1
|
Ossato A, Gasperoni L, Del Bono L, Messori A, Damuzzo V. Efficacy of Immune Checkpoint Inhibitors vs. Tyrosine Kinase Inhibitors/Everolimus in Adjuvant Renal Cell Carcinoma: Indirect Comparison of Disease-Free Survival. Cancers (Basel) 2024; 16:557. [PMID: 38339309 PMCID: PMC10854775 DOI: 10.3390/cancers16030557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/19/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND The proven efficacy of mTOR inhibitors (mTORIs), tyrosine kinase inhibitors (TKIs) or immune checkpoint inhibitors (ICIs) in metastatic renal cell carcinoma (RCC) suggests that these agents should be investigated as adjuvant therapy with the aim of eliminating undetectable microscopic residual disease after curative resection. The aim of our study was to compare the efficacy of these treatments using an innovative method of reconstructing individual patient data. METHODS Nine phase III trials describing adjuvant RCC treatments were selected. The IPDfromKM method was used to reconstruct individual patient data from Kaplan-Meier (KM) curves. The combination treatments were compared with the control arm (placebo) for disease-free survival (DFS). Multi-treatment KM curves were used to summarize the results. Standard statistical tests were performed. These included hazard ratio and likelihood ratio tests for heterogeneity. RESULTS In the overall population, the study showed that two ICIs (nivolumab plus ipilimumab and pembrolizumab) and one TKI (sunitinib) were superior to the placebo, whereas both TKIs and mTORIs were inferior. As we assessed DFS as the primary endpoint for the adjuvant comparison, the overall survival benefit remains unknown. CONCLUSIONS This novel approach to investigating survival has allowed us to conduct all indirect head-to-head comparisons between these agents in a context where no "real" comparative trials have been conducted.
Collapse
Affiliation(s)
- Andrea Ossato
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, 35131 Padova, Italy;
| | - Lorenzo Gasperoni
- Oncological Pharmacy Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy;
| | - Luna Del Bono
- Azienda Ospedaliera Universitaria Pisana, 56100 Pisa, Italy;
| | - Andrea Messori
- HTA Unit, Regional Health Service, 50139 Florence, Italy
| | - Vera Damuzzo
- Hospital Pharmacy, Vittorio Veneto Hospital, 31029 Vittorio Veneto, Italy
- Italian Society of Clinical Pharmacy and Therapeutics (SIFaCT), 10123 Turin, Italy
| |
Collapse
|
2
|
Ossato A, Gasperoni C, Stella M, Montagner G, Trojan D, Giovagnoni G, Giannini M, Realdon F, Mezzadrelli V, Realdon N, Zuppini T, Tessari R. Validation of orthopedic allograft preparation process: a new application of media fill test. Cell Tissue Bank 2023:10.1007/s10561-023-10107-y. [PMID: 37728671 DOI: 10.1007/s10561-023-10107-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 08/02/2023] [Indexed: 09/21/2023]
Abstract
Musculoskeletal allografts represent an important practice in orthopedic surgeries and the demand for them has been growing. For this reason, in order to reduce clinical risk and to more efficiently manage the increase of allograft usage and also to optimize timing of the surgeries, the thawing and washing processes with aseptic technique were centralized in the department of Hospital Pharmacy. This study describe the design and execution of an adapted Media Fill Test (MFT) to demonstrate aseptic thawing and washing of allografts. For this specific and innovative setting, to better simulate the actual processing steps, a surrogate system was developed to simulate the tendon allograft. The aseptic technique of four operators was assessed and an initial performance validation and the first revalidation were described. All MFT were completed successfully, with no observation of turbidity. The readapted MFT shown in this study can provide insight into this innovative and growing field to other health professionals who want to implement this service.
Collapse
Affiliation(s)
- Andrea Ossato
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Padova, Italy
| | | | | | | | - Diletta Trojan
- Fondazione Banca dei Tessuti del Veneto Onlus, Treviso, Italy
| | - Giuseppe Giovagnoni
- Hospital Pharmacy, IRCCS Ospedale Sacro Cuore Don Calabria, Via don A. Sempreboni, 5, 37024, Negrar di Valpolicella, Verona, Italy
| | - Michele Giannini
- Hospital Pharmacy, IRCCS Ospedale Sacro Cuore Don Calabria, Via don A. Sempreboni, 5, 37024, Negrar di Valpolicella, Verona, Italy
| | - Francesca Realdon
- Hospital Pharmacy, IRCCS Ospedale Sacro Cuore Don Calabria, Via don A. Sempreboni, 5, 37024, Negrar di Valpolicella, Verona, Italy
| | - Valeria Mezzadrelli
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Padova, Italy
| | - Nicola Realdon
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Padova, Italy
| | - Teresa Zuppini
- Hospital Pharmacy, IRCCS Ospedale Sacro Cuore Don Calabria, Via don A. Sempreboni, 5, 37024, Negrar di Valpolicella, Verona, Italy
| | - Roberto Tessari
- Hospital Pharmacy, IRCCS Ospedale Sacro Cuore Don Calabria, Via don A. Sempreboni, 5, 37024, Negrar di Valpolicella, Verona, Italy.
| |
Collapse
|
3
|
Ossato A, Tessari R, Trabucchi C, Zuppini T, Realdon N, Marchesini F. Comparison of medium-term adverse reactions induced by the first and second dose of mRNA BNT162b2 (Comirnaty, Pfizer-BioNTech) vaccine: a post-marketing Italian study conducted between 1 January and 28 February 2021. Eur J Hosp Pharm 2023; 30:e15. [PMID: 34315774 PMCID: PMC8318724 DOI: 10.1136/ejhpharm-2021-002933] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 07/12/2021] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES On 21 December 2020 the European Commission granted conditional marketing authorisation in the European Union for the anti-COVID-19 mRNA vaccine Bnt162b2 (Comirnaty, Pfizer/BioNTech). The main endpoint of this epidemiological, observational, prospective and monocentric study was to identify the number, types, and severity of adverse events following immunisation that occurred in subjects who had been previously infected with COVID-19, and in those who had not, after vaccination with Comirnaty, and to compare the two groups of subjects looking at events that occurred within a month after the first and the second dose. METHODS Data were gathered by a questionnaire. The results included the responses of all healthcare workers (2030) of the IRCCS Sacro Cuore Don Calabria Hospital (Italy) vaccinated between 1st January and 28th February 2021. Adverse effects of the vaccine were reported after the first and the second doses. RESULTS There was a statistically significant increase (p<0.001, χ2=35.60) in participants who experienced some side-effects after receiving the first dose of the vaccine and who had previously been infected with the coronavirus, compared with participants who had not previously been infected. 46.76% (136) of the participants who had previously been infected experienced some side-effects after the first dose of vaccine, and 63.23% (184) experienced some side-effects after the second dose, compared with 29.15% (507) after the first dose and 70.79% (1231) after the second dose in those who had not been previously infected. The number of participants who experienced side-effects after the second dose and had previously been infected was significantly lower compared with participants who had not previously been infected (p=0.0094, χ2=6.743). CONCLUSIONS Most of the side-effects identified in this trial were also reported by the manufacturer and the US Food and Drug Administration. Active surveillance should always continue to constantly check the vaccine's risk/benefit ratio over time.
