatrists was slightly more elevated than that found in the French general population.
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Affiliation(s)
- Léa Leclerc
- Service universitaire d'addictologie de Lyon (SUAL), hospices civils de Lyon, pavillon K, hôpital Édouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France.
| | - Eric Fakra
- Service de psychiatrie, CHU Saint-Étienne, université Jean-Monnet, Saint-Étienne, France; PSYR2, CRNL, CNRS UMR5292, Inserm U1028, UCBL1, université de Lyon, Bron, France
| | - Baptiste Pignon
- AP-HP, hôpitaux universitaires « H. Mondor », DMU IMPACT, Inserm, IMRB, Translational Neuropsychiatry, Fondation FondaMental, université Paris-Est-Créteil (UPEC), 94010 Créteil, France
| | - Amine Benyamina
- Centre d'enseignement, de recherche et de traitement des addictions, hôpital universitaire Paul-Brousse (AP-HP), université Paris- Saclay, France UR PSYCOMADD, Villejuif, France
| | - Raphaël Gaillard
- Inserm, UMR S894, Paris Cité University and Sorbonne University, Paris, France; Centre hospitalier Sainte-Anne, Paris, France; Centre de psychiatrie et neurosciences, Paris, France
| | - Benjamin Rolland
- Service universitaire d'addictologie de Lyon (SUAL), hospices civils de Lyon, pavillon K, hôpital Édouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France; PSYR2, CRNL, CNRS UMR5292, Inserm U1028, UCBL1, université de Lyon, Bron, France
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Jochen A, Holben D. School Nurse Perspectives of Medical Cannabis Policy in K-12 Schools: An Exploratory Descriptive Study. J Sch Nurs 2024; 40:596-607. [PMID: 36377286 PMCID: PMC11558934 DOI: 10.1177/10598405221136288] [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: 02/17/2024] Open
Abstract
As states legalize medical cannabis, school nurses face increased parent questions about administration at school. Although school nurses frequently collaborate on the development and implementation of medication administration policies, their perceptions of barriers to school-based medical cannabis administration are not well-documented. To explore these perceptions, we surveyed school nurses (n = 379) in sixteen states about their beliefs related to school-based medical cannabis administration policy development. Findings revealed school nurses from states completely legalizing cannabis expressed significantly fewer concerns about the safety, stigma, and federal status of medical cannabis than their peers in more restrictive states. Implications for practice include (a) education of key stakeholders, (b) collaboration with stakeholders to formulate medication administration policy; and (c) development of state-level guidance for school professionals.
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Affiliation(s)
- Alison Jochen
- Ross and Carol Nese College of Nursing, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Diane Holben
- Secondary Education Department, East Stroudsburg University in the Professional, East Stroudsburg University, Pennsylvania, USA
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Chumchuen K, Chongsuvivatwong V. Increased active pulmonary tuberculosis risk from sharing bong of cannabis: a case-control study from Thailand. Front Public Health 2024; 12:1474761. [PMID: 39606083 PMCID: PMC11598918 DOI: 10.3389/fpubh.2024.1474761] [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: 08/02/2024] [Accepted: 10/23/2024] [Indexed: 11/29/2024] Open
Abstract
Introduction Tuberculosis (TB) is a chronic lung disease caused by Mycobacterium tuberculosis. Tobacco smoking and sharing of instruments have been reported to increase TB risk. In 2022, cannabis was legalized in Thailand. To address for the potential increase in cannabis use after legalization and the reported increased TB risk associated with cannabis usage, we aimed to estimate the odds ratio and population-attributable fraction (PAF) of different types of cannabis use. Materials and methods A matched case-control study was conducted in the Songkhla Province of Southern Thailand in 2023. Face-to-face interviews were conducted to collect information on cannabis consumption. Multivariate logistic regression was performed to estimate the odds ratios representing TB risk from the independent variables. PAF was also calculated to compare the public health impacts of the variables. Results Among the 148 TB cases and 117 healthy controls, we observed lower socioeconomic status and higher proportions of tobacco and alcohol use in these cases. Eleven percent of the controls were current cannabis users, while nearly 19% had ever experienced cannabis use. The proportions of ever-used, smoked, and shared cannabis use were significantly higher in these cases. After adjusting for covariates, the best-fit model showed an odds ratio of 4.22 (95% confidence interval: 1.47-12.07) for smoking and sharing a bong of cannabis. No statistical significance was found for the other types of consumption. PAF of smoked and shared bongs of cannabis was 12.16, which was slightly lower than that found in smoking tobacco (12.62). Conclusion Increased numbers of cannabis users, especially shared smokers, may have an impact on TB risk in lower-middle-income countries, where TB is already highly prevalent.
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Akkuzinova K, Inoue K, Toleuov E, Moldagaliyev T, Seksenbayev N, Jamedinova U, Ospanova N, Dyussupov A. Differences in the Rates of Diagnoses of Mental and Behavioral Disorders Due to Psychoactive Substance Use by Sex and Age during Pre-Pandemic and COVID-19 Pandemic Periods in Kazakhstan. Healthcare (Basel) 2024; 12:2012. [PMID: 39451427 PMCID: PMC11506856 DOI: 10.3390/healthcare12202012] [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: 09/21/2024] [Revised: 10/06/2024] [Accepted: 10/08/2024] [Indexed: 10/26/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic had profound impacts worldwide on individuals with mental and behavioral disorders, including disorders due to psychoactive substance use. We investigated how the COVID-19 pandemic affected the trends in these disorders in the Republic of Kazakhstan. METHODS We researched and compared ICD-10 data on mental and behavioral disorders due to substance use in Kazakhstan that were diagnosed in 2018-2019 (pre-pandemic) versus 2020-2021 (the pandemic period). RESULTS The data for the pandemic period were significantly different from those of the pre-pandemic in that (i) 'other stimulant-related disorders (F15)' and 'other psychoactive substance-related disorders (F19)' were increased in the younger age groups, (ii) the risk of 'opioid-related disorders (F11)' was decreased in the 30-year-old group in both males and females, and (iii) the risk of 'alcohol-related disorders (F10)' was increased in the 30-year-old group and decreased in the 20- and 50-year-old groups. In only the males, (iv) the risk of 'other psychoactive substance-related disorders (F19)' was increased in almost all of the age groups, and (v) the risk of 'cannabis-related disorders (F12)' was increased in the ≥50-year-olds. The pre-pandemic and pandemic periods thus involved changes due to COVID-19 in both males and females that were especially notable in males. CONCLUSIONS These results indicate that further measures designed to prevent mental and behavioral disorders due to psychoactive substances are necessary at the primary, secondary, and tertiary levels, and personnel in medicine/nursing, the government, private organizations, and the public need to collaborate to devise such measures.
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Affiliation(s)
- Kamila Akkuzinova
- Board, Semey Medical University, Semey 071400, Kazakhstan; (K.A.); (E.T.); (T.M.); (N.S.); (N.O.)
| | - Ken Inoue
- Research and Education Faculty, Medical Sciences Cluster, Health Service Center, Kochi University, Kochi 780-8520, Japan
| | - Elaman Toleuov
- Board, Semey Medical University, Semey 071400, Kazakhstan; (K.A.); (E.T.); (T.M.); (N.S.); (N.O.)
| | - Timur Moldagaliyev
- Board, Semey Medical University, Semey 071400, Kazakhstan; (K.A.); (E.T.); (T.M.); (N.S.); (N.O.)
| | - Nursultan Seksenbayev
- Board, Semey Medical University, Semey 071400, Kazakhstan; (K.A.); (E.T.); (T.M.); (N.S.); (N.O.)
| | - Ulzhan Jamedinova
- Department of Biostatistics and Epidemiology, Semey Medical University, Semey 071400, Kazakhstan;
| | - Nargul Ospanova
- Board, Semey Medical University, Semey 071400, Kazakhstan; (K.A.); (E.T.); (T.M.); (N.S.); (N.O.)
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Bartkowiak-Wieczorek J, Bienert A, Czora-Poczwardowska K, Kujawski R, Szulc M, Mikołajczak P, Wizner AM, Jamka M, Hołysz M, Wielgus K, Słomski R, Mądry E. Cannabis sativa L. Extract Alleviates Neuropathic Pain and Modulates CB1 and CB2 Receptor Expression in Rat. Biomolecules 2024; 14:1065. [PMID: 39334832 PMCID: PMC11430414 DOI: 10.3390/biom14091065] [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: 07/25/2024] [Revised: 08/22/2024] [Accepted: 08/23/2024] [Indexed: 09/30/2024] Open
Abstract
INTRODUCTION Cannabis sativa L. (CSL) extract has pain-relieving potential due to its cannabinoid content, so the effects of two CSL extracts on alleviating neuropathic pain were investigated in vivo. Methods and groups: Male Wistar rats (n = 130) were divided into groups and received vincristine (0.1 mg/kg) and gabapentin (60 mg/kg) to induce and relieve neuropathic pain or CSL extracts (D and B). The mRNA and protein expression of the cannabinoid receptors type 1 and 2 (CB1R, CB2R) were evaluated in the cerebral cortex, hippocampus, and lymphocytes. Behavioural tests (Tail-Flick and von Frey) were performed on all animals. RESULTS VK-induced neuropathic pain was accompanied by decreased CB1R protein level and CB2R mRNA expression in the cortex. Gabapentin relieved pain and increased CB1R protein levels in the hippocampus compared to the vincristine group. Hippocampus CB1R protein expression increased with the administration of extract D (10 mg/kg, 40 mg/kg) and extract B (7.5 mg/kg, 10 mg/kg) compared to VK group. In the cerebral cortex CSL decreased CB1R protein expression (10 mg/kg, 20 mg/kg, 40 mg/kg of extract B) and mRNA level (5 mg/kg, 7.5 mg/kg of extract B; 20 mg/kg of extract D) compared to the VK-group.CB2R protein expression increased in the hippocampus after treatment with extract B (7.5 mg/kg) compared to the VK-group. In the cerebral cortex extract B (10 mg/kg, 20 mg/kg) increased CB2R protein expression compared to VK-group. CONCLUSION Alterations in cannabinoid receptor expression do not fully account for the observed behavioural changes in rats. Therefore, additional signalling pathways may contribute to the initiation and transmission of neuropathic pain. The Cannabis extracts tested demonstrated antinociceptive effects comparable to gabapentin, highlighting the antinociceptive properties of Cannabis extracts for human use.
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Affiliation(s)
| | - Agnieszka Bienert
- Department of Clinical Pharmacy and Biopharmacy, Poznan University of Medical Sciences, 60-781 Poznan, Poland; (A.B.); (A.-M.W.)
| | - Kamila Czora-Poczwardowska
- Department of Pharmacology, Poznan University of Medical Sciences, 60-806 Poznan, Poland; (K.C.-P.); (R.K.); (M.S.); (P.M.)
| | - Radosław Kujawski
- Department of Pharmacology, Poznan University of Medical Sciences, 60-806 Poznan, Poland; (K.C.-P.); (R.K.); (M.S.); (P.M.)
| | - Michał Szulc
- Department of Pharmacology, Poznan University of Medical Sciences, 60-806 Poznan, Poland; (K.C.-P.); (R.K.); (M.S.); (P.M.)
| | - Przemysław Mikołajczak
- Department of Pharmacology, Poznan University of Medical Sciences, 60-806 Poznan, Poland; (K.C.-P.); (R.K.); (M.S.); (P.M.)
| | - Anna-Maria Wizner
- Department of Clinical Pharmacy and Biopharmacy, Poznan University of Medical Sciences, 60-781 Poznan, Poland; (A.B.); (A.-M.W.)
| | - Małgorzata Jamka
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, 60-572 Poznan, Poland; (M.J.); (K.W.)
| | - Marcin Hołysz
- Department of Biochemistry and Molecular Biology, Poznan University of Medical Sciences, 60-781 Poznan, Poland;
| | - Karolina Wielgus
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, 60-572 Poznan, Poland; (M.J.); (K.W.)
| | - Ryszard Słomski
- Department of Biotechnology, Institute of Natural Fibres and Medicinal Plants National Research Institute, 60-630 Poznan, Poland;
| | - Edyta Mądry
- Physiology Department, Poznan University of Medical Sciences, 60-781 Poznan, Poland;
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Bezuglov E, Achkasov E, Rudiakova E, Shurygin V, Malyakin G, Svistunov D, Butovskiy M, Fedorova A, Kapralova E. The Effect of Cannabidiol on Performance and Post-Load Recovery among Healthy and Physically Active Individuals: A Systematic Review. Nutrients 2024; 16:2840. [PMID: 39275158 PMCID: PMC11397692 DOI: 10.3390/nu16172840] [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] [Received: 07/09/2024] [Revised: 08/18/2024] [Accepted: 08/23/2024] [Indexed: 09/16/2024] Open
Abstract
Athlete performance and post-load recovery can be considered one of the most important and actively discussed topics in professional sport. One substance aimed at improving performance is cannabidiol (CBD), which has been actively gaining popularity with several studies published in recent years. The PubMed, Scopus, and Cochrane Library databases were searched from inception to April 2024 according to PRISMA recommendations to identify studies on the effects of CBD on exercise capacity and post-load recovery. An initial search identified 901 publications, of which seven fully met the inclusion criteria. Current evidence supports a limited beneficial effect of CBD on a number of physiological parameters, such as VO2, mean power, and relative mean power. At the same time, there were limited data on the beneficial effects of CBD on strength parameters (including vertical jump, counter movement jump, one repetition max bench press, and barbell back squat) and post-load recovery. Notably, most of the studies included in the analysis were conducted between 2021 and 2024, indicating a growing interest among researchers in the use of CBD in healthy, physically active individuals. Further studies are needed to assess the safety of different CBD administration protocols in professional athletes.
