1
|
Gorbenko AA, Heuberger JAAC, Klumpers LE, de Kam ML, Strugala PK, de Visser SJ, Groeneveld GJ. Cannabidiol Increases Psychotropic Effects and Plasma Concentrations of Δ 9-Tetrahydrocannabinol Without Improving Its Analgesic Properties. Clin Pharmacol Ther 2024. [PMID: 39054656 DOI: 10.1002/cpt.3381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 06/29/2024] [Indexed: 07/27/2024]
Abstract
Cannabidiol (CBD), the main non-intoxicating compound in cannabis, has been hypothesized to reduce the adverse effects of Δ9-tetrahydrocannabinol (THC), the main psychoactive and analgesic component of cannabis. This clinical trial investigated the hypothesis that CBD counteracts the adverse effects of THC and thereby potentially improves the tolerability of cannabis as an analgesic. A randomized, double-blind, placebo-controlled, five-way cross-over trial was performed in 37 healthy volunteers. On each visit, a double-placebo, THC 9 mg with placebo CBD, or THC 9 mg with 10, 30, or 450 mg CBD was administered orally. Psychoactive and analgesic effects were quantified using standardized test batteries. Pharmacokinetic sampling was performed. Data were analyzed using mixed-effects model. Co-administration of 450 mg CBD did not reduce, but instead significantly increased subjective, psychomotor, cognitive, and autonomous effects of THC (e.g., VAS "Feeling High" by 60.5% (95% CI: 12.7%, 128.5%, P < 0.01)), whereas THC effects with 10 and 30 mg CBD were not significantly different from THC alone. CBD did not significantly enhance THC analgesia at any dose level. Administration of 450 mg CBD significantly increased AUClast of THC (AUClast ratio: 2.18, 95% CI: 1.54, 3.08, P < 0.0001) and 11-OH-THC (AUClast ratio: 6.24, 95% CI: 4.27, 9.12, P < 0.0001) compared with THC alone, and 30 mg CBD significantly increased AUClast of 11-OH-THC (AUClast ratio: 1.89, 95% CI: 1.30, 2.77, P = 0.0013), and of THC (AUClast ratio: 1.44, 95% CI: 1.01, 2.04, P = 0.0446). Present findings do not support the use of CBD to reduce adverse effects of oral THC or enhance THC analgesia.
Collapse
Affiliation(s)
- Andriy A Gorbenko
- Centre for Human Drug Research, Leiden, The Netherlands
- Leiden University Medical Centre, Leiden, The Netherlands
| | | | - Linda E Klumpers
- Verdient Science, Denver, Colorado, USA
- Tomori Pharmacology, Denver, Colorado, USA
- Larner College of Medicine, University of Vermont, Burlington, Vermont, USA
| | | | | | - Saco J de Visser
- Centre for Future Affordable and Sustainable Therapy Development (FAST), The Hague, The Netherlands
| | - Geert J Groeneveld
- Centre for Human Drug Research, Leiden, The Netherlands
- Leiden University Medical Centre, Leiden, The Netherlands
| |
Collapse
|
2
|
Avalos LA, Adams SR, Alexeeff SE, Oberman NR, Does MB, Ansley D, Goler N, Padon AA, Silver LD, Young-Wolff KC. Neonatal outcomes associated with in utero cannabis exposure: a population-based retrospective cohort study. Am J Obstet Gynecol 2024; 231:132.e1-132.e13. [PMID: 38029850 PMCID: PMC11128475 DOI: 10.1016/j.ajog.2023.11.1232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 11/06/2023] [Accepted: 11/14/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND The full spectrum of associations between in utero cannabis exposure and adverse neonatal outcomes is still unclear. OBJECTIVE This study aimed to evaluate the associations between in utero cannabis exposure and neonatal outcomes. STUDY DESIGN This population-based retrospective cohort study of singleton births among Kaiser Permanente Northern California members (January 1, 2011-July 31, 2020) included parent-infant dyads in which the pregnant parent was screened for cannabis use as part of standard prenatal care, generally upon entrance into care. Data were ascertained from electronic health records. Generalized estimating equation models were adjusted for sociodemographic characteristics, other non-cannabis prenatal substance use, medical and mental health comorbidities, and adequacy of prenatal care. In utero cannabis exposure was defined as self-reported use since becoming pregnant and/or a positive urine toxicology test for cannabis at any time during pregnancy (yes/no; primary exposure). Frequency of use was self-reported and categorized as daily, weekly, monthly or less, never, or unknown (secondary exposure). Neonatal outcomes included low birthweight, small for gestational age, preterm birth, neonatal intensive care unit admission, and infant respiratory support. RESULTS Of 364,924 infants, 22,624 (6.2%) were exposed to cannabis in utero. After adjustment for potential confounders, including in utero exposure to other substances, in utero exposure to cannabis was associated with greater odds of low birthweight (adjusted odds ratio, 1.20; 95% confidence interval, 1.12-1.28), small for gestational age (adjusted odds ratio, 1.24; 95% confidence interval, 1.18-1.30), preterm birth (<37 weeks; adjusted odds ratio, 1.06; 95% confidence interval, 1.00-1.13), and neonatal intensive care unit admission (adjusted odds ratio, 1.06; 95% confidence interval, 1.01-1.11). There was a suggestive association with early preterm birth (<34 weeks; adjusted odds ratio, 1.11; 95% confidence interval, 1.00-1.23; P=.055), but no significant association with respiratory support (adjusted odds ratio, 1.07; 95% confidence interval, 0.97-1.18). Dose-response analysis found an increasing likelihood of low birthweight and small for gestational age with increasing frequency of prenatal cannabis use by the pregnant individual. Sensitivity analyses further supported an increased likelihood of low birthweight and small for gestational age, although associations with other outcomes did not reach statistical significance. CONCLUSION In utero cannabis exposure was associated with increased likelihood of low birthweight, small for gestational age, preterm birth, and neonatal intensive care unit admission. Clinicians should counsel individuals who are pregnant or considering pregnancy about the potential adverse neonatal health outcomes associated with prenatal cannabis use.
Collapse
Affiliation(s)
- Lyndsay A Avalos
- Division of Research, Kaiser Permanente Northern California, Oakland, CA.
| | - Sara R Adams
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Stacey E Alexeeff
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Nina R Oberman
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Monique B Does
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Deborah Ansley
- Regional Offices, Kaiser Permanente Northern California, Oakland, CA
| | - Nancy Goler
- Regional Offices, Kaiser Permanente Northern California, Oakland, CA
| | | | | | - Kelly C Young-Wolff
- Division of Research, Kaiser Permanente Northern California, Oakland, CA; Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA
| |
Collapse
|
3
|
Marliani G, Vaccari L, Cavallini D, Montesano CS, Buonaiuto G, Accorsi PA. Assessing the effectiveness of cannabidiol additive supplementation on canine behavior and cortisol levels. Heliyon 2024; 10:e31345. [PMID: 38803908 PMCID: PMC11129091 DOI: 10.1016/j.heliyon.2024.e31345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 05/14/2024] [Accepted: 05/15/2024] [Indexed: 05/29/2024] Open
Abstract
In veterinary medicine, Cannabis has been used to treat pain conditions, inflammation, and seizures. However, little is known about its effect on dogs' behavior. This preliminary research aims to address this knowledge gap by evaluating the effectiveness of cannabidiol (CBD) oil in canine behavioral therapy. Twenty dogs, diagnosed with behavioral disorders and housed in a municipal shelter, participated in a double-blind trial. Ten dogs received CBD oil treatment, while the other ten received a control oil without CBD. Before (T0) and after (T1) the treatment, all the dogs underwent a temperament test to assess their behavior in the presence of four different stimuli: a human stranger, a novel object, a child-like doll, and a conspecific (another dog). Each stimulus was presented individually, and the dogs' behaviors were recorded on video and analyzed. Additionally, hair samples were collected using a shave-reshave technique for cortisol determination through Radio-Immuno-Assay. No behavioral differences were found between the two groups at both T0 and T1. There were no significant differences in the behavioral responses of either group when comparing T0 and T1. However, individual responses to the CBD oil treatment appeared to vary among subjects. A significant increase in hair cortisol levels (p-value <0.05) was observed in the group treated with CBD oil [T0 = 1.60 (1.44-1.93) pg/mg, T1 = 4.81(2.57-6.01) pg/mg]. These findings highlight the importance of individualized treatment when using Cannabis and encourage further research on the use of CBD oil in animal behavioral medicine.
Collapse
Affiliation(s)
- Giovanna Marliani
- Department of Veterinary Sciences, University of Bologna, 40064 Ozzano Emilia, BO, Italy
| | - Lucrezia Vaccari
- Department of Veterinary Sciences, University of Bologna, 40064 Ozzano Emilia, BO, Italy
| | - Damiano Cavallini
- Department of Veterinary Sciences, University of Bologna, 40064 Ozzano Emilia, BO, Italy
| | | | - Giovanni Buonaiuto
- Department of Veterinary Sciences, University of Bologna, 40064 Ozzano Emilia, BO, Italy
| | - Pier Attilio Accorsi
- Department of Veterinary Sciences, University of Bologna, 40064 Ozzano Emilia, BO, Italy
| |
Collapse
|
4
|
Pathak S, Jeyabalan JB, Liu K, Cook P, Lange B, Kim S, Nadar R, Ward K, Watts Alexander CS, Kumar A, Dua K, Moore T, Govindasamy J, Dhanasekaran M. Assessing effects of Cannabis on various neuropathologies: A systematic review. J Ayurveda Integr Med 2024; 15:100911. [PMID: 38876946 DOI: 10.1016/j.jaim.2024.100911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 01/12/2024] [Accepted: 02/19/2024] [Indexed: 06/16/2024] Open
Abstract
Natural bioactives possess a wide range of chemical structures that can exert a plethora of pharmacological and toxicological actions, resulting in neuroprotection or neurotoxicity. These pharmacodynamic properties can positively or negatively impact human and animal global healthcare. Remarkably, Ayurvedic botanical Cannabis has been used worldwide by different ethnicities and religions for spiritual, commercial, recreational, nutraceutical, cosmeceutical, and medicinal purposes for centuries. Cannabis-based congeners have been approved by the United States of America's (USA) Food & Drug Administration (FDA) and other global law agencies for various therapeutic purposes. Surprisingly, the strict laws associated with possessing cannabis products have been mitigated in multiple states in the USA and across the globe for recreational use. This has consequently led to a radical escalation of exposure to cannabis-related substances of abuse. However, there is a lacuna in the literature on the acute and chronic effects of Cannabis and its congeners on various neuropathologies. Moreover, in the post-COVID era, there has been a drastic increase in the incidence and prevalence of numerous neuropathologies, leading to increased morbidity and mortality. There is an impending necessity for a safe, economically viable, multipotent, natural bioactive to prevent and treat various neuropathologies. The ayurvedic herb, Cannabis is one of the oldest botanicals known to humans and has been widely used. However, the comprehensive effect of Cannabis on various neuropathologies is not well established. Hence, this review presents effects of Cannabis on various neuropathologies.
Collapse
Affiliation(s)
- Suhrud Pathak
- Harrison College of Pharmacy, Auburn University, Auburn, AL, 36849, USA
| | - Jeyaram Bharathi Jeyabalan
- Harrison College of Pharmacy, Auburn University, Auburn, AL, 36849, USA; Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Nilgiris, Ooty, Tamil Nadu, 643 001, India
| | - Keyi Liu
- Harrison College of Pharmacy, Auburn University, Auburn, AL, 36849, USA
| | - Preston Cook
- Harrison College of Pharmacy, Auburn University, Auburn, AL, 36849, USA
| | - Bennett Lange
- Harrison College of Pharmacy, Auburn University, Auburn, AL, 36849, USA
| | - Shannon Kim
- Harrison College of Pharmacy, Auburn University, Auburn, AL, 36849, USA
| | - Rishi Nadar
- Harrison College of Pharmacy, Auburn University, Auburn, AL, 36849, USA
| | - Kiersten Ward
- Harrison College of Pharmacy, Auburn University, Auburn, AL, 36849, USA
| | | | - Ashwani Kumar
- Patanjali Herbal Research Department, Patanjali Research Foundation, Haridwar, 249405, India
| | - Kamal Dua
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia; Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Ultimo, NSW, Australia
| | - Timothy Moore
- Harrison College of Pharmacy, Auburn University, Auburn, AL, 36849, USA
| | | | | |
Collapse
|
5
|
Ajrawat P, Yang Y, Wasilewski E, Leroux T, Ladha KS, Bhatia A, Singh M, Thaker S, Kapoor M, Furlan AD, Kotra LP, Clarke H. Medical Cannabis Use and Inflammatory Cytokines and Chemokines Among Adult Chronic Pain Patients. Cannabis Cannabinoid Res 2024; 9:267-281. [PMID: 36342776 DOI: 10.1089/can.2022.0143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background: Utilizing cannabis as a therapeutic option for chronic pain (CP) has increased significantly. However, data regarding the potential immunomodulatory effects of cannabis in CP patients remain scarce. We aimed at exploring the relationship between cannabis use and inflammatory cytokines and chemokines among a cohort of CP patients. Methods: Adult patients with a CP diagnosis and medical authorization of cannabis were enrolled. Patients completed validated clinical questionnaires and self-reported the effectiveness of cannabis for symptom management. Patients' blood and cannabis samples were analyzed for the presence of four major cannabinoids, two major cannabinoid metabolites, 29 different cytokines/chemokines, and cortisol. The multivariable linear regression model was used to identify cannabis and patient factors associated with immune markers. Results: Fifty-six patients (48±15 years; 64% females) were included, with dried cannabis (53%) being the most common type of cannabis consumed. Seventy percent of products were considered delta-9-tetrahydrocannabinol (Δ9-THC)-dominant. The majority of patients (96%) self-reported effective pain management, and 76% reported a significant decrease in analgesic medication usage (p≤0.001). Compared with males, female patients had higher plasma levels of cannabidiol (CBD), cannabidiolic acid, Δ9-THC, and 11-hydroxy-Δ9-tetrahydrocannabinol but lower concentrations of delta-9-tetrahydrocannabinolic acid and 11-nor-9-carboxy-Δ9-tetrahydrocannabinol (THC-COOH). Females had significantly lower eotaxin levels (p=0.04) in comparison to male patients. The regression analysis indicated that high cannabis doses were related to increased levels of interleukin (IL)-12p40 (p=0.02) and IL-6 (p=0.01), whereas female sex was associated with decreased eotaxin (p≤0.01) concentrations. Blood CBD levels were associated with lower vascular endothelial growth factor (p=0.04) concentrations, and THC-COOH was a factor related to decreased tumor necrosis factor alpha (p=0.02) and IL-12p70 (p=0.03). Conclusion: This study provides further support for the patient-perceived effectiveness of cannabis in managing CP symptoms and reducing analgesic medication consumption. The results suggest a potential sex difference in metabolizing cannabinoids, and the varying immune marker concentrations may support a possible immunomodulatory effect associated with patient sex and cannabis product type. These preliminary findings provide grounds for further validation using larger, well-designed studies with longer follow-up periods.