Collapse
Affiliation(s)
- Andrea Ossato
- Pharmaceutical & Pharmacological Sciences Department, University of Padua, Padova, Italy
| | - Roberto Tessari
- Hospital Pharmacy, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy
| | - Carlotta Trabucchi
- Hospital Pharmacy, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy
| | - Teresa Zuppini
- Hospital Pharmacy, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy
| | - Nicola Realdon
- Pharmaceutical & Pharmacological Sciences Department, University of Padua, Padova, Italy
| | - Francesca Marchesini
- Hospital Pharmacy, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy
| |
Collapse
|
4
|
Ossato A, Mezzadrelli V, Montagner G, Trojan D, Giovagnoni G, Giannini M, Trabucchi C, Angelini C, Realdon F, Cipriano L, Realdon N, Zuppini T, Tessari R. A retrospective hospital benefit and cost analysis of the management of human tissues for orthopaedic allografts. Eur J Hosp Pharm 2023:ejhpharm-2023-003744. [PMID: 37316166 DOI: 10.1136/ejhpharm-2023-003744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 05/30/2023] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVES The transplantation of human tissues is a greatly expanding field of medicine with unquestionable benefits that raise questions about safety, quality and ethics. Since 1 October 2019, the Fondazione Banca dei Tessuti del Veneto (FBTV) stopped sending thawed and ready to be transplanted cadaveric human tissues to hospitals. A retrospective analysis of the period 2016-2019 found a significant number of unused tissues. For this reason, the hospital pharmacy has developed a new centralised service characterised by thawing and washing human tissues for orthopaedic allografts. This study aims to analyse the hospital cost and benefit derived from this new service. METHODS Aggregate data relating to tissue flows were obtained retrospectively for the period 2016-2022 through the hospital data warehouse. All tissues arriving from FBTV for each year were analysed, dividing them according to the outcome (if used or wasted). The percentage of wasted tissues as well as the economic loss due to wasted allografts were analysed per year and trimester. RESULTS We identified 2484 allografts requested for the period 2016-2022. In the last 3 years of the analysis, characterised by the new tissue management of the pharmacy department, we found a statistically significant reduction in wasted tissues (p<0.0001) from 16.33% (216/1323) with a cost to the hospital of 176 866€ during the period 2016-2019 to 6.72% (78/1161) with a cost to the hospital of 79 423€ during the period 2020-2022. CONCLUSION This study shows how the centralised processing of human tissues in the hospital pharmacy makes the procedure safer and more efficient, demonstrating how the synergy between different hospital departments, high professional skills and ethics can lead to a clinical advantage for patients and a better economic impact for the hospital.
Collapse
Affiliation(s)
- Andrea Ossato
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padova, Italy
| | - Valeria Mezzadrelli
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padova, Italy
| | | | - Diletta Trojan
- Fondazione Banca dei Tessuti del Veneto Onlus, Treviso, Italy
| | - Giuseppe Giovagnoni
- Hospital Pharmacy, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy
| | - Michele Giannini
- Hospital Pharmacy, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy
| | - Carlotta Trabucchi
- Hospital Pharmacy, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy
| | - Chiara Angelini
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padova, Italy
| | - Francesca Realdon
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padova, Italy
| | - Lorenza Cipriano
- Hospital Pharmacy, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy
| | - Nicola Realdon
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padova, Italy
| | - Teresa Zuppini
- Hospital Pharmacy, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy
| | - Roberto Tessari
- Hospital Pharmacy, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy
| |
Collapse
|
5
|
Ossato A, Mengato D, Chiumente M, Messori A, Damuzzo V. Progression-Free and Overall Survival of First-Line Treatments for Advanced Renal Cell Carcinoma: Indirect Comparison of Six Combination Regimens. Cancers (Basel) 2023; 15:cancers15072029. [PMID: 37046690 PMCID: PMC10093553 DOI: 10.3390/cancers15072029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/21/2023] [Accepted: 03/28/2023] [Indexed: 03/31/2023] Open
Abstract
Background: Recently, numerous combination therapies based on immune checkpoint inhibitors (ICI) and vascular endothelial growth factor (VEGF) inhibitors have been proposed as first-line treatments for advanced renal cell carcinoma (aRCC). Our study aimed to compare the efficacy of these combination regimens by the application of an innovative method that reconstructs individual patient data. Methods: Six phase III studies describing different combination regimens for aRCC were selected. Individual patient data were reconstructed from Kaplan–Meier (KM) curves through the “Shiny method”. Overall survival (OS) and progression-free survival (PFS) were compared among combination treatments and sunitinib. Results were summarized as multi-treatment KM curves. Standard statistical testing was used, including hazard ratio and likelihood ratio tests for heterogeneity. Results: In the overall population of aRCC patients, pembrolizumab + lenvatinib showed the longest median PFS and was expected to determine the longest OS. Pembrolizumab + axitinib, nivolumab + cabozantinib and nivolumab + ipilimumab were similar in terms of PFS, but pembrolizumab + axitinib also demonstrated a better OS. Our subgroup analysis showed that sunitinib is still a valuable option, whereas, in intermediate-poor risk patients, pembrolizumab + axitinib and nivolumab + ipilimumab significantly improve OS compared to sunitinib. Conclusion: The Shiny method allowed us to perform all head-to-head indirect comparisons between these agents in a context in which “real” comparative trials have not been performed.
Collapse
|
6
|
Messori A, Damuzzo V, Rivano M, Cancanelli L, Di Spazio L, Ossato A, Chiumente M, Mengato D. Application of the IPDfromKM-Shiny Method to Compare the Efficacy of Novel Treatments Aimed at the Same Disease Condition: A Report of 14 Analyses. Cancers (Basel) 2023; 15:cancers15061633. [PMID: 36980518 PMCID: PMC10046165 DOI: 10.3390/cancers15061633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/05/2023] [Accepted: 03/05/2023] [Indexed: 03/09/2023] Open
Abstract
In the area of evidence-based medicine, the IPDfromKM-Shiny method is an innovative method of survival analysis, midway between artificial intelligence and advanced statistics. Its main characteristic is that an original software investigates the Kaplan-Meier graphs of trials so that individual-patient data are reconstructed. These reconstructed patients represent a new form of original clinical material. The typical objective of investigations based on this method is to analyze the available evidence, especially in oncology, to perform indirect comparisons, and determine the place in therapy of individual agents. This review examined the most recent applications of the IPDfromKM-Shiny method, in which a new web-based software—published in 2021—was used. Reported here are 14 analyses, mostly focused on oncological treatments. Indirect comparisons were based on overall survival or progression free survival. Each of these analyses provided original information to compare treatments with one another and select the most appropriate depending on patient characteristics. These analyses can also be useful to assess equivalence from a regulatory viewpoint. All investigations stressed the importance of heterogeneity to better interpret the evidence generated by IPDfromKM-Shiny investigations. In conclusion, these investigations showed that the reconstruction of individual patient data through this online tool is a promising new method for analyzing trials based on survival endpoints. This new approach deserves further investigation, particularly in the area of indirect comparisons.
Collapse
Affiliation(s)
- Andrea Messori
- Unità di HTA, Regione Toscana, 50139 Firenze, Italy
- Correspondence: ; Tel.: +39-3389513583
| | - Vera Damuzzo
- Dipartimento Politiche del Farmaco, Azienda ULSS 2 Marca Trevigiana, 31100 Treviso, Italy
| | - Melania Rivano
- Farmacia Ospedaliera, Ospedale Binaghi, 09121 Cagliari, Italy
| | - Luca Cancanelli
- Dipartimento Politiche del Farmaco, Azienda ULSS 2 Marca Trevigiana, 31100 Treviso, Italy
| | - Lorenzo Di Spazio
- Farmacia Ospedaliera Nord, Ospedale Santa Chiara di Trento, Azienda Provinciale per i Servizi Sanitari (APSS), 38122 Trento, Italy
| | - Andrea Ossato
- Scuola di Specializzazione in Farmacia Ospedaliera, Università di Padova, 35128 Padova, Italy
| | - Marco Chiumente
- Società Italiana di Farmacia Clinica e Terapia (SIFaCT), 10123 Torino, Italy
| | - Daniele Mengato
- Farmacia Ospedaliera, Azienda Ospedale Università di Padova, 35128 Padova, Italy
| |
Collapse
|
7
|
Martini A, Pivetta L, Schmid F, Ossato A, Dal Mas L, Caeran M, Scandola A, Realdon N, Font Pous M, Joppi R. [Dissemination and reporting bias of clinical and observational studies conducted in the Local health unit of Verona.]. Recenti Prog Med 2023; 114:163-169. [PMID: 36815420 DOI: 10.1701/3981.39641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
INTRODUCTION Bias in dissemination and reporting of clinical research findings has an impact on the pooled summary utilised to produce clinical-therapeutic guidelines and recommendations. This analysis aims to evaluate the dissemination and reporting biases of interventional and observational studies conducted in the setting of the Local health authority of Verona (Aulss). The possible correlation between both biases and profit versus no-profit sponsors was also evaluated. METHODS Verona's Aulss studies completed in the period 01.01.2014-31.01.2021 were extracted from the Clinical study register of the Veneto Region and any form of results' dissemination was identified and compared with the original protocol. Identified studies were stratified by profit or no-profit sponsor and results compared using the Chi-Square test. RESULTS 67 studies (29 profit; 38 non-profit) were included in this analysis. 58.2% of the studies (n=39/67) reports at least one type of findings' dissemination, for 22.4% data-analysis or publication is in progress, while 19.4% has not been published. Regarding the evaluation on reporting bias, 36 of the 39 published studies were considered (n=19 profit; n=17 non-profit): 64% (23/36) showed inconsistencies between the results reported in the manuscript and the protocol. The number of non-compliant profit studies (n=15/19; 79%) was statistically higher than the compliant ones [n=8/17; 47%; (p=0.049; χ2=3.845)]. DISCUSSION This study highlights that findings' dissemination occurs for the majority of the studies evaluated and that the odds of selective reporting are higher for industry funded studies than for publicly funded studies, affecting the quality of the research.
