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de Oliveira MC, Vides MC, Lassi DLS, Torales J, Ventriglio A, Bombana HS, Leyton V, Périco CDAM, Negrão AB, Malbergier A, Castaldelli-Maia JM. Toxicity of Synthetic Cannabinoids in K2/Spice: A Systematic Review. Brain Sci 2023; 13:990. [PMID: 37508922 PMCID: PMC10377539 DOI: 10.3390/brainsci13070990] [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: 05/17/2023] [Revised: 06/19/2023] [Accepted: 06/22/2023] [Indexed: 07/30/2023] Open
Abstract
(1) Background: Synthetic cannabinoids (SCs) are emerging drugs of abuse sold as 'K2', 'K9' or 'Spice'. Evidence shows that using SCs products leads to greater health risks than cannabis. They have been associated with greater toxicity and higher addiction potential unrelated to the primary psychoactive component of marijuana, Δ9-tetrahydrocannabinol (Δ9-THC). Moreover, early cases of intoxication and death related to SCs highlight the inherent danger that may accompany the use of these substances. However, there is limited knowledge of the toxicology of Spice ingredients. This systematic review intends to analyze the toxicity of SCs compounds in Spice/K2 drugs. (2) Methods: Studies analyzing synthetic cannabinoid toxicity and dependence were included in the present review. We searched the PubMed database of the US National Library of Medicine, Google Scholar, CompTox Chemicals, and Web of Science up to May 2022. (3) Results: Sixty-four articles reporting the effects of synthetic cannabinoids in humans were included in our review. Ten original papers and fifty-four case studies were also included. Fourteen studies reported death associated with synthetic cannabinoid use, with AB-CHMINACA and MDMB-CHMICA being the main reported SCs. Tachycardia and seizures were the most common toxicity symptoms. The prevalence of neuropsychiatric symptoms was higher in third-generation SCs. (4) Conclusion: SCs may exhibit higher toxicity than THC and longer-lasting effects. Their use may be harmful, especially in people with epilepsy and schizophrenia, because of the increased risk of the precipitation of psychiatric and neurologic disorders. Compared to other drugs, SCs have a higher potential to trigger a convulsive crisis, a decline in consciousness, and hemodynamic changes. Therefore, it is crucial to clarify their potential harms and increase the availability of toxicology data in both clinical and research settings.
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Affiliation(s)
- Mariana Campello de Oliveira
- Interdisciplinary Group of Alcohol and Drug Studies (GREA), Institute Perdizes, Department of Psychiatry Medical School, São Paulo University, São Paulo 05403-903, SP, Brazil
| | - Mariana Capelo Vides
- Interdisciplinary Group of Alcohol and Drug Studies (GREA), Institute Perdizes, Department of Psychiatry Medical School, São Paulo University, São Paulo 05403-903, SP, Brazil
| | - Dângela Layne Silva Lassi
- Interdisciplinary Group of Alcohol and Drug Studies (GREA), Institute Perdizes, Department of Psychiatry Medical School, São Paulo University, São Paulo 05403-903, SP, Brazil
| | - Julio Torales
- Department of Psychological Medicine, School of Medical Sciences, National University of Asuncion, San Lorenzo 111421, Paraguay
| | - Antonio Ventriglio
- Department of Experimental Medicine, Medical School, University of Foggia, 71122 Foggia, Italy
| | - Henrique Silva Bombana
- Department of Legal Medicine, Medical School, São Paulo University, São Paulo 05508-090, SP, Brazil
| | - Vilma Leyton
- Department of Legal Medicine, Medical School, São Paulo University, São Paulo 05508-090, SP, Brazil
| | | | - André Brooking Negrão
- Interdisciplinary Group of Alcohol and Drug Studies (GREA), Institute Perdizes, Department of Psychiatry Medical School, São Paulo University, São Paulo 05403-903, SP, Brazil
| | - André Malbergier
- Interdisciplinary Group of Alcohol and Drug Studies (GREA), Institute Perdizes, Department of Psychiatry Medical School, São Paulo University, São Paulo 05403-903, SP, Brazil
| | - João Maurício Castaldelli-Maia
- Interdisciplinary Group of Alcohol and Drug Studies (GREA), Institute Perdizes, Department of Psychiatry Medical School, São Paulo University, São Paulo 05403-903, SP, Brazil
- Department of Neuroscience, Medical School, FMABC University Center, Santo André 09060-870, SP, Brazil
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
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Corli G, Tirri M, Bilel S, Arfè R, Coccini T, Roda E, Marchetti B, Vincenzi F, Zauli G, Borea PA, Locatelli CA, Varani K, Marti M. MAM-2201 acute administration impairs motor, sensorimotor, prepulse inhibition, and memory functions in mice: a comparison with its analogue AM-2201. Psychopharmacology (Berl) 2023:10.1007/s00213-023-06378-8. [PMID: 37233813 DOI: 10.1007/s00213-023-06378-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 05/02/2023] [Indexed: 05/27/2023]
Abstract
RATIONALE 1-[(5-fluoropentyl)-1H-indol-3-yl](4-methyl-1-naphthalenyl) methanone (MAM-2201) is a potent synthetic cannabinoid receptor agonist illegally marketed in "spice" products and as "synthacaine" for its psychoactive effects. It is a naphthoyl-indole derivative which differs from its analogue 1-[(5-Fluoropentyl)-1H-indol-3-yl](1-naphthylenyl) methanone (AM-2201) by the presence of a methyl substituent on carbon 4 (C-4) of the naphthoyl moiety. Multiple cases of intoxication and impaired driving have been linked to AM-2201 and MAM-2201 consumption. OBJECTIVES This study aims to investigate the in vitro (murine and human cannabinoid receptors) and in vivo (CD-1 male mice) pharmacodynamic activity of MAM-2201 and compare its effects with those induced by its desmethylated analogue, AM-2201. RESULTS In vitro competition binding studies confirmed that MAM-2201 and AM-2201 possess nanomolar affinity for both CD-1 murine and human CB1 and CB2 receptors, with preference for the CB1 receptor. In agreement with the in vitro binding data, in vivo studies showed that MAM-2201 induces visual, acoustic, and tactile impairments that were fully prevented by pretreatment with CB1 receptor antagonist/partial agonist AM-251, indicating a CB1 receptor mediated mechanism of action. Administration of MAM-2201 also altered locomotor activity and PPI responses of mice, pointing out its detrimental effect on motor and sensory gating functions and confirming its potential use liability. MAM-2201 and AM-2201 also caused deficits in short- and long-term working memory. CONCLUSION These findings point to the potential public health burden that these synthetic cannabinoids may pose, with particular emphasis on impaired driving and workplace performance.
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Affiliation(s)
- Giorgia Corli
- Department of Translational Medicine, Section of Legal Medicine, LTTA Center and University Center of Gender Medicine, University of Ferrara, Via Fossato Di Mortara 17-19, 44121, Ferrara, Italy
| | - Micaela Tirri
- Department of Translational Medicine, Section of Legal Medicine, LTTA Center and University Center of Gender Medicine, University of Ferrara, Via Fossato Di Mortara 17-19, 44121, Ferrara, Italy
| | - Sabrine Bilel
- Department of Translational Medicine, Section of Legal Medicine, LTTA Center and University Center of Gender Medicine, University of Ferrara, Via Fossato Di Mortara 17-19, 44121, Ferrara, Italy
| | - Raffaella Arfè
- Department of Translational Medicine, Section of Legal Medicine, LTTA Center and University Center of Gender Medicine, University of Ferrara, Via Fossato Di Mortara 17-19, 44121, Ferrara, Italy
| | - Teresa Coccini
- Laboratory of Clinical and Experimental Toxicology, and Poison Control Centre and National Toxicology Information Centre, Toxicology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Via Maugeri 10, 27100, Pavia, Italy
| | - Elisa Roda
- Laboratory of Clinical and Experimental Toxicology, and Poison Control Centre and National Toxicology Information Centre, Toxicology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Via Maugeri 10, 27100, Pavia, Italy
| | - Beatrice Marchetti
- Department of Translational Medicine, Section of Legal Medicine, LTTA Center and University Center of Gender Medicine, University of Ferrara, Via Fossato Di Mortara 17-19, 44121, Ferrara, Italy
| | - Fabrizio Vincenzi
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Giorgio Zauli
- Research Department, King Khaled Eye Specialistic Hospital, Riyadh, Saudi Arabia
| | | | - Carlo Alessandro Locatelli
- Laboratory of Clinical and Experimental Toxicology, and Poison Control Centre and National Toxicology Information Centre, Toxicology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Via Maugeri 10, 27100, Pavia, Italy
| | - Katia Varani
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Matteo Marti
- Department of Translational Medicine, Section of Legal Medicine, LTTA Center and University Center of Gender Medicine, University of Ferrara, Via Fossato Di Mortara 17-19, 44121, Ferrara, Italy.
- Department of Anti-Drug Policies, Collaborative Center for the Italian National Early Warning System, Presidency of the Council of Ministers, Ferrara, Italy.
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Sparkes E, Boyd R, Chen S, Markham JW, Luo JL, Foyzun T, Zaman H, Fletcher C, Ellison R, McGregor IS, Santiago MJ, Lai F, Gerona RR, Connor M, Hibbs DE, Cairns EA, Glass M, Ametovski A, Banister SD. Synthesis and pharmacological evaluation of newly detected synthetic cannabinoid receptor agonists AB-4CN-BUTICA, MMB-4CN-BUTINACA, MDMB-4F-BUTICA, MDMB-4F-BUTINACA and their analogs. Front Psychiatry 2022; 13:1010501. [PMID: 36245876 PMCID: PMC9558907 DOI: 10.3389/fpsyt.2022.1010501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 08/24/2022] [Indexed: 11/13/2022] Open
Abstract
Synthetic cannabinoid receptor agonists (SCRAs) continue to make up a significant portion new psychoactive substances (NPS) detected and seized worldwide. Due to their often potent activation of central cannabinoid receptors in vivo, use of SCRAs can result in severe intoxication, in addition to other adverse health effects. Recent detections of AB-4CN-BUTICA, MMB-4CN-BUTINACA, MDMB-4F-BUTICA and MDMB-4F-BUTINACA mark a continuation in the appearance of SCRAs bearing novel tail substituents. The proactive characterization campaign described here has facilitated the detection of several new SCRAs in toxicological case work. Here we detail the synthesis, characterization, and pharmacological evaluation of recently detected SCRAs, as well as a systematic library of 32 compounds bearing head, tail, and core group combinations likely to appear in future. In vitro radioligand binding assays revealed most compounds showed moderate to high affinity at both CB1 (pK i = < 5 to 8.89 ± 0.09 M) and CB2 (pK i = 5.49 ± 0.03 to 9.92 ± 0.09 M) receptors. In vitro functional evaluation using a fluorescence-based membrane potential assay showed that most compounds were sub-micromolar to sub-nanomolar agonists at CB1 (pEC50 = < 5 to 9.48 ± 0.14 M) and CB2 (pEC50 = 5.92 ± 0.16 to 8.64 ± 0.15 M) receptors. An in silico receptor-ligand docking approach was utilized to rationalize binding trends for CB2 with respect to the tail substituent, and indicated that rigidity in this region (i.e., 4-cyanobutyl) was detrimental to affinity.