Collapse
Affiliation(s)
- Prabjit Ajrawat
- Department of Anesthesiology and Pain Management, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Yi Yang
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Ewa Wasilewski
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Timothy Leroux
- Osteoarthritis Research Program, Division of Orthopedics, Schroeder Arthritis Institute, University Health Network, Toronto, Ontario, Canada
| | - Karim S Ladha
- Department of Anesthesia, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Anuj Bhatia
- Department of Anesthesiology and Pain Management, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Mandeep Singh
- Department of Anesthesiology and Pain Management, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Sonalben Thaker
- Pain Research Unit, Toronto General Hospital, Toronto, Ontario, Canada
| | - Mohit Kapoor
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
- Osteoarthritis Research Program, Division of Orthopedics, Schroeder Arthritis Institute, University Health Network, Toronto, Ontario, Canada
- Centre for Cannabinoid Therapeutics, Toronto, Ontario, Canada
| | - Andrea D Furlan
- Centre for Cannabinoid Therapeutics, Toronto, Ontario, Canada
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- Department of Medicine, Faculty of Medicine, University of Toronto, Ontario, Canada
| | - Lakshmi P Kotra
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
- Pain Research Unit, Toronto General Hospital, Toronto, Ontario, Canada
- Centre for Cannabinoid Therapeutics, Toronto, Ontario, Canada
| | - Hance Clarke
- Department of Anesthesiology and Pain Management, University Health Network, University of Toronto, Toronto, Ontario, Canada
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
- Pain Research Unit, Toronto General Hospital, Toronto, Ontario, Canada
- Centre for Cannabinoid Therapeutics, Toronto, Ontario, Canada
| |
Collapse
|
6
|
Chester LA, Englund A, Chesney E, Oliver D, Wilson J, Sovi S, Dickens AM, Oresic M, Linderman T, Hodsoll J, Minichino A, Strang J, Murray RM, Freeman TP, McGuire P. Effects of Cannabidiol and Delta-9-Tetrahydrocannabinol on Plasma Endocannabinoid Levels in Healthy Volunteers: A Randomized Double-Blind Four-Arm Crossover Study. Cannabis Cannabinoid Res 2024; 9:188-198. [PMID: 36493386 PMCID: PMC10874814 DOI: 10.1089/can.2022.0174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background: The effects of cannabis are thought to be mediated by interactions between its constituents and the endocannabinoid system. Delta-9-tetrahydrocannabinol (THC) binds to central cannabinoid receptors, while cannabidiol (CBD) may influence endocannabinoid function without directly acting on cannabinoid receptors. We examined the effects of THC coadministered with different doses of CBD on plasma levels of endocannabinoids in healthy volunteers. Methods: In a randomized, double-blind, four-arm crossover study, healthy volunteers (n=46) inhaled cannabis vapor containing 10 mg THC plus either 0, 10, 20, or 30 mg CBD, in four experimental sessions. The median time between sessions was 14 days (IQR=20). Blood samples were taken precannabis inhalation and at 0-, 5-, 15-, and 90-min postinhalation. Plasma concentrations of THC, CBD, anandamide, 2-arachidonoylglycerol (2-AG), and related noncannabinoid lipids were measured using liquid chromatography-mass spectrometry. Results: Administration of cannabis induced acute increases in plasma concentrations of anandamide (+18.0%, 0.042 ng/mL [95%CI: 0.023-0.062]), and the noncannabinoid ethanolamides, docosatetraenylethanolamide (DEA; +35.8%, 0.012 ng/mL [95%CI: 0.008-0.016]), oleoylethanolamide (+16.1%, 0.184 ng/mL [95%CI: 0.076-0.293]), and N-arachidonoyl-L-serine (+25.1%, 0.011 ng/mL [95%CI: 0.004-0.017]) (p<0.05). CBD had no significant effect on the plasma concentration of anandamide, 2-AG or related noncannabinoid lipids at any of three doses used. Over the four sessions, there were progressive decreases in the preinhalation concentrations of anandamide and DEA, from 0.254 ng/mL [95%CI: 0.223-0.286] to 0.194 ng/mL [95%CI: 0.163-0.226], and from 0.039 ng/mL [95%CI: 0.032-0.045] to 0.027 ng/mL [95%CI: 0.020-0.034] (p<0.05), respectively. Discussion: THC induced acute increases in plasma levels of anandamide and noncannabinoid ethanolamides, but there was no evidence that these effects were influenced by the coadministration of CBD. It is possible that such effects may be evident with higher doses of CBD or after chronic administration. The progressive reduction in pretreatment anandamide and DEA levels across sessions may be related to repeated exposure to THC or participants becoming less anxious about the testing procedure and requires further investigation. The study was registered on clinicaltrials.gov (NCT05170217).
Collapse
Affiliation(s)
- Lucy A. Chester
- Department of Psychosis Studies and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Amir Englund
- National Addiction Centre (NAC), Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Edward Chesney
- Department of Psychosis Studies and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Dominic Oliver
- Department of Psychosis Studies and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Department of Psychiatry, Oxford University, Warneford Hospital, Oxford, United Kingdom
| | - Jack Wilson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, New South Wales, Australia
| | - Simina Sovi
- Department of Psychosis Studies and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Alex M. Dickens
- Turku Bioscience Center, University of Turku and Åbo Akademi University, Turku, Finland
- Department of Chemistry, University of Turku, Turku, Finland
| | - Matej Oresic
- Turku Bioscience Center, University of Turku and Åbo Akademi University, Turku, Finland
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Tuomas Linderman
- Turku Bioscience Center, University of Turku and Åbo Akademi University, Turku, Finland
| | - John Hodsoll
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Amedeo Minichino
- Department of Psychosis Studies and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Department of Psychiatry, Oxford University, Warneford Hospital, Oxford, United Kingdom
| | - John Strang
- National Addiction Centre (NAC), Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Robin M. Murray
- Department of Psychosis Studies and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Tom P. Freeman
- Department of Psychology, University of Bath, Bath, United Kingdom
| | - Philip McGuire
- Department of Psychosis Studies and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Department of Psychiatry, Oxford University, Warneford Hospital, Oxford, United Kingdom
| |
Collapse
|
7
|
Pabon E, de Wit H. Effects of Oral Delta-9-Tetrahydrocannabinol in Women During the Follicular Phase of the Menstrual Cycle. Cannabis Cannabinoid Res 2023; 8:1117-1125. [PMID: 35593915 PMCID: PMC10714110 DOI: 10.1089/can.2022.0045] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: This study examined effects of oral delta-9-tetrahydrocannabinol (THC) in women at two phases of the menstrual cycle differing in circulating levels of estrogen (E). Pre-clinical findings indicate that E increases sensitivity to THC and other cannabinoids, raising the possibility that higher E may be a risk factor for adverse responses to THC in women. Methods: We examined subjective and behavioral responses to THC (7.5 and 15 mg oral) and placebo in women during the early follicular (EF) phase when E levels are low and the late follicular (LF) phase when E levels are higher. Outcome measures included self-report ratings of drug effects, cardiovascular measures, and biochemical verification of ovarian hormone levels. We hypothesized that women would exhibit greater responses to THC during the LF phase compared to the EF phase. Results: On most measures, responses to THC were similar during the two phases. However, on two self-report measures, "Wanting More" drug and anxiety, the effects occurred slightly earlier after drug administration in women who were tested during the EF phase. Conclusions: We conclude that the differences in levels of E occurring during the early and LF phase of the menstrual cycle do not strongly influence responses to THC. It remains to be determined whether responses are similarly stable across other cycle phases, or in women receiving exogenous hormone treatments.
Collapse
Affiliation(s)
- Elisa Pabon
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago Medical Center, Chicago, Illinois, USA
| | - Harriet de Wit
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago Medical Center, Chicago, Illinois, USA
| |
Collapse
|
8
|
Johnson-Ferguson L, Shanahan L, Bechtiger L, Steinhoff A, Zimmermann J, Baumgartner MR, Binz TM, Eisner M, Ribeaud D, Quednow BB. Associations of psychoactive substances and steroid hormones in hair: Findings relevant to stress research from a large cohort of young adults. Psychoneuroendocrinology 2023; 157:106369. [PMID: 37639800 DOI: 10.1016/j.psyneuen.2023.106369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/03/2023] [Accepted: 08/13/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVE Epidemiological studies increasingly use hair samples to assess people's cumulative exposure to steroid hormones, but how the use of different psychoactive substances may affect steroid hormone levels in hair is, so far, largely unknown. The current study addresses this gap by establishing the substance exposure correlates of cortisol, cortisone, and testosterone in hair, while also accounting for a number of relevant covariates. METHOD Data came from a large urban community-sample of young adults with a high prevalence of substance use (N = 1002, mean age=20.6 years, 50.2% female), who provided 3 cm of hair samples. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) quantified cortisol, cortisone, and testosterone, as well as delta-9-tetrahydrocannabinol (THC), 3,4-methylenedioxymethamphetamine (MDMA, "Ecstasy"), cocaine, several opioids, and their respective metabolites. Multiple linear regression models with covariates were used to predict steroid hormone levels from substance exposure in a four-step approach: In the full sample, low and high substance hair concentrations (median split) were first tested against no use for each substance individually (step 1) and for all substances together (step 2). Then, within the participants with any substance in hair only, the continuous hair concentration of each substance in pg/mg (step 3) and finally of all substances together, were regressed (step 4). RESULTS Low, high, and continuous levels of THC in hair were robustly associated with higher levels of cortisol (sig. in step 1 low THC: β = 0.29, p = .021; high THC: β = 0.42, p = .001; step 2: low THC: β = 0.27, p = 0.036, and high THC: β = 0.40, p = .004, and step 4: β = 0.12, p = .041). Participants with high MDMA levels had higher levels of cortisone without adjusting for other substances (step 1: β = 0.34, p = .026), but this effect was not significant in the other models. While high THC levels were associated with lower levels of testosterone in step 2 (β = -0.35, p = .018), MDMA concentration was positively related to testosterone concentration with and without adjusting for other substances (step 3: β = 0.24, p = .041; step 4: β = 0.17, 95%, p = .015) in male participants. CONCLUSION The use of psychoactive substances, especially of cannabis and ecstasy, should be considered in studies investigating steroid hormones in hair.
Collapse
Affiliation(s)
- Lydia Johnson-Ferguson
- Jacobs Center for Productive Youth Development, University of Zurich, Switzerland; Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Switzerland.
| | - Lilly Shanahan
- Jacobs Center for Productive Youth Development, University of Zurich, Switzerland; Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Laura Bechtiger
- Jacobs Center for Productive Youth Development, University of Zurich, Switzerland
| | - Annekatrin Steinhoff
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern, Switzerland
| | - Josua Zimmermann
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Switzerland; Neuroscience Center Zurich, ETH Zurich and University of Zurich, Zurich, Switzerland
| | - Markus R Baumgartner
- Zurich Institute of Legal Medicine, University of Zurich, Switzerland; Center for Forensic Hair Analytics, University of Zurich, Switzerland
| | - Tina M Binz
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern, Switzerland
| | - Manuel Eisner
- Jacobs Center for Productive Youth Development, University of Zurich, Switzerland; Institute of Criminology, University of Cambridge, United Kingdom
| | - Denis Ribeaud
- Jacobs Center for Productive Youth Development, University of Zurich, Switzerland
| | - Boris B Quednow
- Jacobs Center for Productive Youth Development, University of Zurich, Switzerland; Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Switzerland; Neuroscience Center Zurich, ETH Zurich and University of Zurich, Zurich, Switzerland
| |
Collapse
|
9
|
Harris M, Schiff DM, Saia K, Muftu S, Standish KR, Wachman EM. Academy of Breastfeeding Medicine Clinical Protocol #21: Breastfeeding in the Setting of Substance Use and Substance Use Disorder (Revised 2023). Breastfeed Med 2023; 18:715-733. [PMID: 37856658 PMCID: PMC10775244 DOI: 10.1089/bfm.2023.29256.abm] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
Background: The Academy of Breastfeeding Medicine (ABM) revised the 2015 version of the substance use disorder (SUD) clinical protocol to review the evidence and provide updated literature-based recommendations related to breastfeeding in the setting of substance use and SUD treatments. Key Information: Decisions around breastfeeding are an important aspect of care during the peripartum period, and there are specific benefits and risks for substance-exposed mother-infant dyads. Recommendations: This protocol provides breastfeeding recommendations in the setting of nonprescribed opioid, stimulant, sedative-hypnotic, alcohol, nicotine, and cannabis use, and SUD treatments. Additionally, we offer guidance on the utility of toxicology testing in breastfeeding recommendations. Individual programs and institutions should establish consistent breastfeeding approaches that mitigate bias, facilitate consistency, and empower mothers with SUD. For specific breastfeeding recommendations, given the complexity of breastfeeding in mothers with SUD, individualized care plans should be created in partnership with the patient and multidisciplinary team with appropriate clinical support and follow-up. In general, breastfeeding is recommended among mothers who stop nonprescribed substance use by the time of delivery, and they should continue to receive ongoing postpartum care, such as lactation support and SUD treatment. Overall, enhancing breastfeeding education regarding substance use in pregnancy and lactation is essential to allow for patient-centered guidance.