Collapse
Affiliation(s)
| | | | | | - Andrea Ossato
- Dipartimento di scienze del farmaco, Università di Padova
| | - Liana Dal Mas
- Dipartimento di scienze del farmaco, Università di Padova
| | - Michele Caeran
- Dipartimento di scienze del farmaco, Università di Padova
| | - Antonella Scandola
- UOC Assistenza farmaceutica territoriale, Azienda ULSS n. 9 Scaligera, Verona
| | - Nicola Realdon
- Dipartimento di scienze del farmaco, Università di Padova
| | - Maria Font Pous
- UOC Assistenza farmaceutica territoriale, Azienda ULSS n. 9 Scaligera, Verona
| | - Roberta Joppi
- UOC Assistenza farmaceutica territoriale, Azienda ULSS n. 9 Scaligera, Verona
| |
Collapse
|
8
|
Damuzzo V, Rivano M, Baldo P, Cancanelli L, Di Spazio L, Ossato A, Chiumente M, Messori A, Mengato D. [Application of artificial intelligence for an early comparison of efficacy between new cancer drugs.]. Recenti Prog Med 2022; 113:680-687. [PMID: 36318172 DOI: 10.1701/3907.38896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
INTRODUCTION The clinical choice among recently approved cancer drugs is burdened by the absence of direct comparisons in terms of efficacy across these new agents. In this article we present the IPDfromKM method, an artificial intelligence (AI) application that aims to facilitate the analyses on efficacy based on secondary data. METHODS Seven therapeutic areas were selected in which at least three new agents were recently approved. Kaplan-Meier curves of related clinical trials were digitized. Then, the IPDfromKM method was employed to reconstruct patient-level survival data. This information allowed us to compare selected agents in each therapeutic area and to rank them in terms of efficacy. RESULTS We identified the most effective treatment in each of the seven selected therapeutic areas. In two cases, immunotherapies, sharing similar mechanisms of actions, were compared highlighting the most effective one. In the remaining cases, our comparison included also the standard of care, which proved to be superior to new agents in patients with osteosarcoma. DISCUSSION When randomized clinical trials are not available, indirect comparisons can be a valuable source of information. The experience described herein recommends the use of a new method endowed by two important advantages: remarkable speed of analysis and free access to computational tools. In assessing the place in therapy for newly developed agents, this approach can further promote the application of evidence-based principles.
Collapse
Affiliation(s)
- Vera Damuzzo
- Dipartimento Politiche del Farmaco, Azienda ULSS 2 Marca Trevigiana, Treviso
| | | | - Paolo Baldo
- Farmacia Ospedaliera, Centro di Riferimento Oncologico di Aviano (Pordenone)
| | - Luca Cancanelli
- Dipartimento Politiche del Farmaco, Azienda ULSS 2 Marca Trevigiana, Treviso
| | - Lorenzo Di Spazio
- Farmacia Ospedaliera Nord, Ospedale Santa Chiara di Trento, Azienda Provinciale per i Servizi Sanitari (APSS)
| | - Andrea Ossato
- Scuola di Specializzazione in Farmacia Ospedaliera, Università di Padova
| | - Marco Chiumente
- Società Italiana di Farmacia Clinica e Terapia (SIFaCT), Milano
| | | | | |
Collapse
|
9
|
Messori A, Rivano M, Cancanelli L, Damuzzo V, Ossato A, Chiumente M, Mengato D. The “One-to-Many” Survival Analysis to Evaluate a New Treatment in Comparison With Therapeutic Alternatives Based on Reconstructed Patient Data: Enfortumab Vedotin Versus Standard of Care in Advanced or Metastatic Urothelial Carcinoma. Cureus 2022; 14:e28369. [PMID: 36171827 PMCID: PMC9508613 DOI: 10.7759/cureus.28369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2022] [Indexed: 11/05/2022] Open
Abstract
Objective This paper presents a preliminary experience based on the "one-to-many" approach of the Shiny method. Numerous (or "many") treatments for advanced or metastatic urothelial carcinoma have recently been reviewed. More recently, "one" potentially innovative treatment has been made available. Our analysis was aimed at assessing the benefits of the new treatment in comparison with the alternatives developed previously. Materials and methods The Shiny method was employed to reconstruct patient-level survival data. This information allowed us to compare the Kaplan-Meier (KM) curves of five treatments previously available (i.e., pembrolizumab, nivolumab, atezolizumab, vinflunine, and standard chemotherapy) with the potentially innovative agent represented by enfortumab vedotin. Overall survival was evaluated for each agent. Statistical tests to assess head-to-head indirect comparisons were performed through standard survival analysis. The hazard ratio (HR) was the main parameter. Results In ranking the efficacy across these agents, enfortumab vedotin was first, followed by immune checkpoint inhibitors (ICIs). Standard chemotherapy and vinflunine were the least effective. The remarkable survival results of enfortumab were, to some extent, influenced by the slightly better prognosis of the population enrolled in the enfortumab trial in comparison with patients enrolled in the three ICI trials. Conclusions The experience described herein shows that, when a potential innovative treatment (enfortumab vedotin) is developed in an already investigated area (metastatic urothelial cancer), the Shiny method can be applied according to the "one-to-many" approach. This allows us to quickly assess the place in therapy of the new treatment (the "one") and to evaluate whether the new treatment determines a relevant incremental benefit in comparison with previous treatments (the "many").
Collapse
|
10
|
Ossato A, Damuzzo V, Baldo P, Mengato D, Chiumente M, Messori A. Immune checkpoint inhibitors as first line in advanced melanoma: Evaluating progression-free survival based on reconstructed individual patient data. Cancer Med 2022; 12:2155-2165. [PMID: 35920297 PMCID: PMC9939083 DOI: 10.1002/cam4.5067] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/13/2022] [Accepted: 07/13/2022] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND In patients with advanced melanoma, immune-checkpoint inhibitors (ICIs) represent the mainstay for first line treatment. Recently, relatlimab+nivolumab was proposed as a new combination therapy. This review was aimed at summarizing the current data of effectiveness for ICIs. Progression-free survival (PFS) was the endpoint of our analysis. METHODS After a standard literature search, Phase II/III studies comparing different ICI regimens in previously untreated advanced melanoma patients were analyzed. Patient-level data were reconstructed from Kaplan-Meier curves by application of the IPDfromKM method. These reconstructed datasets were used to perform indirect comparisons between treatments. Standard statistical testing was used, including hazard ratio and medians. A secondary analysis employed the restricted mean survival time. RESULTS Six trials were included in our analysis. Information on PFS from these trials was pooled according to the following treatments: nivolumab or pembrolizumab as monotherapy, or in combination with ipilimumab, and relatlimab + nivolumab. Pembrolizumab+ipilimumab showed significantly better PFS compared with the other treatments; nivolumab+ipilimumab ranked second; the other treatments showed a similar survival pattern. CONCLUSIONS The picture of comparative effectiveness resulting from our analysis is complex. The IPDfromKM method is advantageous because it accounts for the length of follow-up but loses the balance between treatment group and controls determined by randomization. Based on indirect comparisons, the combination of pembrolizumab+ipilimumab showed a particularly high efficacy, and so deserves further investigation. While the effect of between-trial differences in inclusion criteria plays an important role, our results do not support the proposal of relatlimab+nivolumab as a new standard of care.