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Affiliation(s)
- Eduard Bezuglov
- Department of Sports Medicine and Medical Rehabilitation, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, 119991 Moscow, Russia; (E.B.); (E.A.); (E.R.); (V.S.); (G.M.); (D.S.)
- High Performance Sports Laboratory, Sechenov First Moscow State Medical University, 119991 Moscow, Russia
| | - Evgeniy Achkasov
- Department of Sports Medicine and Medical Rehabilitation, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, 119991 Moscow, Russia; (E.B.); (E.A.); (E.R.); (V.S.); (G.M.); (D.S.)
| | - Elizaveta Rudiakova
- Department of Sports Medicine and Medical Rehabilitation, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, 119991 Moscow, Russia; (E.B.); (E.A.); (E.R.); (V.S.); (G.M.); (D.S.)
| | - Vladimir Shurygin
- Department of Sports Medicine and Medical Rehabilitation, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, 119991 Moscow, Russia; (E.B.); (E.A.); (E.R.); (V.S.); (G.M.); (D.S.)
| | - Georgiy Malyakin
- Department of Sports Medicine and Medical Rehabilitation, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, 119991 Moscow, Russia; (E.B.); (E.A.); (E.R.); (V.S.); (G.M.); (D.S.)
- High Performance Sports Laboratory, Sechenov First Moscow State Medical University, 119991 Moscow, Russia
| | - Danila Svistunov
- Department of Sports Medicine and Medical Rehabilitation, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, 119991 Moscow, Russia; (E.B.); (E.A.); (E.R.); (V.S.); (G.M.); (D.S.)
| | - Mikhail Butovskiy
- Department of Rehabilitation and Sports Medicine, Kazan State Medical University of the Ministry of Health of the Russian Federation, 420012 Kazan, Russia;
| | | | - Elizaveta Kapralova
- Department of Sports Medicine and Medical Rehabilitation, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, 119991 Moscow, Russia; (E.B.); (E.A.); (E.R.); (V.S.); (G.M.); (D.S.)
- High Performance Sports Laboratory, Sechenov First Moscow State Medical University, 119991 Moscow, Russia
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Tyrakis P, Agridi C, Kourti M. A Comprehensive Exploration of the Multifaceted Neuroprotective Role of Cannabinoids in Alzheimer's Disease across a Decade of Research. Int J Mol Sci 2024; 25:8630. [PMID: 39201317 PMCID: PMC11354546 DOI: 10.3390/ijms25168630] [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] [Received: 05/20/2024] [Revised: 07/15/2024] [Accepted: 08/05/2024] [Indexed: 09/02/2024] Open
Abstract
Alzheimer's disease (AD), a progressive neurodegenerative disorder, manifests through dysregulation of brain function and subsequent loss of bodily control, attributed to β-amyloid plaque deposition and TAU protein hyperphosphorylation and aggregation, leading to neuronal death. Concurrently, similar cannabinoids to the ones derived from Cannabis sativa are present in the endocannabinoid system, acting through receptors CB1R and CB2R and other related receptors such as Trpv-1 and GPR-55, and are being extensively investigated for AD therapy. Given the limited efficacy and adverse effects of current available treatments, alternative approaches are crucial. Therefore, this review aims to identify effective natural and synthetic cannabinoids and elucidate their beneficial actions for AD treatment. PubMed and Scopus databases were queried (2014-2024) using keywords such as "Alzheimer's disease" and "cannabinoids". The majority of natural (Δ9-THC, CBD, AEA, etc.) and synthetic (JWH-133, WIN55,212-2, CP55-940, etc.) cannabinoids included showed promise in improving memory, cognition, and behavioral symptoms, potentially via pathways involving antioxidant effects of selective CB1R agonists (such as the BDNF/TrkB/Akt pathway) and immunomodulatory effects of selective CB2R agonists (TLR4/NF-κB p65 pathway). Combining anticholinesterase properties with a cannabinoid moiety may enhance therapeutic responses, addressing cholinergic deficits of AD brains. Thus, the positive outcomes of the vast majority of studies discussed support further advancing cannabinoids in clinical trials for AD treatment.
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Affiliation(s)
| | | | - Malamati Kourti
- Department of Life Sciences, School of Sciences, European University Cyprus, Nicosia 1516, Cyprus; (P.T.); (C.A.)
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Floccari S, Sabry R, Choux L, Neal MS, Khokhar JY, Favetta LA. DNA methylation, but not microRNA expression, is affected by in vitro THC exposure in bovine granulosa cells. BMC Pharmacol Toxicol 2024; 25:42. [PMID: 39010179 PMCID: PMC11247865 DOI: 10.1186/s40360-024-00763-5] [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: 08/11/2023] [Accepted: 07/03/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND A global increase in cannabis use has led to questions about its effects on fertility. The rise in consumption amongst women of reproductive age is a growing concern, as this group is vulnerable in terms of reproductive health. Ample evidence suggests that the psychoactive component of cannabis, Δ9-Tetrahydrocannabinol (THC), interacts with the endocannabinoid system (ECS), that helps regulate mammalian reproduction. This study aimed to research the epigenetic effects of THC in bovine granulosa cells (GCs) by (1) investigating global DNA methylation via measuring 5-mC and 5-hmC levels; (2) measuring key methylation regulators, including the methylating enzymes DNMT1, DNMT3a, DNMT3b and the demethylases TDG and TET1/2/3; and (3) assessing fertility-associated miRNAs key in developmental competency, including miR-21, -155, -33b, -324 and -346. METHODS Bovine GCs were used as a translational model for reproductive toxicity in humans. To determine THC effects, GCs were isolated from Cumulus-Oocyte-Complexes (COCs) from bovine ovaries, cultured in vitro for 7 days, or until confluent, and cryopreserved at passage 1 (P1). For experimentation, cells were thawed, cultured until passage 2 (P2), serum restricted for 24-h and treated for 24-h in one of five groups: control, vehicle (1:1:18 ethanol: tween: saline) and three clinically relevant THC doses (0.032, 0.32 and 3.2 μM). Global methylation was assessed by measuring 5-mC and 5-hmC levels with flow cytometry. To assess mRNA and protein expression of methylation regulators and miRNA profiles, qPCR and Western Blotting were utilized. Shapiro-Wilk test was used to determine normality within datasets. One-way ANOVA was applied to determine statistical significance using GraphPad Prism 6.0.0. RESULTS Results indicate a significant decrease (p = 0.0435) in 5-mC levels following low THC exposure, while no changes were observed in 5-hmC levels. A significant increase in DNMT1 following high THC exposure at the RNA level (p < 0.05) and a significant increase following low THC exposure at the protein level (p = 0.0048) were also observed. No significant differences were observed in DNMT3a/3b, TDG, TET1/2/3 mRNAs or in any of the miRNAs analyzed. CONCLUSIONS This research suggests that THC mainly affects DNA methylation, but not miRNA profiles, ultimately altering gene expression and likely impairing oocyte competence, maturation, and fertilization potential.
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Affiliation(s)
- Sabrina Floccari
- Reproductive Health and Biotechnology Lab, Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Reem Sabry
- Reproductive Health and Biotechnology Lab, Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Laurie Choux
- Reproductive Health and Biotechnology Lab, Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Michael S Neal
- ONE Fertility, Burlington, ON, Canada
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON, Canada
| | - Jibran Y Khokhar
- Department of Anatomy and Cell Biology, Western University, London, ON, Canada
| | - Laura A Favetta
- Reproductive Health and Biotechnology Lab, Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada.
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Couch AN, Lanza JM, Zall CM, Davidson JT. Differentiation of Δ 9-THC and CBD Using Silver-Ligand Ion Complexation and Electrospray Ionization Tandem Mass Spectrometry (ESI-MS/MS). JOURNAL OF THE AMERICAN SOCIETY FOR MASS SPECTROMETRY 2024; 35:1413-1421. [PMID: 38804709 DOI: 10.1021/jasms.3c00452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
The 2018 Farm Bill defines marijuana as Cannabis sativa L. or any derivative thereof that contains greater than 0.3% Δ9-tetrahydrocannabinol (Δ9-THC) on a dry weight basis. The main cannabinoids present in Cannabis sativa L., Δ9-THC and cannabidiol (CBD), are structural isomers that cannot be differentiated using direct mass spectrometry with soft ionization techniques alone. Due to the classification of marijuana as a Schedule I controlled substance, the differentiation of Δ9-THC and CBD is crucial within the seized drug community. This study explores the use of Ag-ligand ion complexation and electrospray ionization tandem mass spectrometry (ESI-MS/MS) for the differentiation of Δ9-THC and CBD using six different Ag complexes. Differences between the binding affinities of Δ9-THC and CBD for [Ag(PPh3)(OTf)]2 lead to the formation of unique product ions at m/z 421/423, m/z 353/355, and m/z 231 for CBD, enabling the differentiation of CBD from Δ9-THC. When applied to the analysis of known Δ9-THC:CBD mixture ratios, the developed [Ag(PPh3)(OTf)]2 ion complexation method was able to differentiate Δ9-THC-rich and CBD-rich samples based on the average abundance of the product ions at m/z 421/423. The developed approach was then applied to methanolic extracts of 20 authentic cannabis samples with known Δ9-THC and CBD compositions, resulting in a 95% correct classification rate. Even though the developed Ag-ligand ion complexation method was only demonstrated for the qualitative differentiation of Δ9-THC-rich and CBD-rich cannabis, this study establishes a foundation for the use of Ag-ligand ion complexation that is essential for future quantitative approaches.
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Affiliation(s)
- Alleigh N Couch
- Department of Forensic Science, Sam Houston State University, Huntsville, Texas 77341-2116, United States
| | - Jayleigh M Lanza
- Department of Chemistry, Sam Houston State University, Huntsville, Texas 77341-2116, United States
| | - Christopher M Zall
- Department of Chemistry, Sam Houston State University, Huntsville, Texas 77341-2116, United States
| | - J Tyler Davidson
- Department of Forensic Science, Sam Houston State University, Huntsville, Texas 77341-2116, United States
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Nahar L, Chaiwut P, Sangthong S, Theansungnoen T, Sarker SD. Progress in the analysis of phytocannabinoids by HPLC and UPLC (or UHPLC) during 2020-2023. PHYTOCHEMICAL ANALYSIS : PCA 2024; 35:927-989. [PMID: 38837522 DOI: 10.1002/pca.3374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 04/22/2024] [Accepted: 04/22/2024] [Indexed: 06/07/2024]
Abstract
INTRODUCTION Organic molecules that bind to cannabinoid receptors are known as cannabinoids. These molecules possess pharmacological properties similar to those produced by Cannabis sativa L. High-performance liquid chromatography (HPLC) and ultra-performance liquid chromatography (UPLC, also known as ultra-high-performance liquid chromatography, UHPLC) have become the most widely used analytical tools for detection and quantification of phytocannabinoids in various matrices. HPLC and UPLC (or UHPLC) are usually coupled to an ultraviolet (UV), photodiode array (PDA), or mass spectrometric (MS) detector. OBJECTIVE To critically appraise the literature on the application of HPLC and UPLC (or UHPLC) methods for the analysis of phytocannabinoids published from January 2020 to December 2023. METHODOLOGY An extensive literature search was conducted using Web of Science, PubMed, and Google Scholar and published materials including relevant books. In various combinations, using cannabinoid in all combinations, cannabis, hemp, hashish, C. sativa, marijuana, analysis, HPLC, UHPLC, UPLC, and quantitative, qualitative, and quality control were used as the keywords for the literature search. RESULTS Several HPLC- and UPLC (or UHPLC)-based methods for the analysis of phytocannabinoids were reported. While simple HPLC-UV or HPLC-PDA-based methods were common, the use of HPLC-MS, HPLC-MS/MS, UPLC (or UHPLC)-PDA, UPLC (or UHPLC)-MS, and UPLC (or UHPLC)-MS/MS was also reported. Applications of mathematical and computational models for optimization of protocols were noted. Pre-analyses included various environmentally friendly extraction protocols. CONCLUSION During the last 4 years, HPLC and UPLC (or UHPLC) remained the main analytical tools for phytocannabinoid analysis in different matrices.