Collapse
Affiliation(s)
- Miriam Harris
- Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine and Boston Medical Center, Boston, Massachusetts, USA
- Grayken Center for Addiction, Boston Medical Center, Boston, Massachusetts, USA
| | - Davida M. Schiff
- Divisions of Newborn Medicine and Mass General Hospital for Children, Boston, Massachusetts, USA
- Divisions of General Academic Pediatrics, Mass General Hospital for Children, Boston, Massachusetts, USA
| | - Kelley Saia
- Grayken Center for Addiction, Boston Medical Center, Boston, Massachusetts, USA
- Department of Obstetrics and Gynecology, Chobanian & Avedisian Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA
| | - Serra Muftu
- Divisions of Newborn Medicine and Mass General Hospital for Children, Boston, Massachusetts, USA
- Divisions of General Academic Pediatrics, Mass General Hospital for Children, Boston, Massachusetts, USA
| | - Katherine R. Standish
- Department of Family Medicine, and Chobanian & Avedisian Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA
| | - Elisha M. Wachman
- Grayken Center for Addiction, Boston Medical Center, Boston, Massachusetts, USA
- Department of Pediatrics, Chobanian & Avedisian Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA
| |
Collapse
|
10
|
Piscura MK, Henderson-Redmond AN, Barnes RC, Mitra S, Guindon J, Morgan DJ. Mechanisms of cannabinoid tolerance. Biochem Pharmacol 2023; 214:115665. [PMID: 37348821 PMCID: PMC10528043 DOI: 10.1016/j.bcp.2023.115665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/09/2023] [Accepted: 06/13/2023] [Indexed: 06/24/2023]
Abstract
Cannabis has been used recreationally and medically for centuries, yet research into understanding the mechanisms of its therapeutic effects has only recently garnered more attention. There is evidence to support the use of cannabinoids for the treatment of chronic pain, muscle spasticity, nausea and vomiting due to chemotherapy, improving weight gain in HIV-related cachexia, emesis, sleep disorders, managing symptoms in Tourette syndrome, and patient-reported muscle spasticity from multiple sclerosis. However, tolerance and the risk for cannabis use disorder are two significant disadvantages for cannabinoid-based therapies in humans. Recent work has revealed prominent sex differences in the acute response and tolerance to cannabinoids in both humans and animal models. This review will discuss evidence demonstrating cannabinoid tolerance in rodents, non-human primates, and humans and our current understanding of the neuroadaptations occurring at the cannabinoid type 1 receptor (CB1R) that are responsible tolerance. CB1R expression is downregulated in tolerant animals and humans while there is strong evidence of CB1R desensitization in cannabinoid tolerant rodent models. Throughout the review, critical knowledge gaps are indicated and discussed, such as the lack of a neuroimaging probe to assess CB1R desensitization in humans. The review discusses the intracellular signaling pathways that are responsible for mediating CB1R desensitization and downregulation including the action of G protein-coupled receptor kinases, β-arrestin2 recruitment, c-Jun N-terminal kinases, protein kinase A, and the intracellular trafficking of CB1R. Finally, the review discusses approaches to reduce cannabinoid tolerance in humans based on our current understanding of the neuroadaptations and mechanisms responsible for this process.
Collapse
Affiliation(s)
- Mary K Piscura
- Department of Biomedical Sciences, Marshall University, Huntington, WV 25755, USA; Department of Biomedical Sciences, Edward Via College of Osteopathic Medicine, Auburn, AL 36832, USA
| | | | - Robert C Barnes
- Department of Pharmacology and Neuroscience, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Swarup Mitra
- Department of Biomedical Sciences, Marshall University, Huntington, WV 25755, USA
| | - Josée Guindon
- Department of Pharmacology and Neuroscience, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Daniel J Morgan
- Department of Biomedical Sciences, Marshall University, Huntington, WV 25755, USA.
| |
Collapse
|
11
|
Gräfe EL, Reid HMO, Shkolnikov I, Conway K, Kit A, Acosta C, Christie BR. Women are Taking the Hit: Examining the Unique Consequences of Cannabis Use Across the Female Lifespan. Front Neuroendocrinol 2023; 70:101076. [PMID: 37217080 DOI: 10.1016/j.yfrne.2023.101076] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 04/28/2023] [Accepted: 05/15/2023] [Indexed: 05/24/2023]
Abstract
Cannabis use has risen dramatically in recent years due to global decriminalization and a resurgence in the interest of potential therapeutic benefits. While emerging research is shaping our understanding of the benefits and harms of cannabis, there remains a paucity of data specifically focused on how cannabis affects the female population. The female experience of cannabis use is unique, both in the societal context and because of the biological ramifications. This is increasingly important given the rise in cannabis potency, as well as the implications this has for the prevalence of Cannabis Use Disorder (CUD). Therefore, this scoping review aims to discuss the prevalence of cannabis use and CUD in women throughout their lifespan and provide a balanced prospective on the positive and negative consequences of cannabis use. In doing so, this review will highlight the necessity for continued research that goes beyond sex differences.
Collapse
Affiliation(s)
- E L Gräfe
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
| | - H M O Reid
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
| | - I Shkolnikov
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
| | - K Conway
- Island Medical Program, University of British Columbia, Victoria, British Columbia, Canada
| | - A Kit
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
| | - C Acosta
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
| | - B R Christie
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada; Island Medical Program, University of British Columbia, Victoria, British Columbia, Canada.
| |
Collapse
|
12
|
Dufour J, Sabry R, Khokhar JY, Favetta LA. Delta-9 tetrahydrocannabinol (THC) effects on the cortisol stress response in bovine granulosa cells. Toxicol In Vitro 2023; 88:105549. [PMID: 36596389 DOI: 10.1016/j.tiv.2022.105549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 12/01/2022] [Accepted: 12/30/2022] [Indexed: 01/02/2023]
Abstract
Maternal stress can result in changes in the hypothalamic-pituitary-adrenal (HPA) axis and lead to stress-related behaviours in offspring. Under physiological conditions, delta-9 tetrahydrocannabinol (THC) appears to be detrimental for fertility. However, cannabis is also commonly used for stress-relief. THC acts on the endocannabinoid receptors in granulosa cells (GCs), which affect oocyte competency. The objective of this study was to evaluate the effects of THC on in vitro bovine granulosa cell viability, apoptosis, and stress response pathway. GCs were cultured in vitro in the presence of clinically relevant therapeutic and recreational plasma doses of THC. Cortisol doses reflecting normal and elevated plasma levels were used to evaluate the effects of THC under induced stress in vitro. No effect of THC was observed on cell viability or apoptosis. High and low cortisol concentrations caused significant increases in 11β-HSD1 mRNA expression (n = 6, p < 0.0001). Interestingly, when combined with high [THC], there was a significant decrease in 11β-HSD1 expression compared to high and low cortisol treatments alone (p < 0.001, p < 0.05). GR expression was unaffected by cortisol treatments, and low [THC] treatment maintained increased expression in the presence of high and low cortisol treatments (n = 6, p < 0.01, p < 0.0001). Our findings represent a foundation to obtain useful data for evaluating THC potential therapeutic benefit.
Collapse
Affiliation(s)
- Jaustin Dufour
- Reproductive Health and Biotechnology Laboratory, Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Reem Sabry
- Reproductive Health and Biotechnology Laboratory, Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Jibran Y Khokhar
- Department of Anatomy and Cell Biology, Western University, London, ON, Canada
| | - Laura A Favetta
- Reproductive Health and Biotechnology Laboratory, Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada.
| |
Collapse
|
13
|
Watling SE, Gill T, Gaudette EV, Richardson JD, McCluskey T, Tong J, Meyer JH, Warsh J, Jetly R, Hutchison MG, Rhind SG, Houle S, Kish SJ, Boileau I. Investigating TSPO levels in occupation-related posttraumatic stress disorder. Sci Rep 2023; 13:4970. [PMID: 36973385 PMCID: PMC10041517 DOI: 10.1038/s41598-023-31327-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 03/09/2023] [Indexed: 03/29/2023] Open
Abstract
Microglia are immune brain cells implicated in stress-related mental illnesses including posttraumatic stress disorder (PTSD). Their role in the pathophysiology of PTSD, and on neurobiological systems that regulate stress, is not completely understood. We tested the hypothesis that microglia activation, in fronto-limbic brain regions involved in PTSD, would be elevated in participants with occupation-related PTSD. We also explored the relationship between cortisol and microglia activation. Twenty participants with PTSD and 23 healthy controls (HC) completed positron emission tomography (PET) scanning of the 18-kDa translocator protein (TSPO), a putative biomarker of microglia activation using the probe [18F]FEPPA, and blood samples for measurement of cortisol. [18F]FEPPA VT was non-significantly elevated (6.5-30%) in fronto-limbic regions in PTSD participants. [18F]FEPPA VT was significantly higher in PTSD participants reporting frequent cannabis use compared to PTSD non-users (44%, p = 0.047). Male participants with PTSD (21%, p = 0.094) and a history of early childhood trauma (33%, p = 0.116) had non-significantly higher [18F]FEPPA VT. Average fronto-limbic [18F]FEPPA VT was positively related to cortisol (r = 0.530, p = 0.028) in the PTSD group only. Although we did not find a significant abnormality in TSPO binding in PTSD, findings suggest microglial activation might have occurred in a subgroup who reported frequent cannabis use. The relationship between cortisol and TSPO binding suggests a potential link between hypothalamic-pituitary-adrenal-axis dysregulation and central immune response to trauma which warrants further study.
Collapse
Affiliation(s)
- Sarah E Watling
- Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Talwinder Gill
- Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Erin V Gaudette
- Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - J Don Richardson
- The MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, ON, Canada
- Department of Psychiatry, University of Western Ontario, London, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- St Joseph's, London OSI, Parkwood Institute, St. Joseph's Health Care, London, ON, Canada
| | - Tina McCluskey
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Campbell Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Junchao Tong
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Campbell Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Jeffrey H Meyer
- Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Campbell Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Jerry Warsh
- Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Campbell Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Rakesh Jetly
- Directorate of Mental Health, Canadian Forces Health Services, Ottawa, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Michael G Hutchison
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
- David L. MacIntosh Sport Medicine Clinic, Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
- Keenan Research Centre for Biomedical Science of St. Michael's Hospital, Toronto, ON, Canada
| | - Shawn G Rhind
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
- Defence Research and Development Canada, Toronto Research Centre, Toronto, ON, Canada
| | - Sylvain Houle
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Campbell Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Stephen J Kish
- Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Campbell Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Isabelle Boileau
- Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada.
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada.
- Campbell Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
| |
Collapse
|
14
|
Rokeby ACE, Natale BV, Natale DRC. Cannabinoids and the placenta: Receptors, signaling and outcomes. Placenta 2023; 135:51-61. [PMID: 36965349 DOI: 10.1016/j.placenta.2023.03.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/06/2023] [Accepted: 03/09/2023] [Indexed: 03/12/2023]
Abstract
Cannabis use during pregnancy is increasing. The improvement of pregnancy-related symptoms including morning sickness and management of mood and stress are among the most reported reasons for its use. Δ9-tetrahydrocannabinol (Δ9-THC) and cannabidiol (CBD) are the most abundant cannabinoids found within the cannabis flower. The concentration of these components has drastically increased in the past 20 years. Additionally, many edibles contain only one cannabinoid and are marketed to achieve a specific goal, meaning there are an increasing number of pregnancies that are exposed to isolated cannabinoids. Both Δ9-THC and CBD cross the placenta and can impact the fetus directly, but the receptors through which cannabinoids act are also expressed throughout the placenta, suggesting that the effects of in-utero cannabinoid exposure may include indirect effects from the placenta. In-utero cannabis research focuses on short and long-term fetal health and development; however, these studies include little to no placenta analysis. Prenatal cannabinoid exposure is linked to small for gestational age and fetal growth-restricted babies. Compromised placental development is also associated with fetal growth restriction and the few studies (clinical and animal models) that included placental analysis, identify changes in placental vasculature and function in these cannabinoid-exposed pregnancies. In vitro studies further support cannabinoid impact on cell function in the different populations that comprise the placenta. In this article, we aim to summarize how phytocannabinoids can impact placental development and function. Specifically, the cannabinoids and their actions at the different receptors are described, with receptor localization throughout the human and murine placenta discussed. Findings from studies that included placental analysis and how cannabinoid signaling may modulate critical developmental processing including cell proliferation, angiogenesis and migration are described. Considering the current research, prenatal cannabinoid exposure may significantly impact placental development, and, as such, identifying windows of placental vulnerability for each cannabinoid will be critical to elucidate the etiology of fetal outcome studies.