Collapse
Affiliation(s)
- Andrea Ossato
- Department of Pharmaceutical and Pharmacological SciencesUniversity of PadovaPadovaItaly
| | - Vera Damuzzo
- Department of Pharmaceutical and Pharmacological SciencesUniversity of PadovaPadovaItaly
| | - Paolo Baldo
- Centro di Riferimento Oncologico di Aviano IRCCSAvianoItaly
| | - Daniele Mengato
- Italian Society of Clinical Pharmacy and Therapeutics‐SIFaCTMilanItaly
| | - Marco Chiumente
- Italian Society of Clinical Pharmacy and Therapeutics‐SIFaCTMilanItaly
| | - Andrea Messori
- HTA Unit, Regione Toscana, Regional Health ServiceFlorenceItaly
| |
Collapse
|
11
|
Marchesini F, Ossato A, Zendrini A, Arginelli F, Zuppini T, Realdon N, Zamperini M, Tessari R. Dabigatran-Induced Nephropathy and Gastrointestinal Bleeding and Its Successful Treatment with Idarucizumab: A Case Report. Hosp Pharm 2021; 57:241-245. [PMID: 35601714 PMCID: PMC9117771 DOI: 10.1177/00185787211016335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Recently, the atrial fibrillation treatment guidelines have been updated to now recommend Non-vitamin K antagonist oral anticoagulants (NOACs) as the preferred alternative to warfarin for systemic embolism and stroke prevention in patients with non-valvular atrial fibrillation. NOACs have major pharmacologic advantages over warfarin, although the most common complications are gastrointestinal bleeding and NOAC-induced nephropathy within 6 weeks after starting therapy, as several recent case-reports stated. We are reporting for the first time a chronic delayed adverse reaction (regularly reported to Authorities) observed in an 82-year-old woman 27 months after starting dabigatran (110 mg twice a day), characterized by concomitant gastrointestinal bleeding and nephropathy. Idarucizumab administration immediately improved both bleeding and renal parameters. Moreover, we are going to highlight the importance of the compliance, the adherence to the therapeutic plan and the supervision of the Hospital Pharmacy on drug prescriptions. In fact in our case, dabigatran was firstly prescribed by the neurologist and delivered by the hospital pharmacy, but the patient continued the treatment for 27 months, prescribed by general practitioner without any laboratory control. This lack of supervision certainly contributed to the onset of the adverse reaction reported.
Collapse
Affiliation(s)
| | | | - Alberto Zendrini
- IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy
| | | | - Teresa Zuppini
- IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy
| | | | - Massimo Zamperini
- IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy
| | - Roberto Tessari
- IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy
| |
Collapse
|
12
|
De-Giorgio F, Bilel S, Ossato A, Tirri M, Arfè R, Foti F, Serpelloni G, Frisoni P, Neri M, Marti M. Reply to "MDPV-induced aggression in humans not established". Int J Legal Med 2019; 134:263-265. [PMID: 31773317 DOI: 10.1007/s00414-019-02176-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 10/07/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Fabio De-Giorgio
- Institute of Public Health, Section of Legal Medicine, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy
| | - Sabrine Bilel
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Ferrara, Italy
| | - Andrea Ossato
- Institute of Public Health, Section of Legal Medicine, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy
| | - Micaela Tirri
- Collaborative Center for the Italian National Early Warning System, Department of Anti-Drug Policies, Presidency of the Council of Ministers, Rome, Italy
| | - Raffaella Arfè
- Institute of Public Health, Section of Legal Medicine, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy.,Department of Morphology, Experimental Medicine and Surgery, Section of Legal Medicine and LTTA Centre, University of Ferrara, Ferrara, Italy
| | - Federica Foti
- Institute of Public Health, Section of Legal Medicine, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy
| | - Giovanni Serpelloni
- Department of Psychiatry, College of Medicine, Drug Policy Institute, University of Florida, Gainesville, FL, USA
| | - Paolo Frisoni
- Department of Morphology, Experimental Medicine and Surgery, Section of Legal Medicine and LTTA Centre, University of Ferrara, Ferrara, Italy
| | - Margherita Neri
- Department of Morphology, Experimental Medicine and Surgery, Section of Legal Medicine and LTTA Centre, University of Ferrara, Ferrara, Italy
| | - Matteo Marti
- Department of Morphology, Experimental Medicine and Surgery, Section of Legal Medicine and LTTA Centre, University of Ferrara, Ferrara, Italy. .,Collaborative Center for the Italian National Early Warning System, Department of Anti-Drug Policies, Presidency of the Council of Ministers, Rome, Italy.
| |
Collapse
|
13
|
Bilel S, Tirri M, Arfè R, Ossato A, Trapella C, Serpelloni G, Neri M, Fattore L, Marti M. Novel halogenated synthetic cannabinoids impair sensorimotor functions in mice. Neurotoxicology 2019; 76:17-32. [PMID: 31610187 DOI: 10.1016/j.neuro.2019.10.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 09/18/2019] [Accepted: 10/07/2019] [Indexed: 02/06/2023]
Abstract
JWH-018-Cl, JWH-018-Br and AM-2201 (JWH-018 halogenated-derivatives; JWH-018-R compounds) are synthetic cannabinoid agonists illegally marketed as "Spice", "K2", "herbal blend" and research chemicals for their cannabis-like psychoactive effects. In rodents, JWH-018 and its halogenated derivatives reproduce the typical effects of Δ9-tetrahydrocannabinol (Δ9-THC), i.e. hypothermia, analgesia, hypolocomotion and akinesia. Yet, the effects of JWH-018-R compounds on sensorimotor functions are still unknown. This study was designed to investigate the effect of an acute intraperitoneal (i.p.) administration of JWH-018-R compounds (0.01-6 mg/kg) on sensorimotor functions in mice and to compare them to those caused by the reference compound JWH-018 and Δ9-THC. A well validated battery of behavioral tests was used to investigate the effects of these synthetic cannabinoids on the visual, auditory and tactile responses in mice, while the pre-pulse inhibition (PPI) test was used to investigate their effect on sensorimotor gating. The effect of the synthetic cannabinoids on spontaneous locomotion was also measured by a video tracking analysis to assess potential cannabinoid-induced motor impairment. Results showed that, similarly to JWH-018, systemic administration of JWH-018-R compounds inhibits sensorimotor and PPI responses at lower doses (0.01-0.1 mg/kg) and reduced spontaneous locomotion at intermediate/high doses (1-6 mg/kg). All effects were prevented by the administration of the selective cannabinoid CB1 receptor antagonist/inverse agonist AM-251 thus confirming a CB1 receptor-mediated action. Finding that lower doses of JWH-018-R compounds selectively impair sensorimotor and PPI responses without affecting locomotion should be carefully considered to better understand the potential danger that halogenated-derivatives of JWH-018 may pose to public health, with particular reference to decreased performance in driving and hazardous works.
Collapse
Affiliation(s)
- Sabrine Bilel
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Italy
| | - Micaela Tirri
- Department of Morphology, Experimental Medicine and Surgery, Section of Legal Medicine, University of Ferrara, Ferrara, Italy
| | - Raffaella Arfè
- Institute of Public Health, Section of Legal Medicine, Catholic University of Rome, Rome, Italy
| | - Andrea Ossato
- Institute of Public Health, Section of Legal Medicine, Catholic University of Rome, Rome, Italy
| | - Claudio Trapella
- Department of Chemistry and Pharmaceutical Sciences, University of Ferrara, Italy
| | - Giovanni Serpelloni
- Drug Policy Institute, Department of Psychiatry in the College of Medicine, University of Florida, USA
| | - Margherita Neri
- Department of Morphology, Experimental Medicine and Surgery, Section of Legal Medicine, University of Ferrara, Ferrara, Italy
| | - Liana Fattore
- Institute of Neuroscience-Cagliari, National Research Council, Italy.
| | - Matteo Marti
- Department of Morphology, Experimental Medicine and Surgery, Section of Legal Medicine, University of Ferrara, Ferrara, Italy; Center for Neuroscience and National Institute of Neuroscience, Italy; Collaborative Center for the Italian National Early Warning System, Department of Anti-Drug Policies, Presidency of the Council of Ministers, Italy
| |
Collapse
|
14
|
De-Giorgio F, Bilel S, Ossato A, Tirri M, Arfè R, Foti F, Serpelloni G, Frisoni P, Neri M, Marti M. Acute and repeated administration of MDPV increases aggressive behavior in mice: forensic implications. Int J Legal Med 2019; 133:1797-1808. [PMID: 31154497 DOI: 10.1007/s00414-019-02092-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 05/22/2019] [Indexed: 01/18/2023]
Abstract
MDPV is a synthetic cathinone illegally marketed and consumed for its psychostimulant effects, which are similar to those produced by cocaine, amphetamines, and MDMA. Clinical reports indicate that MDPV produces euphoria, increases alertness, and at high doses causes agitation, psychosis, tachycardia and hypertension, hallucinations, delirium, hyperthermia, rhabdomyolysis, and even death. In rodents, MDPV reproduces the typical physiological effects of psychostimulant drugs, demonstrating greater potency than cocaine. Nevertheless, its role in aggressive behavior has been reported but not yet experimentally confirmed. Therefore, the aim of this study was to evaluate the effects of acute and repeated MDPV (0.01-10 mg/kg i.p.) administration on aggressive behavior in mice and to compare them with those of cocaine (0.01-10 mg/kg i.p.) administration. To this purpose, the resident-intruder test in isolated mice and the spontaneous and stimulated aggressiveness tests for group-housed mice were employed. The present study shows for the first time that MDPV enhances aggressive behavior and locomotion in mice with greater potency and efficacy than cocaine treatment. Moreover, the aggressive and locomotor responses are enhanced after repeated administration, indicating that a sensitization mechanism comes into play. These results, although from preclinical investigation, are suggestive that human MDPV intake could be a problem for public health and the criminal justice system. Thus, investigation by police officers and medical staff is needed to prevent interpersonal violence induced by the consumption of synthetic cathinones.