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Affiliation(s)
- Lutfun Nahar
- Laboratory of Growth Regulators, Palacký University and Institute of Experimental Botany, The Czech Academy of Sciences, Olomouc, Czech Republic
| | - Phanuphong Chaiwut
- Green Cosmetic Technology Research Group, School of Cosmetic Science, Mae Fah Luang University, Chiang Rai, Thailand
| | - Sarita Sangthong
- Green Cosmetic Technology Research Group, School of Cosmetic Science, Mae Fah Luang University, Chiang Rai, Thailand
| | - Tinnakorn Theansungnoen
- Green Cosmetic Technology Research Group, School of Cosmetic Science, Mae Fah Luang University, Chiang Rai, Thailand
| | - Satyajit D Sarker
- Centre for Natural Products Discovery, School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, UK
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da Costa-Oliveira C, Pereira ML, de Carvalho NF, Silvério LAL, Jessé Ramos Y, Mazzola PG. Exploring the Significance of Pharmaceutical Care in Mental Health: A Spotlight on Cannabis. PHARMACY 2024; 12:100. [PMID: 39051384 PMCID: PMC11270281 DOI: 10.3390/pharmacy12040100] [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: 04/04/2024] [Revised: 06/06/2024] [Accepted: 06/12/2024] [Indexed: 07/27/2024] Open
Abstract
Although preliminary evidence suggests Cannabis's efficacy in symptom control for anxiety and depression-psychiatric disorders that significantly impact mental health-much remains to be understood about its effects on the central nervous system (CNS) and how to optimize treatment for these disorders. This study aims to conduct a narrative review to evaluate pharmaceutical care in treating symptoms of anxiety and depression alongside Cannabis use, focusing on safety and therapeutic efficacy optimization. We seek to conceptualize anxiety and depression disorders, review evidence on Cannabis use, evaluate the evidence quality, and identify knowledge gaps. Twelve articles were identified, revealing a significant gap in the literature regarding the integration of pharmaceutical care with Cannabis-based therapies, specifically for anxiety and depression. Despite a growing interest in the relationship between Cannabis and mental health, current research is insufficient for a comprehensive understanding. The relationship between Cannabis use and anxiety and depression disorders requires further, more targeted investigations. This study underscores the importance of future research to fill existing gaps, providing informed insights and robust guidelines for the safe and effective use of Cannabis as part of the treatment for anxiety and depression. It is crucial that pharmaceutical care integrates these therapies responsibly to improve the overall well-being of patients.
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Affiliation(s)
- Claudete da Costa-Oliveira
- Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas 13083-887, Brazil
- APEPI—Medicinal Cannabis Research and Patient Support Association, Rio de Janeiro 20040-030, Brazil
| | - Michele Lafayette Pereira
- Faculdade de Ciências Biológicas e Saúde, Universidade do Estado do Rio de Janeiro, Campus Zona Oeste, Rio de Janeiro 23070-200, Brazil
| | - Nicole Ferrari de Carvalho
- Faculdade de Ciências Farmacêuticas, Universidade Estadual de Campinas, Campinas 13083-871, Brazil; (N.F.d.C.); (L.A.L.S.); (P.G.M.)
| | - Luiza Aparecida Luna Silvério
- Faculdade de Ciências Farmacêuticas, Universidade Estadual de Campinas, Campinas 13083-871, Brazil; (N.F.d.C.); (L.A.L.S.); (P.G.M.)
| | - Ygor Jessé Ramos
- Farmácia da Terra Laboratory, Faculty of Pharmacy, Federal University of Bahia, Salvador 40170-115, Brazil;
| | - Priscila Gava Mazzola
- Faculdade de Ciências Farmacêuticas, Universidade Estadual de Campinas, Campinas 13083-871, Brazil; (N.F.d.C.); (L.A.L.S.); (P.G.M.)
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Thetsane RM. Envisaging challenges for the emerging medicinal Cannabis sector in Lesotho. J Cannabis Res 2024; 6:23. [PMID: 38755701 PMCID: PMC11097424 DOI: 10.1186/s42238-024-00229-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 03/25/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Cultivation of Cannabis and its use for medical purposes has existed for millennia on the African continent. The plant has also been widely consumed in the African continent since time immemorial. In particular, Lesotho has been largely growing Cannabis since approximately the 1550s and was illegally grown and unlawfully used for both medicinal and recreational purposes. It was only in 2017 when Lesotho started licensing Cannabis companies and regulating cultivation of Cannabis for medicinal purposes. However, the Lesotho Cannabis industry seems to have excluded the Small, Medium and Micro Enterprises (SMMEs) in the legalisation of Cannabis, the sector has the potential for small Cannabis enterprises in Lesotho. OBJECTIVE This study attempts to examine challenges facing the evolving Cannabis sector in Lesotho as envisaged by Cannabis company managers with the aim of being proactive while addressing such challenges. METHODS The qualitative descriptive method was employed using both primary and secondary data. For the selection of the three Cannabis managers exponential non-discriminative snowball sampling was adopted and interviews with the managers were recorded and transcribed verbatim. Thematic analysis was used to analyse the descriptive explanations of the Cannabis managers to determine the themes that were further consolidated into categories. RESULTS The implementation and compliance with the laws in the Lesotho medicinal Cannabis sector has proved very challenging, with long timeframes for finalising regulatory frameworks and not being applied objectively. The industry does not provide opportunities for Small, Medium and Micro Enterprises (SMMEs) to venture into the Cannabis business. CONCLUSION In Lesotho, the Cannabis sector appears to be faced with many challenges emanating from the implementation and enforcement of Cannabis laws. The Lesotho Government should review its Cannabis laws and regulations with a view to benefiting SMMEs and legalising Cannabis production so as to serve both the domestic and international markets.
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Affiliation(s)
- Regina M Thetsane
- Department of Business Administration, National University of Lesotho, BTM - Building. Office Number BTM 201 P.0. Roma. 180, Maseru, Lesotho.
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Puri S, Ong C, Chiu YF, Lebowitz J, Sideris A, Gonzalez Della Valle A, Chalmers BP. Preoperative Cannabis Use Did Not Increase Opioid Utilization After Primary Total Knee Arthroplasty in a Propensity Score-Matched Model. HSS J 2024; 20:268-273. [PMID: 39281986 PMCID: PMC11393616 DOI: 10.1177/15563316221151158] [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] [Received: 08/17/2022] [Accepted: 10/14/2022] [Indexed: 09/18/2024]
Abstract
Background: Recreational and medicinal cannabis use is becoming increasingly popular, but there are little data on its effect on postoperative pain and opioid consumption after primary total knee arthroplasty (TKA). Purpose: We sought to evaluate the relationship between self-reported preoperative cannabis use and postoperative opioid consumption and post-discharge opioid prescriptions following elective primary TKA. Methods: We identified all patients who underwent unilateral, primary TKA for a diagnosis of osteoarthritis at a single institution between February 1, 2019, and April 30, 2021, and subdivided them into current cannabis users and non-users based on self-reported data. Regular users were propensity score-matched 1:6 with non-users using logistic regression on age, sex, body mass index (BMI), history of chronic pain, smoking status, history of anxiety/depression, American Society of Anesthesiology (ASA) classification, and type of anesthesia. Outcomes of interest included median inpatient (total, daily, and hourly) morphine milligram equivalents (MMEs), discharge MMEs, and outpatient MMEs within 90 days after surgery. Results: A cohort of 70 current cannabis users was matched with 420 non-users. There were no significant differences in opioid use in inpatient MMEs (hourly, daily, or total), discharge MMEs, or outpatient MMEs between cohorts. Also, there was no significant difference in hospital stay between cohorts. Conclusion: In this retrospective propensity score-matched model, preoperative cannabis use did not independently increase opioid use post-TKA in the inpatient or outpatient setting when compared with non-use. More rigorous, prospective study is warranted.
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Affiliation(s)
- Simarjeet Puri
- Adult Reconstruction and Joint Replacement, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Christian Ong
- Adult Reconstruction and Joint Replacement, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Yu-fen Chiu
- Biostatistics Core, Research Administration, Hospital for Special Surgery, New York, NY, USA
| | - Juliana Lebowitz
- Operational Excellence, Hospital for Special Surgery, New York, NY, USA
| | - Alexandra Sideris
- Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA
| | - Alejandro Gonzalez Della Valle
- Adult Reconstruction and Joint Replacement, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Brian P. Chalmers
- Adult Reconstruction and Joint Replacement, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
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Hossein-Javaheri N, O’Connor K, Steinhart H, Deshpande A, Maxwell C, Huang V, Tandon P. Perceptions and Prevalence of Cannabis Use in Women With Inflammatory Bowel Disease of Reproductive Age: A Cross-Sectional Study. J Can Assoc Gastroenterol 2024; 7:204-211. [PMID: 38596807 PMCID: PMC10999762 DOI: 10.1093/jcag/gwad049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/11/2024] Open
Abstract
Background Many patients with inflammatory bowel disease (IBD) may use cannabis for relief of symptoms. During pregnancy, however, cannabis exposure may be associated with adverse pregnancy outcomes. We aimed to determine the prevalence and perceptions of cannabis use in women with IBD. Methods Through recruitment at Mount Sinai Hospital and online platforms such as Twitter, women with IBD (age 18-45) were asked to complete anonymous surveys on demographics, cannabis use, perception of use during pregnancy, and discussing its use with healthcare providers (HCP). Categorical variables were reported as frequencies and compared across groups with the chi-square test. Results One-hundred and two pregnant patients with IBD were included in this study, 19 (18.6%) reported using cannabis. Current users were more likely to report constant pain in the last 12 months and discuss its use with their HCP. Fifty-three (52.0%) women were unsure of the specific risks associated with cannabis use during pregnancy, and only 15 (14.7%) had ever discussed its use with their HCP. Those who had discussed cannabis use with their HCP were more likely to have prior IBD-related surgery, perceive its use unsafe during pregnancy, and be more likely to be using cannabis. Conclusion Many women with IBD report uncertainty of the risks of cannabis use during pregnancy and the majority have never discussed cannabis use with their providers. With the increasing legalization of cannabis in many jurisdictions, it is imperative patients and healthcare providers discuss the risks and benefits of its use, particularly during vulnerable times such as pregnancy.
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Affiliation(s)
- Nariman Hossein-Javaheri
- Department of Internal Medicine, University at Buffalo-State University of New York, Buffalo, New York, USA
| | - Katie O’Connor
- Division of Gastroenterology and Hepatology, University Health Network/Mount Sinai Hospital, University of Toronto, Toronto, Ontario, M5G 1X5Canada
| | - Hillary Steinhart
- Division of Gastroenterology and Hepatology, University Health Network/Mount Sinai Hospital, University of Toronto, Toronto, Ontario, M5G 1X5Canada
| | - Amol Deshpande
- Department of Family and Community Medicine, Toronto Rehabilitation Institute, Quality and Innovation, University of Toronto, Ontario, Canada
| | - Cynthia Maxwell
- Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Ontario, Canada
| | - Vivian Huang
- Division of Gastroenterology and Hepatology, University Health Network/Mount Sinai Hospital, University of Toronto, Toronto, Ontario, M5G 1X5Canada
| | - Parul Tandon
- Division of Gastroenterology and Hepatology, University Health Network/Mount Sinai Hospital, University of Toronto, Toronto, Ontario, M5G 1X5Canada
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Torabi A, Madsen FB, Skov AL. Permeation-Enhancing Strategies for Transdermal Delivery of Cannabinoids. Cannabis Cannabinoid Res 2024; 9:449-463. [PMID: 37751171 DOI: 10.1089/can.2023.0130] [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: 09/27/2023] Open
Abstract
Introduction: This review aims to provide an overview of the advancements and status of clinical studies and potential permeation-enhancing strategies in the transdermal delivery of cannabinoids. Methods: A systematic and comprehensive literature search across academic databases, search engines, and online sources to identify relevant literature on the transdermal administration of cannabinoids. Results: Cannabinoids have proven beneficial in the treatment of wide-ranging physical and psychological disorders. A shift toward legalized cannabinoid products has increased both interests in cannabinoid research and the development of novel medicinal exploitations of cannabinoids in recent years. Oral and pulmonary delivery of cannabinoids has several limitations, including poor bioavailability, low solubility, and potential side effects. This has diverted scientific attention toward the transdermal route, successfully overcoming these hurdles by providing higher bioavailability, safety, and patient compliance. Yet, due to the barrier properties of the skin and the lipophilic nature of cannabinoids, there is a need to increase the permeation of the drugs to the underneath layers of skin to reach desired therapeutic plasma levels. Literature describing detailed clinical trials on cannabinoid transdermal delivery, either with or without permeation-enhancing strategies, is limited. Conclusion: The limited number of reports indicates that increased attention is needed on developing and examining efficient transdermal delivery systems for cannabinoids, including patch design and composition, drug-patch interaction, clinical effectiveness and safety in vivo, and permeation-enhancing strategies.
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Affiliation(s)
- Atefeh Torabi
- Danish Polymer Centre, Department of Chemical and Biochemical Engineering, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Frederikke Bahrt Madsen
- Danish Polymer Centre, Department of Chemical and Biochemical Engineering, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Anne Ladegaard Skov
- Danish Polymer Centre, Department of Chemical and Biochemical Engineering, Technical University of Denmark, Kgs. Lyngby, Denmark
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Qian L, Beers JL, Jackson KD, Zhou Z. CBD and THC in Special Populations: Pharmacokinetics and Drug-Drug Interactions. Pharmaceutics 2024; 16:484. [PMID: 38675145 PMCID: PMC11054161 DOI: 10.3390/pharmaceutics16040484] [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: 02/18/2024] [Revised: 03/13/2024] [Accepted: 03/25/2024] [Indexed: 04/28/2024] Open
Abstract
Cannabinoid use has surged in the past decade, with a growing interest in expanding cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC) applications into special populations. Consequently, the increased use of CBD and THC raises the risk of drug-drug interactions (DDIs). Nevertheless, DDIs for cannabinoids, especially in special populations, remain inadequately investigated. While some clinical trials have explored DDIs between therapeutic drugs like antiepileptic drugs and CBD/THC, more potential interactions remain to be examined. This review summarizes the published studies on CBD and THC-drug interactions, outlines the mechanisms involved, discusses the physiological considerations in pharmacokinetics (PK) and DDI studies in special populations (including pregnant and lactating women, pediatrics, older adults, patients with hepatic or renal impairments, and others), and presents modeling approaches that can describe the DDIs associated with CBD and THC in special populations. The PK of CBD and THC in special populations remain poorly characterized, with limited studies investigating DDIs involving CBD/THC in these populations. Therefore, it is critical to evaluate potential DDIs between CBD/THC and medications that are commonly used in special populations. Modeling approaches can aid in understanding these interactions.
