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Lea Houston M, Morgan J, Kelso C. Narrative Review of the Pharmacodynamics, Pharmacokinetics, and Toxicities of Illicit Synthetic Cannabinoid Receptor Agonists. Mini Rev Med Chem 2024; 24:92-109. [PMID: 37190813 DOI: 10.2174/1389557523666230515163107] [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: 12/13/2022] [Revised: 03/20/2023] [Accepted: 04/03/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Synthetic cannabinoid receptor agonists (SCRAs) are the most diverse class of new psychoactive substances worldwide, with approximately 300 unique SCRAs identified to date. While the use of this class of drug is not particularly prevalent, SCRAs are associated with several deaths every year due to their severe toxicity. METHODS A thorough examination of the literature identified 15 new SCRAs with a significant clinical impact between 2015 and 2021. RESULTS These 15 SCRAs have been implicated in 154 hospitalizations and 209 deaths across the US, Europe, Asia, and Australasia during this time period. CONCLUSION This narrative review provides pharmacodynamic, pharmacokinetic, and toxicologic data for SCRAs as a drug class, including an in-depth review of known pharmacological properties of 15 recently identified and emerging SCRAs for the benefit of researchers, policy makers, and clinicians who wish to be informed of developments in this field.
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Affiliation(s)
- Matilda Lea Houston
- Griffith Institute for Drug Discovery, Griffith University, Nathan, Queensland, Australia
| | - Jody Morgan
- School of Chemistry and Molecular Bioscience, University of Wollongong, Wollongong, New South Wales, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Celine Kelso
- School of Chemistry and Molecular Bioscience, University of Wollongong, Wollongong, New South Wales, Australia
- Molecular Horizons Institute, University of Wollongong, Wollongong, New South Wales, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
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Roque-Bravo R, Silva RS, Malheiro RF, Carmo H, Carvalho F, da Silva DD, Silva JP. Synthetic Cannabinoids: A Pharmacological and Toxicological Overview. Annu Rev Pharmacol Toxicol 2023; 63:187-209. [PMID: 35914767 DOI: 10.1146/annurev-pharmtox-031122-113758] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Synthetic cannabinoids (SCs) are a chemically diverse group of new psychoactive substances (NPSs) that target the endocannabinoid system, triggering a plethora of actions (e.g., elevated mood sensation, relaxation, appetite stimulation) that resemble, but are more intense than, those induced by cannabis. Although some of these effects have been explored for therapeutic applications, anticipated stronger psychoactive effects than cannabis and reduced risk perception have increased the recreational use of SCs, which have dominated the NPS market in the United States and Europe over the past decade. However, rising SC-related intoxications and deaths represent a major public health concern and embody a major challenge for policy makers. Here, we review the pharmacology and toxicology of SCs. A thorough characterization of SCs' pharmacodynamics and toxicodynamics is important to better understand the main mechanisms underlying acute and chronic effects of SCs, interpret the clinical/pathological findings related to SC use, and improve SC risk awareness.