Collapse
Affiliation(s)
- Abbey C E Rokeby
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Bryony V Natale
- Department of Obstetrics and Gynaecology, Queen's University, Kingston, ON, Canada
| | - David R C Natale
- Department of Obstetrics and Gynaecology, Queen's University, Kingston, ON, Canada; Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada.
| |
Collapse
|
15
|
Narayan AJ, Downey LA, Manning B, Hayley AC. Cannabinoid treatments for anxiety: A systematic review and consideration of the impact of sleep disturbance. Neurosci Biobehav Rev 2022. [DOI: https:/doi.org.ezproxy.mnsu.edu/10.1016/j.neubiorev.2022.104941] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
|
16
|
Luke S, Hobbs AJ, Smith M, Riddell C, Murphy P, Agborsangaya C, Cantin C, Fahey J, Der K, Pederson A, Nelson C. Cannabis use in pregnancy and maternal and infant outcomes: A Canadian cross-jurisdictional population-based cohort study. PLoS One 2022; 17:e0276824. [PMID: 36417349 PMCID: PMC9683571 DOI: 10.1371/journal.pone.0276824] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 10/13/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND With the recent legalization of cannabis in Canada, there is an urgent need to understand the effect of cannabis use in pregnancy. Our population-based study investigated the effects of prenatal cannabis use on maternal and newborn outcomes, and modification by infant sex. METHODS The cohort included 1,280,447 singleton births from the British Columbia Perinatal Data Registry, the Better Outcomes Registry & Network Ontario, and the Perinatal Program Newfoundland Labrador from April 1st, 2012 to March 31st, 2019. Logistic regression determined the associations between prenatal cannabis use and low birth weight, small-for-gestational age, large-for-gestational age, spontaneous and medically indicated preterm birth, very preterm birth, stillbirth, major congenital anomalies, caesarean section, gestational diabetes and gestational hypertension. Models were adjusted for other substance use, socio-demographic and-economic characteristics, co-morbidities. Interaction terms were included to investigate modification by infant sex. RESULTS The prevalence of cannabis use in our cohort was approximately 2%. Prenatal cannabis use is associated with increased risks of spontaneous and medically indicated preterm birth (1.80[1.68-1.93] and 1.94[1.77-2.12], respectively), very preterm birth (1.73[1.48-2.02]), low birth weight (1.90[1.79-2.03]), small-for-gestational age (1.21[1.16-1.27]) and large-for-gestational age (1.06[1.01-1.12]), any major congenital anomaly (1.71[1.49-1.97]), caesarean section (1.13[1.09-1.17]), and gestational diabetes (1.32[1.23-1.42]). No association was found for stillbirth or gestational hypertension. Only small-for-gestational age (p = 0.03) and spontaneous preterm birth (p = 0.04) showed evidence of modification by infant sex. CONCLUSIONS Prenatal cannabis use increases the likelihood of preterm birth, low birth weight, small-for-gestational age and major congenital anomalies with prenatally exposed female infants showing evidence of increased susceptibility. Additional measures are needed to inform the public and providers of the inherent risks of cannabis exposure in pregnancy.
Collapse
Affiliation(s)
- Sabrina Luke
- Perinatal Services British Columbia, Provincial Health Services Authority, Vancouver, British Columbia, Canada
- Women’s Health Research Institute, BC Women’s Hospital + Health Centre, Provincial Health Services Authority, Vancouver, British Columbia, Canada
- * E-mail:
| | - Amy J. Hobbs
- Perinatal Services British Columbia, Provincial Health Services Authority, Vancouver, British Columbia, Canada
- Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Michaela Smith
- Better Outcomes Registry Network Ontario, Ottawa, Ontario, Canada
| | | | - Phil Murphy
- Children’s & Women’s Health Program, Eastern Health, St. John’s, Newfoundland and Labrador, Canada
| | | | - Christina Cantin
- Champlain Maternal Newborn Regional Program, Ottawa, Ontario, Canada
| | - John Fahey
- Reproductive Care Program of Nova Scotia, Halifax, Nova Scotia, Canada
| | - Kenny Der
- Perinatal Services British Columbia, Provincial Health Services Authority, Vancouver, British Columbia, Canada
| | - Ann Pederson
- Perinatal Services British Columbia, Provincial Health Services Authority, Vancouver, British Columbia, Canada
- Women’s Health Research Institute, BC Women’s Hospital + Health Centre, Provincial Health Services Authority, Vancouver, British Columbia, Canada
| | | | | |
Collapse
|
17
|
Narayan A, Downey LA, Manning B, Hayley AC. Cannabinoid Treatments for Anxiety: A Systematic Review and Consideration of the Impact of Sleep Disturbance. Neurosci Biobehav Rev 2022; 143:104941. [DOI: 10.1016/j.neubiorev.2022.104941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 10/13/2022] [Accepted: 10/30/2022] [Indexed: 11/11/2022]
|
18
|
Josan C, Shiplo S, Fusch G, Raha S, Shea AK. Cannabis use during lactation may alter the composition of human breast milk. Pediatr Res 2022:10.1038/s41390-022-02315-1. [PMID: 36195631 DOI: 10.1038/s41390-022-02315-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/20/2022] [Accepted: 09/07/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Cannabis is often used by women to manage symptoms of morning sickness during pregnancy, and postpartum stress and anxiety. While exclusive breastfeeding has been recommended for the first 6 months of an infant's life, the presence of cannabinoids in the milk of cannabis users complicates this recommendation. The objective of this study was to investigate the effect of maternal cannabis use on changes in the levels of macronutrients and bioactive factors in breast milk. METHODS Milk was collected from women who were 6-8 weeks postpartum and were either using cannabis post-delivery, had used cannabis during pregnancy, or were non-users. Levels of cannabinoids, macronutrients, lactose, and SIgA were assessed in the milk of all subjects. RESULTS THC was detected in the milk of women who reported cannabis use during lactation (n = 13, median: 22 ng/mL). Carboxy-THC, 11-hydroxy-THC, CBD, and CBN were also detected in the milk of women who used cannabis postpartum. Relative to non-users (n = 17), lactose levels were higher and SIgA levels were significantly lower in the milk of subjects who used cannabis during lactation (n = 14). CONCLUSIONS The presence of cannabinoids, along with altered lactose and SIgA levels in the milk of cannabis users, may have implications for infant health. IMPACT Metabolites of cannabis are found in breast milk and can accumulate in higher concentrations with ongoing consumption, which is concerning for potential exposure among infants born to mothers who consume cannabis. This work reports that lactose levels are increased and SIgA levels are decreased in the breast milk of cannabis users, relative to the milk of non-users. Change in levels of lactose and SIgA in the milk of cannabis users may have significant implications on infant health, which must be investigated in the future to better inform mothers.
Collapse
Affiliation(s)
- Chitmandeep Josan
- Department of Pediatrics and the Medical Science Graduate Program, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Samantha Shiplo
- Obstetrics and Gynecology, McMaster University, Hamilton, ON, Canada
| | - Gerhard Fusch
- Department of Pediatrics, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Sandeep Raha
- Department of Pediatrics and the Medical Science Graduate Program, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
| | - Alison K Shea
- Department of Obstetrics and Gynecology, St. Joseph's Healthcare and McMaster University, Hamilton, ON, Canada
| |
Collapse
|
19
|
Meah F, Lundholm M, Emanuele N, Amjed H, Poku C, Agrawal L, Emanuele MA. The effects of cannabis and cannabinoids on the endocrine system. Rev Endocr Metab Disord 2022; 23:401-420. [PMID: 34460075 DOI: 10.1007/s11154-021-09682-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/15/2021] [Indexed: 01/24/2023]
Abstract
With the increase in cannabis use due to policy changes and areas of decriminalization, it is important to recognize the potential impact of these substances on endocrine processes. Cannabinoids have many effects by activating the endocannabinoid system. This system plays a role in the normal functioning of nearly every organ and consists of the body's natural endocannabinoids, the cannabinoid receptors, and the enzymes and processes that regulate endocannabinoids. Exogenous cannabinoids such as Δ9-tetrahydrocannabinol (THC) are known to act through cannabinoid type 1 and 2 receptors, and have been shown to mimic endocannabinoid signaling and affect receptor expression. This review summarizes the known impacts of cannabis on thyroid, adrenal, and gonadal function in addition to glucose control, lipids, and bone metabolism, including: reduced female fertility, increased risk of adverse pregnancy outcomes, reduced sperm counts and function, lower thyroid hormone levels with acute use, blunting of stress response with chronic use, increased risk of prediabetes but lower risk of diabetes, suggested improvement of high density lipoproteins and triglycerides, and modest increase in fracture risk. The known properties of endocannabinoids, animal data, population data, and the possible benefits and concerns of cannabinoid use on hormonal function are discussed. The interconnectivity of the endocrine and endocannabinoid systems suggests opportunities for future therapeutic modalities which are an area of active investigation.
Collapse
Affiliation(s)
- Farah Meah
- Endocrinology Section, Medical Service, VA Hospital, Hines, Illinois, USA
| | - Michelle Lundholm
- Department of Internal Medicine, Loyola University Medical Center, Maywood, IL, USA
| | - Nicholas Emanuele
- Endocrinology Section, Medical Service, VA Hospital, Hines, Illinois, USA
| | - Hafsa Amjed
- Department of Medicine, Division of Endocrinology, Loyola University Health Care System, Maywood, Illinois, USA
| | - Caroline Poku
- Department of Medicine, Division of Endocrinology, Loyola University Health Care System, Maywood, Illinois, USA
| | - Lily Agrawal
- Endocrinology Section, Medical Service, VA Hospital, Hines, Illinois, USA
| | - Mary Ann Emanuele
- Department of Medicine, Division of Endocrinology, Loyola University Health Care System, Maywood, Illinois, USA.
| |
Collapse
|
20
|
Teixeira TA, Iori I, Andrade G, Saldiva PHN, Drevet JR, Costa EMF, Hallak J. Marijuana Is Associated With a Hormonal Imbalance Among Several Habits Related to Male Infertility: A Retrospective Study. FRONTIERS IN REPRODUCTIVE HEALTH 2022; 4:820451. [PMID: 36303626 PMCID: PMC9580681 DOI: 10.3389/frph.2022.820451] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 01/26/2022] [Indexed: 12/02/2023] Open
Abstract
Marijuana is one of the most consumed drugs worldwide. There is increasing evidence of an association between marijuana and male infertility. This study intends to assess the repercussion of marijuana smoking and other habits (sedentary lifestyle, alcohol, and tobacco use) in the testicular function of infertile men seeking andrological evaluation. A retrospective study was performed using medical records data of men aged 18-59 years from 2009 to 2017. Complete semen analyses, sperm functional tests, SHBG, and hormonal levels, testosterone-to-estradiol ratio (T/E2), and testis volume were evaluated. Exclusion criteria included cryptorchidism, infertility caused by genetic or infectious diseases, and cancer. A multiple linear regression analysis was performed to investigate which habit could predict certain parameters using the software SPSS 23.0 (P < 0.05). In a sample of 153 men, semen parameters, testosterone levels, and testis volume were not significantly influenced. Marijuana use had the broader hormonal changes since it influences estradiol (P = 0.000; B = -11.616), prolactin (P = 0.000; B = 3.211), SHBG levels (P = 0.017; B = 7.489), and T/E2 (P = 0.004; B = 14.030). Sedentary lifestyle (P = 0.028; B = 1.279) and tobacco smoking (P = 0.031; B = -2.401) influenced the prolactin levels. Marijuana is associated with hormonal imbalance in this infertile cohort by lowering estradiol levels and inhibiting aromatase function.
Collapse
Affiliation(s)
- Thiago A. Teixeira
- Androscience—Science and Innovation Center in Andrology and High-Complex Clinical and Research Andrology Laboratory, São Paulo, Brazil
- Division of Urology, Hospital das Clinicas, University of São Paulo Medical School, São Paulo, Brazil
- Institute of Advanced Studies, University of São Paulo, São Paulo, Brazil
| | - Ivan Iori
- Androscience—Science and Innovation Center in Andrology and High-Complex Clinical and Research Andrology Laboratory, São Paulo, Brazil
- Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil
| | - Gustavo Andrade
- Androscience—Science and Innovation Center in Andrology and High-Complex Clinical and Research Andrology Laboratory, São Paulo, Brazil
- Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil
| | - Paulo H. N. Saldiva
- Reproductive Toxicology Unit, Department of Pathology, University of São Paulo Medical School, São Paulo, Brazil
| | - Joël R. Drevet
- GReD Institute, CRBC Building, Faculty of Medicine, CNRS-INSERM-Université Clermont Auvergne, Clermont-Ferrand, France
| | - Elaine M. F. Costa
- Androscience—Science and Innovation Center in Andrology and High-Complex Clinical and Research Andrology Laboratory, São Paulo, Brazil
- Division of Endocrinology, Hospital das Clinicas, University of São Paulo Medical School, São Paulo, Brazil
| | - Jorge Hallak
- Androscience—Science and Innovation Center in Andrology and High-Complex Clinical and Research Andrology Laboratory, São Paulo, Brazil
- Division of Urology, Hospital das Clinicas, University of São Paulo Medical School, São Paulo, Brazil
- Institute of Advanced Studies, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
21
|
Laufer S, Engel S, Lupien S, Knaevelsrud C, Schumacher S. The Cortisol Assessment List (CoAL) A tool to systematically document and evaluate cortisol assessment in blood, urine and saliva. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2022; 9:100108. [PMID: 35755928 PMCID: PMC9216417 DOI: 10.1016/j.cpnec.2021.100108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 12/22/2021] [Accepted: 12/22/2021] [Indexed: 10/27/2022] Open
|
22
|
Examining the Use of Antidepressants for Adolescents with Depression/Anxiety Who Regularly Use Cannabis: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19010523. [PMID: 35010782 PMCID: PMC8744706 DOI: 10.3390/ijerph19010523] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/21/2021] [Accepted: 12/23/2021] [Indexed: 11/21/2022]
Abstract
Depression and anxiety disorders are two of the most common and growing mental health concerns in adolescents. Consequently, antidepressant medication (AD) use has increased widely during the last decades. Several classes of antidepressants are used mainly to treat depression, anxiety, and obsessive-compulsive disorders by targeting relevant brain neurochemical pathways. Almost all randomized clinical trials of antidepressants examined patients with no concomitant medications or drugs. This does not address the expected course of therapy and outcome in cannabis users. Cannabis is the most commonly used illicit substance globally. Substantial changes in its regulation are recently taking place. Many countries and US states are becoming more permissive towards its medical and recreational use. The psychological and physiological effects of cannabis (mainly of its major components, tetrahydrocannabinol (THC) and cannabidiol (CBD)) have been extensively characterized. Cannabis use can be a risk factor for depressive and anxiety symptoms, but some constituents or mixtures may have antidepressant and/or anxiolytic potential. The aim of this literature review is to explore whether simultaneous use of AD and cannabis in adolescence can affect AD treatment outcomes. Based on the current literature, it is reasonable to assume that antidepressants are less effective for adolescents with depression/anxiety who frequently use cannabis. The mechanisms of action of antidepressants and cannabis point to several similarities and conjunctions that merit future investigation regarding the potential effectiveness of antidepressants among adolescents who consume cannabis regularly.