Collapse
Affiliation(s)
- Fabio De-Giorgio
- Institute of Public Health, Section of Legal Medicine, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy
| | - Sabrine Bilel
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Ferrara, Italy
| | - Andrea Ossato
- Institute of Public Health, Section of Legal Medicine, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy
| | - Micaela Tirri
- Collaborative Center for the Italian National Early Warning System, Department of Anti-Drug Policies, Presidency of the Council of Ministers, Ferrara, Italy.,Department of Morphology, Experimental Medicine and Surgery, Section of Legal Medicine and LTTA Centre, University of Ferrara, via Fossato di Mortara 70, 44121, Ferrara, Italy
| | - Raffaella Arfè
- Institute of Public Health, Section of Legal Medicine, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy.,Department of Morphology, Experimental Medicine and Surgery, Section of Legal Medicine and LTTA Centre, University of Ferrara, via Fossato di Mortara 70, 44121, Ferrara, Italy
| | - Federica Foti
- Institute of Public Health, Section of Legal Medicine, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy
| | - Giovanni Serpelloni
- Department of Psychiatry in the College of Medicine, Drug Policy Institute, University of Florida, Gainesville, FL, USA
| | - Paolo Frisoni
- Department of Morphology, Experimental Medicine and Surgery, Section of Legal Medicine and LTTA Centre, University of Ferrara, via Fossato di Mortara 70, 44121, Ferrara, Italy
| | - Margherita Neri
- Department of Morphology, Experimental Medicine and Surgery, Section of Legal Medicine and LTTA Centre, University of Ferrara, via Fossato di Mortara 70, 44121, Ferrara, Italy
| | - Matteo Marti
- Collaborative Center for the Italian National Early Warning System, Department of Anti-Drug Policies, Presidency of the Council of Ministers, Ferrara, Italy. .,Department of Morphology, Experimental Medicine and Surgery, Section of Legal Medicine and LTTA Centre, University of Ferrara, via Fossato di Mortara 70, 44121, Ferrara, Italy.
| |
Collapse
|
15
|
Ossato A, Bilel S, Gregori A, Talarico A, Trapella C, Gaudio RM, De-Giorgio F, Tagliaro F, Neri M, Fattore L, Marti M. Neurological, sensorimotor and cardiorespiratory alterations induced by methoxetamine, ketamine and phencyclidine in mice. Neuropharmacology 2018; 141:167-180. [PMID: 30165078 DOI: 10.1016/j.neuropharm.2018.08.017] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 08/10/2018] [Accepted: 08/17/2018] [Indexed: 01/01/2023]
Abstract
Novel psychoactive substances are intoxicating compounds developed to mimic the effects of well-established drugs of abuse. They are not controlled by the United Nations drug convention and pose serious health concerns worldwide. Among them, the dissociative drug methoxetamine (MXE) is structurally similar to ketamine (KET) and phencyclidine (PCP) and was created to purposely mimic the psychotropic effects of its "parent" compounds. Recent animal studies show that MXE is able to stimulate the mesolimbic dopaminergic transmission and to induce KET-like discriminative and rewarding effects. In light of the renewed interest in KET and PCP analogs, we decided to deepen the investigation of MXE-induced effects by a battery of behavioral tests widely used in studies of "safety-pharmacology" for the preclinical characterization of new molecules. To this purpose, the acute effects of MXE on neurological and sensorimotor functions in mice, including visual, acoustic and tactile responses, thermal and mechanical pain, motor activity and acoustic startle reactivity were evaluated in comparisons with KET and PCP to better appreciate its specificity of action. Cardiorespiratory parameters and blood pressure were also monitored in awake and freely moving animals. Acute systemic administrations of MXE, KET and PCP (0.01-30 mg/kg i.p.) differentially alter neurological and sensorimotor functions in mice depending in a dose-dependent manner specific for each parameter examined. MXE and KET (1 and 30 mg/kg i.p.) and PCP (1 and 10 mg/kg i.p.) also affect significantly cardiorespiratory parameters, systolic and diastolic blood pressure in mice.
Collapse
Affiliation(s)
- Andrea Ossato
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Italy; Institute of Public Health, Section of Legal Medicine, Catholic University of Rome, Rome, Italy
| | - Sabrine Bilel
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Italy
| | - Adolfo Gregori
- Carabinieri, Department of Scientific Investigation (RIS), 00191, Rome, Italy
| | - Anna Talarico
- Department of Chemistry and Pharmaceutical Sciences, University of Ferrara, Italy
| | - Claudio Trapella
- Department of Chemistry and Pharmaceutical Sciences, University of Ferrara, Italy
| | - Rosa Maria Gaudio
- Department of Medical Sciences, Section of Forensic Pathology, University of Ferrara, Italy
| | - Fabio De-Giorgio
- Institute of Public Health, Section of Legal Medicine, Catholic University of Rome, Rome, Italy
| | - Franco Tagliaro
- Unit of Forensic Medicine, Department of Diagnostics and Public Health, University of Verona, Policlinico ''G.B. Rossi'', Verona, Italy; Institute of Pharmacy and Translational Medicine, Sechenov First Moscow State Medical University, Russian Federation
| | - Margherita Neri
- Department of Morphology, Surgery and Experimental Medicine, Section of Legal Medicine, University of Ferrara, Italy
| | - Liana Fattore
- Institute of Neuroscience-Cagliari, National Research Council (CNR), Italy
| | - Matteo Marti
- Department of Morphology, Surgery and Experimental Medicine, Section of Legal Medicine, University of Ferrara, Italy; Collaborative Center for the Italian National Early Warning System, Department of Anti-Drug Policies, Presidency of the Council of Ministers, Italy.
| |
Collapse
|
16
|
Giannotti G, Canazza I, Caffino L, Bilel S, Ossato A, Fumagalli F, Marti M. The Cathinones MDPV and α-PVP Elicit Different Behavioral and Molecular Effects Following Acute Exposure. Neurotox Res 2017. [PMID: 28646469 DOI: 10.1007/s12640-017-9769-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Since the mid-to-late 2000s, synthetic cathinones have gained popularity among drug users due to their psychostimulant effects greater than those produced by cocaine and amphetamine. Among them, 3,4-methylenedioxypyrovalerone (MDPV) and 1-phenyl-2-(pyrrolidin-1-yl)pentan-1-one (α-PVP) are ones of the most popular cathinones available in the clandestine market as "bath salts" or "fertilizers." Pre-clinical studies indicate that MDPV and α-PVP induced psychomotor stimulation, affected thermoregulation, and promoted reinforcing properties in rodents. However, a direct comparative analysis on the effects caused by MDPV and α-PVP on the behavior and neuronal activation in rodents is still lacking. Behavioral analyses revealed that both MDPV and α-PVP affect spontaneous and stimulated motor responses. In particular, MDPV showed a greater psychomotor effect than α-PVP in line with its higher potency in blocking the dopamine transporter (DAT). Notably, MDPV was found to be more effective than α-PVP in facilitating spontaneous locomotion and it displayed a biphasic effect in contrast to the monophasically stimulated locomotion induced by α-PVP. In addition to the behavioral results, we also found a different modulation of immediate early genes (IEGs) such as Arc/Arg3.1 and c-Fos in the frontal lobe, striatum, and hippocampus, indicating that these drugs do impact brain homeostasis with changes in neuronal activity that depend on the drug, the brain area analyzed, and the timing after the injection. These results provide the first discrimination between MDPV and α-PVP based on behavioral and molecular data that may contribute to explain, at least in part, their toxicity.