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Affiliation(s)
- Eric Sparkes
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
- Faculty of Science, School of Chemistry, The University of Sydney, Sydney, NSW, Australia
| | - Rochelle Boyd
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
- Faculty of Science, School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Shuli Chen
- Department of Pharmacology and Toxicology, University of Otago, Dunedin, New Zealand
| | - Jack W. Markham
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
- Faculty of Science, School of Chemistry, The University of Sydney, Sydney, NSW, Australia
- Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Sydney, NSW, Australia
| | - Jia Lin Luo
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
- Faculty of Science, School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Tahira Foyzun
- Macquarie Medical School, Macquarie University, Sydney, NSW, Australia
| | - Humayra Zaman
- Macquarie Medical School, Macquarie University, Sydney, NSW, Australia
| | - Charlotte Fletcher
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
- Faculty of Science, School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Ross Ellison
- Clinical Toxicology and Environmental Biomonitoring Laboratory, University of California, San Francisco, San Francisco, CA, United States
| | - Iain S. McGregor
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
- Faculty of Science, School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | | | - Felcia Lai
- Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Sydney, NSW, Australia
| | - Roy R. Gerona
- Clinical Toxicology and Environmental Biomonitoring Laboratory, University of California, San Francisco, San Francisco, CA, United States
| | - Mark Connor
- Macquarie Medical School, Macquarie University, Sydney, NSW, Australia
| | - David E. Hibbs
- Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Sydney, NSW, Australia
| | - Elizabeth A. Cairns
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
- Faculty of Science, School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Michelle Glass
- Department of Pharmacology and Toxicology, University of Otago, Dunedin, New Zealand
| | - Adam Ametovski
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
- Faculty of Science, School of Chemistry, The University of Sydney, Sydney, NSW, Australia
| | - Samuel D. Banister
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
- Faculty of Science, School of Chemistry, The University of Sydney, Sydney, NSW, Australia
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Malaca S, Busardò FP, Nittari G, Sirignano A, Ricci G. Fourth Generation of Synthetic Cannabinoid Receptor Agonists: A Review on the Latest Insights. Curr Pharm Des 2022; 28:2603-2617. [PMID: 34781870 DOI: 10.2174/1381612827666211115170521] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 10/08/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Over the past few years, an emerging number of new psychoactive substances (NPSs) entered the illicit market. NPSs are designed to resemble the effects of classical drugs of abuse, reinforcing their effects and duration. Among the most abused NPS, synthetic cannabinoids are cannabinoid receptor agonists (SCRAs) that mimic the effect of the main psychotropic phytocannabinoid Δ9-tetrahydrocannabinol (THC). METHODS We herein reviewed the international literature to provide available information on the newest SCRAs generation. RESULTS Compared to the previous SCRAs generations, the structures of the last generation result in increased affinity for and efficacy at cannabinoid CB1 receptors, which are thought to be mainly responsible for the psychoactive effects of THC and its analogues. Accordingly, these more potent cannabimimetic effects may increase the number of adverse reactions such as neurological disorders (e.g., psychosis, agitation, irritability, paranoia, confusion, and anxiety), psychiatric episodes (e.g., hallucinations, delusions, self-harm), other physical conditions (e.g., tachycardia, hypertension, arrhythmia, chest pain, nausea, vomiting, and fever) and deaths. In the last decade, more than a hundred SCRAs from different chemical classes emerged on the illicit web market. SCRAs have been thoroughly studied: they were physico-chemically characterized, and pharmaco-toxicological characteristics were investigated. The last SCRAs generations include increasingly potent and toxic compounds, posing a potential health threat to consumers. CONCLUSION From November 2017 to February 2021, at least 20 new "fourth-generation" SCRAs were formally reported to international drug agencies. Our understanding of the neurotoxicity of these compounds is still limited due to the lack of global data, but their potency and their toxicity are likely higher than those of the previous generations.
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Affiliation(s)
- Sara Malaca
- Department of Excellence of Biomedical Sciences and Public Health, University "Politecnica delle Marche" of Ancona, Ancona, Italy
| | - Francesco P Busardò
- Department of Excellence of Biomedical Sciences and Public Health, University "Politecnica delle Marche" of Ancona, Ancona, Italy
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Bukke VN, Archana M, Villani R, Serviddio G, Cassano T. Pharmacological and Toxicological Effects of Phytocannabinoids and Recreational Synthetic Cannabinoids: Increasing Risk of Public Health. Pharmaceuticals (Basel) 2021; 14:ph14100965. [PMID: 34681189 PMCID: PMC8541640 DOI: 10.3390/ph14100965] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 09/19/2021] [Accepted: 09/20/2021] [Indexed: 01/01/2023] Open
Abstract
Synthetic Cannabinoids (CBs) are a novel class of psychoactive substances that have rapidly evolved around the world with the addition of diverse structural modifications to existing molecules which produce new structural analogues that can be associated with serious adverse health effects. Synthetic CBs represent the largest class of drugs detected by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) with a total of 207 substances identified from 2008 to October 2020, and 9 compounds being reported for the first time. Synthetic CBs are sprayed on natural harmless herbs with an aim to mimic the euphoric effect of Cannabis. They are sold under different brand names including Black mamba, spice, K2, Bombay Blue, etc. As these synthetic CBs act as full agonists at the CB receptors, they are much more potent than natural Cannabis and have been increasingly associated with acute to chronic intoxications and death. Due to their potential toxicity and abuse, the US government has listed some synthetic CBs under schedule 1 classification. The present review aims to provide a focused overview of the literature concerning the development of synthetic CBs, their abuse, and potential toxicological effects including renal toxicity, respiratory depression, hyperemesis syndrome, cardiovascular effects, and a range of effects on brain function.
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Relation Between Acute Administration of Synthetic Cannabinoids and Induction of Epileptic Seizures. ADDICTIVE DISORDERS & THEIR TREATMENT 2021. [DOI: 10.1097/adt.0000000000000286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Luethi D, Liechti ME. Designer drugs: mechanism of action and adverse effects. Arch Toxicol 2020; 94:1085-1133. [PMID: 32249347 PMCID: PMC7225206 DOI: 10.1007/s00204-020-02693-7] [Citation(s) in RCA: 125] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 02/25/2020] [Indexed: 12/18/2022]
Abstract
Psychoactive substances with chemical structures or pharmacological profiles that are similar to traditional drugs of abuse continue to emerge on the recreational drug market. Internet vendors may at least temporarily sell these so-called designer drugs without adhering to legal statutes or facing legal consequences. Overall, the mechanism of action and adverse effects of designer drugs are similar to traditional drugs of abuse. Stimulants, such as amphetamines and cathinones, primarily interact with monoamine transporters and mostly induce sympathomimetic adverse effects. Agonism at μ-opioid receptors and γ-aminobutyric acid-A (GABAA) or GABAB receptors mediates the pharmacological effects of sedatives, which may induce cardiorespiratory depression. Dissociative designer drugs primarily act as N-methyl-D-aspartate receptor antagonists and pose similar health risks as the medically approved dissociative anesthetic ketamine. The cannabinoid type 1 (CB1) receptor is thought to drive the psychoactive effects of synthetic cannabinoids, which are associated with a less desirable effect profile and more severe adverse effects compared with cannabis. Serotonergic 5-hydroxytryptamine-2A (5-HT2A) receptors mediate alterations of perception and cognition that are induced by serotonergic psychedelics. Because of their novelty, designer drugs may remain undetected by routine drug screening, thus hampering evaluations of adverse effects. Intoxication reports suggest that several designer drugs are used concurrently, posing a high risk for severe adverse effects and even death.
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Affiliation(s)
- Dino Luethi
- Center for Physiology and Pharmacology, Institute of Pharmacology, Medical University of Vienna, Währinger Strasse 13a, 1090, Vienna, Austria.
- Institute of Applied Physics, Vienna University of Technology, Getreidemarkt 9, 1060, Vienna, Austria.
- Division of Clinical Pharmacology and Toxicology, University Hospital Basel and University of Basel, Schanzenstrasse 55, 4056, Basel, Switzerland.
| | - Matthias E Liechti
- Division of Clinical Pharmacology and Toxicology, University Hospital Basel and University of Basel, Schanzenstrasse 55, 4056, Basel, Switzerland.
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Cannabinoids in the Pathophysiology of Skin Inflammation. Molecules 2020; 25:molecules25030652. [PMID: 32033005 PMCID: PMC7037408 DOI: 10.3390/molecules25030652] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 01/26/2020] [Accepted: 02/02/2020] [Indexed: 12/22/2022] Open
Abstract
Cannabinoids are increasingly-used substances in the treatment of chronic pain, some neuropsychiatric disorders and more recently, skin disorders with an inflammatory component. However, various studies cite conflicting results concerning the cellular mechanisms involved, while others suggest that cannabinoids may even exert pro-inflammatory behaviors. This paper aims to detail and clarify the complex workings of cannabinoids in the molecular setting of the main dermatological inflammatory diseases, and their interactions with other substances with emerging applications in the treatment of these conditions. Also, the potential role of cannabinoids as antitumoral drugs is explored in relation to the inflammatory component of skin cancer. In vivo and in vitro studies that employed either phyto-, endo-, or synthetic cannabinoids were considered in this paper. Cannabinoids are regarded with growing interest as eligible drugs in the treatment of skin inflammatory conditions, with potential anticancer effects, and the readiness in monitoring of effects and the facility of topical application may contribute to the growing support of the use of these substances. Despite the promising early results, further controlled human studies are required to establish the definitive role of these products in the pathophysiology of skin inflammation and their usefulness in the clinical setting.
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Mutluay D, Güngör Ş, Tenekeci GY, Köksoy S, Çoban CS. Effects of synthetic (JWH-018) cannabinoids treatment on spermatogenesis and sperm function. Drug Chem Toxicol 2019; 45:215-222. [PMID: 31645148 DOI: 10.1080/01480545.2019.1680686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
JWH-018 is a synthetic cannabinoid which has been increasingly used by adolescents and adults, and is known to cause severe multi-organ failure. However, little is known about the complications and toxicological effects of JWH-018 on reproduction system. Therefore, the aim of the present study is to investigate the effects of JWH-018 on testis and spermatogenesis. Thirty CD-1 male rats were distributed into six groups, control group (C1 and C2), ethanol group (E1 and E2), and JWH-018 group (JWH1 and JWH2), which were administered 0.9% NaCl, %100 ethanol, and JWH-018 (0.3 mg/kg) respectively for 9 d. We euthanized C1, E1, and JWH1 group mice at day 2 and C2, E2, and JWH2 group mice at 45 d after the last injection to evaluate the acute testis damage and potential recovery of spermatogenesis. The histopathology of seminiferous epithelium was evaluated and organ weight, sperm concentration and motility, membrane integrity, and serum testosterone levels were statistically analyzed. In JWH1, seminiferous tubule degeneration, partial germ cell depletion disorganized seminiferous epitheliums were seen. We also observed significantly decreased sperm concentration, sperm motility, intact membrane, and testosterone levels in JWH1 group compared to other groups. Forty-five days after the JWH-018 treatment, sperm concentration, motility, and testosterone level were increased, suggesting that testis and spermatogenesis can recover. We concluded that the use of JWH-018 may adversely affect male reproductive potential and testis histopathology.
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Affiliation(s)
- Duygu Mutluay
- Department of Histology and Embryology, Faculty of Veterinary Medicine, Mehmet Akif Ersoy University , Burdur , Turkey
| | - Şükrü Güngör
- Department of Reproduction and Artificial Insemination, Faculty of Veterinary Medicine, Mehmet Akif Ersoy University , Burdur , Turkey
| | - Gözde Yücel Tenekeci
- Department of Pathology, Faculty of Veterinary Medicine, Ankara University , Ankara , Turkey
| | - Serkan Köksoy
- Faculty of Health Science, Mehmet Akif Ersoy University , Burdur , Turkey
| | - Cennet Sinem Çoban
- Department of Histology and Embryology, Institute of Health Sciences, Mehmet Akif Ersoy University , Burdur , Turkey
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Bilel S, Tirri M, Arfè R, Ossato A, Trapella C, Serpelloni G, Neri M, Fattore L, Marti M. Novel halogenated synthetic cannabinoids impair sensorimotor functions in mice. Neurotoxicology 2019; 76:17-32. [PMID: 31610187 DOI: 10.1016/j.neuro.2019.10.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 09/18/2019] [Accepted: 10/07/2019] [Indexed: 02/06/2023]
Abstract
JWH-018-Cl, JWH-018-Br and AM-2201 (JWH-018 halogenated-derivatives; JWH-018-R compounds) are synthetic cannabinoid agonists illegally marketed as "Spice", "K2", "herbal blend" and research chemicals for their cannabis-like psychoactive effects. In rodents, JWH-018 and its halogenated derivatives reproduce the typical effects of Δ9-tetrahydrocannabinol (Δ9-THC), i.e. hypothermia, analgesia, hypolocomotion and akinesia. Yet, the effects of JWH-018-R compounds on sensorimotor functions are still unknown. This study was designed to investigate the effect of an acute intraperitoneal (i.p.) administration of JWH-018-R compounds (0.01-6 mg/kg) on sensorimotor functions in mice and to compare them to those caused by the reference compound JWH-018 and Δ9-THC. A well validated battery of behavioral tests was used to investigate the effects of these synthetic cannabinoids on the visual, auditory and tactile responses in mice, while the pre-pulse inhibition (PPI) test was used to investigate their effect on sensorimotor gating. The effect of the synthetic cannabinoids on spontaneous locomotion was also measured by a video tracking analysis to assess potential cannabinoid-induced motor impairment. Results showed that, similarly to JWH-018, systemic administration of JWH-018-R compounds inhibits sensorimotor and PPI responses at lower doses (0.01-0.1 mg/kg) and reduced spontaneous locomotion at intermediate/high doses (1-6 mg/kg). All effects were prevented by the administration of the selective cannabinoid CB1 receptor antagonist/inverse agonist AM-251 thus confirming a CB1 receptor-mediated action. Finding that lower doses of JWH-018-R compounds selectively impair sensorimotor and PPI responses without affecting locomotion should be carefully considered to better understand the potential danger that halogenated-derivatives of JWH-018 may pose to public health, with particular reference to decreased performance in driving and hazardous works.