Collapse
|
23
|
Ghobadian R, Khaleghzadeh-Ahangar H. Smoke, nicotine, opioids, and cannabinoids effects on the ACE2 protein level and possibility of COVID-19 infection: Suggesting potential preventives and therapeutics. ACTA FACULTATIS MEDICAE NAISSENSIS 2022. [DOI: 10.5937/afmnai39-33402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Introduction. The coronavirus caused the pandemic COVID-19 that has an extensive influence in the world. The virus enters and infects body cells through superficial protein ACE2. Each cell possessing ACE2 is potentially vulnerable to this virus. Since the respiratory system is exposed to the environment and has ACE2, it is one of the first candidates infected by the virus. One of the considerable complications in the severe stage of COVID-19 is an intense adaptive immunological response that is detrimental to body organs. Methods. This is a review article. All relevant articles which were accessible were reviewed. Results. Some drugs of abuse may have an adverse or beneficial influence on the disease, and their simultaneity with COVID-19 is remarkable. Nicotine and cholinergic nicotinic receptor agonists seem to decrease the cell's membrane superficial ACE2 protein number; thus, they would be appropriate candidates for COVID-19 prevention and expansion. Both opioids and cannabinoids attenuate the immune system and seem to be adverse for disease incidence but can be beneficial for the severe stage of COVID19. The antitussive effect of some opioids would be advantageous. Furthermore, some opioids are substrates for ACE2 and they bind it. Therefore, they would be an appropriate candidate to design a drug covering ACE2 with a high affinity to prevent coronavirus infection. Conclusion. Some drugs, such as nicotine and opioids, may have beneficial effects on preventing or reducing COVID-19 complications.
Collapse
|
24
|
Glodosky NC, Cuttler C, McLaughlin RJ. A review of the effects of acute and chronic cannabinoid exposure on the stress response. Front Neuroendocrinol 2021; 63:100945. [PMID: 34461155 PMCID: PMC8605997 DOI: 10.1016/j.yfrne.2021.100945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/28/2021] [Accepted: 08/24/2021] [Indexed: 10/20/2022]
Abstract
While cannabis has been used for centuries for its stress-alleviating properties, the effects of acute and chronic cannabinoid exposure on responses to stress remain poorly understood. This review provides an overview of studies that measured stress-related endpoints following acute or chronic cannabinoid exposure in humans and animals. Acute cannabinoid exposure increases basal concentrations of stress hormones in rodents and humans and has dose-dependent effects on stress reactivity in humans and anxiety-like behavior in rodents. Chronic cannabis exposure is associated with dampened stress reactivity, a blunted cortisol awakening response (CAR), and flattened diurnal cortisol slope in humans. Sex differences in these effects remain underexamined, with limited evidence for sex differences in effects of cannabinoids on stress reactivity in rodents. Future research is needed to better understand sex differences in the effects of cannabis on the stress response, as well as downstream impacts on mental health and stress-related disorders.
Collapse
Affiliation(s)
| | - Carrie Cuttler
- Department of Psychology, Washington State University, Pullman, WA, USA.
| | - Ryan J McLaughlin
- Department of Psychology, Washington State University, Pullman, WA, USA; Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, WA, USA
| |
Collapse
|
25
|
Ryan KS, Mahalingaiah S, Campbell LR, Roberts VHJ, Terrobias JJD, Naito CS, Boniface ER, Borgelt LM, Hedges JC, Hanna CB, Hennebold JD, Lo JO. The effects of delta-9-tetrahydrocannabinol exposure on female menstrual cyclicity and reproductive health in rhesus macaques. F&S SCIENCE 2021; 2:287-294. [PMID: 34901892 PMCID: PMC8661554 DOI: 10.1016/j.xfss.2021.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To determine the dose-dependent effect of contemporary marijuana exposure on female menstrual cyclicity and reproductive endocrine physiology in a nonhuman primate model. DESIGN Research animal study. SETTING Research institute environment. ANIMALS Adult female rhesus macaques (6-12 years of age; n = 8). INTERVENTIONS Daily delta-9-tetrahydrocannabinol (THC) edible at medically and recreationally relevant contemporary doses. MAIN OUTCOME MEASURES Menstrual cycle length (MCL), anti-Müllerian hormone, prolactin, basal follicle-stimulating hormone (FSH), estradiol (E2) and progesterone, luteinizing hormone (LH), and thyroid-stimulating hormone. RESULTS The average before THC weight was 6.9 kg (standard deviation, 0.8), and at the highest THC dosing, the average weight was 7.2 kg (standard deviation, 0.8). With increasing THC dosing, MCL and FSH concentrations increased, while basal E2 concentration was stable. The average MCL concentration increased 4.0 days for each mg/7 kg/day of THC (95% CI, 1.4-6.6 days). Follicle-stimulating hormone concentration increased significantly with increasing THC dose, 0.34 ng/mL for each mg/7 kg/day of THC (95% CI, 0.14-0.57 ng/mL). No significant trends were observed between THC dosing and average basal progesterone, anti-Müllerian hormone, prolactin, LH, or thyroid-stimulating hormone concentrations. CONCLUSIONS In rhesus macaques, a dose response toward increased MCL and basal FSH concentrations but plateau of basal E2 and LH concentrations was observed with increasing THC dosing, suggesting ovulatory dysfunction. Further studies are needed to determine the effects of a longer duration of exposure and whether the significant increase in MCL and FSH concentrations results in reduced fecundity.
Collapse
Affiliation(s)
- Kimberly S. Ryan
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Oregon Health & Science University, Portland, Oregon
| | - Shruthi Mahalingaiah
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Massachusetts General Hospital Fertility Center, Department of Obstetrics, Gynecology, and Reproductive Biology, Division of Reproductive Endocrinology and Infertility, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | | | - Victoria H. J. Roberts
- Division of Reproductive and Developmental Sciences, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, Oregon
| | - Juanito Jose D. Terrobias
- Division of Reproductive and Developmental Sciences, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, Oregon
| | - Chelsey S. Naito
- Division of Reproductive and Developmental Sciences, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, Oregon
| | - Emily R. Boniface
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Oregon Health & Science University, Portland, Oregon
| | - Laura M. Borgelt
- Department of Clinical Pharmacy and Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Jason C. Hedges
- Department of Urology, Oregon Health & Science University, Portland, Oregon
| | - Carol B. Hanna
- Division of Reproductive and Developmental Sciences, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, Oregon
| | - Jon D. Hennebold
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Oregon Health & Science University, Portland, Oregon
- Division of Reproductive and Developmental Sciences, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, Oregon
| | - Jamie O. Lo
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Oregon Health & Science University, Portland, Oregon
- Division of Reproductive and Developmental Sciences, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, Oregon
| |
Collapse
|
26
|
Kuzma-Hunt AG, Truong VB, Favetta LA. Glucocorticoids, Stress and Delta-9 Tetrahydrocannabinol (THC) during Early Embryonic Development. Int J Mol Sci 2021; 22:7289. [PMID: 34298908 PMCID: PMC8307766 DOI: 10.3390/ijms22147289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 06/24/2021] [Accepted: 06/29/2021] [Indexed: 12/13/2022] Open
Abstract
Elevated molecular stress in women is known to have negative impacts on the reproductive development of oocytes and the embryos prior to implantation. In recent years, the prevalence of cannabis use among women of reproductive age has risen due to its ability to relieve psychological stress and nausea, which are mediated by its psychoactive component, ∆-9-tetrahydrocannabinol (THC). Although cannabis is the most popular recreational drug of the 21st century, much is unknown about its influence on molecular stress in reproductive tissues. The current literature has demonstrated that THC causes dose- and time-dependent alterations in glucocorticoid signaling, which have the potential to compromise morphology, development, and quality of oocytes and embryos. However, there are inconsistencies across studies regarding the mechanisms for THC-dependent changes in stress hormones and how either compounds may drive or arrest development. Factors such as variability between animal models, physiologically relevant doses, and undiscovered downstream gene targets of both glucocorticoids and THC could account for such inconsistencies. This review evaluates the results of studies which have investigated the effects of glucocorticoids on reproductive development and how THC may alter stress signaling in relevant tissues.
Collapse
Affiliation(s)
| | | | - Laura A. Favetta
- Reproductive Health and Biotechnology Laboratory, Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, 50 Stone Road East, Guelph, ON N1G 2W1, Canada; (A.G.K.-H.); (V.B.T.)
| |
Collapse
|
27
|
al'Absi M, Allen AM. Impact of Acute and Chronic Cannabis Use on Stress Response Regulation: Challenging the Belief That Cannabis Is an Effective Method for Coping. Front Psychol 2021; 12:687106. [PMID: 34276511 PMCID: PMC8283823 DOI: 10.3389/fpsyg.2021.687106] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 05/21/2021] [Indexed: 11/16/2022] Open
Abstract
Although research has only recently started to examine the impact of cannabis use on stress response, there is some evidence that indicates acute and chronic impacts of cannabis on these processes. In this paper, we review processes involved in regulating the stress response and we review the influence of acute and chronic exposure to cannabis on patterns and regulation of the stress response. We also highlight the role of stress as a risk factor for initiation and maintenance of cannabis use. In this context, we examine moderating variables, including sex and life adversity. In light of recent observations indicating increasing prevalence of cannabis use during pregnancy, we provide additional focus on cannabis use in this vulnerable population, including how acute and chronic stress may predispose some individuals to use cannabis during pregnancy. While this line of research is in its infancy, we review available articles that focus on the perinatal period and that examined the association between cannabis use and various life stressors, including partner violence, job loss, and lack of housing. We also review psychiatric co-morbidities (e.g., post-traumatic stress disorder, anxiety). A better understanding of the way stress and cannabis use relate within the general population, as well as within certain subgroups that may be at a greater risk of using and/or at greater risk for adverse outcomes of use, may lead to the development of novel prevention and intervention approaches.
Collapse
Affiliation(s)
- Mustafa al'Absi
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, MN, United States
| | - Alicia M Allen
- Department of Family and Community Medicine, University of Arizona, Tucson, AZ, United States
| |
Collapse
|
28
|
Pandey S, Bolstad I, Lien L, Bramness JG. Factors associated with the level of prolactin in patients under remission from Alcohol Use Disorder: A gender perspective. Neuropsychopharmacol Rep 2021; 41:352-361. [PMID: 33961352 PMCID: PMC8411308 DOI: 10.1002/npr2.12182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/28/2021] [Accepted: 04/11/2021] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Prolactin mirrors the dopaminergic activity in the brain which is key to understanding alcohol use disorders (AUD). Still, patients with AUD are a heterogenous group and there seem to be gender differences in the relationship between alcohol use and the level of prolactin. In this study, we examined gender-wise relationship of alcohol use trait- and state-related factors with the level of prolactin among AUD inpatients in remission. METHODS This cross-sectional study examined the level of prolactin along with general patient characteristics and alcohol use trait- and state-related factors that could influence the level of prolactin in 112 AUD inpatients at three rehabilitation clinics in Norway. Logistic regression was performed to identify the gender-specific predictors of level of prolactin. RESULTS Male and female AUD patients had similar level of prolactin. Among females, younger age, early alcohol debut, and absence of parental drinking problem predicted higher level of prolactin. In males, presence of other substance dependence predicted a lower level of prolactin. CONCLUSIONS There were gender differences in the factors associated with the level of prolactin among the AUD patients. Especially in the female AUD patients under remission, alcohol use trait-related factors were better predictors of the level of prolactin than the alcohol use state-related factors, indicating that individuals might characteristically have varying degree of dopamine reactivity.