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Affiliation(s)
- Rita Roque-Bravo
- Associate Laboratory i4HB - Institute for Health and Bioeconomy, and UCIBIO, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal; ,
| | - Rafaela Sofia Silva
- Associate Laboratory i4HB - Institute for Health and Bioeconomy, and UCIBIO, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal; ,
| | - Rui F Malheiro
- Associate Laboratory i4HB - Institute for Health and Bioeconomy, and UCIBIO, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal; ,
| | - Helena Carmo
- Associate Laboratory i4HB - Institute for Health and Bioeconomy, and UCIBIO, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal; ,
| | - Félix Carvalho
- Associate Laboratory i4HB - Institute for Health and Bioeconomy, and UCIBIO, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal; ,
| | - Diana Dias da Silva
- Associate Laboratory i4HB - Institute for Health and Bioeconomy, and UCIBIO, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal; , .,Toxicology Research Unit (TOXRUN), University Institute of Health Sciences, IUCS-CESPU, Gandra, Portugal
| | - João Pedro Silva
- Associate Laboratory i4HB - Institute for Health and Bioeconomy, and UCIBIO, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal; ,
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Cheng JYK, Hui JWS, Chan WS, So MH, Hong YH, Leung WT, Ku KW, Yeung HS, Lo KM, Fung KM, Ip CY, Dao KL, Cheung BKK. Interpol review of toxicology 2019-2022. Forensic Sci Int Synerg 2022; 6:100303. [PMID: 36597440 PMCID: PMC9799715 DOI: 10.1016/j.fsisyn.2022.100303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Bobbie Kwok-keung Cheung
- Corresponding author. Government Laboratory, 7/F, Homantin Government Offices, 88 Chung Hau Street, Ho Man Tin, Kowloon, SAR, Hong Kong, China. http://www.govtlab.gov.hk/
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Detection of the Synthetic Cannabinoids AB-CHMINACA, ADB-CHMINACA, MDMB-CHMICA, and 5F-MDMB-PINACA in Biological Matrices: A Systematic Review. BIOLOGY 2022; 11:biology11050796. [PMID: 35625524 PMCID: PMC9139075 DOI: 10.3390/biology11050796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/13/2022] [Accepted: 05/18/2022] [Indexed: 11/17/2022]
Abstract
Simple Summary Synthetic cannabinoids were originally developed for scientific research and potential therapeutic agents. However, clandestine laboratories synthesize them and circumvent legal barriers by falsely marketing them as incense or herbal products. They have serious adverse effects, and new derivatives are continuously found in the market, making their detection difficult due to the lack of comparative standards. Human matrices are used to identify the type of synthetic cannabinoid and the time of its consumption. This review discusses the use of hair, oral fluid, blood, and urine in the detection and quantification of some of the major synthetic cannabinoids. Based on the results, some recommendations can be followed, for example, the use of hair to detect chronic and retrospective consumption (although sensitive to external contamination) and oral fluid or blood for the simultaneous detection of the parent compounds and their metabolites. If longer detection times than blood or oral fluid are needed, urine is the matrix of choice, although its pH may intervene in the analysis. This work highlights the use of new techniques, such as high-resolution mass spectrometry, to avoid the use of previous standards and to monitor new trends in the drug market. Abstract New synthetic cannabinoids (SCs) are emerging rapidly and continuously. Biological matrices are key for their precise detection to link toxicity and symptoms to each compound and concentration and ascertain consumption trends. The objective of this study was to determine the best human biological matrices to detect the risk-assessed compounds provided by The European Monitoring Centre for Drugs and Drug Addiction: AB-CHMINACA, ADB-CHMNACA, MDMB-CHMICA, and 5F-MDMB-PINACA. We carried out a systematic review covering 2015 up to the present date, including original articles assessing detection in antemortem human biological matrices with detailed validation information of the technique. In oral fluid and blood, SC parent compounds were found in oral fluid and blood at low concentrations and usually with other substances; thus, the correlation between SCs concentrations and severity of symptoms could rarely be established. When hair is used as the biological matrix, there are difficulties in excluding passive contamination when evaluating chronic consumption. Detection of metabolites in urine is complex because it requires prior identification studies. LC-MS/MS assays were the most widely used approaches for the selective identification of SCs, although the lack of standard references and the need for revalidation with the continuous emergence of new SCs are limiting factors of this technique. A potential solution is high-resolution mass spectrometry screening, which allows for non-targeted detection and retrospective data interrogation.