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Affiliation(s)
- Lixuan Qian
- Department of Chemistry, York College, City University of New York, Jamaica, NY 11451, USA;
| | - Jessica L. Beers
- Division of Pharmacotherapy and Experimental Therapeutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA (K.D.J.)
| | - Klarissa D. Jackson
- Division of Pharmacotherapy and Experimental Therapeutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA (K.D.J.)
| | - Zhu Zhou
- Department of Chemistry, York College, City University of New York, Jamaica, NY 11451, USA;
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Lee S, Lee Y, Kim Y, Kim H, Rhyu H, Yoon K, Lee CD, Lee S. Beneficial effects of cannabidiol from Cannabis. APPLIED BIOLOGICAL CHEMISTRY 2024; 67:32. [DOI: 10.1186/s13765-024-00867-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 01/26/2024] [Indexed: 01/05/2025]
Abstract
AbstractCannabis, traditionally used for recreation due to psychoactive compounds in its leaves, flowers, and seeds, has not been thoroughly explored for potential therapeutic benefits. Δ9-trans-Tetrahydrocannabinol, a key cannabinoid in cannabis, causes hallucinogenic effects and delirium symptoms. In contrast, cannabidiol (CBD) does not induce hallucinations and has shown effectiveness in treating symptoms of various rare, incurable diseases. Cannabis exhibits neuroprotective, anti-inflammatory, anti-thrombotic, anti-bacterial, analgesic, and antiepileptic properties, recently attracting more attention. This review aims to summarize comprehensively the impact of cannabis on human health, focusing on endocannabinoids and their receptors. It also delves into recent CBD research advancements, highlighting the compound’s potential medical applications. Overall, this paper provides valuable insights into the prospective development of medical cannabis, with a particular emphasis on CBD.
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28
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Lo BD, Chen SY, Stem M, Papanikolaou A, Gabre-Kidan A, Safar B, Efron JE, Atallah C. Prevalence of cannabis use disorder and perioperative outcomes in adult colectomy patients: A propensity score-matched analysis. World J Surg 2024; 48:701-712. [PMID: 38342773 DOI: 10.1002/wjs.12085] [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] [Received: 12/06/2023] [Accepted: 01/06/2024] [Indexed: 02/13/2024]
Abstract
BACKGROUND The decriminalization of cannabis across the United States has led to an increased number of patients reporting cannabis use prior to surgery. However, it is unknown whether preoperative cannabis use disorder (CUD) increases the risk of postoperative complications among adult colectomy patients. METHODS Adult patients undergoing an elective colectomy were retrospectively analyzed from the National Inpatient Sample database (2004-2018). To control for potential confounders, patients with CUD, defined using ICD-9/10 codes, were propensity score matched to patients without CUD in a 1:1 ratio. The association between preoperative CUD and composite morbidity, the primary outcome of interest, was assessed. Subgroup analyses were performed after stratification by age (≥50 years). RESULTS Among 432,018 adult colectomy patients, 816 (0.19%) reported preoperative CUD. The prevalence of CUD increased nearly three-fold during the study period from 0.8/1000 patients in 2004 to 2.0/1000 patients in 2018 (P-trend<0.001). After propensity score matching, patients with CUD exhibited similar rates of composite morbidity (140 of 816; 17.2%) as those without CUD (151 of 816; 18.5%) (p = 0.477). Patients with CUD also had similar anastomotic leak rates (CUD: 5.64% vs. No CUD: 6.25%; p = 0.601), hospital lengths of stay (CUD: 5 days, IQR 4-7 vs. No CUD: 5 days, IQR 4-7) (p = 0.415), and hospital charges as those without CUD. Similar findings were seen among patients aged ≥50 years in the subgroup analysis. CONCLUSIONS Though the prevalence of CUD has increased drastically over the past 15 years, preoperative CUD was not associated with an increased risk of composite morbidity among adult patients undergoing an elective colectomy.
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Affiliation(s)
- Brian D Lo
- Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Sophia Y Chen
- Colorectal Research Unit, Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Miloslawa Stem
- Colorectal Research Unit, Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Angelos Papanikolaou
- Colorectal Research Unit, Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Alodia Gabre-Kidan
- Colorectal Research Unit, Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Bashar Safar
- Division of Colon and Rectal Surgery, Department of Surgery, NYU Grossman School of Medicine, New York City, New York, USA
| | - Jonathan E Efron
- Colorectal Research Unit, Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Chady Atallah
- Division of Colon and Rectal Surgery, Department of Surgery, NYU Grossman School of Medicine, New York City, New York, USA
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Kale R, Chaturvedi D, Dandekar P, Jain R. Analytical techniques for screening of cannabis and derivatives from human hair specimens. ANALYTICAL METHODS : ADVANCING METHODS AND APPLICATIONS 2024; 16:1133-1149. [PMID: 38314866 DOI: 10.1039/d3ay00786c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
Cannabis and associated substances are some of the most frequently abused drugs across the globe, mainly due to their anxiolytic and euphorigenic properties. Nowadays, the analysis of hair samples has been given high importance in forensic and analytical sciences and in clinical studies because they are associated with a low risk of infection, do not require complicated storage conditions, and offer a broad window of non-invasive detection. Analysis of hair samples is very easy compared to the analysis of blood, urine, and saliva samples. This review places particular emphasis on methodologies of analyzing hair samples containing cannabis, with a special focus on the preparation of samples for analysis, which involves screening and extraction techniques, followed by confirmatory assays. Through this manuscript, we have presented an overview of the available literature on the screening of cannabis using mass spectroscopy techniques. We have presented a detailed overview of the advantages and disadvantages of this technique, to establish it as a suitable method for the analysis of cannabis from hair samples.
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Affiliation(s)
- Rohit Kale
- Department of Biological Sciences and Biotechnology, Institute of Chemical Technology, Mumbai 400019, India.
| | - Deepa Chaturvedi
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, Mumbai 400019, India.
| | - Prajakta Dandekar
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, Mumbai 400019, India.
| | - Ratnesh Jain
- Department of Biological Sciences and Biotechnology, Institute of Chemical Technology, Mumbai 400019, India.
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Malík M, Doskočil I, Pavlík J, Ulman M, Praus L, Kouřimský P, Lampová B, Kuklina A, Tlustoš P. Selective Cytotoxicity of Medical Cannabis ( Cannabis sativa L.) Extracts Across the Whole Vegetation Cycle Under Various Hydroponic and Nutritional Treatments. Cannabis Cannabinoid Res 2024; 9:409-420. [PMID: 36459627 DOI: 10.1089/can.2022.0243] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Introduction: The use of Cannabis sativa L. in health care requires stringent care for the optimal production of the bioactive compounds. However, plant phenotypes and the content of secondary metabolites, such as phytocannabinoids, are strongly influenced by external factors, such as nutrient availability. It has been shown that phytocannabinoids can exhibit selective cytotoxicity against various cancer cell lines while protecting healthy tissue from apoptosis. Research Aim: This study aimed to clarify the cytotoxic effect of cannabis extracts on colorectal cell lines by identifying the main active compounds and determining their abundance and activity across all developmental stages of medical cannabis plants cultivated under hydroponic conditions. Materials and Methods: Dimethyl sulfoxide extracts of medical cannabis plants bearing the genotype classified as chemotype I were analyzed by high-performance liquid chromatography, and their cytotoxic activity was determined by measuring cell viability by methylthiazolyldiphenyl-tetrazolium bromide assay on the human colon cancer cell lines, Caco-2 and HT-29, and the normal human epithelial cell line, CCD 841 CoN. Results: The most abundant phytocannabinoid in cannabis extracts was tetrahydrocannabinolic acid (THCA). Its maximum concentrations were reached from the 7th to the 13th plant vegetation week, depending on the nutritional cycle and treatment. Almost all extracts were cytotoxic to the human colorectal cancer (CRC) cell line HT-29 at lower concentrations than the other cell lines. The phytocannabinoids that most affected the cytotoxicity of individual extracts on HT-29 were cannabigerol, Δ9-tetrahydrocannabinol, cannabidiol, cannabigerolic acid, and THCA. The tested model showed almost 70% influence of these cannabinoids. However, THCA alone influenced the cytotoxicity of individual extracts by nearly 65%. Conclusions: Phytocannabinoid extracts from plants of the THCA-dominant chemotype interacted synergistically and showed selective cytotoxicity against the CRC cell line, HT-29. This positive extract response indicates possible therapeutic value.
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Affiliation(s)
- Matěj Malík
- Department of Agroenvironmental Chemistry and Plant Nutrition, Nutrition and Dietetics, Faculty of Agrobiology, Food and Natural Resources, Czech University of Life Sciences Prague, Praha, Czech Republic
| | - Ivo Doskočil
- Department of Microbiology, Nutrition and Dietetics, Faculty of Agrobiology, Food and Natural Resources, Czech University of Life Sciences Prague, Praha, Czech Republic
| | - Jan Pavlík
- Department of Information Technologies, Faculty of Economics and Management, Czech University of Life Sciences Prague, Praha, Czech Republic
| | - Miloš Ulman
- Department of Information Technologies, Faculty of Economics and Management, Czech University of Life Sciences Prague, Praha, Czech Republic
| | - Lukáš Praus
- Department of Agroenvironmental Chemistry and Plant Nutrition, Nutrition and Dietetics, Faculty of Agrobiology, Food and Natural Resources, Czech University of Life Sciences Prague, Praha, Czech Republic
| | - Pavel Kouřimský
- Department of Microbiology, Nutrition and Dietetics, Faculty of Agrobiology, Food and Natural Resources, Czech University of Life Sciences Prague, Praha, Czech Republic
| | - Barbora Lampová
- Department of Microbiology, Nutrition and Dietetics, Faculty of Agrobiology, Food and Natural Resources, Czech University of Life Sciences Prague, Praha, Czech Republic
| | - Alexandra Kuklina
- Department of Agroenvironmental Chemistry and Plant Nutrition, Nutrition and Dietetics, Faculty of Agrobiology, Food and Natural Resources, Czech University of Life Sciences Prague, Praha, Czech Republic
| | - Pavel Tlustoš
- Department of Agroenvironmental Chemistry and Plant Nutrition, Nutrition and Dietetics, Faculty of Agrobiology, Food and Natural Resources, Czech University of Life Sciences Prague, Praha, Czech Republic
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Yeganegi A, Fardindoost S, Tasnim N, Hoorfar M. Molecularly imprinted polymers (MIP) combined with Raman spectroscopy for selective detection of Δ⁹-tetrahydrocannabinol (THC). Talanta 2024; 267:125271. [PMID: 37806109 DOI: 10.1016/j.talanta.2023.125271] [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] [Received: 06/14/2023] [Revised: 09/05/2023] [Accepted: 10/02/2023] [Indexed: 10/10/2023]
Abstract
A proof-of-concept sensor is developed for the sensitive and selective detection of Trans-Δ⁹-tetrahydrocannabinol (THC) based on a molecularly imprinted polymer (MIP) synthesized with a THC template which was analyzed using Raman spectroscopy to perform label-free monitoring of THC based on a single identifying Raman peak. The MIP sensor produced a peak at 1614 cm-1 in the Raman spectrum originating from the THC target molecule, allowing for the selective quantification of bound THC with the lowest detection limit of 250 ppm. A higher sensitivity of the MIP to the THC target molecule was observed compared to the non-imprinted polymer (NIP) control which confirmed the presence of THC-specific recognition sites within the synthesized MIP sensing material. The selectivity of this MIP-based sensor was determined by measuring the Raman spectrum of MIP exposed to Cannabidiol (CBD), ethanol, and acetone.
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Affiliation(s)
- Arian Yeganegi
- School of Engineering and Computer Science, University of Victoria, Victoria, BC, Canada
| | - Somayeh Fardindoost
- School of Engineering and Computer Science, University of Victoria, Victoria, BC, Canada
| | - Nishat Tasnim
- School of Engineering and Computer Science, University of Victoria, Victoria, BC, Canada
| | - Mina Hoorfar
- School of Engineering and Computer Science, University of Victoria, Victoria, BC, Canada.