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Affiliation(s)
- Sabrine Bilel
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Italy
| | - Micaela Tirri
- Department of Morphology, Experimental Medicine and Surgery, Section of Legal Medicine, University of Ferrara, Ferrara, Italy
| | - Raffaella Arfè
- Institute of Public Health, Section of Legal Medicine, Catholic University of Rome, Rome, Italy
| | - Andrea Ossato
- Institute of Public Health, Section of Legal Medicine, Catholic University of Rome, Rome, Italy
| | - Claudio Trapella
- Department of Chemistry and Pharmaceutical Sciences, University of Ferrara, Italy
| | - Giovanni Serpelloni
- Drug Policy Institute, Department of Psychiatry in the College of Medicine, University of Florida, USA
| | - Margherita Neri
- Department of Morphology, Experimental Medicine and Surgery, Section of Legal Medicine, University of Ferrara, Ferrara, Italy
| | - Liana Fattore
- Institute of Neuroscience-Cagliari, National Research Council, Italy.
| | - Matteo Marti
- Department of Morphology, Experimental Medicine and Surgery, Section of Legal Medicine, University of Ferrara, Ferrara, Italy; Center for Neuroscience and National Institute of Neuroscience, Italy; Collaborative Center for the Italian National Early Warning System, Department of Anti-Drug Policies, Presidency of the Council of Ministers, Italy
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Synthetic cannabinoids are substrates and inhibitors of multiple drug-metabolizing enzymes. Arch Pharm Res 2018; 41:691-710. [PMID: 30039377 DOI: 10.1007/s12272-018-1055-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Accepted: 07/11/2018] [Indexed: 01/06/2023]
Abstract
Synthetic cannabinoids, a new class of psychoactive substances, are potent agonists of cannabinoid receptors, which mimic the psychoactive effects of the principal psychoactive component of cannabis, ∆9-tetrahydrocannabinol. Despite governmental scheduling as illicit drugs, new synthetic cannabinoids are being produced. The abuse of synthetic cannabinoids with several drugs containing different chemical groups has resulted in large numbers of poisonings. This has increased the urgency for forensic and public health laboratories to identify the metabolites of synthetic cannabinoids and apply this knowledge to the development of analytical methods and for toxicity prediction. It is necessary to determine whether synthetic cannabinoids are involved in drug-metabolizing enzyme-mediated drug-drug interactions. This review describes the metabolic pathways of 13 prevalent synthetic cannabinoids and various drug-metabolizing enzymes responsible for their metabolism, including cytochrome P450 (CYP), UDP-glucuronosyltransferases (UGTs), and carboxylesterases. The inhibitory effects of synthetic cannabinoids on CYP and UGT activities are also reviewed to predict the potential of synthetic cannabinoids for drug-drug interactions. The drug-metabolizing enzymes responsible for metabolism of synthetic cannabinoids should be characterized and the effects of synthetic cannabinoids on CYP and UGT activities should be determined to predict the pharmacokinetics of synthetic cannabinoids and synthetic cannabinoid-induced drug-drug interactions in the clinic.
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12
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Babi MA, Robinson CP, Maciel CB. A spicy status: Synthetic cannabinoid (spice) use and new-onset refractory status epilepticus-A case report and review of the literature. SAGE Open Med Case Rep 2017; 5:2050313X17745206. [PMID: 29238581 PMCID: PMC5721953 DOI: 10.1177/2050313x17745206] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 11/07/2017] [Indexed: 02/02/2023] Open
Abstract
Synthetic cannabinoids refer to a wide variety of chemicals engineered to bind cannabinoid receptors (CB1 and CB2) and mimic the effects of delta-9-tetrahydrocanabinol. The potential for severe toxicity and limited in vivo data make synthetic cannabinoid intake an important public health and safety concern. Neurologic toxidromes associated with their use include mental status changes, panic attacks, memory distortions, acute psychosis (e.g. paranoia, delusional thoughts), disorganized behavior, and suicidal and homicidal thoughts. Systemic complications include vomiting, sinus tachycardia, myocardial infarction, and acute kidney injury. Seizures are common; however, status epilepticus is not widely reported. In this case report, we describe a patient who developed acute psychosis and new-onset refractory status epilepticus necessitating emergent neurological life-support and prolonged admission to an intensive care unit following abuse of synthetic cannabinoids. We include a brief review of the literature to prepare the treating clinician for the broad clinical spectrum of this increasingly common intoxication.
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Affiliation(s)
- Marc-Alain Babi
- Department of Neurology, University of Florida, Gainesville, FL, USA
| | | | - Carolina B Maciel
- Department of Neurology, University of Florida, Gainesville, FL, USA
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13
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Funada M, Takebayashi-Ohsawa M. Synthetic cannabinoid AM2201 induces seizures: Involvement of cannabinoid CB 1 receptors and glutamatergic transmission. Toxicol Appl Pharmacol 2017; 338:1-8. [PMID: 29042214 DOI: 10.1016/j.taap.2017.10.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 10/11/2017] [Accepted: 10/13/2017] [Indexed: 12/01/2022]
Abstract
Abuse of synthetic cannabinoids is a serious social problem worldwide. Intentional ingestion of synthetic cannabinoids can cause severe toxicity, including seizures. Here we investigated the effects of acute administration of synthetic cannabinoids on the induction of epileptic seizures by monitoring electroencephalographic activity in freely moving mice. The synthetic cannabinoid, AM2201, induced abnormal, high-amplitude (>2-fold baseline amplitude), sharp-wave activity. The abnormal spike-wave discharges were accompanied by epileptiform behavior: rigid posture, tail extension, rearing with forepaws extended, jumping, and intermittent tonic-clonic jerking movements. The abnormal spike-wave discharges and behavioral changes were suppressed by pretreatment with the selective CB1 receptor antagonist AM251, but not with the selective CB2 receptor antagonist AM630 or the vanilloid receptor antagonist, capsazepine. Furthermore, the group 1 metabotropic glutamate receptor antagonist SIB1757 eliminated AM2201-induced spike-wave discharges and episodes of epileptiform behavior. AM2201 markedly increased the extracellular glutamate concentration in the hippocampus during periods of AM2201-induced abnormal spike-wave discharges and behavioral changes. These findings are the first evidence that AM2201 induces epileptic seizures by enhancing glutamatergic transmission in the hippocampus. Our findings demonstrate that induction of epileptic seizures by synthetic cannabinoids is mediated by CB1 receptors, but not by CB2 receptors, and further suggest that rapid elevation of glutamatergic transmission may play an important role in the induction of seizures following intentional ingestion of synthetic cannabinoids.
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Affiliation(s)
- Masahiko Funada
- Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-higashi, Kodaira, Tokyo 187-8553, Japan.
| | - Mika Takebayashi-Ohsawa
- Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-higashi, Kodaira, Tokyo 187-8553, Japan
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Palamar JJ, Barratt MJ, Coney L, Martins SS. Synthetic Cannabinoid Use Among High School Seniors. Pediatrics 2017; 140:peds.2017-1330. [PMID: 28893851 PMCID: PMC5613996 DOI: 10.1542/peds.2017-1330] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/11/2017] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES In this study, we examined the prevalence and correlates of current synthetic cannabinoid (SC) use among high school seniors in the United States. METHODS Monitoring the Future, an annual nationally representative survey of high school seniors, began querying current (30-day) SC use in 2014. Data were examined from the 2 most recent cohorts (2014-2015; N = 7805). Prevalence of self-reported use was examined and differences in demographics and recency and frequency of other drug use was compared between current marijuana-only users and current SC (plus marijuana) users using χ2 and generalized linear model using Poisson. RESULTS We found that 2.9% of students reported current SC use; 1.4% of students (49.7% of users) reported using SCs on ≥3 days in the past month. SC users were more likely to report more recent (and often more frequent) use of lysergic acid diethylamide, cocaine, heroin, and/or nonmedical use of opioids compared with marijuana-only users. Compared with current marijuana-only users, SC users were more likely to report lower parent education (P < .05) and current use of a higher number of illegal drugs other than marijuana (Ps < .001). Students using SCs ≥10 times in the past month were more likely to be boys, frequent marijuana users (Ps < .01), African American, and users of multiple other illegal drugs (Ps < .001). CONCLUSIONS SC use is typically part of a repertoire of polydrug use, and polydrug use is less prevalent among marijuana-only users. Current SC users are at risk for poisoning from use of the newest generation of SCs and from concurrent drug use.
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Affiliation(s)
- Joseph J. Palamar
- Department of Population Health, Langone Medical Center, New York University, New York, New York
| | - Monica J. Barratt
- Drug Policy Modelling Program, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia;,National Drug Research Institute, Faculty of Health Sciences, Curtin University, Bentley, Australia;,Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia; and
| | - Leigh Coney
- Drug Policy Modelling Program, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Silvia S. Martins
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
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15
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Mdege ND, Meader N, Lloyd C, Parrott S, McCambridge J. The Novel Psychoactive Substances in the UK Project: empirical and conceptual review work to produce research recommendations. PUBLIC HEALTH RESEARCH 2017. [DOI: 10.3310/phr05040] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BackgroundAlthough illegal drug use has largely been declining in the UK over the past decade, this period has witnessed the emergence of a range of novel psychoactive substances (NPS) (‘legal highs’). These are new, mostly synthetic, substances that mimic the effects of existing drugs). Despite there being many causes for concern in relation to NPS, there has been little prior study of the burden associated with their use in public health terms. Clarity is lacking on research priorities in this rapidly developing literature.ObjectivesTo inform the development of public health intervention research on NPS by reviewing existing data on their use, associated problems and potential responses to such problems.DesignA scoping review and narrative synthesis of selected bodies of evidence was undertaken to summarise and evaluate what is known about NPS use and the related harms of, and responses to, such use. Relevant literature was identified from electronic databases (covering January 2006 to June 2016 inclusive), Google (Google Inc., Mountain View, CA, USA), relevant websites and online drug forums and by contacting experts. Articles were included if they were primary studies, secondary studies involving the analysis and interpretation of primary research or discussion papers. A conceptual framework postulating an evidence-informed public health approach to NPS use in the UK was developed through a pragmatic literature review, the iterative development of concepts and finalisation in light of the results from the empirical review work. The process also involved feedback from various stakeholders. Research recommendations were developed from both strands of work.ResultsA total of 995 articles were included in the scoping review, the majority of which related to individual-level health-related adverse effects attributable to NPS use. The prevalence of lifetime NPS use varied widely between (e.g. with higher prevalence in young males) and within population subgroups. The most commonly reported adverse effects were psychiatric/other neurological, cardiovascular, renal and gastrointestinal manifestations, and there is limited evidence available on responses. In these and other respects, available evidence is at an early stage of development. Initial evidence challenges the view that NPS should be treated differently from other illicit drugs. The conceptual framework indicated that much of the evidence that would be useful to inform public health responses does not yet exist. We propose a systems-based prevention approach that develops existing responses, is multilevel and life course informed in character, and emphasises commonalities between NPS and other legal and illegal drug use. We make 20 recommendations for research, including nine key recommendations.LimitationsScoping reviews do not interrogate evidence in depth, and the disjunction between the scoping review and the conceptual framework findings is worthy of careful attention.ConclusionsKey research recommendations build on those that have previously been made and offer more evidence-based justification and detail, as previous recommendations have not yet been acted on. The case for decision-making on commissioning new research based on these recommendations is both strong and urgent.Future workThe validity of recommendations generated through this project could be enhanced via further work with research commissioners, policy-makers, researchers and the public.Study registrationThe systematic review element of this study is registered as PROSPERO CRD42016026415.FundingThe National Institute for Health Research Public Health Research programme.