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Romańczuk A, Rojek S, Kula K, Maciów-Głąb M, Synowiec K, Moskała A, Rzepecka-Woźniak E, Kłys M. Post-aggression suicide under the influence of new psychoactive substances AMB–FUBINACA and U-47700. Leg Med (Tokyo) 2022; 56:102053. [DOI: 10.1016/j.legalmed.2022.102053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 02/21/2022] [Accepted: 03/02/2022] [Indexed: 10/18/2022]
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Fabregat-Safont D, Mata-Pesquera M, Barneo-Muñoz M, Martinez-Garcia F, Mardal M, Davidsen AB, Sancho JV, Hernández F, Ibáñez M. In-depth comparison of the metabolic and pharmacokinetic behaviour of the structurally related synthetic cannabinoids AMB-FUBINACA and AMB-CHMICA in rats. Commun Biol 2022; 5:161. [PMID: 35210552 PMCID: PMC8873228 DOI: 10.1038/s42003-022-03113-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 02/01/2022] [Indexed: 12/01/2022] Open
Abstract
Synthetic cannabinoids receptor agonists (SCRAs) are often almost completely metabolised, and hence their pharmacokinetics should be carefully evaluated for determining the most adequate biomarker in toxicological analysis. Two structurally related SCRAs, AMB-FUBINACA and AMB-CHMICA, were selected to evaluate their in vivo metabolism and pharmacokinetics using male Sprague-Dawley rats. Brain, liver, kidney, blood (serum) and urine samples were collected at different times to assess the differences in metabolism, metabolic reactions, tissue distribution and excretion. Both compounds experimented O-demethyl reaction, which occurred more rapidly for AMB-FUBINACA. The parent compounds and O-demethyl metabolites were highly bioaccumulated in liver, and were still detected in this tissue 48 h after injection. The different indazole/indole N-functionalisation produced diverse metabolic reactions in this moiety and thus, different urinary metabolites were formed. Out of the two compounds, AMB-FUBINACA seemed to easily cross the blood-brain barrier, presenting higher brain/serum concentrations ratio than AMB-CHMICA. Synthetic cannabinoids are amongst the most widely used psychoactive drugs which are tightly controlled by government agencies around the world. Here, pharmacokinetics of two synthetic cannabinoids in rats are evaluated along with their metabolites and tissue distribution, aiding in identifying distinct biomarkers that reflect the consumption of synthetic cannabinoids based on the tissue.
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Affiliation(s)
- David Fabregat-Safont
- Environmental and Public Health Analytical Chemistry, Research Institute for Pesticides and Water (IUPA), University Jaume I, Avda. Sos Baynat s/n, 12071, Castellón, Spain
| | - María Mata-Pesquera
- Environmental and Public Health Analytical Chemistry, Research Institute for Pesticides and Water (IUPA), University Jaume I, Avda. Sos Baynat s/n, 12071, Castellón, Spain
| | - Manuela Barneo-Muñoz
- Predepartmental Unit of Medicine, Unitat Mixta de Neuroanatomia Funcional NeuroFun-UVEG-UJI, University Jaume I, Castellón, Spain
| | - Ferran Martinez-Garcia
- Predepartmental Unit of Medicine, Unitat Mixta de Neuroanatomia Funcional NeuroFun-UVEG-UJI, University Jaume I, Castellón, Spain
| | - Marie Mardal
- Section of Forensic Chemistry, Department of Forensic Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anders B Davidsen
- Section of Forensic Chemistry, Department of Forensic Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Juan V Sancho
- Environmental and Public Health Analytical Chemistry, Research Institute for Pesticides and Water (IUPA), University Jaume I, Avda. Sos Baynat s/n, 12071, Castellón, Spain
| | - Félix Hernández
- Environmental and Public Health Analytical Chemistry, Research Institute for Pesticides and Water (IUPA), University Jaume I, Avda. Sos Baynat s/n, 12071, Castellón, Spain
| | - María Ibáñez
- Environmental and Public Health Analytical Chemistry, Research Institute for Pesticides and Water (IUPA), University Jaume I, Avda. Sos Baynat s/n, 12071, Castellón, Spain.