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Shafiee A, Rafiei MA, Jafarabady K, Eskandari A, Abhari FS, Sattari MA, Amini MJ, Bakhtiyari M. Effect of cannabis use on blood levels of brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF): A systematic review and meta-analysis. Brain Behav 2024; 14:e3340. [PMID: 38376038 PMCID: PMC10757895 DOI: 10.1002/brb3.3340] [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: 09/08/2023] [Revised: 11/10/2023] [Accepted: 11/11/2023] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND The impact of cannabis uses on blood levels of brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) remains uncertain, with conflicting findings reported in the literature. BDNF and NGF both are essential proteins for neuron's growth, and their dysregulation is seen in various mental disorders. This study aims to evaluate the relationship between cannabis usage and BDNF and NGF levels due to their potential implications for mental health. METHODS A comprehensive search of electronic databases was performed using appropriate MeSH terms and keywords. Inclusion criteria comprised human studies investigating the relationship between cannabis use and BDNF and NGF levels. RESULTS A total of 11 studies met the inclusion criteria and were included. The pooled analysis revealed a nonsignificant association between cannabis use and dysregulated blood levels of BDNF (random-effects model, standardized mean differences [SMD] = .26, 95% CI -.34 to .76, p = .40). The results of our subgroup analysis based on BDNF source showed a nonsignificant between-group difference. For NGF levels, four studies were included, the pooled analysis revealed a nonsignificant association between cannabis use and dysregulated blood levels of NGF (random-effects model, SMD = -.60, 95% CI -1.43 to -.23, p = .16). In both analyses, high heterogeneity was observed among the included studies which is a notable limitation to current meta-analysis. CONCLUSION This systematic review highlights the need for further research to elucidate the relationship between cannabis use and these neurotrophic factors. A better understanding of these associations can contribute to our knowledge of the neurobiological effects of cannabis and inform potential implications for mental health, cognitive function, and neurodegenerative disorders.
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Affiliation(s)
- Arman Shafiee
- Department of Psychiatry and Mental HealthAlborz University of Medical SciencesKarajIran
- Student Research Committee, School of MedicineAlborz University of Medical SciencesKarajIran
| | | | - Kyana Jafarabady
- Student Research Committee, School of MedicineAlborz University of Medical SciencesKarajIran
| | - Alireza Eskandari
- Student Research Committee, School of MedicineAlborz University of Medical SciencesKarajIran
| | | | - Mohammad Amin Sattari
- Department of Psychiatry and Mental HealthAlborz University of Medical SciencesKarajIran
| | - Mohammad Javad Amini
- Student Research Committee, School of MedicineAlborz University of Medical SciencesKarajIran
| | - Mahmood Bakhtiyari
- Department of Psychiatry and Mental HealthAlborz University of Medical SciencesKarajIran
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Hansen JS, Boix F, Hasselstrøm JB, Sørensen L, Kjolby M, Gustavsen S, Hansen R, Petersen T, Sellebjerg F, Kasch H, Rasmussen PV, Finnerup NB, Sædder EA, Svendsen KB. Pharmacokinetics and pharmacodynamics of cannabis-based medicine in a patient population included in a randomized, placebo-controlled, clinical trial. Clin Transl Sci 2024; 17:e13685. [PMID: 38054364 PMCID: PMC10772478 DOI: 10.1111/cts.13685] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 10/16/2023] [Accepted: 10/26/2023] [Indexed: 12/07/2023] Open
Abstract
Information on the pharmacokinetics (PK) and pharmacodynamics (PD) of orally administered cannabis-based medicine (CBM) in capsule formulation in patient populations is sparse. In this exploratory study, we aimed to evaluate the PK and PD in a probable steady state of CBM in neuropathic pain and spasticity in a population of patients with multiple sclerosis (MS). Of 134 patients participating in a randomized, double-blinded, placebo-controlled, trial, 23 patients with MS (17 female) mean age 52 years (range 21-67) were enrolled in this substudy. They received oral capsules containing Δ9 -tetrahydrocannabinol (THC, n = 4), cannabidiol (CBD, n = 6), a combination (THC&CBD, n = 4), or placebo (n = 9). Maximum doses were 22.5 mg (THC) and 45 mg (CBD) a day divided into three administrations. PD parameters were evaluated for pain and spasticity. Blood samples were analyzed using an ultra-high-performance liquid chromatography-tandem mass spectrometer after protein precipitation and phospholipid removal. PK parameters were estimated using computerized modeling. The variation in daily dose and PK between individuals was considerable in a steady state, yet comparable with previous reports from healthy controls. Based on a simulation of the best model, the estimated PK parameters (mean) for THC (5 mg) were Cmax 1.21 ng/mL, Tmax 2.68 h, and half-life 2.75 h, and for CBD (10 mg) were Cmax 2.67 ng/mL, Tmax 0.10 h, and half-life 4.95 h, respectively. No effect was found on the PD parameters, but the placebo response was considerable. More immediate adverse events were registered in the active treatment groups compared with the placebo group.
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Affiliation(s)
- Julie Schjødtz Hansen
- Department of NeurologyAarhus University HospitalAarhusDenmark
- Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Fernando Boix
- Section for Drug Abuse Research, Department of Forensic Sciences, Division of Laboratory MedicineOslo University HospitalOsloNorway
| | | | | | - Mads Kjolby
- Department of Clinical PharmacologyAarhus University HospitalAarhusDenmark
- Department of BiomedicineAarhus UniversityAarhusDenmark
| | - Stefan Gustavsen
- Danish Multiple Sclerosis Center, Department of NeurologyCopenhagen University Hospital – RigshospitaletGlostrupDenmark
| | | | - Thor Petersen
- Department of NeurologyHospital of Southern Jutland and Research Unit in NeurologyAabenraaDenmark
- Department of Regional Health ResearchUniversity of Southern DenmarkOdenseDenmark
| | - Finn Sellebjerg
- Danish Multiple Sclerosis Center, Department of NeurologyCopenhagen University Hospital – RigshospitaletGlostrupDenmark
| | - Helge Kasch
- Department of NeurologyAarhus University HospitalAarhusDenmark
- Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | | | - Nanna Brix Finnerup
- Department of NeurologyAarhus University HospitalAarhusDenmark
- Danish Pain Research Centre, Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Eva Aggerholm Sædder
- Department of Clinical PharmacologyAarhus University HospitalAarhusDenmark
- Department of BiomedicineAarhus UniversityAarhusDenmark
| | - Kristina Bacher Svendsen
- Department of NeurologyAarhus University HospitalAarhusDenmark
- Department of Clinical MedicineAarhus UniversityAarhusDenmark
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Miller G, Pareek O, Penman SL, Thanos PK. The Effects of Nicotine and Cannabinoids on Cytokines. Curr Pharm Des 2024; 30:2468-2484. [PMID: 38859790 DOI: 10.2174/0113816128293077240529111824] [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] [Received: 01/11/2024] [Revised: 03/11/2024] [Accepted: 04/04/2024] [Indexed: 06/12/2024]
Abstract
BACKGROUND The usage of nicotine and cannabinoids has rapidly grown in popularity, leading to increased research into how they can affect people's health, both positively and negatively. Nicotine, Cannabidiol (CBD), and Δ9-tetrahydrocannabinol (THC) have been shown to have significant effects on cytokine function and inflammatory response. OBJECTIVE This study aimed to review and summarize the current literature on the effects of nicotine and cannabinoids on cytokines, including interleukins, TNF, IFN, and TGF-β. METHODS Literature search was conducted on Medline/PubMed electronic databases utilizing the search terms "nicotine" OR "cannabis" OR "cannabinoids" AND "cytokine" AND "inflammation" AND "stress" AND "immune" from 11/1973 to 02/2024. RESULTS THC and CBD usage have been associated with conflicting impacts on immune response, and observed to both exacerbate and inhibit inflammation. Nicotine has been shown to be generally proinflammatory with regards to cytokines. These responses have been reported to have significant effects on bodily response to inflammation-related diseases. Nicotine usage is associated with worsened outcomes for some conditions, like chronic pain, but improved outcomes for others, like arthritis. The impacts of cannabinoid usage tend to be more positive, exerting anti-inflammatory effects across a wide range of diseases. Given the widespread usage of these substances, it is important to understand the nature of their consequences on immune functions and the underlying mechanisms by which they act. CONCLUSION This review has covered how cannabinoids and nicotine affect inflammation directly and how these effects can be attributed to the treatment of inflammatory diseases. In summary, the existing research studying the effects of cannabinoids and nicotine supports the major relationship between nicotine and cannabis use and inflammatory diseases.
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Affiliation(s)
- Grace Miller
- Department of Pharmacology Toxicology, University at Buffalo, State University of New York, Buffalo, NY 14068, United States
| | - Ojas Pareek
- Department of Pharmacology Toxicology, University at Buffalo, State University of New York, Buffalo, NY 14068, United States
| | - Samantha L Penman
- Department of Pharmacology Toxicology, University at Buffalo, State University of New York, Buffalo, NY 14068, United States
| | - Panayotis K Thanos
- Department of Pharmacology Toxicology, University at Buffalo, State University of New York, Buffalo, NY 14068, United States
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Mutlu E, Özden HC, Ertuğrul A. Linking Substance Use and Schizophrenia. HANDBOOK OF THE BEHAVIOR AND PSYCHOLOGY OF DISEASE 2024:1-26. [DOI: 10.1007/978-3-031-32046-0_179-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Accepted: 04/25/2024] [Indexed: 11/17/2024]
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Zhang Q, Melchert PW, Markowitz JS. Pharmacokinetic Variability of Oral Cannabidiol and Its Major Metabolites after Short-Term High-Dose Exposure in Healthy Subjects. Med Cannabis Cannabinoids 2024; 7:1-9. [PMID: 38292071 PMCID: PMC10824522 DOI: 10.1159/000535726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 12/04/2023] [Indexed: 02/01/2024] Open
Abstract
Introduction Cannabidiol (CBD) is a widely utilized nonpsychoactive cannabinoid available as a prescriptive drug treatment and over-the-counter supplement. In humans, CBD is metabolized and forms the major active metabolite 7-hydroxy-cannabidiol (7-OH-CBD), which is further metabolized to 7-carboxy-cannabidiol (7-COOH-CBD). In the current study, plasma concentrations of CBD, 7-OH-CBD, and 7-COOH-CBD were measured, and the potential influences of sex, race, and body mass index (BMI) on the pharmacokinetic variability were assessed. Methods Blood samples from a previously conducted CBD drug interaction study in healthy volunteers (n = 12) were utilized. The subjects received orally administered CBD (Epiodiolex®), 750 mg twice daily for 3 days and a single dose on the 4th day. Nine plasma samples were collected, and plasma concentrations of CBD, 7-OH-CBD, and 7-COOH-CBD were analyzed by LC-MS/MS. Peak plasma concentration (Cmax), time to Cmax (Tmax), area under the curve (AUC), and metabolite-to-parent drug exposure ratios (MPR) were calculated. Statistical analysis was performed to determine the correlations of Cmax, AUC, and MPR of CBD, 7-OH-CBD, and 7-COOH-CBD in different sex, race, BMI, and body weight. Results For CBD, the mean Cmax was 389.17 ± 153.23 ng/mL, and the mean AUC was 1,542.19 ± 488.04 ng/mL*h. For 7-OH-CBD, the mean Cmax was 81.35 ± 36.64 ng/mL, the mean AUC was 364.70 ± 105.59 ng/mL*h, and the mean MPR was 0.25 ± 0.07. For 7-COOH-CBD, the mean Cmax was 1,717.33 ± 769.22 ng/mL, the mean AUC was 9,888.42 ± 3,961.47 ng/mL*h, and the mean MPR was 7.11 ± 3.48. For 7-COOH-CBD, a 2.25-fold higher Cmax was observed in female subjects (p = 0.0155) and a 1.97-fold higher AUC for female subjects (p = 0.0285) with the normalization of body weight. A significant linearity (p = 0.0135) of 7-OH-CBD AUC with body weight in females was observed. No significant differences were identified in Cmax, AUC, and PMR with race and BMI. Conclusion Observed differences in sex were in agreement with previously reported findings. A larger population pharmacokinetics study is warranted to validate the observed higher Cmax and AUC in females and significant linearity with body weight in females from the current study.
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Affiliation(s)
- Qingchen Zhang
- Department of Pharmacotherapy and Translational Research, Center for Pharmacogenomics and Precision Medicine University of Florida, Gainesville, FL, USA
| | - Philip W Melchert
- Department of Pharmacotherapy and Translational Research, Center for Pharmacogenomics and Precision Medicine University of Florida, Gainesville, FL, USA
| | - John S Markowitz
- Department of Pharmacotherapy and Translational Research, Center for Pharmacogenomics and Precision Medicine University of Florida, Gainesville, FL, USA
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Wilson G, Yang L, Su X, Ding S, Li L, Yang Y, Wang X, Wang W, Sa Y, Zhang Y, Chen J, Ma X. Exploring the therapeutic potential of natural compounds modulating the endocannabinoid system in various diseases and disorders: review. Pharmacol Rep 2023; 75:1410-1444. [PMID: 37906390 DOI: 10.1007/s43440-023-00544-7] [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: 07/21/2023] [Revised: 10/07/2023] [Accepted: 10/09/2023] [Indexed: 11/02/2023]
Abstract
Cannabinoid receptors, endogenous cannabinoids (endocannabinoids), and the enzymes involved in the biosynthesis and degradation of the endocannabinoids make up the endocannabinoid system (ECS). The components of the ECS are proven to modulate a vast bulk of various physiological and pathological processes due to their abundance throughout the human body. Such discoveries have attracted the researchers' attention and emerged as a potential therapeutical target for the treatment of various diseases. In the present article, we reviewed the discoveries of natural compounds, herbs, herbs formula, and their therapeutic properties in various diseases and disorders by modulating the ECS. We also summarize the molecular mechanisms through which these compounds elicit their properties by interacting with the ECS based on the existing findings. Our study provides the insight into the use of natural compounds that modulate ECS in various diseases and disorders, which in turn may facilitate future studies exploiting natural lead compounds as novel frameworks for designing more effective and safer therapeutics.