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Affiliation(s)
- Noreen D Mdege
- Department of Health Sciences, University of York, York, UK
| | - Nick Meader
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Charlie Lloyd
- Department of Health Sciences, University of York, York, UK
| | - Steve Parrott
- Department of Health Sciences, University of York, York, UK
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16
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Lamy FR, Daniulaityte R, Nahhas RW, Barratt MJ, Smith AG, Sheth A, Martins SS, Boyer EW, Carlson RG. Increases in synthetic cannabinoids-related harms: Results from a longitudinal web-based content analysis. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2017; 44:121-129. [PMID: 28578250 DOI: 10.1016/j.drugpo.2017.05.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 03/07/2017] [Accepted: 05/02/2017] [Indexed: 01/04/2023]
Abstract
BACKGROUND Synthetic Cannabinoid Receptor Agonists (SCRA), also known as "K2" or "Spice," have drawn considerable attention due to their potential of abuse and harmful consequences. More research is needed to understand user experiences of SCRA-related effects. We use semi-automated information processing techniques through eDrugTrends platform to examine SCRA-related effects and their variations through a longitudinal content analysis of web-forum data. METHOD English language posts from three drug-focused web-forums were extracted and analyzed between January 1st 2008 and September 30th 2015. Search terms are based on the Drug Use Ontology (DAO) created for this study (189 SCRA-related and 501 effect-related terms). EDrugTrends NLP-based text processing tools were used to extract posts mentioning SCRA and their effects. Generalized linear regression was used to fit restricted cubic spline functions of time to test whether the proportion of drug-related posts that mention SCRA (and no other drug) and the proportion of these "SCRA-only" posts that mention SCRA effects have changed over time, with an adjustment for multiple testing. RESULTS 19,052 SCRA-related posts (Bluelight (n=2782), Forum A (n=3882), and Forum B (n=12,388)) posted by 2543 international users were extracted. The most frequently mentioned effects were "getting high" (44.0%), "hallucinations" (10.8%), and "anxiety" (10.2%). The frequency of SCRA-only posts declined steadily over the study period. The proportions of SCRA-only posts mentioning positive effects (e.g., "High" and "Euphoria") steadily decreased, while the proportions of SCRA-only posts mentioning negative effects (e.g., "Anxiety," 'Nausea," "Overdose") increased over the same period. CONCLUSION This study's findings indicate that the proportion of negative effects mentioned in web forum posts and linked to SCRA has increased over time, suggesting that recent generations of SCRA generate more harms. This is also one of the first studies to conduct automated content analysis of web forum data related to illicit drug use.
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Affiliation(s)
- Francois R Lamy
- Center for Interventions, Treatment, and Addictions Research, Department of Population and Public Health Sciences, Wright State University, Dayton, OH, United States; Ohio Center of Excellence in Knowledge-enabled Computing, Department of Computer Science and Engineering, Wright State University, Dayton, OH, United States.
| | - Raminta Daniulaityte
- Center for Interventions, Treatment, and Addictions Research, Department of Population and Public Health Sciences, Wright State University, Dayton, OH, United States; Ohio Center of Excellence in Knowledge-enabled Computing, Department of Computer Science and Engineering, Wright State University, Dayton, OH, United States
| | - Ramzi W Nahhas
- Department of Population and Public Health Sciences, Wright State University, Dayton, OH, United States; Department of Psychiatry, Wright State University, Dayton, OH, United States
| | - Monica J Barratt
- Drug Policy Modelling Program, National Drug and Alcohol Research Centre, UNSW Australia; National Drug Research Institute, Faculty of Health Sciences, Curtin University, Australia; Centre of Population Health, Burnet Institute, Australia
| | - Alan G Smith
- Ohio Center of Excellence in Knowledge-enabled Computing, Department of Computer Science and Engineering, Wright State University, Dayton, OH, United States
| | - Amit Sheth
- Ohio Center of Excellence in Knowledge-enabled Computing, Department of Computer Science and Engineering, Wright State University, Dayton, OH, United States
| | - Silvia S Martins
- Department of Epidemiology, Columbia University, New York, NY, United States
| | - Edward W Boyer
- Brigham and Women's Hospital, Harvard Medical School, MA, United States
| | - Robert G Carlson
- Center for Interventions, Treatment, and Addictions Research, Department of Population and Public Health Sciences, Wright State University, Dayton, OH, United States; Ohio Center of Excellence in Knowledge-enabled Computing, Department of Computer Science and Engineering, Wright State University, Dayton, OH, United States
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17
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Canazza I, Ossato A, Vincenzi F, Gregori A, Di Rosa F, Nigro F, Rimessi A, Pinton P, Varani K, Borea PA, Marti M. Pharmaco-toxicological effects of the novel third-generation fluorinate synthetic cannabinoids, 5F-ADBINACA, AB-FUBINACA, and STS-135 in mice. In vitro and in vivo studies. Hum Psychopharmacol 2017; 32. [PMID: 28597570 DOI: 10.1002/hup.2601] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 04/10/2017] [Accepted: 04/11/2017] [Indexed: 01/08/2023]
Abstract
INTRODUCTION 5F-ADBINACA, AB-FUBINACA, and STS-135 are 3 novel third-generation fluorinate synthetic cannabinoids that are illegally marketed as incense, herbal preparations, or research chemicals for their psychoactive cannabis-like effects. METHODS The present study aims at investigating the in vitro and in vivo pharmacological activity of 5F-ADBINACA, AB-FUBINACA, and STS-135 in male CD-1 mice, comparing their in vivo effects with those caused by the administration of Δ9 -THC and JWH-018. In vitro competition binding experiments revealed a nanomolar affinity and potency of the 5F-ADBINACA, AB-FUBINACA, and STS-135 on mouse and human CB1 and CB2 receptors. Moreover, these synthetic cannabinoids induced neurotoxicity in murine neuro-2a cells. RESULTS In vivo studies showed that 5F-ADBINACA, AB-FUBINACA, and STS-135 induced hypothermia; increased pain threshold to both noxious mechanical and thermal stimuli; caused catalepsy; reduced motor activity; impaired sensorimotor responses (visual, acoustic, and tactile); caused seizures, myoclonia, and hyperreflexia; and promoted aggressiveness in mice. Behavioral and neurological effects were fully prevented by the selective CB1 receptor antagonist/inverse agonist AM 251. Differently, the visual sensory response induced by STS-135 was only partly prevented by the AM 251, suggesting a CB1 -independent mechanism. CONCLUSIONS For the first time, the present study demonstrates the pharmaco-toxicological effects induced by the administration of 5F-ADBINACA, AB-FUBINACA, and STS-135 in mice and suggests their possible detrimental effects on human health.
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Affiliation(s)
- Isabella Canazza
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Ferrara, Italy.,Institute of Public Health, Section of Legal Medicine, Catholic University of Rome, Rome, Italy
| | - Andrea Ossato
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Ferrara, Italy.,Institute of Public Health, Section of Legal Medicine, Catholic University of Rome, Rome, Italy
| | - Fabrizio Vincenzi
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Adolfo Gregori
- Carabinieri, Department of Scientific Investigation (RIS), Rome, Italy
| | - Fabiana Di Rosa
- Carabinieri, Department of Scientific Investigation (RIS), Rome, Italy
| | - Federica Nigro
- Department of Morphology, Surgery and Experimental Medicine, Section of Pathology, Oncology and Experimental Biology, Laboratory for Technologies of Advanced Therapies (LTTA), University of Ferrara, Ferrara, Italy
| | - Alessandro Rimessi
- Department of Morphology, Surgery and Experimental Medicine, Section of Pathology, Oncology and Experimental Biology, Laboratory for Technologies of Advanced Therapies (LTTA), University of Ferrara, Ferrara, Italy
| | - Paolo Pinton
- Department of Morphology, Surgery and Experimental Medicine, Section of Pathology, Oncology and Experimental Biology, Laboratory for Technologies of Advanced Therapies (LTTA), University of Ferrara, Ferrara, Italy
| | - Katia Varani
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Pier Andrea Borea
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Matteo Marti
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Ferrara, Italy.,Center for Neuroscience and Istituto Nazionale di Neuroscienze, University of Ferrara, Ferrara, Italy
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Kim JH, Kwon SS, Kong TY, Cheong JC, Kim HS, In MK, Lee HS. AM-2201 Inhibits Multiple Cytochrome P450 and Uridine 5'-Diphospho-Glucuronosyltransferase Enzyme Activities in Human Liver Microsomes. Molecules 2017; 22:molecules22030443. [PMID: 28287454 PMCID: PMC6155437 DOI: 10.3390/molecules22030443] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 03/08/2017] [Indexed: 01/07/2023] Open
Abstract
AM-2201 is a synthetic cannabinoid that acts as a potent agonist at cannabinoid receptors and its abuse has increased. However, there are no reports of the inhibitory effect of AM-2201 on human cytochrome P450 (CYP) or uridine 5′-diphospho-glucuronosyltransferase (UGT) enzymes. We evaluated the inhibitory effect of AM-2201 on the activities of eight major human CYPs (1A2, 2A6, 2B6, 2C8, 2C9, 2C19, 2D6, and 3A4) and six major human UGTs (1A1, 1A3, 1A4, 1A6, 1A9, and 2B7) enzymes in pooled human liver microsomes using liquid chromatography–tandem mass spectrometry to investigate drug interaction potentials of AM-2201. AM-2201 potently inhibited CYP2C9-catalyzed diclofenac 4′-hydroxylation, CYP3A4-catalyzed midazolam 1′-hydroxylation, UGT1A3-catalyzed chenodeoxycholic acid 24-acyl-glucuronidation, and UGT2B7-catalyzed naloxone 3-glucuronidation with IC50 values of 3.9, 4.0, 4.3, and 10.0 µM, respectively, and showed mechanism-based inhibition of CYP2C8-catalyzed amodiaquine N-deethylation with a Ki value of 2.1 µM. It negligibly inhibited CYP1A2, CYP2A6, CYP2B6, CYP2C19, CYP2D6, UGT1A1, UGT1A4, UGT1A6, and UGT1A9 activities at 50 μM in human liver microsomes. These in vitro results indicate that AM-2201 needs to be examined for potential pharmacokinetic drug interactions in vivo due to its potent inhibition of CYP2C8, CYP2C9, CYP3A4, UGT1A3, and UGT2B7 enzyme activities.