Collapse
Affiliation(s)
- Susmita Pandey
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingeborg Bolstad
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway
| | - Lars Lien
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway.,Department of Health and Social Science, Innlandet University of Applied Science, Elverum, Norway
| | - Jørgen G Bramness
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway.,Department of Clinical Medicine, UiT - Norway's Arctic University, Tromsø, Norway.,Norwegian Institute of Public Health, Oslo, Norway
| |
Collapse
|
29
|
Ferber SG, Namdar D, Hen-Shoval D, Eger G, Koltai H, Shoval G, Shbiro L, Weller A. The "Entourage Effect": Terpenes Coupled with Cannabinoids for the Treatment of Mood Disorders and Anxiety Disorders. Curr Neuropharmacol 2020; 18:87-96. [PMID: 31481004 PMCID: PMC7324885 DOI: 10.2174/1570159x17666190903103923] [Citation(s) in RCA: 106] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 08/27/2019] [Accepted: 08/29/2019] [Indexed: 12/27/2022] Open
Abstract
Mood disorders are the most prevalent mental conditions encountered in psychiatric practice. Numerous patients suffering from mood disorders present with treatment-resistant forms of depression, co-morbid anxiety, other psychiatric disorders and bipolar disorders. Standardized essential oils (such as that of Lavender officinalis) have been shown to exert clinical efficacy in treating anxiety disorders. As endocannabinoids are suggested to play an important role in major depression, generalized anxiety and bipolar disorders, Cannabis sativa was suggested for their treatment. The endocannabinoid system is widely distributed throughout the body including the brain, modulating many functions. It is involved in mood and related disorders, and its activity may be modified by exogenous cannabinoids. CB1 and CB2 receptors primarily serve as the binding sites for endocannabinoids as well as for phytocannabinoids, produced by cannabis inflorescences. However, ‘cannabis’ is not a single compound product but is known for its complicated molecular profile, producing a plethora of phytocannabinoids alongside a vast array of terpenes. Thus, the “entourage effect” is the suggested positive contribution derived from the addition of terpenes to cannabinoids. Here, we review the literature on the effects of cannabinoids and discuss the possibility of enhancing cannabinoid activity on psychiatric symptoms by the addition of terpenes and terpenoids. Possible underlying mechanisms for the anti-depressant and anxiolytic effects are reviewed. These natural products may be an important potential source for new medications for the treatment of mood and anxiety disorders.
Collapse
Affiliation(s)
- Sari Goldstein Ferber
- Psychology Department, Bar-Ilan University, Ramat Gan, Israel.,Gonda Brain Research Center, Bar-Ilan University, Ramat Gan, Israel
| | - Dvora Namdar
- ARO, Volcani Center, Rishon LeZion 7505101, Israel
| | - Danielle Hen-Shoval
- Psychology Department, Bar-Ilan University, Ramat Gan, Israel.,Gonda Brain Research Center, Bar-Ilan University, Ramat Gan, Israel
| | - Gilad Eger
- Geha Mental Health Center, Petah Tiqva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Gal Shoval
- Geha Mental Health Center, Petah Tiqva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Liat Shbiro
- Geha Mental Health Center, Petah Tiqva, Israel
| | - Aron Weller
- Psychology Department, Bar-Ilan University, Ramat Gan, Israel.,Gonda Brain Research Center, Bar-Ilan University, Ramat Gan, Israel
| |
Collapse
|
30
|
Colizzi M, Weltens N, Lythgoe DJ, Williams SC, Van Oudenhove L, Bhattacharyya S. Differential sensitivity to the acute psychotomimetic effects of delta-9-tetrahydrocannabinol associated with its differential acute effects on glial function and cortisol. Psychol Med 2020; 52:1-8. [PMID: 33107418 DOI: 10.1017/s0033291720003827] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Cannabis use has been associated with psychosis through exposure to delta-9-tetrahydrocannabinol (Δ9-THC), its key psychoactive ingredient. Although preclinical and human evidence suggests that Δ9-THC acutely modulates glial function and hypothalamic-pituitary-adrenal (HPA) axis activity, whether differential sensitivity to the acute psychotomimetic effects of Δ9-THC is associated with differential effects of Δ9-THC on glial function and HPA-axis response has never been tested. METHODS A double-blind, randomized, placebo-controlled, crossover study investigated whether sensitivity to the psychotomimetic effects of Δ9-THC moderates the acute effects of a single Δ9-THC dose (1.19 mg/2 ml) on myo-inositol levels, a surrogate marker of glia, in the Anterior Cingulate Cortex (ACC), and circadian cortisol levels, the key neuroendocrine marker of the HPA-axis, in a set of 16 healthy participants (seven males) with modest previous cannabis exposure. RESULTS The Δ9-THC-induced change in ACC myo-inositol levels differed significantly between those sensitive to (Δ9-THC minus placebo; M = -0.251, s.d. = 1.242) and those not sensitive (M = 1.615, s.d. = 1.753) to the psychotomimetic effects of the drug (t(14) = 2.459, p = 0.028). Further, the Δ9-THC-induced change in cortisol levels over the study period (baseline minus 2.5 h post-drug injection) differed significantly between those sensitive to (Δ9-THC minus placebo; M = -275.4, s.d. = 207.519) and those not sensitive (M = 74.2, s.d. = 209.281) to the psychotomimetic effects of the drug (t(13) = 3.068, p = 0.009). Specifically, Δ9-THC exposure lowered ACC myo-inositol levels and disrupted the physiological diurnal cortisol decrease only in those subjects developing transient psychosis-like symptoms. CONCLUSIONS The interindividual differences in transient psychosis-like effects of Δ9-THC are the result of its differential impact on glial function and stress response.
Collapse
Affiliation(s)
- Marco Colizzi
- National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, and Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Nathalie Weltens
- Laboratory for Brain-Gut Axis Studies (LaBGAS), Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases, Metabolism and Ageing, University of Leuven, Belgium
| | - David J Lythgoe
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Steve Cr Williams
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Lukas Van Oudenhove
- Laboratory for Brain-Gut Axis Studies (LaBGAS), Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases, Metabolism and Ageing, University of Leuven, Belgium
| | - Sagnik Bhattacharyya
- National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, and Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| |
Collapse
|
31
|
Glodosky NC, Cuttler C, Freels TG, Wright HR, Rojas MJ, Baglot SL, Hill MN, McLaughlin RJ. Cannabis vapor self-administration elicits sex- and dose-specific alterations in stress reactivity in rats. Neurobiol Stress 2020; 13:100260. [PMID: 33344714 PMCID: PMC7739171 DOI: 10.1016/j.ynstr.2020.100260] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 10/14/2020] [Accepted: 10/15/2020] [Indexed: 01/15/2023] Open
Abstract
Rationale Cannabis users frequently report stress relief as their primary reason for use. Recent studies indicate that human cannabis users exhibit blunted stress reactivity; however, it is unknown whether this is a cause or a consequence of chronic cannabis use. Objectives To determine whether chronic cannabis vapor self-administration elicits sex- and/or dose-dependent alterations in stress reactivity and basal corticosterone (CORT) concentrations, or whether pre-vapor exposure stress reactivity predicts rates of cannabis vapor self-administration. Methods Male and female rats were subjected to 30 min acute restraint stress to assess stress reactivity prior to vapor self-administration. Rats were then trained to self-administer cannabis extract vapor containing 69.9% Δ9-tetrahydrocannabinol (THC) at one of four extract concentrations (0, 75, 150, or 300 mg/ml) daily for 30 days. Half of the rats were then subjected to a second restraint stress challenge 24 h after the final self-administration session, while the other half served as no-stress controls. Plasma CORT concentrations were measured prior to stress and immediately post-stress offset. Results Female rats earned significantly more vapor deliveries than male rats. Pre-vapor stress reactivity was not a predictor of self-administration rates in either sex. Basal CORT concentrations were increased following vapor self-administration relative to pre-vapor assessment, irrespective of treatment condition. Importantly, cannabis self-administration dose-dependently reduced stress reactivity in female, but not male, rats. Conclusions These data indicate that chronic cannabis use can significantly dampen stress reactivity in female rats and further support the use of the cannabis vapor self-administration model in rats of both sexes.
Collapse
Affiliation(s)
| | - Carrie Cuttler
- Department of Psychology, Washington State University, Pullman, WA, USA
| | - Timothy G. Freels
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, WA, USA
| | - Hayden R. Wright
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, WA, USA
| | - Manuel J. Rojas
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, WA, USA
- Animal Health Department, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Samantha L. Baglot
- Departments of Cell Biology and Anatomy and Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Matthew N. Hill
- Departments of Cell Biology and Anatomy and Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Ryan J. McLaughlin
- Department of Psychology, Washington State University, Pullman, WA, USA
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, WA, USA
- Corresponding author. Washington State University, College of Veterinary Medicine, Department of Integrative Physiology and Neuroscience, P.O. Box 647620, Pullman, WA, 99164, USA.
| |
Collapse
|
32
|
Schindler EAD, Schnakenberg Martin AM, Sewell RA, Ranganathan M, DeForest A, Pittman BP, Perrino A, D'Souza DC. In an exploratory randomized, double-blind, placebo-controlled, cross-over study, psychoactive doses of intravenous delta-9-tetrahydrocannabinol fail to produce antinociceptive effects in healthy human volunteers. Psychopharmacology (Berl) 2020; 237:3097-3107. [PMID: 32632491 DOI: 10.1007/s00213-020-05595-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 06/17/2020] [Indexed: 01/09/2023]
Abstract
RATIONALE Animal studies and anecdotal human reports suggest that cannabinoids have antinociceptive effects. Controlled human studies have produced mixed results. OBJECTIVES We sought to reduce existing variability by investigating the effects of intravenous delta-9-tetrahydrocannabinol (THC) in several pain paradigms within the same human subjects, addressing some of the limitations to the published literature. METHODS In this exploratory randomized, double-blind, placebo-controlled, cross-over study, healthy human subjects received 0.01 mg/kg or 0.03 mg/kg intravenous THC or placebo (ethanol vehicle) infused over 10 min on three test days, each separated by at least 72 h. Capsaicin (250 μg) was injected intradermally to induce chemical pain and hyperalgesia. Four other forms of acute pain were induced: mechanical (von Frey filament), hot and cold (thermode), and electrical (pulse generator). Pain ratings were obtained before drug administration, at peak drug effects, and 2 h after drug administration and included both objective and subjective measures. THC drug effects and vital signs were also collected during experimental sessions. Nonparametric analysis with repeated measures was performed. RESULTS THC induced euphoria, perceptual and cognitive alterations, and tachycardia in a dose-related manner, but failed to have significant effects in experimentally induced acute chemical, mechanical, thermal, or electrical pain and capsaicin-induced hyperalgesia. CONCLUSIONS In this exploratory controlled study, intravenous THC lacked significant antinociceptive properties in experimental models of acute pain and capsaicin-induced hyperalgesia in healthy human subjects. Continued study of THC and other cannabinoids through high-quality, controlled studies in both healthy volunteers and patients with pain conditions is warranted to inform the growing demand for the clinical application of cannabinoids in pain management.
Collapse
Affiliation(s)
- Emmanuelle A D Schindler
- Neurology Service, MS 127, Veterans Affairs (VA) Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516, USA. .,Department of Neurology, Yale School of Medicine, New Haven, CT, USA.
| | - Ashley M Schnakenberg Martin
- Psychology Service, VA Connecticut Healthcare System, West Haven, CT, USA.,Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - R Andrew Sewell
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.,Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Mohini Ranganathan
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.,Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Anna DeForest
- Neurology Service, MS 127, Veterans Affairs (VA) Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516, USA.,Department of Neurology, Yale School of Medicine, New Haven, CT, USA
| | - Brian P Pittman
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Albert Perrino
- Anesthesia Service, VA Connecticut Healthcare System, West Haven, CT, USA.,Department of Anesthesia, Yale School of Medicine, New Haven, CT, USA
| | - Deepak C D'Souza
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.,Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA
| |
Collapse
|
33
|
Labad J, Ortega L, Cabezas Á, Montalvo I, Arranz S, Algora MJ, Solé M, Martorell L, Vilella E, Sánchez-Gistau V. Hypothalamic-pituitary-adrenal axis function and exposure to stress factors and cannabis use in recent-onset psychosis. World J Biol Psychiatry 2020; 21:564-571. [PMID: 31244371 DOI: 10.1080/15622975.2019.1628301] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: Previous studies suggest that childhood trauma, stressful life events, and cannabis use are associated with psychosis. We aimed to explore whether these environmental factors have an effect on hypothalamic-pituitary-adrenal (HPA) axis indices in recent-onset psychosis.Methods: We studied 56 recent-onset psychosis outpatients and 47 healthy controls. Childhood trauma was assessed with the Childhood Trauma Questionnaire. Stressful life events were assessed with the Holmes-Rahe Social Readjustment Scale. Cannabis use was assessed by semistructured interviews. Several HPA axis measures were analysed in saliva: cortisol awakening response (CAR), diurnal cortisol slope, and dexamethasone suppression test ratio (DSTR) after 0.25 mg of dexamethasone. Multiple linear regression analyses were conducted to explore the contribution of environmental factors to each HPA axis measure while adjusting for covariates (diagnosis, age, gender, smoking, body mass index and treatments).Results: There were no significant differences in HPA axis measures between diagnostic groups. Cannabis use was associated with a more flattened diurnal cortisol slope (standardized β = 0.21, p = 0.038), independent of recent-onset psychosis diagnosis. No associations were found between environmental factors and other HPA axis measures (CAR, DSTR).Conclusions: Our study provides evidence for the effect of cannabis exposure in cortisol secretion patterns in both healthy controls and recent-onset psychosis patients.