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Affiliation(s)
- Gidion Wilson
- Department of Pharmaceutical Analysis, School of Pharmacy, Key Laboratory of Hui Ethnic Medicine Modernization, Ministry of Education, Ningxia Medical University, 1160 Shenli Street, Yinchuan, 750004, China
| | - Lingling Yang
- Department of Pharmaceutical Analysis, School of Pharmacy, Key Laboratory of Hui Ethnic Medicine Modernization, Ministry of Education, Ningxia Medical University, 1160 Shenli Street, Yinchuan, 750004, China
| | - Xiaojuan Su
- Department of Pharmaceutical Analysis, School of Pharmacy, Key Laboratory of Hui Ethnic Medicine Modernization, Ministry of Education, Ningxia Medical University, 1160 Shenli Street, Yinchuan, 750004, China
| | - Shuqin Ding
- Department of Pharmaceutical Analysis, School of Pharmacy, Key Laboratory of Hui Ethnic Medicine Modernization, Ministry of Education, Ningxia Medical University, 1160 Shenli Street, Yinchuan, 750004, China
| | - Liuyan Li
- Department of Pharmaceutical Analysis, School of Pharmacy, Key Laboratory of Hui Ethnic Medicine Modernization, Ministry of Education, Ningxia Medical University, 1160 Shenli Street, Yinchuan, 750004, China
| | - Youyue Yang
- Department of Pharmaceutical Analysis, School of Pharmacy, Key Laboratory of Hui Ethnic Medicine Modernization, Ministry of Education, Ningxia Medical University, 1160 Shenli Street, Yinchuan, 750004, China
| | - Xiaoying Wang
- Department of Pharmaceutical Analysis, School of Pharmacy, Key Laboratory of Hui Ethnic Medicine Modernization, Ministry of Education, Ningxia Medical University, 1160 Shenli Street, Yinchuan, 750004, China
| | - Weibiao Wang
- Department of Pharmaceutical Analysis, School of Pharmacy, Key Laboratory of Hui Ethnic Medicine Modernization, Ministry of Education, Ningxia Medical University, 1160 Shenli Street, Yinchuan, 750004, China
| | - Yuping Sa
- Department of Pharmaceutical Analysis, School of Pharmacy, Key Laboratory of Hui Ethnic Medicine Modernization, Ministry of Education, Ningxia Medical University, 1160 Shenli Street, Yinchuan, 750004, China
| | - Yue Zhang
- Department of Pharmaceutical Analysis, School of Pharmacy, Key Laboratory of Hui Ethnic Medicine Modernization, Ministry of Education, Ningxia Medical University, 1160 Shenli Street, Yinchuan, 750004, China
| | - Jianyu Chen
- Fujian University of Traditional Chinese Medicine, No. 1, Huatuo Road, Minhoushangjie, Fuzhou, 350122, China.
| | - Xueqin Ma
- Department of Pharmaceutical Analysis, School of Pharmacy, Key Laboratory of Hui Ethnic Medicine Modernization, Ministry of Education, Ningxia Medical University, 1160 Shenli Street, Yinchuan, 750004, China.
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Siwar MAAL, Mansour SHED, Aldubayan MA, Alhowail AH, Almogbel YS, Emara AM. Health status outcome among cannabis addicts after treatment of addiction. PLoS One 2023; 18:e0290730. [PMID: 38011195 PMCID: PMC10681311 DOI: 10.1371/journal.pone.0290730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 08/14/2023] [Indexed: 11/29/2023] Open
Abstract
The abuse of Cannabis is a widespread issue in the Asir region. It has a lot of legal and occupational repercussions. The purpose of this study was to evaluate the health status of cannabis addicts at admission and after treatment using body mass index, glycemic status, liver function, renal function, and oxidative stress. A cross-sectional study was conducted with 120 participants. The study was conducted at Al Amal Hospital for Mental Health in Asir region of Saudi Arabia, with 100 hospitalized patients receiving addiction treatment and 20 healthy volunteers. The participants were divided into two groups: group I, the control group, and group II, the cannabis addicts. The socio-demographic data were gathered. The level of cannabis in the urine and the CWAS [Cannabis Withdrawal Assessment Scale] were determined. In addition, the Body Mass Index [BMI], vital signs [temperature, heart rate, systolic blood pressure, diastolic blood pressure, and respiratory rate], serum levels of albumin, total bilirubin, direct bilirubin, AST, ALT, and ALP, urea, creatinine, Thiobarbituric acid-reactive substances [TBARS], superoxide dismutase [SOD], reduced glutathione [GSH], and catalase [CAT] were analyzed on the first day of admission and after treatment. According to the results, there was no significant change in the body mass index. The vital signs in the cannabis user group were significantly lower than the corresponding admission values. Regarding renal function tests such as urea and creatinine, we found that after treatment, the mean urea and creatinine values in the cannabis user group did not differ significantly from the corresponding admission values. However, after treatment, the mean values of fasting blood glucose levels in the cannabis user group were significantly lower than at admission. Also, the mean values of liver function tests such as albumin, total bilirubin, direct bilirubin, AST, ALT, and ALP in the cannabis user group were significantly lower than the corresponding admission values after treatment. In assessing the antioxidant system, we found that the mean values of TBARS, SOD, GSH, and CAT in the cannabis user group did not differ significantly from the corresponding admission values after treatment. The current findings have revealed that cannabis addiction harms the various body systems and has significant implications for the addict's state of health. The values of oxidative stress biomarkers did not change in this study, but other measured parameters improved after treatment.
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Affiliation(s)
- Mohammed Ali A. L. Siwar
- Department of Pharmacology and Toxicology, College of Pharmacy, Qassim University, Buraydah, Qassim, Saudi Arabia
- Asir Central Hospital, Asir, Saudi Arabia
| | | | - Maha A. Aldubayan
- Department of Pharmacology and Toxicology, College of Pharmacy, Qassim University, Buraydah, Qassim, Saudi Arabia
| | - Ahmad H. Alhowail
- Department of Pharmacology and Toxicology, College of Pharmacy, Qassim University, Buraydah, Qassim, Saudi Arabia
| | - Yasser S. Almogbel
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Buraydah, Saudi Arabia
| | - Ashraf Mahmoud Emara
- Department of Pharmacology and Toxicology, College of Pharmacy, Qassim University, Buraydah, Qassim, Saudi Arabia
- Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Tanta University, Tanta, Egypt
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Demartini C, Greco R, Zanaboni AM, Francavilla M, Facchetti S, Tassorelli C. URB937 Prevents the Development of Mechanical Allodynia in Male Rats with Trigeminal Neuralgia. Pharmaceuticals (Basel) 2023; 16:1626. [PMID: 38004491 PMCID: PMC10675761 DOI: 10.3390/ph16111626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/03/2023] [Accepted: 11/16/2023] [Indexed: 11/26/2023] Open
Abstract
Cannabinoids are proposed for alleviating neuropathic pain, but their use is limited by cannabimimetic side effects. The inhibition of the fatty acid amide hydrolase (FAAH), the degrading enzyme of the endocannabinoid anandamide, has received attention as an alternative to cannabinoids in the treatment of neuropathic pain. Here, we investigated the effect of URB937, a blood-brain barrier impermeant FAAH inhibitor, on experimentally induced mechanical allodynia in an animal model of trigeminal neuralgia. Male Sprague-Dawley rats were subjected to chronic constriction injury of the infraorbital nerve (IoN-CCI); operated animals were treated sub-chronically with URB937 (1 mg/kg, i.p.) or vehicle before or after trigeminal mechanical allodynia establishment. We also assayed mRNA expression levels of the pain neuropeptide calcitonin gene-related peptide (CGRP) and cytokines in the medulla, cervical spinal cord, and trigeminal ganglion ipsilateral to IoN-CCI using rt-PCR. URB937 treatment prevented the development of mechanical allodynia and IoN-CCI-induced changes in mRNA expression levels of CGRP and cytokines in the evaluated areas. When administered after allodynia development, URB937 prevented IoN-CCI-induced changes in CGRP and cytokine gene expression; this was not associated with a significant abrogation of the mechanical allodynia. These findings suggest that URB937 may counteract, but not reverse, the development of allodynia in trigeminal neuralgia. Further research is needed to elucidate the underlying mechanisms.
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Affiliation(s)
- Chiara Demartini
- Department of Brain and Behavioral Sciences, University of Pavia, Via Bassi 21, 27100 Pavia, Italy; (A.M.Z.); (M.F.); (C.T.)
- Section of Translational Neurovascular Research, IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy; (R.G.); (S.F.)
| | - Rosaria Greco
- Section of Translational Neurovascular Research, IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy; (R.G.); (S.F.)
| | - Anna Maria Zanaboni
- Department of Brain and Behavioral Sciences, University of Pavia, Via Bassi 21, 27100 Pavia, Italy; (A.M.Z.); (M.F.); (C.T.)
- Section of Translational Neurovascular Research, IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy; (R.G.); (S.F.)
| | - Miriam Francavilla
- Department of Brain and Behavioral Sciences, University of Pavia, Via Bassi 21, 27100 Pavia, Italy; (A.M.Z.); (M.F.); (C.T.)
- Section of Translational Neurovascular Research, IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy; (R.G.); (S.F.)
| | - Sara Facchetti
- Section of Translational Neurovascular Research, IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy; (R.G.); (S.F.)
| | - Cristina Tassorelli
- Department of Brain and Behavioral Sciences, University of Pavia, Via Bassi 21, 27100 Pavia, Italy; (A.M.Z.); (M.F.); (C.T.)
- Section of Translational Neurovascular Research, IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy; (R.G.); (S.F.)
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Dou Q, Liu W, Xiang P, Zhao J. Quantitative Analysis of Three Synthetic Cannabinoids MDMB-4en-PINACA, ADB-BUTINACA, and ADB-4en-PINACA by Thermal-Assisted Carbon Fiber Ionization Mass Spectrometry. JOURNAL OF THE AMERICAN SOCIETY FOR MASS SPECTROMETRY 2023; 34:2316-2322. [PMID: 37641897 DOI: 10.1021/jasms.3c00229] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Recently, synthetic cannabinoids (SCs) have emerged as new psychoactive substances (NPS) and have been frequently added to e-liquids, leading to their abuse. In order to detect SCs in e-liquids quickly and accurately, a thermal-assisted carbon fiber ionization mass spectrometry technique has been developed. The introduction of a heat source helps to reduce the matrix effects. The results indicate that the ratio of the slope of the matrix curve (e-liquids matrix) and the standard curve (methanol solution) for SCs analysis is close to 1, indicating a minimized matrix effect of this method. Furthermore, this method exhibits good quantitative ability when applied to real samples. It does not require sample pretreatment and is sensitive enough to directly quantify SCs in e-liquids. Our method is characterized by the ability to achieve rapid and direct quantitative analysis with minimized matrix effects. It provides a rapid and simple method for analyzing SCs in e-liquids.
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Affiliation(s)
- Quanlu Dou
- Department of Forensic Toxicology, Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China
- School of Pharmacy, Yantai University, Yantai 264005, China
| | - Wanhui Liu
- School of Pharmacy, Yantai University, Yantai 264005, China
| | - Ping Xiang
- Department of Forensic Toxicology, Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China
| | - Junbo Zhao
- Department of Forensic Toxicology, Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China
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Leinen ZJ, Mohan R, Premadasa LS, Acharya A, Mohan M, Byrareddy SN. Therapeutic Potential of Cannabis: A Comprehensive Review of Current and Future Applications. Biomedicines 2023; 11:2630. [PMID: 37893004 PMCID: PMC10604755 DOI: 10.3390/biomedicines11102630] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/18/2023] [Accepted: 09/21/2023] [Indexed: 10/29/2023] Open
Abstract
Historically, cannabis has been valued for its pain-relieving, anti-inflammatory, and calming properties. Ancient civilizations like the Egyptians, Greeks, and Chinese medicines recognized their therapeutic potential. The discovery of the endocannabinoid system, which interacts with cannabis phytoconstituents, has scientifically explained how cannabis affects the human immune system, including the central nervous system (CNS). This review explores the evolving world of cannabis-based treatments, spotlighting its diverse applications. By researching current research and clinical studies, we probe into how cannabinoids like Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD) help to manage conditions ranging from chronic pain, persistent inflammation, cancer, inflammatory bowel disease, and neurological disorders to even viral diseases such as Human Immunodeficiency virus (HIV), SARS-CoV-2. and the emerging monkeypox. The long-term recreational use of cannabis can develop into cannabis use disorder (CUD), and therefore, understanding the factors contributing to the development and maintenance of cannabis addiction, including genetic predisposition, neurobiological mechanisms, and environmental influences, will be timely. Shedding light on the adverse impacts of CUD underscores the importance of early intervention, effective treatment approaches, and public health initiatives to address this complex issue in an evolving landscape of cannabis policies and perceptions.