Collapse
Affiliation(s)
- Giuseppe Giannotti
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Via Balzaretti 9, 20133, Milan, Italy
| | - Isabella Canazza
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, via Fossato di Mortara 17-19, 44121, Ferrara, Italy.,Institute of Public Health, Section of Legal Medicine, Catholic University of Rome, Rome, Italy
| | - Lucia Caffino
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Via Balzaretti 9, 20133, Milan, Italy
| | - Sabrine Bilel
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, via Fossato di Mortara 17-19, 44121, Ferrara, Italy
| | - Andrea Ossato
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, via Fossato di Mortara 17-19, 44121, Ferrara, Italy.,Institute of Public Health, Section of Legal Medicine, Catholic University of Rome, Rome, Italy
| | - Fabio Fumagalli
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Via Balzaretti 9, 20133, Milan, Italy
| | - Matteo Marti
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, via Fossato di Mortara 17-19, 44121, Ferrara, Italy. .,Center for Neuroscience and Istituto Nazionale di Neuroscienze, Ferrara, Italy.
| |
Collapse
|
17
|
Canazza I, Ossato A, Vincenzi F, Gregori A, Di Rosa F, Nigro F, Rimessi A, Pinton P, Varani K, Borea PA, Marti M. Pharmaco-toxicological effects of the novel third-generation fluorinate synthetic cannabinoids, 5F-ADBINACA, AB-FUBINACA, and STS-135 in mice. In vitro and in vivo studies. Hum Psychopharmacol 2017; 32. [PMID: 28597570 DOI: 10.1002/hup.2601] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 04/10/2017] [Accepted: 04/11/2017] [Indexed: 01/08/2023]
Abstract
INTRODUCTION 5F-ADBINACA, AB-FUBINACA, and STS-135 are 3 novel third-generation fluorinate synthetic cannabinoids that are illegally marketed as incense, herbal preparations, or research chemicals for their psychoactive cannabis-like effects. METHODS The present study aims at investigating the in vitro and in vivo pharmacological activity of 5F-ADBINACA, AB-FUBINACA, and STS-135 in male CD-1 mice, comparing their in vivo effects with those caused by the administration of Δ9 -THC and JWH-018. In vitro competition binding experiments revealed a nanomolar affinity and potency of the 5F-ADBINACA, AB-FUBINACA, and STS-135 on mouse and human CB1 and CB2 receptors. Moreover, these synthetic cannabinoids induced neurotoxicity in murine neuro-2a cells. RESULTS In vivo studies showed that 5F-ADBINACA, AB-FUBINACA, and STS-135 induced hypothermia; increased pain threshold to both noxious mechanical and thermal stimuli; caused catalepsy; reduced motor activity; impaired sensorimotor responses (visual, acoustic, and tactile); caused seizures, myoclonia, and hyperreflexia; and promoted aggressiveness in mice. Behavioral and neurological effects were fully prevented by the selective CB1 receptor antagonist/inverse agonist AM 251. Differently, the visual sensory response induced by STS-135 was only partly prevented by the AM 251, suggesting a CB1 -independent mechanism. CONCLUSIONS For the first time, the present study demonstrates the pharmaco-toxicological effects induced by the administration of 5F-ADBINACA, AB-FUBINACA, and STS-135 in mice and suggests their possible detrimental effects on human health.
Collapse
Affiliation(s)
- Isabella Canazza
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Ferrara, Italy.,Institute of Public Health, Section of Legal Medicine, Catholic University of Rome, Rome, Italy
| | - Andrea Ossato
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Ferrara, Italy.,Institute of Public Health, Section of Legal Medicine, Catholic University of Rome, Rome, Italy
| | - Fabrizio Vincenzi
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Adolfo Gregori
- Carabinieri, Department of Scientific Investigation (RIS), Rome, Italy
| | - Fabiana Di Rosa
- Carabinieri, Department of Scientific Investigation (RIS), Rome, Italy
| | - Federica Nigro
- Department of Morphology, Surgery and Experimental Medicine, Section of Pathology, Oncology and Experimental Biology, Laboratory for Technologies of Advanced Therapies (LTTA), University of Ferrara, Ferrara, Italy
| | - Alessandro Rimessi
- Department of Morphology, Surgery and Experimental Medicine, Section of Pathology, Oncology and Experimental Biology, Laboratory for Technologies of Advanced Therapies (LTTA), University of Ferrara, Ferrara, Italy
| | - Paolo Pinton
- Department of Morphology, Surgery and Experimental Medicine, Section of Pathology, Oncology and Experimental Biology, Laboratory for Technologies of Advanced Therapies (LTTA), University of Ferrara, Ferrara, Italy
| | - Katia Varani
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Pier Andrea Borea
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Matteo Marti
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Ferrara, Italy.,Center for Neuroscience and Istituto Nazionale di Neuroscienze, University of Ferrara, Ferrara, Italy
| |
Collapse
|
18
|
Fantinati A, Ossato A, Bianco S, Canazza I, De Giorgio F, Trapella C, Marti M. 1-cyclohexyl-x-methoxybenzene derivatives, novel psychoactive substances seized on the internet market. Synthesis and in vivo pharmacological studies in mice. Hum Psychopharmacol 2017; 32. [PMID: 28657178 DOI: 10.1002/hup.2560] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Among novel psychoactive substances notified to EMCDDA and Europol were 1-cyclohexyl-x-methoxybenzene stereoisomers (ortho, meta, and para). These substances share some structural characteristics with phencyclidine and tramadol. Nowadays, no information on the pharmacological and toxicological effects evoked by 1-cyclohexyl-x-methoxybenzene are reported. The aim of this study was to investigate the effect evoked by each one stereoisomer on visual stimulation, body temperature, acute thermal pain, and motor activity in mice. METHODS Mice were evaluated in behavioral tests carried out in a consecutive manner according to the following time scheme: observation of visual placing response, measures of core body temperature, determination of acute thermal pain, and stimulated motor activity. RESULTS All three stereoisomers dose-dependent inhibit visual placing response (rank order: meta > ortho > para), induce hyperthermia at lower and hypothermia at higher doses (meta > ortho > para) and cause analgesia to thermal stimuli (para > meta = ortho), while they do not alter motor activity. CONCLUSIONS For the first time, this study demonstrates that systemic administration of 1-cyclohexyl-x-methoxybenzene compounds markedly inhibit visual response, promote analgesia, and induce core temperature alterations in mice. This data, although obtained in animal model, suggest their possible hazard for human health (i.e., hyperthermia and sensorimotor alterations). In particular, these novel psychoactive substances may have a negative impact in many daily activities, greatly increasing the risk factors for workplace accidents and traffic injuries.