Collapse
Affiliation(s)
- Javier Labad
- Department of Mental Health, Parc Taulí Hospital Universitari, Institut d'Investigació Sanitària Parc Taulí (I3PT), Universitat Autònoma de Barcelona. CIBERSAM, Sabadell, Spain
| | - Laura Ortega
- Hospital Universitari Institut Pere Mata, Institut d'Investigació Sanitària Pere Virgili (IISPV), Universitat Rovira i Virgili. CIBERSAM. Reus, Spain
| | - Ángel Cabezas
- Hospital Universitari Institut Pere Mata, Institut d'Investigació Sanitària Pere Virgili (IISPV), Universitat Rovira i Virgili. CIBERSAM. Reus, Spain
| | - Itziar Montalvo
- Department of Mental Health, Parc Taulí Hospital Universitari, Institut d'Investigació Sanitària Parc Taulí (I3PT), Universitat Autònoma de Barcelona. CIBERSAM, Sabadell, Spain
| | - Sara Arranz
- Hospital Universitari Institut Pere Mata, Institut d'Investigació Sanitària Pere Virgili (IISPV), Universitat Rovira i Virgili. CIBERSAM. Reus, Spain
| | - Maria José Algora
- Hospital Universitari Institut Pere Mata, Institut d'Investigació Sanitària Pere Virgili (IISPV), Universitat Rovira i Virgili. CIBERSAM. Reus, Spain
| | - Montse Solé
- Hospital Universitari Institut Pere Mata, Institut d'Investigació Sanitària Pere Virgili (IISPV), Universitat Rovira i Virgili. CIBERSAM. Reus, Spain
| | - Lourdes Martorell
- Hospital Universitari Institut Pere Mata, Institut d'Investigació Sanitària Pere Virgili (IISPV), Universitat Rovira i Virgili. CIBERSAM. Reus, Spain
| | - Elisabet Vilella
- Hospital Universitari Institut Pere Mata, Institut d'Investigació Sanitària Pere Virgili (IISPV), Universitat Rovira i Virgili. CIBERSAM. Reus, Spain
| | - Vanessa Sánchez-Gistau
- Hospital Universitari Institut Pere Mata, Institut d'Investigació Sanitària Pere Virgili (IISPV), Universitat Rovira i Virgili. CIBERSAM. Reus, Spain
| |
Collapse
|
34
|
Vidot DC, Deo S, Daunert S, Joseph WL, de la Cruz-Munoz N, Messiah SE. A Preliminary Study on the Influence of Cannabis and Opioid Use on Weight Loss and Mental Health Biomarkers Post-weight Loss Surgery. Obes Surg 2020; 30:4331-4338. [PMID: 32860570 DOI: 10.1007/s11695-020-04828-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE A subpopulation of weight loss surgery (WLS) patients endorse cannabis and/or opioid use; however, impact on post-WLS anxiety and depression is unclear. This study examined the influence of the independent and combined use of cannabis and opioids on (1) depression and anxiety, (2) duodenum serotonin and cortisol, and (3) total percent weight loss. MATERIALS AND METHODS A cross-sectional analysis was conducted among patients (N = 18) who had biomarkers of serotonin and cortisol collected from the duodenum during WLS. Cannabis and opioid use was determined by self-reported lifetime, past-year, and past 30-day use. The Beck Anxiety Inventory and Depression Inventory-II assessed depression and anxiety symptoms. Total percent weight loss was calculated from pre-WLS and post-WLS weight (kg). Chi-squared analyses and t tests were conducted. RESULTS Over a quarter (27.8%) were cannabis-only users and 16.7% used a combination of cannabis and opioids. None reported using only opioids in this sample. Combination users presented with greater depressive symptoms (22.7%, p = 0.01) and greater total percent weight loss (34.1%, p = 0.04) than cannabis users (7.8, 23.2%, respectively). Cannabis users had greater serotonin (p = 0.02) and cortisol (p = 0.01) levels than combination users and never users. CONCLUSIONS Cannabis users had greater cortisol levels than never users and combination users. Combination users had greater weight loss and depression symptoms than cannabis users. Future studies should consider a larger sample size, utilization of a cohort design to address causality, and examination of the type, dose, and route of cannabis and opioid administration to further understand the impact of the combined use of cannabis and opioids post-WLS.
Collapse
Affiliation(s)
- Denise C Vidot
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA. .,Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - Sapna Deo
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sylvia Daunert
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Willie L Joseph
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Sarah E Messiah
- University of Texas Health Science Center School of Public Health, Dallas Campus, Dallas, TX, USA.,Center for Pediatric Population Health, UT Health School of Public Health and Children's Health System of Texas, Dallas, TX, USA
| |
Collapse
|
35
|
Delta-9 THC can be detected and quantified in the semen of men who are chronic users of inhaled cannabis. J Assist Reprod Genet 2020; 37:1497-1504. [PMID: 32356125 PMCID: PMC7311607 DOI: 10.1007/s10815-020-01762-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 03/27/2020] [Indexed: 02/06/2023] Open
Abstract
PURPOSE The purpose of this proof-of-concept study was to determine whether delta-9-tetrahydrocannabinol (THC) and THC metabolites (11-OH THC and THC-COOH) can be detected in semen. METHODS Twelve healthy men aged 18-45 years who identified as chronic and heavy users of inhaled cannabis were recruited. THC and THC metabolite levels were measured in serum, urine, and semen of the participants. Semen analyses were performed. Serum reproductive hormones were measured. RESULTS The median age and BMI of participants were 27.0 years and 24.7 kg/m2, respectively. Over half the participants were daily users of cannabis for over 5 years. Serum reproductive hormones were generally within normal ranges, except prolactin, which was elevated in 6 of 12 participants (mean 13.9 ng/mL). The median sperm concentration, motility, and morphology were 75.5 million/mL, 69.5%, and 5.5%, respectively. Urinary THC-COOH was detected in all 12 participants, and at least one serum THC metabolite was present in 10 of 12 participants. Two semen samples had insufficient volume to be analyzed. THC was above the reporting level of 0.50 ng/mL in the semen of two of the remaining participants. Seminal THC was moderately correlated with serum levels of THC (r = 0.66), serum 11-OH THC (r = 0.57), and serum THC-COOH (r = 0.67). Seminal delta-9 THC was not correlated with urinary cannabinoid levels or semen analysis parameters. CONCLUSION This is the first study to identify and quantify THC in human semen, demonstrating that THC can cross the blood-testis barrier in certain individuals. Seminal THC was found to be moderately correlated with serum THC and THC metabolites.
Collapse
|
36
|
Δ9-tetrahydrocannabinol exposure during rat pregnancy leads to symmetrical fetal growth restriction and labyrinth-specific vascular defects in the placenta. Sci Rep 2020; 10:544. [PMID: 31953475 PMCID: PMC6969028 DOI: 10.1038/s41598-019-57318-6] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 12/20/2019] [Indexed: 02/08/2023] Open
Abstract
1 in 5 women report cannabis use during pregnancy, with nausea cited as their primary motivation. Studies show that (-)-△9-tetrahydrocannabinol (Δ9-THC), the major psychoactive ingredient in cannabis, causes fetal growth restriction, though the mechanisms are not well understood. Given the critical role of the placenta to transfer oxygen and nutrients from mother, to the fetus, any compromise in the development of fetal-placental circulation significantly affects maternal-fetal exchange and thereby, fetal growth. The goal of this study was to examine, in rats, the impact of maternal Δ9-THC exposure on fetal development, neonatal outcomes, and placental development. Dams received a daily intraperitoneal injection (i.p.) of vehicle control or Δ9-THC (3 mg/kg) from embryonic (E)6.5 through 22. Dams were allowed to deliver normally to measure pregnancy and neonatal outcomes, with a subset sacrificed at E19.5 for placenta assessment via immunohistochemistry and qPCR. Gestational Δ9-THC exposure resulted in pups born with symmetrical fetal growth restriction, with catch up growth by post-natal day (PND)21. During pregnancy there were no changes to maternal food intake, maternal weight gain, litter size, or gestational length. E19.5 placentas from Δ9-THC-exposed pregnancies exhibited a phenotype characterized by increased labyrinth area, reduced Epcam expression (marker of labyrinth trophoblast progenitors), altered maternal blood space, decreased fetal capillary area and an increased recruitment of pericytes with greater collagen deposition, when compared to vehicle controls. Further, at E19.5 labyrinth trophoblast had reduced glucose transporter 1 (GLUT1) and glucocorticoid receptor (GR) expression in response to Δ9-THC exposure. In conclusion, maternal exposure to Δ9-THC effectively compromised fetal growth, which may be a result of the adversely affected labyrinth zone development. These findings implicate GLUT1 as a Δ9-THC target and provide a potential mechanism for the fetal growth restriction observed in women who use cannabis during pregnancy.
Collapse
|
37
|
Abstract
Understanding the neurobiological basis of post-traumatic stress disorder (PTSD) is fundamental to accurately diagnose this neuropathology and offer appropriate treatment options to patients. The lack of pharmacological effects, too often observed with the most currently used drugs, the selective serotonin reuptake inhibitors (SSRIs), makes even more urgent the discovery of new pharmacological approaches. Reliable animal models of PTSD are difficult to establish because of the present limited understanding of the PTSD heterogeneity and of the influence of various environmental factors that trigger the disorder in humans. We summarize knowledge on the most frequently investigated animal models of PTSD, focusing on both their behavioral and neurobiological features. Most of them can reproduce not only behavioral endophenotypes, including anxiety-like behaviors or fear-related avoidance, but also neurobiological alterations, such as glucocorticoid receptor hypersensitivity or amygdala hyperactivity. Among the various models analyzed, we focus on the social isolation mouse model, which reproduces some deficits observed in humans with PTSD, such as abnormal neurosteroid biosynthesis, changes in GABAA receptor subunit expression and lack of pharmacological response to benzodiazepines. Neurosteroid biosynthesis and its interaction with the endocannabinoid system are altered in PTSD and are promising neuronal targets to discover novel PTSD agents. In this regard, we discuss pharmacological interventions and we highlight exciting new developments in the fields of research for novel reliable PTSD biomarkers that may enable precise diagnosis of the disorder and more successful pharmacological treatments for PTSD patients.
Collapse
|
38
|
Abstract
Given the aging Baby Boomer generation, changes in cannabis legislation, and the growing acknowledgment of cannabis for its therapeutic potential, it is predicted that cannabis use in the older population will escalate. It is, therefore, important to determine the interaction between the effects of cannabis and aging. The aim of this report is to describe the link between cannabis use and the aging brain. Our review of the literature found few and inconsistent empirical studies that directly address the impact of cannabis use on the aging brain. However, research focused on long-term cannabis use points toward cumulative effects on multimodal systems in the brain that are similarly affected during aging. Specifically, the effects of cannabis and aging converge on overlapping networks in the endocannabinoid, opioid, and dopamine systems that may affect functional decline particularly in the hippocampus and prefrontal cortex, which are critical areas for memory and executive functioning. To conclude, despite the limited current knowledge on the potential interactive effects between cannabis and aging, evidence from the literature suggests that cannabis and aging effects are concurrently present across several neurotransmitter systems. There is a great need for future research to directly test the interactions between cannabis and aging.
Collapse
Affiliation(s)
- Hye Bin Yoo
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas, USA
| | - Jennifer DiMuzio
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas, USA
| | - Francesca M Filbey
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas, USA
| |
Collapse
|
39
|
Fekih-Romdhane F, Hakiri A, Fadhel SB, Cheour M. [Cannabis use in subjects at ultra high risk for psychosis]. Presse Med 2019; 48:1229-1236. [PMID: 31732360 DOI: 10.1016/j.lpm.2019.09.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 07/10/2019] [Accepted: 09/23/2019] [Indexed: 11/30/2022] Open
Abstract
Cannabis use is widespread among people at ultra-high risk (UHR) for psychosis. The causal link as well as the temporal link between cannabis use and further occurrence of psychosis in UHR people remain inconclusive. Current science data supported an increased risk of transition to psychosis in cannabis users who are genetically predisposed to psychosis. This risk would be even greater in the presence of a family history of psychosis, in case of a strong use and an early onset use. Several models have been cited to explain the link between cannabis use and the subsequent onset of psychosis or prepsychotic states: cannabis-induced modifications of some brain structures, a dysregulation of the hypothalamic-pituitary axis and an alteration of normal neurological development via the endocannabinoid system. Cannabis represents a modifiable risk for psychosis. Current interventions aim to reduce or stop the cannabis use in order to reduce the risk of transition to psychosis.
Collapse
Affiliation(s)
- Feten Fekih-Romdhane
- Hôpital Razi, service de psychiatrie Ibn-Omrane, 1, rue des orangers, 2010 La-Manouba, Tunisie; Université Tunis El-Manar, faculté de médecine de Tunis, Tunis, Tunisie.
| | - Abir Hakiri
- Hôpital Razi, service de psychiatrie Ibn-Omrane, 1, rue des orangers, 2010 La-Manouba, Tunisie; Université Tunis El-Manar, faculté de médecine de Tunis, Tunis, Tunisie
| | - Sinda Ben Fadhel
- Hôpital Razi, service de psychiatrie Ibn-Omrane, 1, rue des orangers, 2010 La-Manouba, Tunisie; Université Tunis El-Manar, faculté de médecine de Tunis, Tunis, Tunisie
| | - Majda Cheour
- Hôpital Razi, service de psychiatrie Ibn-Omrane, 1, rue des orangers, 2010 La-Manouba, Tunisie; Université Tunis El-Manar, faculté de médecine de Tunis, Tunis, Tunisie
| |
Collapse
|
40
|
Lisano JK, Smith JD, Mathias AB, Christensen M, Smoak P, Phillips KT, Quinn CJ, Stewart LK. Performance and Health-Related Characteristics of Physically Active Males Using Marijuana. J Strength Cond Res 2019; 33:1658-1668. [DOI: 10.1519/jsc.0000000000002238] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
41
|
Pinky PD, Bloemer J, Smith WD, Moore T, Hong H, Suppiramaniam V, Reed MN. Prenatal cannabinoid exposure and altered neurotransmission. Neuropharmacology 2019; 149:181-194. [PMID: 30771373 DOI: 10.1016/j.neuropharm.2019.02.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 01/18/2019] [Accepted: 02/12/2019] [Indexed: 11/26/2022]
Abstract
Marijuana is one of the most commonly used illicit drugs worldwide. In addition, use of synthetic cannabinoids is increasing, especially among adolescents and young adults. Although human studies have shown that the use of marijuana during pregnancy leads to adverse behavioral effects, such as deficiencies in attention and executive function in affected offspring, the rate of marijuana use among pregnant women is steadily increasing. Various aspects of human behavior including emotion, learning, and memory are dependent on complex interactions between multiple neurotransmitter systems that are especially vulnerable to alterations during the developmental period. Thus, exploration of neurotransmitter changes in response to prenatal cannabinoid exposure is crucial to develop an understanding of how homeostatic imbalance and various long-term neurobehavioral deficits manifest following the abuse of marijuana or other synthetic cannabinoids during pregnancy. Current literature confirms that vast alterations to neurotransmitter systems are present following prenatal cannabinoid exposure, and many of these alterations within the brain are region specific, time-dependent, and sexually dimorphic. In this review, we aim to provide a summary of observed changes to various neurotransmitter systems following cannabinoid exposure during pregnancy and to draw possible correlations to reported behavioral alterations in affected offspring.