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Affiliation(s)
- Ju-Hyun Kim
- Drug Metabolism and Bioanalysis Laboratory, College of Pharmacy, The Catholic University of Korea, 43 Jibong-ro, Wonmi-gu, Bucheon 14662, Korea.
| | - Soon-Sang Kwon
- Drug Metabolism and Bioanalysis Laboratory, College of Pharmacy, The Catholic University of Korea, 43 Jibong-ro, Wonmi-gu, Bucheon 14662, Korea.
| | - Tae Yeon Kong
- Drug Metabolism and Bioanalysis Laboratory, College of Pharmacy, The Catholic University of Korea, 43 Jibong-ro, Wonmi-gu, Bucheon 14662, Korea.
| | - Jae Chul Cheong
- Forensic Chemistry Laboratory, Forensic Science Division, Supreme Prosecutor's Office, 157 Banpo-daero, Seocho-gu, Seoul 06590, Korea.
| | - Hee Seung Kim
- Forensic Chemistry Laboratory, Forensic Science Division, Supreme Prosecutor's Office, 157 Banpo-daero, Seocho-gu, Seoul 06590, Korea.
| | - Moon Kyo In
- Forensic Chemistry Laboratory, Forensic Science Division, Supreme Prosecutor's Office, 157 Banpo-daero, Seocho-gu, Seoul 06590, Korea.
| | - Hye Suk Lee
- Drug Metabolism and Bioanalysis Laboratory, College of Pharmacy, The Catholic University of Korea, 43 Jibong-ro, Wonmi-gu, Bucheon 14662, Korea.
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Dilber D, Barić H, Novinščak T, Čerkez-Habek J. Herbal incense-related sudden death: case report. JOURNAL OF SUBSTANCE USE 2017. [DOI: 10.3109/14659891.2016.1162212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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20
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Ford BM, Tai S, Fantegrossi WE, Prather PL. Synthetic Pot: Not Your Grandfather's Marijuana. Trends Pharmacol Sci 2017; 38:257-276. [PMID: 28162792 PMCID: PMC5329767 DOI: 10.1016/j.tips.2016.12.003] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 11/08/2016] [Accepted: 12/13/2016] [Indexed: 01/05/2023]
Abstract
In the early 2000s in Europe and shortly thereafter in the USA, it was reported that 'legal' forms of marijuana were being sold under the name K2 and/or Spice. Active ingredients in K2/Spice products were determined to be synthetic cannabinoids (SCBs), producing psychotropic actions via CB1 cannabinoid receptors, similar to those of Δ9-tetrahydrocannabinol (Δ9-THC), the primary active constituent in marijuana. Often abused by adolescents and military personnel to elude detection in drug tests due to their lack of structural similarity to Δ9-THC, SCBs are falsely marketed as safe marijuana substitutes. Instead, SCBs are a highly structural diverse group of compounds, easily synthesized, which produce very dangerous adverse effects occurring by, as of yet, unknown mechanisms. Therefore, available evidence indicates that K2/Spice products are clearly not safe marijuana alternatives.
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Affiliation(s)
- Benjamin M Ford
- Department of Pharmacology and Toxicology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Sherrica Tai
- Department of Pharmacology and Toxicology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA; Department of Pharmacology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - William E Fantegrossi
- Department of Pharmacology and Toxicology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Paul L Prather
- Department of Pharmacology and Toxicology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
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New-Onset Refractory Status Epilepticus Associated With the Use of Synthetic Cannabinoids. PSYCHOSOMATICS 2017; 58:180-186. [DOI: 10.1016/j.psym.2016.10.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 10/17/2016] [Indexed: 01/02/2023]
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22
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Davidson C, Opacka-Juffry J, Arevalo-Martin A, Garcia-Ovejero D, Molina-Holgado E, Molina-Holgado F. Spicing Up Pharmacology: A Review of Synthetic Cannabinoids From Structure to Adverse Events. CANNABINOID PHARMACOLOGY 2017; 80:135-168. [DOI: 10.1016/bs.apha.2017.05.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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23
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Canazza I, Ossato A, Trapella C, Fantinati A, De Luca MA, Margiani G, Vincenzi F, Rimondo C, Di Rosa F, Gregori A, Varani K, Borea PA, Serpelloni G, Marti M. Effect of the novel synthetic cannabinoids AKB48 and 5F-AKB48 on "tetrad", sensorimotor, neurological and neurochemical responses in mice. In vitro and in vivo pharmacological studies. Psychopharmacology (Berl) 2016; 233:3685-3709. [PMID: 27527584 DOI: 10.1007/s00213-016-4402-y] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 08/01/2016] [Indexed: 02/06/2023]
Abstract
RATIONALE AKB48 and its fluorinate derivate 5F-AKB48 are two novel synthetic cannabinoids belonging to a structural class with an indazole core structure. They are marketed as incense, herbal preparations or chemical supply for their psychoactive Cannabis-like effects. OBJECTIVES The present study was aimed at investigating the in vitro and in vivo pharmacological activity of AKB48 and 5F-AKB48 in male CD-1 mice and comparing their in vivo effects with those caused by the administration of Δ9-THC and JWH-018. RESULTS In vitro competition binding experiments performed on mouse and human CB1 and CB2 receptors revealed a nanomolar affinity and potency of the AKB48 and 5F-AKB48. In vivo studies showed that AKB48 and 5F-AKB48, induced hypothermia, increased pain threshold to both noxious mechanical and thermal stimuli, caused catalepsy, reduced motor activity, impaired sensorimotor responses (visual, acoustic and tactile), caused seizures, myoclonia, hyperreflexia and promoted aggressiveness in mice. Moreover, microdialysis study in freely moving mice showed that systemic administration of AKB48 and 5F-AKB48 stimulated dopamine release in the nucleus accumbens. Behavioural, neurological and neurochemical effects were fully prevented by the selective CB1 receptor antagonist/inverse agonist AM 251. CONCLUSIONS For the first time, the present study demonstrates the overall pharmacological effects induced by the administration of AKB48 and 5F-AKB48 in mice and suggests that the fluorination can increase the power and/or effectiveness of SCBs. Furthermore, this study outlines the potential detrimental effects of SCBs on human health.
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Affiliation(s)
- Isabella Canazza
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, via Fossato di Mortara 17-19, 44121, Ferrara, Italy
| | - Andrea Ossato
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, via Fossato di Mortara 17-19, 44121, Ferrara, Italy
| | - Claudio Trapella
- Department of Chemistry and Pharmaceutical Sciences, University of Ferrara, Ferrara, Italy
| | - Anna Fantinati
- Department of Chemistry and Pharmaceutical Sciences, University of Ferrara, Ferrara, Italy
| | | | - Giulia Margiani
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Fabrizio Vincenzi
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Claudia Rimondo
- Department of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - Fabiana Di Rosa
- Department of Scientific Investigation (RIS), Carabinieri, 00191, Rome, Italy
| | - Adolfo Gregori
- Department of Scientific Investigation (RIS), Carabinieri, 00191, Rome, Italy
| | - Katia Varani
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Pier Andrea Borea
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Giovanni Serpelloni
- U.R.I.To.N., Forensic Toxicology Unit, Department of Health Science, University of Florence, Florence, Italy
| | - Matteo Marti
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, via Fossato di Mortara 17-19, 44121, Ferrara, Italy. .,Center for Neuroscience and Istituto Nazionale di Neuroscienze, ᅟ, Italy.
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Obafemi AI, Kleinschmidt K, Goto C, Fout D. Cluster of Acute Toxicity from Ingestion of Synthetic Cannabinoid-Laced Brownies. J Med Toxicol 2016; 11:426-9. [PMID: 25967137 DOI: 10.1007/s13181-015-0482-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Synthetic cannabinoid receptor agonists (SCRAs) are emerging designer drugs of abuse. Most reports on the health effects of these drugs are case reports. Unlike SCRAs, marijuana has classically been used via many routes of exposure including oral, such as in brownies. We report on 11 symptomatic patients who unknowingly ingested brownies laced with analytically confirmed SCRA and presented with mostly neuropsychiatric and cardiovascular symptoms. CASE SERIES All 11 patients were taken to the ED within 1 h of exposure with the onset of various symptoms. There were five males and six females, age range 20-57 years. Neuropsychiatric and cardiovascular symptoms predominated: memory impairment (91 %, 10/11) and inappropriate giggling (36 %, 4/11). All the patients had light-headedness, perioral and facial numbness and tingling sensation, dry mouth, difficulty focusing/blurring of vision, and sluggishness. No patient had depressed consciousness. Two patients had heart rates >100, and 4 of 11 (36 %) had BP >140/80. One patient had chest pain. All the symptoms were completely resolved 4 h following their onset except two patients who had ongoing weakness and fatigue. All patients had negative urine drugs of abuse immunoassays and ethanol, acetaminophen, and salicylate concentrations, as well as normal electrocardiograms (ECGS) and metabolic panels. The SCRA was confirmed to be AM-2201. All the patients were discharged from the ED in stable condition within 10 h of the exposure. CONCLUSION Oral exposure of 11 patients to brownies laced with analytically confirmed SCRA resulted in neuropsychiatric and cardiovascular symptoms. This series reflects that like marijuana, oral exposures to SCRAs can lead to symptoms.
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Affiliation(s)
| | | | - Collin Goto
- UT Southwestern Medical Center, Dallas, TX, USA
| | - Drew Fout
- Texas Department of Public Safety, Garland, TX, USA
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Aldlgan AA, Torrance. HJ. Bioanalytical methods for the determination of synthetic cannabinoids and metabolites in biological specimens. Trends Analyt Chem 2016. [DOI: 10.1016/j.trac.2016.03.025] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Fattore L. Synthetic Cannabinoids-Further Evidence Supporting the Relationship Between Cannabinoids and Psychosis. Biol Psychiatry 2016; 79:539-48. [PMID: 26970364 DOI: 10.1016/j.biopsych.2016.02.001] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 02/01/2016] [Accepted: 02/01/2016] [Indexed: 12/26/2022]
Abstract
Consumption of synthetic mind-altering compounds, also known as "new psychoactive substances," is increasing globally at an alarming rate. Synthetic cannabinoids (SCs) are among the most commonly used new psychoactive substances. They are usually purchased as marijuana-like drugs, marketed as herbal blends and perceived as risk-free by inexperienced users. Yet, contrary to Δ(9)-tetrahydrocannabinol, SCs may lead to severe health consequences, including anxiety, tachycardia, hallucinations, violent behavior, and psychosis. This review focuses on the latest (2010-2015) evidence of psychotic symptoms induced by ingestion of products containing SCs. Reports suggesting that SCs may either exacerbate previously stable psychotic symptoms (in vulnerable individuals) or trigger new-onset psychosis (in individuals with no previous history of psychosis) are reviewed. Pharmacology and toxicology of these compounds are discussed, with particular reference to their psychoactive effects.
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Affiliation(s)
- Liana Fattore
- CNR Neuroscience Institute, National Research Council (Italy), and Centre of Excellence "Neurobiology of Dependence," Department of Biomedical Sciences, University of Cagliari, Cittadella Universitaria, Monserrato, Cagliari, Sardinia, Italy.
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Castellanos D, Gralnik LM. Synthetic cannabinoids 2015: An update for pediatricians in clinical practice. World J Clin Pediatr 2016; 5:16-24. [PMID: 26862498 PMCID: PMC4737689 DOI: 10.5409/wjcp.v5.i1.16] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 11/15/2015] [Accepted: 01/07/2016] [Indexed: 02/06/2023] Open
Abstract
Synthetic cannabinoids are a group of substances in the world of designer drugs that have become increasingly popular over the past few years. Synthetic cannabinoids are a chemically diverse group of compounds functionally similar to THC. Since first appearing on the world market a few years ago these compounds have evolved rapidly. Newer more potent analogues have been developed. Identifying youth who abuse these substances can be difficult. Newer forms of consumption have also evolved. These products are now manufactured in products that look like natural cannabis resin and in liquid cartridges used in electronic cigarettes. Synthetic cannabinoids appear to be associated with potentially dangerous health effects that are more severe than that of marijuana. Some synthetic cannabinoid compounds have been associated with serious physical consequences, such as, seizures, myocardial infarction and renal damage. In addition, psychoactive effects, such as aggression, confusion, anxiety and psychosis have also been reported. The diagnosis remains primarily clinical with toxicological confirmation difficult due to manufacturers constantly developing new analogues to avoid detection. Pediatricians are urged to familiarize themselves with these drugs and the typical presentations of patients who use them.