Collapse
Affiliation(s)
- Anna Fantinati
- Department of Chemistry and Pharmaceutical Sciences, University of Ferrara, Ferrara, Italy
| | - Andrea Ossato
- Institute of Public Health, Section of Legal Medicine, Catholic University of Rome, Rome, Italy
| | - Sara Bianco
- Department of Chemistry and Pharmaceutical Sciences, University of Ferrara, Ferrara, Italy
| | - Isabella Canazza
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Ferrara, Italy.,Institute of Public Health, Section of Legal Medicine, Catholic University of Rome, Rome, Italy
| | - Fabio De Giorgio
- Institute of Public Health, Section of Legal Medicine, Catholic University of Rome, Rome, Italy
| | - Claudio Trapella
- Department of Chemistry and Pharmaceutical Sciences, University of Ferrara, Ferrara, Italy
| | - Matteo Marti
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Ferrara, Italy.,Center for Neuroscience and Istituto Nazionale di Neuroscienze, Ferrara, Italy
| |
Collapse
|
19
|
Ossato A, Uccelli L, Bilel S, Canazza I, Di Domenico G, Pasquali M, Pupillo G, De Luca MA, Boschi A, Vincenzi F, Rimondo C, Beggiato S, Ferraro L, Varani K, Borea PA, Serpelloni G, De-Giorgio F, Marti M. Psychostimulant Effect of the Synthetic Cannabinoid JWH-018 and AKB48: Behavioral, Neurochemical, and Dopamine Transporter Scan Imaging Studies in Mice. Front Psychiatry 2017; 8:130. [PMID: 28824464 PMCID: PMC5543288 DOI: 10.3389/fpsyt.2017.00130] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 07/06/2017] [Indexed: 12/16/2022] Open
Abstract
JWH-018 and AKB48 are two synthetic cannabinoids (SCBs) belonging to different structural classes and illegally marketed as incense, herbal preparations, or chemical supply for theirs psychoactive cannabis-like effects. Clinical reports from emergency room reported psychomotor agitation as one of the most frequent effects in people assuming SCBs. This study aimed to investigate the psychostimulant properties of JWH-018 and AKB48 in male CD-1 mice and to compare their behavioral and biochemical effects with those caused by cocaine and amphetamine. In vivo studies showed that JWH-018 and AKB48, as cocaine and amphetamine, facilitated spontaneous locomotion in mice. These effects were prevented by CB1 receptor blockade and dopamine (DA) D1/5 and D2/3 receptors inhibition. SPECT-CT studies on dopamine transporter (DAT) revealed that, as cocaine and amphetamine, JWH-018 and AKB48 decreased the [123I]-FP-CIT binding in the mouse striatum. Conversely, in vitro competition binding studies revealed that, unlike cocaine and amphetamine, JWH-018 and AKB48 did not bind to mouse or human DAT. Moreover, microdialysis studies showed that the systemic administration of JWH-018, AKB48, cocaine, and amphetamine stimulated DA release in the nucleus accumbens (NAc) shell of freely moving mice. Finally, unlike amphetamine and cocaine, JWH-018 and AKB48 did not induce any changes on spontaneous [3H]-DA efflux from murine striatal synaptosomes. The present results suggest that SCBs facilitate striatal DA release possibly with different mechanisms than cocaine and amphetamine. Furthermore, they demonstrate, for the first time, that JWH-018 and AKB48 induce a psychostimulant effect in mice possibly by increasing NAc DA release. These data, according to clinical reports, outline the potential psychostimulant action of SCBs highlighting their possible danger to human health.
Collapse
Affiliation(s)
- Andrea Ossato
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Ferrara, Italy.,Section of Legal Medicine, Institute of Public Health, Catholic University of the Sacred Heart, Rome, Italy
| | - Licia Uccelli
- Morphology, Surgery and Experimental Medicine Department, University of Ferrara, Ferrara, Italy
| | - Sabrine Bilel
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Ferrara, Italy
| | - Isabella Canazza
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Ferrara, Italy.,Section of Legal Medicine, Institute of Public Health, Catholic University of the Sacred Heart, Rome, Italy
| | | | - Micol Pasquali
- Physics and Hearth Science Department, University of Ferrara, Ferrara, Italy
| | - Gaia Pupillo
- Legnaro National Laboratories, Italian National Institute for Nuclear Physics (LNL-INFN), Legnaro, Italy
| | | | - Alessandra Boschi
- Morphology, Surgery and Experimental Medicine Department, University of Ferrara, Ferrara, Italy
| | - Fabrizio Vincenzi
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Claudia Rimondo
- Department of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - Sarah Beggiato
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Ferrara, Italy
| | - Luca Ferraro
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Ferrara, Italy
| | - Katia Varani
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Pier Andrea Borea
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Giovanni Serpelloni
- Department of Psychiatry in the College of Medicine, Drug Policy Institute, University of Florida, Gainesville, FL, United States
| | - Fabio De-Giorgio
- Section of Legal Medicine, Institute of Public Health, Catholic University of the Sacred Heart, Rome, Italy
| | - Matteo Marti
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Ferrara, Italy.,Center for Neuroscience, Istituto Nazionale di Neuroscienze, Ferrara, Italy
| |
Collapse
|
20
|
Canazza I, Ossato A, Trapella C, Fantinati A, De Luca MA, Margiani G, Vincenzi F, Rimondo C, Di Rosa F, Gregori A, Varani K, Borea PA, Serpelloni G, Marti M. Effect of the novel synthetic cannabinoids AKB48 and 5F-AKB48 on "tetrad", sensorimotor, neurological and neurochemical responses in mice. In vitro and in vivo pharmacological studies. Psychopharmacology (Berl) 2016; 233:3685-3709. [PMID: 27527584 DOI: 10.1007/s00213-016-4402-y] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 08/01/2016] [Indexed: 02/06/2023]
Abstract
RATIONALE AKB48 and its fluorinate derivate 5F-AKB48 are two novel synthetic cannabinoids belonging to a structural class with an indazole core structure. They are marketed as incense, herbal preparations or chemical supply for their psychoactive Cannabis-like effects. OBJECTIVES The present study was aimed at investigating the in vitro and in vivo pharmacological activity of AKB48 and 5F-AKB48 in male CD-1 mice and comparing their in vivo effects with those caused by the administration of Δ9-THC and JWH-018. RESULTS In vitro competition binding experiments performed on mouse and human CB1 and CB2 receptors revealed a nanomolar affinity and potency of the AKB48 and 5F-AKB48. In vivo studies showed that AKB48 and 5F-AKB48, induced hypothermia, increased pain threshold to both noxious mechanical and thermal stimuli, caused catalepsy, reduced motor activity, impaired sensorimotor responses (visual, acoustic and tactile), caused seizures, myoclonia, hyperreflexia and promoted aggressiveness in mice. Moreover, microdialysis study in freely moving mice showed that systemic administration of AKB48 and 5F-AKB48 stimulated dopamine release in the nucleus accumbens. Behavioural, neurological and neurochemical effects were fully prevented by the selective CB1 receptor antagonist/inverse agonist AM 251. CONCLUSIONS For the first time, the present study demonstrates the overall pharmacological effects induced by the administration of AKB48 and 5F-AKB48 in mice and suggests that the fluorination can increase the power and/or effectiveness of SCBs. Furthermore, this study outlines the potential detrimental effects of SCBs on human health.
Collapse
Affiliation(s)
- Isabella Canazza
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, via Fossato di Mortara 17-19, 44121, Ferrara, Italy
| | - Andrea Ossato
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, via Fossato di Mortara 17-19, 44121, Ferrara, Italy
| | - Claudio Trapella
- Department of Chemistry and Pharmaceutical Sciences, University of Ferrara, Ferrara, Italy
| | - Anna Fantinati
- Department of Chemistry and Pharmaceutical Sciences, University of Ferrara, Ferrara, Italy
| | | | - Giulia Margiani
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Fabrizio Vincenzi
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Claudia Rimondo
- Department of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - Fabiana Di Rosa
- Department of Scientific Investigation (RIS), Carabinieri, 00191, Rome, Italy
| | - Adolfo Gregori
- Department of Scientific Investigation (RIS), Carabinieri, 00191, Rome, Italy
| | - Katia Varani
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Pier Andrea Borea
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Giovanni Serpelloni
- U.R.I.To.N., Forensic Toxicology Unit, Department of Health Science, University of Florence, Florence, Italy
| | - Matteo Marti
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, via Fossato di Mortara 17-19, 44121, Ferrara, Italy. .,Center for Neuroscience and Istituto Nazionale di Neuroscienze, ᅟ, Italy.
| |
Collapse
|
21
|
Barbieri M, Ossato A, Canazza I, Trapella C, Borelli AC, Beggiato S, Rimondo C, Serpelloni G, Ferraro L, Marti M. Synthetic cannabinoid JWH-018 and its halogenated derivatives JWH-018-Cl and JWH-018-Br impair Novel Object Recognition in mice: Behavioral, electrophysiological and neurochemical evidence. Neuropharmacology 2016; 109:254-269. [PMID: 27346209 DOI: 10.1016/j.neuropharm.2016.06.027] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 06/14/2016] [Accepted: 06/22/2016] [Indexed: 01/29/2023]
Abstract
It is well known that an impairment of learning and memory function is one of the major physiological effects caused by natural or synthetic cannabinoid consumption in rodents, nonhuman primates and in humans. JWH-018 and its halogenated derivatives (JWH-018-Cl and JWH-018-Br) are synthetic CB1/CB2 cannabinoid agonists, illegally marketed as "Spice" and "herbal blend" for their Cannabis-like psychoactive effects. In the present study the effects of acute exposure to JWH-018, JWH-018-Cl, JWH-018-Br (JWH-018-R compounds) and Δ(9)-THC (for comparison) on Novel Object Recognition test (NOR) has been investigated in mice. Moreover, to better characterize the effects of JWH-018-R compounds on memory function, in vitro electrophysiological and neurochemical studies in hippocampal preparations have been performed. JWH-018, JWH-018-Cl and JWH-018-Br dose-dependently impaired both short- and long-memory retention in mice (respectively 2 and 24 h after training session). Their effects resulted more potent respect to that evoked by Δ(9)-THC. Moreover, in vitro studies showed as JWH-018-R compounds negatively affected electrically evoked synaptic transmission, LTP and aminoacid (glutamate and GABA) release in hippocampal slices. Behavioral, electrophysiological and neurochemical effects were fully prevented by CB1 receptor antagonist AM251 pretreatment, suggesting a CB1 receptor involvement. These data support the hypothesis that synthetic JWH-018-R compounds, as Δ(9)-THC, impair cognitive function in mice by interfering with hippocampal synaptic transmission and memory mechanisms. This data outline the danger that the use and/or abuse of these synthetic cannabinoids may represent for the cognitive process in human consumer.