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Affiliation(s)
- Zach J. Leinen
- Department of Pharmacology & Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE 68182, USA; (Z.J.L.); (R.M.); (A.A.)
| | - Rahul Mohan
- Department of Pharmacology & Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE 68182, USA; (Z.J.L.); (R.M.); (A.A.)
| | - Lakmini S. Premadasa
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX 78227, USA; (L.S.P.); (M.M.)
| | - Arpan Acharya
- Department of Pharmacology & Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE 68182, USA; (Z.J.L.); (R.M.); (A.A.)
| | - Mahesh Mohan
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX 78227, USA; (L.S.P.); (M.M.)
| | - Siddappa N. Byrareddy
- Department of Pharmacology & Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE 68182, USA; (Z.J.L.); (R.M.); (A.A.)
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Szőke K, Kajtár R, Gyöngyösi A, Czompa A, Fésüs A, Lőrincz EB, Petróczi FD, Herczegh P, Bak I, Borbás A, Bereczki I, Lekli I. Pharmacological Evaluation of Newly Synthesized Cannabidiol Derivates on H9c2 Cells. Antioxidants (Basel) 2023; 12:1714. [PMID: 37760017 PMCID: PMC10525859 DOI: 10.3390/antiox12091714] [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: 08/01/2023] [Revised: 08/25/2023] [Accepted: 08/31/2023] [Indexed: 09/29/2023] Open
Abstract
Cannabidiol (CBD) is a nonpsychoactive phytocannabinoid that can be found in Cannabis sativa and possesses numerous pharmacological effects. Due to these promising effects, CBD can be used in a wide variety of diseases, for instance cardiovascular diseases. However, CBD, like tetrahydrocannabinol (THC), has low bioavailability, poor water solubility, and a variable pharmacokinetic profile, which hinders its therapeutic use. Chemical derivatization of CBD offers us potential ways to overcome these issues. We prepared three new CBD derivatives substituted on the aromatic ring by Mannich-type reactions, which have not been described so far for the modification of cannabinoids, and studied the protective effect they have on cardiomyocytes exposed to oxidative stress and hypoxia/reoxygenation (H/R) compared to the parent compound. An MTT assay was performed to determine the viability of rat cardiomyocytes treated with test compounds. Trypan blue exclusion and lactate dehydrogenase (LDH) release assays were carried out to study the effect of the new compounds in cells exposed to H2O2 or hypoxia/reoxygenation (H/R). Direct antioxidant activity was evaluated by a total antioxidant capacity (TAC) assay. To study antioxidant protein levels, HO-1, SOD, catalase, and Western blot analysis were carried out. pIC50 (the negative log of the IC50) values were as follows: CBD1: 4.113, CBD2: 3.995, CBD3: 4.190, and CBD: 4.671. The newly synthesized CBD derivatives prevented cell death induced by H/R, especially CBD2. CBD has the largest direct antioxidant activity. The levels of antioxidant proteins were increased differently after pretreatment with synthetic CBD derivatives and CBD. Taken together, our newly synthesized CBD derivatives are able to decrease cytotoxicity during oxidative stress and H/R. The compounds have similar or better effects than CBD on H9c2 cells.
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Affiliation(s)
- Kitti Szőke
- Department of Pharmacology, Faculty of Pharmacy, University of Debrecen, 4032 Debrecen, Hungary; (K.S.); (R.K.); (A.G.); (A.C.); (A.F.); (I.B.)
- Institute of Healthcare Industry, University of Debrecen, 4032 Debrecen, Hungary
| | - Richárd Kajtár
- Department of Pharmacology, Faculty of Pharmacy, University of Debrecen, 4032 Debrecen, Hungary; (K.S.); (R.K.); (A.G.); (A.C.); (A.F.); (I.B.)
| | - Alexandra Gyöngyösi
- Department of Pharmacology, Faculty of Pharmacy, University of Debrecen, 4032 Debrecen, Hungary; (K.S.); (R.K.); (A.G.); (A.C.); (A.F.); (I.B.)
| | - Attila Czompa
- Department of Pharmacology, Faculty of Pharmacy, University of Debrecen, 4032 Debrecen, Hungary; (K.S.); (R.K.); (A.G.); (A.C.); (A.F.); (I.B.)
| | - Adina Fésüs
- Department of Pharmacology, Faculty of Pharmacy, University of Debrecen, 4032 Debrecen, Hungary; (K.S.); (R.K.); (A.G.); (A.C.); (A.F.); (I.B.)
- Institute of Healthcare Industry, University of Debrecen, 4032 Debrecen, Hungary
| | - Eszter Boglárka Lőrincz
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Debrecen, 4032 Debrecen, Hungary; (E.B.L.); (F.D.P.); (P.H.); (A.B.)
- Doctoral School of Pharmaceutical Sciences, University of Debrecen, 4032 Debrecen, Hungary
| | - Ferenc Dániel Petróczi
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Debrecen, 4032 Debrecen, Hungary; (E.B.L.); (F.D.P.); (P.H.); (A.B.)
- Doctoral School of Pharmaceutical Sciences, University of Debrecen, 4032 Debrecen, Hungary
| | - Pál Herczegh
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Debrecen, 4032 Debrecen, Hungary; (E.B.L.); (F.D.P.); (P.H.); (A.B.)
| | - István Bak
- Department of Pharmacology, Faculty of Pharmacy, University of Debrecen, 4032 Debrecen, Hungary; (K.S.); (R.K.); (A.G.); (A.C.); (A.F.); (I.B.)
| | - Anikó Borbás
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Debrecen, 4032 Debrecen, Hungary; (E.B.L.); (F.D.P.); (P.H.); (A.B.)
| | - Ilona Bereczki
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Debrecen, 4032 Debrecen, Hungary; (E.B.L.); (F.D.P.); (P.H.); (A.B.)
- National Laboratory of Virology, Szentágothai Research Centre, 7624 Pécs, Hungary
- ELKH-DE Pharmamodul Research Team, University of Debrecen, 4032 Debrecen, Hungary
| | - István Lekli
- Department of Pharmacology, Faculty of Pharmacy, University of Debrecen, 4032 Debrecen, Hungary; (K.S.); (R.K.); (A.G.); (A.C.); (A.F.); (I.B.)
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Moore CF, Marusich J, Haghdoost M, Lefever TW, Bonn-Miller MO, Weerts EM. Evaluation of the Modulatory Effects of Minor Cannabinoids and Terpenes on Delta-9-Tetrahydrocannabinol Discrimination in Rats. Cannabis Cannabinoid Res 2023; 8:S42-S50. [PMID: 37721992 DOI: 10.1089/can.2023.0062] [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: 09/20/2023] Open
Abstract
Introduction: Cannabis contains a multitude of phytocannabinoids and terpenes in addition to its main psychoactive constituent, delta-9-tetrahydrocannabinol (D9-THC). It is believed that the combination of minor cannabinoids and terpenes with D9-THC may impact the subjective and physiological effects of D9-THC. In this study, select minor cannabinoids (cannabigerol [CBG], cannabidivarin [CBDV], cannabichromene [CBC], tetrahydrocannabivarin [THCV], cannabigerolic acid [CBGa], and cannabidiolic acid [CBDa]) and terpenes (beta-caryophyllene and linalool) were evaluated for their potential to decrease the interoceptive effects of D9-THC using drug discrimination methods. Materials and Methods: Male and female rats (n=16; 50% female) were trained to discriminate D9-THC from vehicle. Following training, D9-THC was administered 45 min pre-session, followed by administration of a minor cannabinoid or terpene (or vehicle) 15 min pre-session. CBG, CBDV, CBC, and THCV were administered at doses of 3-30 mg/kg; CBGa and CBDa were administered at doses of 10-100 mg/kg; beta-caryophyllene and linalool were administered at doses of 10-30 mg/kg. Percentage of D9-THC responding (%) was calculated to assess changes to D9-THCs interoceptive effects. Results: CBG, CBDV, CBC, THCV, CBGa, CBDa, beta-caryophyllene, and linalool had little effect on percent D9-THC responding in either sex. No compounds lowered percent D9-THC responding to 50% or below. THCV, CBC, CBDa, and beta-caryophyllene in combination with D9-THC decreased response rates compared with D9-THC alone. Conclusions: The minor cannabinoids and terpenes examined in the current study did not alter the discriminative stimulus effects of D9-THC. These results suggest that these compounds are unlikely to lower the psychoactive effects of D9-THC in human users.
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Affiliation(s)
- Catherine F Moore
- Division of Behavioral Biology, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Julie Marusich
- RTI International, Research Triangle Park, North Carolina, USA
| | | | | | | | - Elise M Weerts
- Division of Behavioral Biology, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Hasan KM. Cannabis Unveiled: An Exploration of Marijuana's History, Active Compounds, Effects, Benefits, and Risks on Human Health. Subst Abuse 2023; 17:11782218231182553. [PMID: 37359105 PMCID: PMC10286197 DOI: 10.1177/11782218231182553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 05/30/2023] [Indexed: 06/28/2023]
Abstract
Marijuana, also known as cannabis, is a psychoactive drug that comes from the Cannabis plant. Marijuana can be smoked, vaporized, or consumed through edibles in a variety of ways. Perception changes, changes in mood, and problems with coordination are all possible side effects. Marijuana is used for both recreational and medical purposes to treat a variety of health conditions. The literature review on the effects of marijuana on the human body has increased in recent years as more states legalize its use. It is important to investigate the benefits and harmful effects of marijuana on individuals due to the widespread use of cannabis-derived substances like marijuana for medical, recreational, and combined purposes. The paper will review different aspects of marijuana in 4 main domains. A thorough discussion of marijuana's definition, history, mechanism of action, pharmacokinetics, and effects on human cells will be given in the first domain. The second domain will concentrate on marijuana's negative effects, while the third domain will look at marijuana's possible positive impacts, such as its usage in controlling multiple sclerosis, treating obesity, lowering social anxiety, and managing pain. The fourth domain will concentrate on marijuana's effects on anxiety, educational attainment, and social consequences. Additionally, this paper also will provide a highlight of the history of marijuana use and governmental legislation, both of which play a significant role in determining how the public views marijuana. In conclusion, this paper provides a comprehensive review of marijuana's effects, which may be of interest to a large readership. This review adds to the continuing discussion about the use of marijuana by analyzing the data that is currently available about the possible advantages and disadvantages of marijuana usage.
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Affiliation(s)
- Khaled M Hasan
- Khaled M Hasan, Physician Assistant Department, School of Pharmacy and Health Professions, University of Maryland Eastern Shore, Hazel Hall, Suite 1042, Princess Anne, MD 21853, USA.
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Police A, Kumar Shankar V, Pandey P, Rangappa S, Doerksen RJ, Narasimha Murthy S. Novel Topical Anandamide Formulation for Alleviating Peripheral Neuropathic Pain. Int J Pharm 2023:123085. [PMID: 37245739 DOI: 10.1016/j.ijpharm.2023.123085] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 05/01/2023] [Accepted: 05/23/2023] [Indexed: 05/30/2023]
Abstract
Peripheral neuropathy (PN) is a condition of peripheral nerve damage leading to severe pain. The first line therapies are associated with adverse psychotropic effects (PSE) and second line therapies are not efficient enough to relieve pain. There is an unmet drug need for relieving pain effectively without PSE in PN. Anandamide, an endocannabinoid activates cannabinoid receptors to relieve the pain due to peripheral neuropathy (PN). Anandamide has a very short biological half-life as they are extensively metabolized by fatty acid amide hydrolase enzyme (FAAH). Regional delivery of safe FAAH inhibitor (FI) with anandamide would be beneficial for PN without psychotropic effects. The objective of the study is to identify a safe FAAH inhibitor and deliver the anandamide in combination with the FAAH inhibitor topically for the management of PN. The FAAH inhibition potential of silymarin constituents was evaluated by molecular docking and in vitro studies. The topical gel formulation was developed to deliver anandamide and FI. The formulation was assessed in chemotherapeutic agent-induced peripheral neuropathy rat models to relieve mechanical-allodynia and thermal-hyperalgesia. The molecular docking studies demonstrated that the Prime MM-GBSA free energy of silymarin constituents were in the order of silybin > isosilybin > silychristin > taxifolin > silydianin. In in vitro studies, silybin 20 µM inhibited >61.8% of FAAH activity and increased the half-life of anandamide. The developed formulation increased permeation of anandamide and silybin across the porcine skin. Furthermore, on the application of anandamide and anandamide-silybin gel to rat paws, there was a significant increase in the pain threshold for allodynic and hyperalgesic stimulus up to 1 h and 4 h, respectively. The topical anandamide with silybin delivery approach could serve to alleviate peripheral neuropathy efficiently and thus could minimize unwanted CNS side effects of synthetic or natural cannabinoids in patients.
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Affiliation(s)
- Anitha Police
- Department of Pharmaceutics and Drug Delivery, School of Pharmacy, The University of Mississippi, University, MS 38677, USA.
| | - Vijay Kumar Shankar
- Department of Pharmaceutics and Drug Delivery, School of Pharmacy, The University of Mississippi, University, MS 38677, USA.
| | - Pankaj Pandey
- National Center for Natural Products Research, University of Mississippi, University, MS 38677, USA.
| | | | - Robert J Doerksen
- Department of BioMolecular Sciences, Division of Medicinal Chemistry, School of Pharmacy, The University of Mississippi, University, MS 38677, USA.
| | - S Narasimha Murthy
- Topical Products Testing LLC, Oxford, MS 38655, USA; Institute for Drug Delivery and Biomedical Research, Bangalore, India.