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Andreeva-Gateva PA, Nankova VH, Angelova VT, Gatev TN. Synthetic cannabimimetics in Bulgaria 2010-2013. Drug Alcohol Depend 2015; 157:200-4. [PMID: 26525417 DOI: 10.1016/j.drugalcdep.2015.10.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 10/06/2015] [Accepted: 10/09/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND The manufacturing, distribution and use of synthetic cannabimimetics (SCs) have seen dynamic changes over the last few years, and have had an unprecedented growth. Forensic toxicologists in Bulgaria faced SCs for the first time in 2010, as compounds detected in seized blends. METHODS This is a retrospective survey on the SCs seized in Bulgaria 2010-2013. RESULTS The number of SCs increased progressively: 17 cases in 2010, 38 in 2011, 75 in 2012, and 80 in 2013. In Bulgaria, from 2010 to 2013, there were two cases of toxicologically proved intoxications (with JWH-018). JWH-018 was the most often detected SC in Bulgaria for the whole studied period. The most popular combination detected in 2013 was: UR-144+MAM-2201 with or without STS-135. Highly potent halogenated SCs appeared in 2013. 5F-AКB-48 (nearly 3 kg) was seized in 12 cases. Published data suggest that SCs may have more severe side effects than marijuana. Parallel adaptation of Bulgarian law with adoption of analog laws tried to meet the increased forensic challenges. CONCLUSIONS Over the last decade, the rapid growth in the number and types of SCs distributed in Europe has challenged the capacity, and sometimes the credibility, of identification, risk assessment and control systems. Forensic toxicology needs to adapt in a timely manner, providing scientific basis of legislative changes.
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Affiliation(s)
- Pavlina A Andreeva-Gateva
- Department of Pharmacology and Toxicology, Pre-clinical Study Center, Faculty of Medicine, Medical University Sofia, 2, Zdrave str., 1421 Sofia, Bulgaria; Department of Internal Medicine, Pharmacology and Clinical Pharmacology, Pediatrics, Epidemiology, Infection Diseases and Dermatology, Faculty of Medicine, Sofia University "St. Kliment Okridsky", 1, Koziak str., 1407 Sofia, Bulgaria.
| | - Vasilka H Nankova
- Department of Forensic Medicine, Faculty of Medicine, Medical University Sofia, 2, Zdrave str., 1421 Sofia, Bulgaria
| | - Violina T Angelova
- Department of Analytical Chemistry, Faculty of Pharmacy, Medical University Sofia, 2, Zdrave str., 1421 Sofia, Bulgaria
| | - Tzvetelin N Gatev
- Department of Forensic Medicine, Military Hospital, 3 "St Georgi Sofiiski str", 1421 Sofia, Bulgaria
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Abstract
Cannabis has been used for centuries to treat seizures. Recent anecdotal reports, accumulating animal model data, and mechanistic insights have raised interest in cannabis-based antiepileptic therapies. In this study, we review current understanding of the endocannabinoid system, characterize the pro- and anticonvulsive effects of cannabinoids [e.g., Δ9-tetrahydrocannabinol and cannabidiol (CBD)], and highlight scientific evidence from pre-clinical and clinical trials of cannabinoids in epilepsy. These studies suggest that CBD avoids the psychoactive effects of the endocannabinoid system to provide a well-tolerated, promising therapeutic for the treatment of seizures, while whole-plant cannabis can both contribute to and reduce seizures. Finally, we discuss results from a new multicenter, open-label study using CBD in a population with treatment-resistant epilepsy. In all, we seek to evaluate our current understanding of cannabinoids in epilepsy and guide future basic science and clinical studies.
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Affiliation(s)
- Evan C Rosenberg
- Department of Neuroscience and Physiology, Neuroscience Institute, NYU Langone Medical Center, New York, NY, 10016, USA
| | - Richard W Tsien
- Department of Neuroscience and Physiology, Neuroscience Institute, NYU Langone Medical Center, New York, NY, 10016, USA
| | - Benjamin J Whalley
- School of Pharmacy, The University of Reading, Whiteknights, Reading, RG6 6AP, UK
| | - Orrin Devinsky
- Department of Neurology, Comprehensive Epilepsy Center, New York University School of Medicine, New York, NY, 10016, UK.
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30
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Banister SD, Stuart J, Kevin RC, Edington A, Longworth M, Wilkinson SM, Beinat C, Buchanan AS, Hibbs DE, Glass M, Connor M, McGregor IS, Kassiou M. Effects of bioisosteric fluorine in synthetic cannabinoid designer drugs JWH-018, AM-2201, UR-144, XLR-11, PB-22, 5F-PB-22, APICA, and STS-135. ACS Chem Neurosci 2015; 6:1445-58. [PMID: 25921407 DOI: 10.1021/acschemneuro.5b00107] [Citation(s) in RCA: 149] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Synthetic cannabinoid (SC) designer drugs featuring bioisosteric fluorine substitution are identified by forensic chemists and toxicologists with increasing frequency. Although terminal fluorination of N-pentyl indole SCs is sometimes known to improve cannabinoid type 1 (CB1) receptor binding affinity, little is known of the effects of fluorination on functional activity of SCs. This study explores the in vitro functional activities of SC designer drugs JWH-018, UR-144, PB-22, and APICA, and their respective terminally fluorinated analogues AM-2201, XLR-11, 5F-PB-22, and STS-135 at human CB1 and CB2 receptors using a FLIPR membrane potential assay. All compounds demonstrated agonist activity at CB1 (EC50 = 2.8-1959 nM) and CB2 (EC50 = 6.5-206 nM) receptors, with the fluorinated analogues generally showing increased CB1 receptor potency (∼2-5 times). Additionally, the cannabimimetic activities and relative potencies of JWH-018, AM-2201, UR-144, XLR-11, PB-22, 5F-PB-22, APICA, and STS-135 in vivo were evaluated in rats using biotelemetry. All SCs dose-dependently induced hypothermia and reduced heart rate at doses of 0.3-10 mg/kg. There was no consistent trend for increased potency of fluorinated SCs over the corresponding des-fluoro SCs in vivo. Based on magnitude and duration of hypothermia, the SCs were ranked for potency (PB-22 > 5F-PB-22 = JWH-018 > AM-2201 > APICA = STS-135 = XLR-11 > UR-144).
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Affiliation(s)
- Samuel D. Banister
- Department
of Radiology, Stanford University School of Medicine, Stanford, California 94305, United States
- School
of Chemistry, The University of Sydney, Sydney, New South Wales 2006, Australia
| | - Jordyn Stuart
- Faculty
of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales 2109, Australia
| | - Richard C. Kevin
- School
of Psychology, The University of Sydney, Sydney, New South Wales 2006, Australia
| | - Amelia Edington
- Faculty
of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales 2109, Australia
| | - Mitchell Longworth
- School
of Chemistry, The University of Sydney, Sydney, New South Wales 2006, Australia
| | - Shane M. Wilkinson
- School
of Chemistry, The University of Sydney, Sydney, New South Wales 2006, Australia
| | - Corinne Beinat
- Department
of Radiology, Stanford University School of Medicine, Stanford, California 94305, United States
- School
of Chemistry, The University of Sydney, Sydney, New South Wales 2006, Australia
| | - Alexandra S. Buchanan
- Center
for Immersive and Simulation-based Learning, Stanford University School of Medicine, Stanford, California 94305, United States
- Department
of Anaesthesia, Prince of Wales Hospital, Randwick, New South Wales 2031, Australia
| | - David E. Hibbs
- Faculty
of Pharmacy, The University of Sydney, Sydney, New South Wales 2006, Australia
| | - Michelle Glass
- School
of Medical Sciences, The University of Auckland, Auckland 1142, New Zealand
| | - Mark Connor
- Faculty
of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales 2109, Australia
| | - Iain S. McGregor
- School
of Psychology, The University of Sydney, Sydney, New South Wales 2006, Australia
| | - Michael Kassiou
- School
of Chemistry, The University of Sydney, Sydney, New South Wales 2006, Australia
- Discipline
of Medical Radiation Sciences, The University of Sydney, Sydney, New South Wales 2006, Australia
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Vigolo A, Ossato A, Trapella C, Vincenzi F, Rimondo C, Seri C, Varani K, Serpelloni G, Marti M. Novel halogenated derivates of JWH-018: Behavioral and binding studies in mice. Neuropharmacology 2015; 95:68-82. [DOI: 10.1016/j.neuropharm.2015.02.008] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 01/30/2015] [Accepted: 02/03/2015] [Indexed: 01/26/2023]
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Ciolino LA. Quantitation of Synthetic Cannabinoids in Plant Materials Using High Performance Liquid Chromatography with UV Detection (Validated Method). J Forensic Sci 2015; 60:1171-81. [DOI: 10.1111/1556-4029.12795] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 06/24/2014] [Accepted: 08/23/2014] [Indexed: 12/18/2022]
Affiliation(s)
- Laura A. Ciolino
- Forensic Chemistry Center; US Food and Drug Administration; 6751 Steger Drive Cincinnati OH 45237
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Davis C, Boddington D. Teenage cardiac arrest following abuse of synthetic cannabis. Heart Lung Circ 2015; 24:e162-3. [PMID: 26256565 DOI: 10.1016/j.hlc.2015.04.176] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 03/25/2015] [Accepted: 04/14/2015] [Indexed: 02/06/2023]
Abstract
INTRODUCTION The cardiac effects of many illegal substances (cocaine, methadone) have previously been well described [1,2]. However the association between synthetic cannabis and cardiac arrest is less well documented. Here we describe an out-of-hospital cardiac arrest in a previously healthy 16-year-old female associated with the use of inhaled synthetic cannabis. METHODS An electronic systematic search of online databases PubMed and Embase was performed using keywords, "synthetic cannabis death" and "cardiac arrest". RESULTS In this case study a previously healthy 16-year-old had a cardiac arrest after synthetic cannabis use. Despite extensive investigations no other cause for her arrest was found. To the best of our knowledge there has been one previous case report of cardiac arrest following synthetic cannabis use in a 56-year-old man [3]. CONCLUSIONS This case report augments the relationship between synthetic cannabis and cardiac arrest in the medical community. More awareness surrounding the risk of synthetic cannabinoids is warranted.
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Affiliation(s)
- C Davis
- Tauranga Hospital, New Zealand.
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35
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Ossato A, Vigolo A, Trapella C, Seri C, Rimondo C, Serpelloni G, Marti M. JWH-018 impairs sensorimotor functions in mice. Neuroscience 2015; 300:174-88. [PMID: 25987201 DOI: 10.1016/j.neuroscience.2015.05.021] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 05/04/2015] [Accepted: 05/09/2015] [Indexed: 02/01/2023]
Abstract
Naphthalen-1-yl-(1-pentylindol-3-yl)methanone (JWH-018) is a synthetic cannabinoid agonist illegally marketed in "Spice" and "herbal blend" for its psychoactive effect greater than those produced by cannabis. In rodents JWH-018 reproduces typical effects of (-)-Δ(9)-THC or Dronabinol® (Δ(9)-THC) such as hypothermia, analgesia, hypolocomotion and akinesia, while its effects on sensorimotor functions are still unknown. Therefore, the aim of the present study is to investigate the effect of acute administration of JWH-018 (0.01-6mg/kg i.p.) on sensorimotor functions in male CD-1 mice and to compare its effects with those caused by the administration of Δ(9)-THC (0.01-6mg/kg i.p.). A specific battery of behavioral tests were adopted to investigate effects of cannabinoid agonists on sensorimotor functions (visual, auditory, tactile) and neurological changes (convulsion, myoclonia, hyperreflexia) while video-tracking analysis was used to study spontaneous locomotion. JWH-018 administration inhibited sensorimotor responses at lower doses (0.01-0.1mg/kg), reduced spontaneous locomotion at intermediate/high doses (1-6mg/kg) and induced convulsions, myoclonia and hyperreflexia at high doses (6mg/kg). Similarly, administration of Δ(9)-THC reduced sensorimotor responses in mice but it did not inhibit spontaneous locomotion and it did not induce neurological alterations. All behavioral effects and neurological alterations were prevented by the administration of the selective CB1 receptor antagonist/inverse agonist 1-(2,4-dichlorophenyl)-5-(4-iodophenyl)-4-methyl-N-(piperidin-1-yl)-1H-pyrazole-3-carboxamide (AM 251). For the first time these data demonstrate that JWH-018 impairs sensorimotor responses in mice. This aspect should be carefully evaluated to better understand the potential danger that JWH-018 may pose to public health, with particular reference to decreased performance in driving and hazardous works.