Collapse
Affiliation(s)
- M Barbieri
- Department of Medical Sciences, University of Ferrara, Italy
| | - A Ossato
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Italy
| | - I Canazza
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Italy
| | - C Trapella
- Department of Chemistry and Pharmaceutical Sciences, University of Ferrara, Italy
| | - A C Borelli
- Department of Medical Sciences, University of Ferrara, Italy
| | - S Beggiato
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Italy
| | - C Rimondo
- Department of Public Health and Community Medicine, University of Verona, Italy
| | - G Serpelloni
- U.R.I.To.N., Forensic Toxicology Unit, Department of Health Science, University of Florence, Florence, Italy
| | - L Ferraro
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Italy
| | - M Marti
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Italy; Center for Neuroscience and Istituto Nazionale di Neuroscienze, Italy.
| |
Collapse
|
22
|
Ossato A, Canazza I, Trapella C, Vincenzi F, De Luca MA, Rimondo C, Varani K, Borea PA, Serpelloni G, Marti M. Effect of JWH-250, JWH-073 and their interaction on "tetrad", sensorimotor, neurological and neurochemical responses in mice. Prog Neuropsychopharmacol Biol Psychiatry 2016; 67:31-50. [PMID: 26780169 DOI: 10.1016/j.pnpbp.2016.01.007] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 01/12/2016] [Accepted: 01/13/2016] [Indexed: 10/22/2022]
Abstract
JWH-250 and JWH-073 are two synthetic cannabinoid agonists with nanomolar affinity at CB1 and CB2 receptors. They are illegally marketed within "herbal blend" for theirs psychoactive effects greater than those produced by Cannabis. Recently, we analyzed an "herbal" preparation containing a mixture of both JWH-250 and JWH-073. The present study was aimed at investigating the in vitro and in vivo pharmacological activity of JWH-250 and JWH-073 in male CD-1 mice. In vitro competition binding experiments performed on mouse and human CB1 and CB2 receptors revealed a nanomolar affinity and potency of the JWH-250 and JWH-073. In vivo studies showed that JWH-250 and JWH-073, administered separately, induced a marked hypothermia, increased pain threshold to both noxious mechanical and thermal stimuli, caused catalepsy, reduced motor activity, impaired sensorimotor responses (visual, acoustic and tactile), caused seizures, myoclonia, hyperreflexia and promote aggressiveness in mice. Moreover, microdialysis study in freely moving mice showed that systemic administration of JWH-250 and JWH-073 stimulated dopamine release in the nucleus accumbens in a dose-dependent manner. Behavioral, neurological and neurochemical effects were fully prevented by the selective CB1 receptor antagonist/inverse agonist AM 251. Co-administration of ineffective doses of JWH-250 and JWH-073 impaired visual sensorimotor responses, improved mechanical pain threshold and stimulated mesolimbic DA transmission in mice, living unchanged all other behavioral and physiological parameters. For the first time the present study demonstrates the overall pharmacological effects induced by the administration of JWH-250 and JWH-073 in mice and it reveals their potentially synergistic action suggesting that co-administration of different synthetic cannabinoids may potentiate the detrimental effects of individual compounds increasing their dangerousness and abuse potential.
Collapse
Affiliation(s)
- Andrea Ossato
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Italy
| | - Isabella Canazza
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Italy
| | - Claudio Trapella
- Department of Chemistry and Pharmaceutical Sciences, University of Ferrara, Italy
| | | | | | - Claudia Rimondo
- Department of Public Health and Community Medicine, University of Verona, Italy
| | - Katia Varani
- Department of Medical Sciences, University of Ferrara, Italy
| | | | - Giovanni Serpelloni
- Department of Neuroscience, Psychology, Medicine and Child Health (NEUROFARBA), University of Florence, Italy
| | - Matteo Marti
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Italy; Center for Neuroscience and Istituto Nazionale di Neuroscienze, Italy.
| |
Collapse
|
23
|
Vigolo A, Ossato A, Trapella C, Vincenzi F, Rimondo C, Seri C, Varani K, Serpelloni G, Marti M. Novel halogenated derivates of JWH-018: Behavioral and binding studies in mice. Neuropharmacology 2015; 95:68-82. [DOI: 10.1016/j.neuropharm.2015.02.008] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 01/30/2015] [Accepted: 02/03/2015] [Indexed: 01/26/2023]
|
24
|
Ossato A, Vigolo A, Trapella C, Seri C, Rimondo C, Serpelloni G, Marti M. JWH-018 impairs sensorimotor functions in mice. Neuroscience 2015; 300:174-88. [PMID: 25987201 DOI: 10.1016/j.neuroscience.2015.05.021] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 05/04/2015] [Accepted: 05/09/2015] [Indexed: 02/01/2023]
Abstract
Naphthalen-1-yl-(1-pentylindol-3-yl)methanone (JWH-018) is a synthetic cannabinoid agonist illegally marketed in "Spice" and "herbal blend" for its psychoactive effect greater than those produced by cannabis. In rodents JWH-018 reproduces typical effects of (-)-Δ(9)-THC or Dronabinol® (Δ(9)-THC) such as hypothermia, analgesia, hypolocomotion and akinesia, while its effects on sensorimotor functions are still unknown. Therefore, the aim of the present study is to investigate the effect of acute administration of JWH-018 (0.01-6mg/kg i.p.) on sensorimotor functions in male CD-1 mice and to compare its effects with those caused by the administration of Δ(9)-THC (0.01-6mg/kg i.p.). A specific battery of behavioral tests were adopted to investigate effects of cannabinoid agonists on sensorimotor functions (visual, auditory, tactile) and neurological changes (convulsion, myoclonia, hyperreflexia) while video-tracking analysis was used to study spontaneous locomotion. JWH-018 administration inhibited sensorimotor responses at lower doses (0.01-0.1mg/kg), reduced spontaneous locomotion at intermediate/high doses (1-6mg/kg) and induced convulsions, myoclonia and hyperreflexia at high doses (6mg/kg). Similarly, administration of Δ(9)-THC reduced sensorimotor responses in mice but it did not inhibit spontaneous locomotion and it did not induce neurological alterations. All behavioral effects and neurological alterations were prevented by the administration of the selective CB1 receptor antagonist/inverse agonist 1-(2,4-dichlorophenyl)-5-(4-iodophenyl)-4-methyl-N-(piperidin-1-yl)-1H-pyrazole-3-carboxamide (AM 251). For the first time these data demonstrate that JWH-018 impairs sensorimotor responses in mice. This aspect should be carefully evaluated to better understand the potential danger that JWH-018 may pose to public health, with particular reference to decreased performance in driving and hazardous works.
Collapse
Affiliation(s)
- A Ossato
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Italy
| | - A Vigolo
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Italy
| | - C Trapella
- Department of Chemistry and Pharmaceutical Sciences, University of Ferrara, Italy
| | - C Seri
- Italian National Early Warning System, Drug Policies Department, Presidency of the Council of Ministers, Verona Coordination Unit, Italy
| | - C Rimondo
- Italian National Early Warning System, Drug Policies Department, Presidency of the Council of Ministers, Verona Coordination Unit, Italy; Department of Public Health and Community Medicine, University of Verona, Italy
| | - G Serpelloni
- Italian National Early Warning System, Drug Policies Department, Presidency of the Council of Ministers, Verona Coordination Unit, Italy
| | - M Marti
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Italy; Center for Neuroscience and Istituto Nazionale di Neuroscienze, Italy.
| |
Collapse
|