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A Systematic Study of the In Vitro Pharmacokinetics and Estimated Human In Vivo Clearance of Indole and Indazole-3-Carboxamide Synthetic Cannabinoid Receptor Agonists Detected on the Illicit Drug Market. Molecules 2021; 26:molecules26051396. [PMID: 33807614 PMCID: PMC7961380 DOI: 10.3390/molecules26051396] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/26/2021] [Accepted: 02/28/2021] [Indexed: 12/13/2022] Open
Abstract
In vitro pharmacokinetic studies were conducted on enantiomer pairs of twelve valinate or tert-leucinate indole and indazole-3-carboxamide synthetic cannabinoid receptor agonists (SCRAs) detected on the illicit drug market to investigate their physicochemical parameters and structure-metabolism relationships (SMRs). Experimentally derived Log D7.4 ranged from 2.81 (AB-FUBINACA) to 4.95 (MDMB-4en-PINACA) and all SCRAs tested were highly protein bound, ranging from 88.9 ± 0.49% ((R)-4F-MDMB-BINACA) to 99.5 ± 0.08% ((S)-MDMB-FUBINACA). Most tested SCRAs were cleared rapidly in vitro in pooled human liver microsomes (pHLM) and pooled cryopreserved human hepatocytes (pHHeps). Intrinsic clearance (CLint) ranged from 13.7 ± 4.06 ((R)-AB-FUBINACA) to 2944 ± 95.9 mL min−1 kg−1 ((S)-AMB-FUBINACA) in pHLM, and from 110 ± 34.5 ((S)-AB-FUBINACA) to 3216 ± 607 mL min−1 kg−1 ((S)-AMB-FUBINACA) in pHHeps. Predicted Human in vivo hepatic clearance (CLH) ranged from 0.34 ± 0.09 ((S)-AB-FUBINACA) to 17.79 ± 0.20 mL min−1 kg−1 ((S)-5F-AMB-PINACA) in pHLM and 1.39 ± 0.27 ((S)-MDMB-FUBINACA) to 18.25 ± 0.12 mL min−1 kg−1 ((S)-5F-AMB-PINACA) in pHHeps. Valinate and tert-leucinate indole and indazole-3-carboxamide SCRAs are often rapidly metabolised in vitro but are highly protein bound in vivo and therefore predicted in vivo CLH is much slower than CLint. This is likely to give rise to longer detection windows of these substances and their metabolites in urine, possibly as a result of accumulation of parent drug in lipid-rich tissues, with redistribution into the circulatory system and subsequent metabolism.
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Schaefer N, Nordmeier F, Kröll AK, Körbel C, Laschke MW, Menger MD, Maurer HH, Meyer MR, Schmidt PH. Is adipose tissue suitable for detection of (synthetic) cannabinoids? A comparative study analyzing antemortem and postmortem specimens following pulmonary administration of JWH-210, RCS-4, as well as ∆9-tetrahydrocannabinol to pigs. Arch Toxicol 2020; 94:3421-3431. [PMID: 32666126 PMCID: PMC7502066 DOI: 10.1007/s00204-020-02843-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 07/09/2020] [Indexed: 11/30/2022]
Abstract
Examining fatal poisonings, chronic exposure may be reflected by the concentration in tissues known for long-term storage of drugs. Δ9-tetrahydrocannabinol (THC) persists in adipose tissue (AT), but sparse data on synthetic cannabinoids (SC) are available. Thus, a controlled pig study evaluating antemortem (AM) disposition and postmortem (PM) concentration changes of the SC 4-ethylnaphthalene-1-yl-(1-pentylindole-3-yl)methanone (JWH-210) and 2-(4-methoxyphenyl)-1-(1-pentyl-indole-3-yl)methanone (RCS-4) as well as THC in AT was performed. The drugs were administered pulmonarily (200 µg/kg body weight) to twelve pigs. Subcutaneous (s.c.) AT specimens were collected after 15 and 30 min and then hourly up to 8 h. At the end, pigs were sacrificed and s.c., perirenal, and dorsal AT specimens were collected. The carcasses were stored at room temperature (RT; n = 6) or 4 °C (n = 6) and specimens were collected after 24, 48, and 72 h. After homogenization in acetonitrile and standard addition, LC-MS/MS was performed. Maximum concentrations were reached 0.5-2 h after administration amounting to 21 ± 13 ng/g (JWH-210), 24 ± 13 ng/g (RCS-4), and 22 ± 20 ng/g (THC) and stayed at a plateau level. Regarding the metabolites, very low concentrations of N-hydroxypentyl-RCS-4 (HO-RCS-4) were detected from 0.5 to 8 h. PM concentrations of parent compounds did not change significantly (p > 0.05) over time under both storage conditions. Concentrations of HO-RCS-4 significantly (p < 0.05) increased in perirenal AT during storage at RT. These results suggest a rapid distribution and persistence in s.c. AT. Furthermore, AT might be resistant to PM redistribution of parent compounds. However, significant PM increases of metabolite concentrations might be considered in perirenal AT.