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Affiliation(s)
- A Ossato
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Italy
| | - A Vigolo
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Italy
| | - C Trapella
- Department of Chemistry and Pharmaceutical Sciences, University of Ferrara, Italy
| | - C Seri
- Italian National Early Warning System, Drug Policies Department, Presidency of the Council of Ministers, Verona Coordination Unit, Italy
| | - C Rimondo
- Italian National Early Warning System, Drug Policies Department, Presidency of the Council of Ministers, Verona Coordination Unit, Italy; Department of Public Health and Community Medicine, University of Verona, Italy
| | - G Serpelloni
- Italian National Early Warning System, Drug Policies Department, Presidency of the Council of Ministers, Verona Coordination Unit, Italy
| | - M Marti
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Italy; Center for Neuroscience and Istituto Nazionale di Neuroscienze, Italy.
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Pélissier-Alicot AL. Les cannabinoïdes de synthèse : épidémiologie, modalités de consommations et effets cliniques. TOXICOLOGIE ANALYTIQUE ET CLINIQUE 2015. [DOI: 10.1016/j.toxac.2014.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Alvarez JC, Pape E, Grassin-Delyle S, Knapp A. Cannabinoïdes de synthèse : aspects pharmacologiques. TOXICOLOGIE ANALYTIQUE ET CLINIQUE 2015. [DOI: 10.1016/j.toxac.2014.09.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Schwartz MD, Trecki J, Edison LA, Steck AR, Arnold JK, Gerona RR. A Common Source Outbreak of Severe Delirium Associated with Exposure to the Novel Synthetic Cannabinoid ADB-PINACA. J Emerg Med 2015; 48:573-80. [PMID: 25726258 DOI: 10.1016/j.jemermed.2014.12.038] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 11/17/2014] [Accepted: 12/21/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Since 2009, synthetic cannabinoid (SC) use has emerged as a growing public health threat in the United States (US). Several outbreaks of unexpected, severe toxicity linked to SC use have been reported since 2012. Reports of varied and significant morbidity after SC use are expected to increase because newer compounds enter the marketplace more frequently as manufacturers attempt to circumvent regulatory efforts. CASE REPORT We report a cluster of 7 patients who experienced a spectrum of anxiety, delirium, psychosis, and aggressive behaviors after smoking the same SC-containing product at a party. An 8th patient with the same exposure source presented with delayed onset seizures. Biologic samples were analyzed for novel, newly identified SCs belonging to the FUBINACA family of compounds. A previously unknown SC, N-(1-amino-3,3-dimethyl-1-oxobutan-2-yl)-1-pentyl-1H-indazole-3-carboxamide (ADB-PINACA) was identified in biologic samples from 7 of the individuals. ADB-PINACA was identified in the SC-containing product ("Crazy Clown") seized by law enforcement and identified as the product smoked by the 8 patients in the reported cluster. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: The information compiled using this cluster of cases, and a similar reported outbreak of altered mental status in Colorado, implicating the same SC (ADB-PINACA) and brands of SC-containing products, aided the US Drug Enforcement Administration in its temporary scheduling of ADB-PINACA and three other SCs. In this outbreak, close cooperation between public health and law enforcement allowed for a rapid intervention, which halted the outbreak by interrupting the common source and accelerated regulatory efforts to prevent further morbidity and mortality.
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Affiliation(s)
- Michael D Schwartz
- Centers for Disease Control and Prevention, National Center for Environmental Health, Office of Environmental Health Emergencies, Atlanta, Georgia
| | - Jordan Trecki
- Drug Enforcement Administration, Office of Diversion Control, Drug and Chemical Evaluation Section, Springfield, Virginia
| | - Laura A Edison
- Centers for Disease Control and Prevention, Epidemiology Program Office, Atlanta, Georgia
| | | | | | - Roy R Gerona
- Department of Laboratory Medicine, University of California-San Francisco, San Francisco, California
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Abstract
The antiepileptic potential of Cannabis sativa preparations has been historically recognized. Recent changes in legal restrictions and new well-documented cases reporting remarkably strong beneficial effects have triggered an upsurge in exploiting medical marijuana in patients with refractory epilepsy. Parallel research efforts in the last decade have uncovered the fundamental role of the endogenous cannabinoid system in controlling neuronal network excitability raising hopes for cannabinoid-based therapeutic approaches. However, emerging data show that patient responsiveness varies substantially, and that cannabis administration may sometimes even exacerbate seizures. Qualitative and quantitative chemical variability in cannabis products and personal differences in the etiology of seizures, or in the pathological reorganization of epileptic networks, can all contribute to divergent patient responses. Thus, the consensus view in the neurologist community is that drugs modifying the activity of the endocannabinoid system should first be tested in clinical trials to establish efficacy, safety, dosing, and proper indication in specific forms of epilepsies. To support translation from anecdote-based practice to evidence-based therapy, the present review first introduces current preclinical and clinical efforts for cannabinoid- or endocannabinoid-based epilepsy treatments. Next, recent advances in our knowledge of how endocannabinoid signaling limits abnormal network activity as a central component of the synaptic circuit-breaker system will be reviewed to provide a framework for the underlying neurobiological mechanisms of the beneficial and adverse effects. Finally, accumulating evidence demonstrating robust synapse-specific pathophysiological plasticity of endocannabinoid signaling in epileptic networks will be summarized to gain better understanding of how and when pharmacological interventions may have therapeutic relevance.
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Affiliation(s)
- István Katona
- Momentum Laboratory of Molecular Neurobiology, Institute of Experimental Medicine, Hungarian Academy of Sciences, Szigony u. 43, Budapest, 1083, Hungary.
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40
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Castaneto MS, Gorelick DA, Desrosiers NA, Hartman RL, Pirard S, Huestis MA. Synthetic cannabinoids: epidemiology, pharmacodynamics, and clinical implications. Drug Alcohol Depend 2014; 144:12-41. [PMID: 25220897 PMCID: PMC4253059 DOI: 10.1016/j.drugalcdep.2014.08.005] [Citation(s) in RCA: 425] [Impact Index Per Article: 42.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 08/04/2014] [Accepted: 08/05/2014] [Indexed: 12/14/2022]
Abstract
BACKGROUND Synthetic cannabinoids (SC) are a heterogeneous group of compounds developed to probe the endogenous cannabinoid system or as potential therapeutics. Clandestine laboratories subsequently utilized published data to develop SC variations marketed as abusable designer drugs. In the early 2000s, SC became popular as "legal highs" under brand names such as Spice and K2, in part due to their ability to escape detection by standard cannabinoid screening tests. The majority of SC detected in herbal products have greater binding affinity to the cannabinoid CB1 receptor than does Δ(9)-tetrahydrocannabinol (THC), the primary psychoactive compound in the cannabis plant, and greater affinity at the CB1 than the CB2 receptor. In vitro and animal in vivo studies show SC pharmacological effects 2-100 times more potent than THC, including analgesic, anti-seizure, weight-loss, anti-inflammatory, and anti-cancer growth effects. SC produce physiological and psychoactive effects similar to THC, but with greater intensity, resulting in medical and psychiatric emergencies. Human adverse effects include nausea and vomiting, shortness of breath or depressed breathing, hypertension, tachycardia, chest pain, muscle twitches, acute renal failure, anxiety, agitation, psychosis, suicidal ideation, and cognitive impairment. Long-term or residual effects are unknown. Due to these public health consequences, many SC are classified as controlled substances. However, frequent structural modification by clandestine laboratories results in a stream of novel SC that may not be legally controlled or detectable by routine laboratory tests. METHODS We present here a comprehensive review, based on a systematic electronic literature search, of SC epidemiology and pharmacology and their clinical implications.
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Affiliation(s)
- Marisol S Castaneto
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore, MD, United States; Program in Toxicology, University of Maryland Baltimore, Baltimore, MD, United States
| | - David A Gorelick
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Nathalie A Desrosiers
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore, MD, United States; Program in Toxicology, University of Maryland Baltimore, Baltimore, MD, United States
| | - Rebecca L Hartman
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore, MD, United States; Program in Toxicology, University of Maryland Baltimore, Baltimore, MD, United States
| | - Sandrine Pirard
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore, MD, United States
| | - Marilyn A Huestis
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore, MD, United States.
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41
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Kim J, Park Y, Park M, Kim E, Yang W, Baeck S, Lee S, Han S. Simultaneous determination of five naphthoylindole-based synthetic cannabinoids and metabolites and their deposition in human and rat hair. J Pharm Biomed Anal 2014; 102:162-75. [PMID: 25282599 DOI: 10.1016/j.jpba.2014.09.013] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 08/30/2014] [Accepted: 09/09/2014] [Indexed: 11/19/2022]
Abstract
The continuing appearance of new synthetic cannabinoids has been a major issue in the field of forensic and clinical toxicology. In response to that, analytical methods for synthetic cannabinoids have been increasingly established in a variety of biological matrices. Since most of synthetic cannabinoids with structure similarity share some enzymatic metabolites, making the interpretation of analytical results and the discovery of the parent drug actually ingested very complicated, the investigation on metabolites of the first generation of synthetic cannabinoids with their relatively short side chains in chemical structure could be more important. Therefore, in the present study, we developed the analytical method for AM-2201, JWH-122 and MAM-2201 with JWH-018 as a precursor and their monohydroxylated metabolites in hair matrix. Also, using a rat model, AM-2201 and its monohydroxylated metabolites were identified and then the ratios of metabolite-to-parent drug were estimated to be used as criteria on external contamination. All analytes were extracted with methanol from washed and cut hair samples and the extracts were injected into LC-MS/MS with electrospray ion source in the positive ionization mode. Matrix effect and recovery were evaluated in hair matrices and no significant variations were observed. The validation results for precision and accuracy were satisfactory in both human and rat hair. The LOD and LOQ were 0.5 pg/10mg and 1.0 pg/10mg in human hair and 0.5 pg/20mg and 1.0 pg/20mg in pigmented and non-pigmented rat hair, respectively. Additionally, as a result of the animal study, there were not significant differences in the effect of pigmentation on the distribution of AM-2201 and its monohydroxylated metabolites in hair. Wide variations were observed for the concentrations of the naphthoylindole-based synthetic cannabinoids and metabolites in authentic hair samples from nine cases; those were 0.4-59.2 pg/mg for JWH-018, 0.1-0.8 pg/mg for JWH-073, 1.7-739.0 pg/mg for AM-2201, 0.1-402.0 pg/mg for JWH-122, 0.2-276.0 pg/mg for MAM-2201, 0.2-1.1 pg/mg for JWH-018 N-COOH, 0.3-37.2 pg/mg for JWH-018 N-5-OH, 0.3 pg/mg for JWH-073 N-COOH, 0.4 pg/mg for AM-2201 N-4-OH, 0.2-3.1 pg/mg for AM-2201 N-6-OHindole and 0.1-3.5 pg/mg for JWH-122 N-5-OH. This quantitative LC-MS/MS analytical method for five naphthoylindole-based synthetic cannabinoids and their metabolites was very useful to be applied to authentic hair samples, of which their analytical results suggested the incorporation of synthetic cannabinoids in the hair matrix and provided the information on ingested parent drugs.