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46
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Rahman A, Alqaisi S. Myopericarditis Associated With Marijuana Intake: A Case Report and Literature Review. Cureus 2023; 15:e39413. [PMID: 37362486 PMCID: PMC10287544 DOI: 10.7759/cureus.39413] [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] [Accepted: 05/23/2023] [Indexed: 06/28/2023] Open
Abstract
A 26-year-old male who endorses daily cigarette smoking and marijuana vaping presented to the emergency department with acute onset of left-sided chest pain radiating to the left shoulder. Physical examination was unremarkable, but laboratory investigations showed elevated white blood cells, cardiac biomarkers including troponin and creatine kinase, and mildly elevated C-reactive protein levels and erythrocyte sedimentation rate. Electrocardiogram displayed subtle ST-segment elevation in a diffuse pattern, leading to a diagnosis of acute myopericarditis. The patient was treated with anti-inflammatory medication and supportive care and instructed to cease cannabis use.
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Affiliation(s)
- Ali Rahman
- Internal Medicine, Northwell Health at Mather Hospital, Port Jefferson, USA
| | - Sura Alqaisi
- Internal Medicine, Memorial Healthcare, Pembroke Pines, USA
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Ang SP, Sidharthan S, Lai W, Hussain N, Patel KV, Gulati A, Henry O, Kaye AD, Orhurhu V. Cannabinoids as a Potential Alternative to Opioids in the Management of Various Pain Subtypes: Benefits, Limitations, and Risks. Pain Ther 2023; 12:355-375. [PMID: 36639601 PMCID: PMC10036719 DOI: 10.1007/s40122-022-00465-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 11/22/2022] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION Pain is a global phenomenon encompassing many subtypes that include neuropathic, musculoskeletal, acute postoperative, cancer, and geriatric pain. Traditionally, opioids have been a mainstay pharmacological agent for managing many types of pain. However, opioids have been a subject of controversy with increased addiction, fatality rates, and cost burden on the US healthcare system. Cannabinoids have emerged as a potentially favorable alternative or adjunctive treatment for various types of acute and chronic pain. This narrative review seeks to describe the efficacy, risks, and benefits of cannabinoids as an adjunct or even potential replacement for opioids in the treatment of various subtypes of pain. METHODS In June of 2022, we performed a comprehensive search across multiple databases for English-language studies related to the use of cannabinoids in the treatment of various types pain: neuropathic pain, musculoskeletal pain, acute postoperative pain, cancer pain, and geriatric pain. Data from meta-analyses, systematic reviews, and randomized control trials (RCTs) were prioritized for reporting. We sought to focus our reported analysis on more recent literature as well as include older relevant studies with particularly notable findings. RESULTS There is conflicting evidence for the use of cannabinoids in the management of pain. While cannabinoids have shown efficacy in treating specific chronic pain subtypes such as neuropathic pain, fibromyalgia pain, and geriatric pain, they do not show as clear benefit in acute postoperative and the majority of musculoskeletal pain syndromes. Data trends towards cannabinoids having a positive effect in treating cancer pain, but results are not as conclusive. To date, there is a paucity of data comparing cannabinoids directly to opioids for pain relief. Overall, the side effects of cannabinoids appear to be relatively mild. However, there is still potential for addiction, altered brain development, psychiatric comorbidities, and drug-drug interactions. CONCLUSION Cannabinoids may be effective in specific subtypes of pain, but current evidence and guidelines do not yet support its use as the first-line treatment for any type of acute or chronic pain. Rather, it may be considered a good adjunct or alternative for patients who have failed more typical or conservative measures. Additional studies are needed with standardized forms of cannabinoids, route of delivery, and dosing for greater-powered analysis. Providers must weigh the individualized patient risks, benefits, and concurrent medication list in order to determine whether cannabinoids are appropriate for a patient's pain treatment plan.
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Affiliation(s)
- Samuel P Ang
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Shawn Sidharthan
- Department of Neurology, Northwell Health-Donald and Barbara Zucker School of Medicine at Hofstra, Hempstead, NY, USA
| | - Wilson Lai
- Department of Anesthesiology and Pain Medicine, Northwell Health-Donald and Barbara Zucker School of Medicine at Hofstra, Hempstead, NY, USA
| | - Nasir Hussain
- Department of Anesthesiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Kiran V Patel
- Department of Anesthesiology, New York University Langone Medical Center, New York, NY, USA
- Department of Anesthesiology and Pain Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, NY, USA
| | - Amitabh Gulati
- Department of Anesthesiology and Critical Care, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Onyeaka Henry
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Alan D Kaye
- Anesthesiology and Pharmacology, Toxicology, and Neurosciences, LSU School of Medicine, Shreveport, LA, USA
- Anesthesiology and Pharmacology, LSU School of Medicine, New Orleans, LA, USA
- Anesthesiology and Pharmacology, Tulane School of Medicine, New Orleans, LA, USA
| | - Vwaire Orhurhu
- University of Pittsburgh Medical Center, Susquehanna, Williamsport, PA, USA.
- MVM Health, East Stroudsburg, PA, USA.
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Johne S, van der Toorn M, Iskandar AR, Majeed S, Torres LO, Hoeng J, Peitsch MC. An in vitro evaluation of e-vapor products: The contributions of chemical adulteration, concentration, and device power. Food Chem Toxicol 2023; 175:113708. [PMID: 36889430 DOI: 10.1016/j.fct.2023.113708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/21/2023] [Accepted: 03/04/2023] [Indexed: 03/08/2023]
Abstract
Homemade e-liquids and power-adjustable vaping devices may carry higher risks than commercial formulations and fixed-power devices. This study used human macrophage-like and bronchial epithelial (NHBE) cell cultures to investigate toxicity of homemade e-liquids containing propylene glycol and vegetable glycerin (PG/VG), nicotine, vitamin E acetate (VEA), medium-chain fatty acids (MCFAs), phytol, and cannabidiol (CBD). SmallAir™ organotypic epithelial cultures were exposed to aerosols generated at different power settings (10-50 W). Carbonyl levels were measured, and endpoints reflecting epithelial function (ciliary beating frequency [CBF]), integrity (transepithelial electrical resistance [TEER]), and structure (histology) were investigated. Treatment with nicotine or VEA alone or with PG/VG did not impact cell viability. CBD, phytol, and lauric acid caused cytotoxicity in both culture systems and increased lipid-laden macrophages. Exposure of SmallAir™ organotypic cultures to CBD-containing aerosols resulted in tissue injury and loss of CBF and TEER, while PG/VG alone or with nicotine or VEA did not. Aerosols generated with higher power settings had higher carbonyl concentrations. In conclusion, the presence and concentration of certain chemicals and device power may induce cytotoxicity in vitro. These results raise concerns that power-adjustable devices may generate toxic compounds and suggest that toxicity assessments should be conducted for both e-liquid formulations and their aerosols.
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Affiliation(s)
- Stephanie Johne
- PMI R&D, Philip Morris Products S.A, Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland.
| | - Marco van der Toorn
- PMI R&D, Philip Morris Products S.A, Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
| | - Anita R Iskandar
- PMI R&D, Philip Morris Products S.A, Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
| | - Shoaib Majeed
- PMI R&D, Philip Morris Products S.A, Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
| | - Laura O Torres
- PMI R&D, Philip Morris Products S.A, Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
| | - Julia Hoeng
- PMI R&D, Philip Morris Products S.A, Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
| | - Manuel C Peitsch
- PMI R&D, Philip Morris Products S.A, Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
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Huang EY, Broderick RC, Li JZ, Serra JL, Ahuja P, Wu S, Genz M, Grunvald E, Kunkel DC, Sandler BJ, Horgan S, Jacobsen GR. Weight loss outcomes are not compromised in bariatric patients using cannabis. Surg Endosc 2023; 37:2194-2201. [PMID: 35861881 DOI: 10.1007/s00464-022-09453-x] [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] [Received: 03/21/2022] [Accepted: 07/05/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND The legalization of cannabis in several states has led to increased documented use in the population. Bariatric surgery patients are no exception with estimates of anywhere from 6 to 8%. Cannabis is known to be associated with increased appetite, mood disorders, hyperphagia, and rarely, hyperemesis, which can potentially affect post-surgical weight loss. We aim to study the differences in bariatric surgery outcomes between cannabis users and non-users. METHODS A retrospective review identified patients undergoing bariatric surgery. Patients were divided into two groups, cannabis users (CU) and non-cannabis users (non-CU). Cannabis users (defined as using at least once weekly) and a group of non-users were called to obtain additional information. Primary outcome was weight loss. Secondary outcomes included incidence of post-operative nausea and vomiting (PONV), length of stay (LOS), readmission, and need for additional intervention. RESULTS A cohort of 364 sleeve gastrectomy patients met inclusion criteria, 31 (8.5%) CU and 333 (91.5%) non-CU. There was no difference in EWL between CU and non-CU at 1 week, 1 month, 3 months, 6 months, 9 months, 1 year, and 2 years. However, the CU group trended towards greater EWL at 3 years (52.9% vs. 38.1%, p = 0.094) and at 5 years (49.8% vs. 32.7%, p = 0.068). There were no significant differences between CU and non-CU with respect to either incidence or severity of PONV at one year after surgery or longer follow-up. CONCLUSION Cannabis users did not experience inferior weight loss after bariatric surgery despite common assumptions that appetite stimulation can lead to suboptimal weight loss outcomes. Our findings add to other work challenging this dogma. Larger, long-term, multicenter studies are warranted.
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Affiliation(s)
- Estella Y Huang
- Division of Minimally Invasive Surgery, Center for the Future of Surgery, University of California San Diego, 9500 Gilman Drive, MET Building 845, La Jolla, CA, 92093-0740, USA.
| | - Ryan C Broderick
- Division of Minimally Invasive Surgery, Center for the Future of Surgery, University of California San Diego, 9500 Gilman Drive, MET Building 845, La Jolla, CA, 92093-0740, USA
| | - Jonathan Z Li
- Division of Minimally Invasive Surgery, Center for the Future of Surgery, University of California San Diego, 9500 Gilman Drive, MET Building 845, La Jolla, CA, 92093-0740, USA
| | - Joaquin L Serra
- Division of Minimally Invasive Surgery, Center for the Future of Surgery, University of California San Diego, 9500 Gilman Drive, MET Building 845, La Jolla, CA, 92093-0740, USA
| | - Pranav Ahuja
- Division of Minimally Invasive Surgery, Center for the Future of Surgery, University of California San Diego, 9500 Gilman Drive, MET Building 845, La Jolla, CA, 92093-0740, USA
| | - Samantha Wu
- Division of Minimally Invasive Surgery, Center for the Future of Surgery, University of California San Diego, 9500 Gilman Drive, MET Building 845, La Jolla, CA, 92093-0740, USA
| | - Michael Genz
- Division of Minimally Invasive Surgery, Center for the Future of Surgery, University of California San Diego, 9500 Gilman Drive, MET Building 845, La Jolla, CA, 92093-0740, USA
| | - Eduardo Grunvald
- Division of General Internal Medicine, UCSD Bariatric and Metabolic Institute, University of California San Diego, La Jolla, CA, USA
| | - David C Kunkel
- Division of Gastroenterology, GI Motility & Physiology Program, University of California San Diego, La Jolla, CA, USA
| | - Bryan J Sandler
- Division of Minimally Invasive Surgery, Center for the Future of Surgery, University of California San Diego, 9500 Gilman Drive, MET Building 845, La Jolla, CA, 92093-0740, USA
| | - Santiago Horgan
- Division of Minimally Invasive Surgery, Center for the Future of Surgery, University of California San Diego, 9500 Gilman Drive, MET Building 845, La Jolla, CA, 92093-0740, USA
| | - Garth R Jacobsen
- Division of Minimally Invasive Surgery, Center for the Future of Surgery, University of California San Diego, 9500 Gilman Drive, MET Building 845, La Jolla, CA, 92093-0740, USA
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Monitoring Perfusion Index in Patients Presenting to the Emergency Department Due to Drug Use. J Pers Med 2023; 13:jpm13020372. [PMID: 36836606 PMCID: PMC9963239 DOI: 10.3390/jpm13020372] [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: 11/25/2022] [Revised: 02/15/2023] [Accepted: 02/17/2023] [Indexed: 02/22/2023] Open
Abstract
(1) Background: The perfusion index (PI) represents the ratio between pulsatile blood flow and non-pulsatile blood flow in the peripheral tissue. (2) We aimed to investigate the blood pressure perfusion of tissues and organs in ethnobotanical, synthetic cannabinoid and cannabis derivative consumers through the value of perfusion index. (3) Results: The patients enrolled were divided into two groups: group A, which included all patients who presented in the ED within the first three hours after consumption, and group B, which included those patients who presented more than three hours and up to 12 h after drug consumption. The average values of the PI in the case of group A/group B were 1.51 ± 1.07/4.55 ± 3.66. Statistically significant correlations in both groups were recorded between the drug intake ED admission, respiratory rate, peripheral blood oxygen saturation and tissue perfusion index (p < 0.001). The average value of the PI measured in group A was significantly lower compared to that measured in patients in group B. Therefore, we concluded that the perfusion of peripheral organs and tissues was lower in the first 3 h after drug administration. (4) Conclusions: PI plays an important role in the early detection of impaired organ perfusion and in monitoring tissue hypoxia. A decreased PI value may be an early indication of decreased perfusion organ damage.
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