Collapse
Affiliation(s)
- Priyanka D Pinky
- Department of Drug Discovery and Development, Auburn University, Auburn, AL, USA
| | - Jenna Bloemer
- Department of Drug Discovery and Development, Auburn University, Auburn, AL, USA
| | - Warren D Smith
- Department of Drug Discovery and Development, Auburn University, Auburn, AL, USA
| | - Timothy Moore
- Department of Drug Discovery and Development, Auburn University, Auburn, AL, USA; Center for Neuroscience Initiative, Auburn University, Auburn, AL, USA
| | - Hao Hong
- Department of Pharmacology, China Pharmaceutical University, Nanjing, China
| | - Vishnu Suppiramaniam
- Department of Drug Discovery and Development, Auburn University, Auburn, AL, USA; Center for Neuroscience Initiative, Auburn University, Auburn, AL, USA.
| | - Miranda N Reed
- Department of Drug Discovery and Development, Auburn University, Auburn, AL, USA; Center for Neuroscience Initiative, Auburn University, Auburn, AL, USA.
| |
Collapse
|
42
|
Wemm SE, Sinha R. Drug-induced stress responses and addiction risk and relapse. Neurobiol Stress 2019; 10:100148. [PMID: 30937354 PMCID: PMC6430516 DOI: 10.1016/j.ynstr.2019.100148] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 12/07/2018] [Accepted: 01/30/2019] [Indexed: 12/21/2022] Open
Abstract
A number of studies have assessed the effects of psychoactive drugs on stress biology, the neuroadaptations resulting from chronic drug use on stress biology, and their effects on addiction risk and relapse. This review mainly covers human research on the acute effects of different drugs of abuse (i.e., nicotine, cannabis, psychostimulants, alcohol, and opioids) on the hypothalamic-pituitary-adrenal (HPA) axis and the autonomic nervous system (ANS) responses. We review the literature on acute peripheral stress responses in naïve or light recreational users and binge/heavy or chronic drug users. We also discuss evidence of alterations in tonic levels, or tolerance, in the latter relative to the former and associated changes in the phasic stress responses. We discuss the impact of the stress system tolerance in heavy users on their response to drug- and stress-related cue responses and craving as compared to control subjects. A summary is provided of the effects of glucocorticoid responses and their adaptations on brain striatal and prefrontal cortices involved in the regulation of drug seeking and relapse risk. Finally, we summarize important considerations, including individual difference factors such as gender, co-occurring drug use, early trauma and adversity and drug use history and variation in methodologies, that may further influence the effects of these drugs on stress biology.
Collapse
Affiliation(s)
- Stephanie E. Wemm
- Yale Stress Center, Yale School of Medicine, 2 Church St South Suite 209, New Haven, CT, 06519, USA
| | | |
Collapse
|
43
|
Fonseca BM, Fernandes R, Almada M, Santos M, Carvalho F, Teixeira NA, Correia-da-Silva G. Synthetic cannabinoids and endometrial stromal cell fate: Dissimilar effects of JWH-122, UR-144 and WIN55,212-2. Toxicology 2019; 413:40-47. [PMID: 30502353 DOI: 10.1016/j.tox.2018.11.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 11/16/2018] [Accepted: 11/20/2018] [Indexed: 11/30/2022]
|
44
|
Yibrah M, Negesso AE, Gebregziabher A, Challa F, Mudi K, Tesfay F, Gebretsadkan M, Kinde S, Asmelash D. Gonadal and Cortisol Hormone Profile among Male Chronic Khat, Marijuana, and Heroin Abuses. Int J Endocrinol 2019; 2019:4178241. [PMID: 31781207 PMCID: PMC6874973 DOI: 10.1155/2019/4178241] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/06/2019] [Accepted: 10/11/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Drugs of abuse could interfere with the hypothalamic-pituitary-gonadal axis, causing impaired functions of the gland and associated functions of target organs. Drugs of abuse tend to cause changes in the endocrine system, and these changes could be physiological, molecular, biochemical, genetic, and cellular. METHOD A case-control study design was conducted from a total of 171 male consented study participants (148 drug abusers and 23 controls). The serum gonadal and cortisol hormone levels were assayed using the electrochemiluminescence immunoassay method. Socio-demographic variables were collected using a semi-structured questionnaire by the interview method. Nonparametric statistical tools (Mann-Whitney test and median) were used to compare the groups. In all cases, P < 0.05 was considered statistically significant. RESULT The median age for drug abusers and control groups was 27, and the age difference between drug abusers and control group was not statistically important. The median estradiol levels among chronic khat chewers (39.4 pg/ml), marijuana (44 pg/mL), and users of heroin (40.2 pg/mL) were significantly higher than control groups (23 pg/mL), P < 0.003. However, the median luteinizing hormone levels among chronic khat chewers (5 IU/L), marijuana users (5 IU/L), and heroin users (5.6 IU/L) were significantly lower than those of control groups (6.2 IU/L), P < 0.02. The median testosterone levels among chronic khat chewers (6.1 ng/mL), marijuana users (6.3 ng/mL), and heroin users (6.6 ng/mL) were significantly lower than control groups (8.0 ng/mL), P < 0.003. However, cortisol and follicle stimulating hormone did not show statistically significant difference between users of khat, marijuana, and heroin compared with the control group. CONCLUSION The drug abuser group had significantly lower testosterone and luteinizing hormone levels compared with control groups. Drug abuse has been shown to affect gonadal hormones in an unusual physiological phenomenon. These findings reveal the need for intervention programs to solve these problems.
Collapse
Affiliation(s)
- Meseret Yibrah
- Department of Medical Laboratory Science, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Abebe Edao Negesso
- Department of Medical Laboratory Science, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Atsbeha Gebregziabher
- HIV and TB Research Directorate, Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | - Feyissa Challa
- HIV and TB Research Directorate, Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | - Kissi Mudi
- HIV and TB Research Directorate, Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | - Feven Tesfay
- Department of Medical Laboratory Science, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Mehari Gebretsadkan
- Department of Medical Laboratory Science, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Samuel Kinde
- Department of Medical Laboratory Science, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Daniel Asmelash
- Department of Clinical Chemistry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
45
|
Petrowski K, Conrad R. Comparison of Cortisol Stress Response in Patients with Panic Disorder, Cannabis-Induced Panic Disorder, and Healthy Controls. Psychopathology 2019; 52:26-32. [PMID: 30879013 DOI: 10.1159/000496559] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 12/24/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Little research effort has so far been dedicated to the analysis of the hypothalamic-pituitary-adrenal axis of aetiologically differing subgroups of patients with panic disorder (PD). The current study aimed at a deeper understanding of the cortisol stress response in cannabis-induced PD (CIPD) patients. METHODS Matched groups of 7 PD patients (mean age ± SD: 32.95 ± 9.04 years), 7 CIPD patients (31.94 ± 8.40 years), and 7 healthy controls (HC) (31.13 ± 8.57 years) were included in the study. The Trier Social Stress Test (TSST) was used for stress induction. Salivary cortisol samples were collected and panic- and depression-related questionnaires were applied. RESULTS A stress response to the TSST was found in 28.6% of PD patients, in 51.1% of CIPD patients, and in 100% of HC subjects. Statistical analyses revealed a cortisol hyporesponsiveness in PD and CIPD patients. While cortisol values of PD patients and HC participants differed significantly, CIPD patients' cortisol courses balanced between those of PD patients and HC subjects. CONCLUSIONS Current findings show a distinctive pattern of the stress-induced cortisol reaction in CIPD patients, which is markedly different from the hormonal response in PD patients as well as HC subjects. Previous findings of cortisol hyporesponsiveness in PD patients compared to HC subjects were confirmed.
Collapse
Affiliation(s)
- Katja Petrowski
- Medical Psychology and Medical Sociology, Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany, .,Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany,
| | - Rupert Conrad
- Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Bonn, Germany
| |
Collapse
|
46
|
The endocannabinoid system in mental disorders: Evidence from human brain studies. Biochem Pharmacol 2018; 157:97-107. [DOI: 10.1016/j.bcp.2018.07.009] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 07/12/2018] [Indexed: 02/06/2023]
|
47
|
Goldfarb EV, Sinha R. Drug-Induced Glucocorticoids and Memory for Substance Use. Trends Neurosci 2018; 41:853-868. [PMID: 30170822 PMCID: PMC6204074 DOI: 10.1016/j.tins.2018.08.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 07/13/2018] [Accepted: 08/08/2018] [Indexed: 11/29/2022]
Abstract
The biological stress response of the body forms one of the foundations of adaptive behavior, including promoting (and impairing) different forms of memory. This response transcends stressful experiences and underlies reactions to challenges and even reinforcers such as addictive substances. Nevertheless, drug-induced stress responses are rarely incorporated into models of addiction. We propose here that drug-induced stress responses (particularly glucocorticoids) play a crucial role in addictive behavior by modulating the formation of memories for substance-use experiences. We review the contributions of amygdala-, striatum-, and hippocampus-based memory systems to addiction, and reveal common effects of addictive drugs and acute stress on these different memories. We suggest that the contributions of drug-induced stress responses to memory may provide insights into the mechanisms driving addictive behavior.
Collapse
Affiliation(s)
- Elizabeth V Goldfarb
- Department of Diagnostic Radiology; Yale Stress Center; Yale University School of Medicine, New Haven, CT, USA.
| | - Rajita Sinha
- Departments of Psychiatry and Neuroscience; Yale Stress Center; Yale University School of Medicine, New Haven, CT, USA
| |
Collapse
|
48
|
Colizzi M, Bhattacharyya S. Cannabis use and the development of tolerance: a systematic review of human evidence. Neurosci Biobehav Rev 2018; 93:1-25. [DOI: 10.1016/j.neubiorev.2018.07.014] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 07/21/2018] [Accepted: 07/24/2018] [Indexed: 01/15/2023]
|
49
|
De Aquino JP, Sherif M, Radhakrishnan R, Cahill JD, Ranganathan M, D’Souza DC. The Psychiatric Consequences of Cannabinoids. Clin Ther 2018; 40:1448-1456. [DOI: 10.1016/j.clinthera.2018.03.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 03/15/2018] [Accepted: 03/23/2017] [Indexed: 12/14/2022]
|
50
|
Modulation of acute effects of delta-9-tetrahydrocannabinol on psychotomimetic effects, cognition and brain function by previous cannabis exposure. Eur Neuropsychopharmacol 2018; 28:850-862. [PMID: 29935939 DOI: 10.1016/j.euroneuro.2018.04.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 04/24/2018] [Accepted: 04/30/2018] [Indexed: 01/31/2023]
Abstract
Cannabis use has been associated with psychosis and cognitive dysfunction. Some evidence suggests that the acute behavioral and neurocognitive effects of the main active ingredient in cannabis, (-)-trans-Δ9-tetrahydrocannabinol (∆9-THC), might be modulated by previous cannabis exposure. However, this has not been investigated either using a control group of non-users, or following abstinence in modest cannabis users, who represent the majority of recreational users. Twenty-four healthy men participated in a double-blind, randomized, placebo-controlled, repeated-measures, within-subject, ∆9-THC challenge study. Compared to non-users (N=12; <5 lifetime cannabis joints smoked), abstinent modest cannabis users (N=12; 24.5±9 lifetime cannabis joints smoked) showed worse performance and stronger right hemispheric activation during cognitive processing, independent of the acute challenge (all P≤0.047). Acute ∆9-THC administration produced transient anxiety and psychotomimetic symptoms (all P≤0.02), the latter being greater in non-users compared to users (P=0.040). Non-users under placebo (control group) activated specific brain areas to perform the tasks, while deactivating others. An opposite pattern was found under acute (∆9-THC challenge in non-users) as well as residual (cannabis users under placebo) effect of ∆9-THC. Under ∆9-THC, cannabis users showed brain activity patterns intermediate between those in non-users under placebo (control group), and non-users under ∆9-THC (acute effect) and cannabis users under placebo (residual effect). In non-users, the more severe the ∆9-THC-induced psychotomimetic symptoms and cognitive impairments, the more pronounced was the neurophysiological alteration (all P≤0.036). Previous modest cannabis use blunts the acute behavioral and neurophysiological effects of ∆9-THC, which are more marked in people who have never used cannabis.
Collapse
|