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Affiliation(s)
- Jihyun Kim
- Narcotics, Forensic Toxicology & Chemistry Division, Seoul Institute, National Forensic Service, 139 Jiyangno, Yangcheon-gu, Seoul 158-707, Republic of Korea; College of Pharmacy, Chungang University, 84 Heukseok-ro, Dongjak-gu, Seoul 156-756, Republic of Korea
| | - Yuran Park
- Narcotics, Forensic Toxicology & Chemistry Division, Seoul Institute, National Forensic Service, 139 Jiyangno, Yangcheon-gu, Seoul 158-707, Republic of Korea
| | - Meejung Park
- Narcotics, Forensic Toxicology & Chemistry Division, Seoul Institute, National Forensic Service, 139 Jiyangno, Yangcheon-gu, Seoul 158-707, Republic of Korea
| | - Eunmi Kim
- Narcotics, Forensic Toxicology & Chemistry Division, Seoul Institute, National Forensic Service, 139 Jiyangno, Yangcheon-gu, Seoul 158-707, Republic of Korea
| | - Wonkyung Yang
- Narcotics, Forensic Toxicology & Chemistry Division, Seoul Institute, National Forensic Service, 139 Jiyangno, Yangcheon-gu, Seoul 158-707, Republic of Korea
| | - Seungkyung Baeck
- Narcotics, Forensic Toxicology & Chemistry Division, Seoul Institute, National Forensic Service, 139 Jiyangno, Yangcheon-gu, Seoul 158-707, Republic of Korea
| | - Sooyeun Lee
- College of Pharmacy, Keimyung University, 1095 Dalgubeoldaero, Dalseo-gu, Daegu 704-701, Republic of Korea.
| | - Sangbeom Han
- College of Pharmacy, Chungang University, 84 Heukseok-ro, Dongjak-gu, Seoul 156-756, Republic of Korea.
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Schep LJ, Slaughter RJ, Hudson S, Place R, Watts M. Delayed seizure-like activity following analytically confirmed use of previously unreported synthetic cannabinoid analogues. Hum Exp Toxicol 2014; 34:557-60. [DOI: 10.1177/0960327114550886] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Synthetic cannabinoid use has become widespread, leading to increased burdens on health care providers. Symptoms range from agitation and psychosis to seizures and acute kidney injury. We report a case where a patient was assessed and treated twice within 12 h for seizures following synthetic cannabinoid intoxication. Blood sample determinations showed low concentrations of analogues not previously reported, some of which are legal. Clinicians should be aware that synthetic cannabinoids may cause an array of severe health consequences. Given the ever evolving structure of available analogues, clinicians must also be prepared for other unexpected adverse effects.
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Affiliation(s)
- LJ Schep
- National Poisons Centre, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - RJ Slaughter
- National Poisons Centre, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - S Hudson
- HFL Sport Science, LGC Health Sciences, Fordham, Cambridgeshire, UK
| | - R Place
- Emergency Department, Southland Hospital, Invercargill, New Zealand
| | - M Watts
- Emergency Department, Southland Hospital, Invercargill, New Zealand
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Abstract
PURPOSE OF REVIEW New psychoactive substances refer to emerging substances that have appeared on the market and are not under international control. NPS have been categorized in different main groups (e.g. synthetic cannabinoids, synthetic cathinones, phenethylamines, piperazines, ketamine and phencyclidine-type substances, tryptamines). This article reviews the recent literature regarding emerging trends of NPS in Europe. RECENT FINDINGS According to the last report of the European Union Early warning system (EWS), 73 NPS were officially identified for the first time. The more frequent NPS self-reported or detected are synthetic cannabinoids and cathinones. A combination of different NPS and also mixed with other drugs, mainly cannabis and ecstasy, is usual among experienced drug users. Acute NPS toxicity includes significant psychoactive and sympathomimetic effects. SUMMARY This article summarizes new European epidemiological and clinical data published between January and December 2013 on NPS. In the last few years, there has been a rapid increase in the number of NPS launched on the European drugs market. The presence of some of these new substances has been detected through surveys/questionnaires, studies in drug samples and biological fluids, and case reports and NPS-induced fatalities.
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Wood DM, Hill SL, Thomas SHL, Dargan PI. Using poisons information service data to assess the acute harms associated with novel psychoactive substances. Drug Test Anal 2014; 6:850-60. [DOI: 10.1002/dta.1671] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Revised: 03/29/2014] [Accepted: 04/03/2014] [Indexed: 11/11/2022]
Affiliation(s)
- D. M. Wood
- Clinical Toxicology; Guy's and St Thomas’ NHS Foundation Trust and Kings Health Partners; London UK
- King's College London; London UK
| | - S. L. Hill
- Medical Toxicology Centre; Newcastle University; Newcastle UK
- Clinical Pharmacology and Therapeutics, Royal Victoria Infirmary; Newcastle Upon Tyne Hospitals NHS Foundation Trust; Newcastle UK
| | - S. H. L. Thomas
- Medical Toxicology Centre; Newcastle University; Newcastle UK
- Clinical Pharmacology and Therapeutics, Royal Victoria Infirmary; Newcastle Upon Tyne Hospitals NHS Foundation Trust; Newcastle UK
| | - P. I. Dargan
- Clinical Toxicology; Guy's and St Thomas’ NHS Foundation Trust and Kings Health Partners; London UK
- King's College London; London UK
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Abstract
Smokeable herbal mixtures containing synthetic agonists of cannabinoid receptors, known under brand names such as Spice, K2 and Kronic, represent a relatively new type of designer psychoactive drugs that has recently emerged on the recreational drug market. Although the Spice packages are labelled 'not for human consumption' or 'for aromatherapy only' and declared to be purely herbal, these herbal mixtures produce cannabis-like effects after smoking. This review surveys the current state of knowledge regarding the pharmacological properties of synthetic cannabimimetics and the prevalence and pattern of their use. Special emphasis is given to the negative consequences of using these products, including, among others, hallucinations, psychoses with delusions, seizures, cardiovascular symptoms and acute kidney injury.
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46
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MAM-2201 (analytically confirmed) intoxication after "Synthacaine" consumption. Ann Emerg Med 2014; 64:629-32. [PMID: 24530110 DOI: 10.1016/j.annemergmed.2014.01.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Revised: 01/06/2014] [Accepted: 01/08/2014] [Indexed: 01/24/2023]
Abstract
Excitatory behavior, xerostomia, chest pain, severe dyspnea, tachycardia (150 beats/min), and mild hypertension (160/80 mm Hg) without ECG abnormalities were observed in a 20-year-old subject 6 hours after nasal insufflation (snorting) of a "legally" obtained white powdered substance sold as Synthacaine. A serum sample was found to contain MAM-2201 (11 ng/mL), a synthetic cannabinoid receptor agonist, and benzocaine. The patient's symptoms improved after administration of diazepam and intravenous fluids. Synthacaine was sold as legal cocaine, suggesting the user can expect an effect like that of cocaine. The pharmacologic receptor profile and chemical structure of MAM-2201 is similar to the synthetic cannabinoid receptor agonists AM-2201 and JWH-122 (2 potent synthetic cannabinoid receptor agonists with high affinity to cannabinoid receptors).
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High times, low sats: diffuse pulmonary infiltrates associated with chronic synthetic cannabinoid use. J Med Toxicol 2013; 9:199-206. [PMID: 23539384 DOI: 10.1007/s13181-013-0288-9] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION In recent years, cases of severe adverse effects from recreational use of synthetic cannabinoids (SC) have established that these agents represent a novel toxicologic hazard. CASE REPORT A 21-year-old male presenting as a vehicular trauma victim was noted with diffuse pulmonary infiltrates related to chronic inhalation of multiple synthetic cannabinoid-containing products. Chest imaging revealed bilateral, subacute lung infiltrates; histopathological analysis of bronchial and alveolar tissues revealed an inflammatory process. An extensive workup failed to identify infectious, malignant, autoimmune, or hematologic causes of the syndrome, and toxicological analysis of the blood and body fluids confirmed the presence of multiple synthetic cannabinoids and metabolites. The patient recovered after an 8-day ICU course, wherein he received antibiotics, steroids, and mechanical ventilation. DISCUSSION This case contributes to the currently evolving knowledge about SC agents, adding a rarely described pulmonary complication to the growing list of adverse effects associated with these products.
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48
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Cytotoxicity of synthetic cannabinoids on primary neuronal cells of the forebrain: the involvement of cannabinoid CB1 receptors and apoptotic cell death. Toxicol Appl Pharmacol 2013; 274:17-23. [PMID: 24211273 DOI: 10.1016/j.taap.2013.10.028] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Revised: 10/17/2013] [Accepted: 10/28/2013] [Indexed: 01/28/2023]
Abstract
The abuse of herbal products containing synthetic cannabinoids has become an issue of public concern. The purpose of this paper was to evaluate the acute cytotoxicity of synthetic cannabinoids on mouse brain neuronal cells. Cytotoxicity induced by synthetic cannabinoid (CP-55,940, CP-47,497, CP-47,497-C8, HU-210, JWH-018, JWH-210, AM-2201, and MAM-2201) was examined using forebrain neuronal cultures. These synthetic cannabinoids induced cytotoxicity in the forebrain cultures in a concentration-dependent manner. The cytotoxicity was suppressed by preincubation with the selective CB1 receptor antagonist AM251, but not with the selective CB2 receptor antagonist AM630. Furthermore, annexin-V-positive cells were found among the treated forebrain cells. Synthetic cannabinoid treatment induced the activation of caspase-3, and preincubation with a caspase-3 inhibitor significantly suppressed the cytotoxicity. These synthetic cannabinoids induced apoptosis through a caspase-3-dependent mechanism in the forebrain cultures. Our results indicate that the cytotoxicity of synthetic cannabinoids towards primary neuronal cells is mediated by the CB1 receptor, but not by the CB2 receptor, and further suggest that caspase cascades may play an important role in the apoptosis induced by these synthetic cannabinoids. In conclusion, excessive synthetic cannabinoid abuse may present a serious acute health concern due to neuronal damage or deficits in the brain.
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Elian AA, Hackett J. Analysis of AM-2201 and metabolites in a drugs and driving case. Drug Test Anal 2013; 6:389-95. [DOI: 10.1002/dta.1535] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2013] [Revised: 08/09/2013] [Accepted: 08/09/2013] [Indexed: 11/12/2022]
Affiliation(s)
- Albert A. Elian
- Massachusetts State Police Crime Laboratory; 59 Horsepond Road Sudbury MA 01776 USA
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50
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Brents LK, Prather PL. The K2/Spice phenomenon: emergence, identification, legislation and metabolic characterization of synthetic cannabinoids in herbal incense products. Drug Metab Rev 2013; 46:72-85. [PMID: 24063277 DOI: 10.3109/03602532.2013.839700] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
In 2008, the European Monitoring Center for Drugs and Drug Addiction (EMCDDA) detected unregulated, psychoactive synthetic cannabinoids (SCBs) in purportedly all-natural herbal incense products (often known as K2 or Spice) that were being covertly abused as marijuana substitutes. These drugs, which include JWH-018, JWH-073 and CP-47,497, bind and activate the cannabinoid receptors CB1R and CB2R with remarkable potency and efficacy. Serious adverse effects that often require medical attention, including severe cardiovascular, gastrointestinal and psychiatric sequelae, are highly prevalent with SCB abuse. Consequently, progressively restrictive legislation in the US and Europe has banned the distribution, sale and use of prevalent SCBs, initiating cycles in which herbal incense manufacturers replace banned SCBs with newer unregulated SCBs. The contents of the numerous, diverse herbal incense products was unknown when SCB abuse first emerged. Furthermore, the pharmacology of the active components was largely uncharacterized, and confirmation of SCB use was hindered by a lack of known biomarkers. These knowledge gaps prompted scientists across multiple disciplines to rapidly (1) monitor, identify and quantify with chromatography/mass spectrometry the ever-changing contents of herbal incense products, (2) determine the metabolic pathways and major urinary metabolites of several commonly abused SCBs and (3) identify active metabolites that possibly contribute to the severe adverse effect profile of SCBs. This review comprehensively describes the emergence of SCB abuse and provides a historical account of the major case reports, legal decisions and scientific discoveries of the "K2/Spice Phenomenon". Hypotheses concerning potential mechanisms SCB adverse effects are proposed in this review.
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Affiliation(s)
- Lisa K Brents
- Department of Pharmacology and Toxicology, University of Arkansas for Medical Sciences , Little Rock, AR , USA and
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