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Affiliation(s)
- Nadine Schaefer
- Institute of Legal Medicine, Saarland University, Building 49.1, 66421, Homburg, Germany.
| | - Frederike Nordmeier
- Institute of Legal Medicine, Saarland University, Building 49.1, 66421, Homburg, Germany
| | - Ann-Katrin Kröll
- Institute of Legal Medicine, Saarland University, Building 49.1, 66421, Homburg, Germany
| | - Christina Körbel
- Institute for Clinical and Experimental Surgery, Saarland University, Building 65/66, 66421, Homburg, Germany
| | - Matthias W Laschke
- Institute for Clinical and Experimental Surgery, Saarland University, Building 65/66, 66421, Homburg, Germany
| | - Michael D Menger
- Institute for Clinical and Experimental Surgery, Saarland University, Building 65/66, 66421, Homburg, Germany
| | - Hans H Maurer
- Department of Experimental and Clinical Toxicology, Center for Molecular Signaling (PZMS), Saarland University, Building 46, 66421, Homburg, Germany
| | - Markus R Meyer
- Department of Experimental and Clinical Toxicology, Center for Molecular Signaling (PZMS), Saarland University, Building 46, 66421, Homburg, Germany
| | - Peter H Schmidt
- Institute of Legal Medicine, Saarland University, Building 49.1, 66421, Homburg, Germany
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Presley BC, Castaneto MS, Logan BK, Jansen-Varnum SA. Assessment of synthetic cannabinoid FUB-AMB and its ester hydrolysis metabolite in human liver microsomes and human blood samples using UHPLC-MS/MS. Biomed Chromatogr 2020; 34:e4884. [PMID: 32415732 DOI: 10.1002/bmc.4884] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/15/2020] [Accepted: 05/11/2020] [Indexed: 12/18/2022]
Abstract
FUB-AMB, an indazole carboxamide synthetic cannabinoid recreational drug, was one of the compounds most frequently reported to governmental agencies worldwide between 2016 and 2019. It has been implicated in intoxications and fatalities, posing a risk to public health. In the current study, FUB-AMB was incubated with human liver microsomes (HLM) to assess its metabolic fate and stability and to determine if its major ester hydrolysis metabolite (M1) was present in 12 authentic forensic human blood samples from driving under the influence of drug cases and postmortem investigations using UHPLC-MS/MS. FUB-AMB was rapidly metabolized in HLM, generating M1 that was stable through a 120-min incubation period, a finding that indicates a potential long detection window in human biological samples. M1 was identified in all blood samples, and no parent drug was detected. The authors propose that M1 is a reliable marker for inclusion in laboratory blood screens for FUB-AMB; this metabolite may be pharmacologically active like its precursor FUB-AMB. M1 frequently appears in samples in which the parent drug is undetectable and can point to the causative agent. The results suggest that it is imperative that synthetic cannabinoid laboratory assay panels include metabolites, especially known or potential pharmacologically active metabolites, particularly for compounds with short half-lives.
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Affiliation(s)
- Brandon C Presley
- Department of Chemistry, Temple University, Philadelphia, Pennsylvania, USA
| | | | - Barry K Logan
- The Center for Forensic Science Research and Education at the Fredric Rieders Family Foundation, Willow Grove, Pennsylvania, USA
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