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Aklillu E, Engidawork E. The impact of catha edulis (vahl) forssk. ex endl. (celestraceae) (khat) on pharmacokinetics of clinically used drugs. Expert Opin Drug Metab Toxicol 2021; 17:1125-1138. [PMID: 34410209 DOI: 10.1080/17425255.2021.1971194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Catha edulis (Vahl) Forssk. ex Endl. (Celestraceae) is used as a recreational drug on daily basis for its euphoric and psychostimulant effects. It is also chewed by individuals who are on medications, raising the possibility of drug-khat interaction. However, limited data are available in the literature, although clinically significant interactions are expected, as khat contains a complex mixture of pharmacologically active constituents. AREAS COVERED It provides an overview of the phytochemistry, pharmacokinetics, pharmacodynamics, and pharmacogenetics of khat based on the literature mined from PubMed, Google Scholar, and Cochrane databases. It also presents a detailed account of drug-khat interactions with specific examples and their clinical significance. The interactions mainly occur at the pharmacokinetics level and particular attention is paid for the phases of absorption and cytochrome P450 enzyme-mediated metabolism. EXPERT OPINION Despite the increasing trend of khat chewing with medications among the populace and the potential risk for the occurrence of clinically significant interactions, there is paucity of data in the literature demonstrating the magnitude of the risk. The available data, however, clearly demonstrate that the consequence of drug-khat interaction is dependent on genotype. Genotyping, where feasible, could be used to improve clinical outcome and minimize adverse reactions.
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Affiliation(s)
- Eleni Aklillu
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital-Huddinge, Stockholm, Sweden
| | - Ephrem Engidawork
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Abdulwadoud Alshoabi S, Noman Aljaber N, Omer Hussain A, Mohammed Aloufi K, Gafar Salih S. Khat Chewing Effect on the International Normalized Ratio in Patients with Mechanical Heart Valves under Warfarin Therapy. Pak J Biol Sci 2020; 23:1487-1491. [PMID: 33274879 DOI: 10.3923/pjbs.2020.1487.1491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND OBJECTIVE Khat is a plant that contains the alkaloids cathine and cathinone which have some amphetamine-like properties. It is cultivated and it's leaves chewed for their euphoric effect. This study intended to elucidate the effect of khat chewing on blood coagulation by using the International Normalized Ratio (INR) value as a calculable benchmark. MATERIALS AND METHODS In this cohort study, 146 patients with Mechanical Heart Valves (MHV) were assessed for two consecutive visits at one-month intervals. For each visit, the date of surgery, the patient's compliance, the dose of warfarin and the INR reading were assessed by the researcher. RESULTS Out of 146 patients with MHV, the mean age was 33.72±12.43 years (range, 14-65 years); 82 (56.2%) were female and 64 (43.8%) were male. The results revealed that the mean of absolute INR readings was lower in khat-chewers than non-chewers by average 0.2 on the first and second visits (p = 0.038 and 0.002, respectively). CONCLUSION Khat chewing has a significant coagulant effect. There was a significant decrease in the value of INR for khat chewers patients with MHV when compared to non-khat chewers.
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Geresu B, Canseco-Alba A, Sanabria B, Lin Z, Liu QR, Onaivi ES, Engidawork E. Involvement of CB2 Receptors in the Neurobehavioral Effects of Catha Edulis (Vahl) Endl. (Khat) in Mice. Molecules 2019; 24:E3164. [PMID: 31480324 PMCID: PMC6749201 DOI: 10.3390/molecules24173164] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 08/26/2019] [Accepted: 08/29/2019] [Indexed: 12/13/2022] Open
Abstract
There is behavioral evidence for the interaction between crude khat extract and the endocannabinoid system, whereby the endocannabinoid system alters khat extract-mediated behavioral effects through modulation of the monoaminergic system. The objective of this study was to investigate the role of the endocannabinoid system on the neurobehavioral effect of khat extract in mice following concomitant administration of khat extract and the CB2R agonist, JWH133. Locomotor activity test, immunohistochemistry, and reverse transcriptase polymerase chain reaction technique were utilized to assess locomotor activity, tyrosine hydroxylase immunoreactivity, and expression of dopamine transporter mRNA gene. The results show sub-acute administration of khat extract alone increased locomotor activity in mice and co-administration of the CB2R agonist, JWH133, reduced khat extract induced hyperlocomotor activity. The data revealed that cell type specific deletion of CB2Rs on dopaminergic neurons increased the hyperlocomotor behavior of khat extract. Furthermore, the results revealed that khat extract attenuated MPTP induced motor deficits, which is enhanced by JWH133. Khat extract also increased expression of tyrosine hydroxylase positive cells and expression of dopamine transporter mRNA gene in wild type mice. Nevertheless, JWH133 did not alter the effect of khat extract on tyrosine hydroxylase immunoreactivity and dopamine transporter mRNA expression when given together with khat extract. Taken together, the results suggest that the CB2Rs selectively interact with khat extract-mediated locomotor effects and could be utilized as therapeutic target in central nervous system movement disorders associated with dopamine dysregulation.
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MESH Headings
- 1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine
- Animals
- Behavior, Animal/drug effects
- Brain/drug effects
- Brain/physiology
- Cannabinoids/administration & dosage
- Cannabinoids/pharmacology
- Catha/chemistry
- Dopamine Plasma Membrane Transport Proteins/genetics
- Dopamine Plasma Membrane Transport Proteins/metabolism
- Dopaminergic Neurons/drug effects
- Dopaminergic Neurons/physiology
- Gene Deletion
- Gene Expression Regulation/drug effects
- Mice, Inbred C57BL
- Mice, Knockout
- Motor Activity/drug effects
- Plant Extracts/pharmacology
- RNA, Messenger/genetics
- RNA, Messenger/metabolism
- Receptor, Cannabinoid, CB2/agonists
- Receptor, Cannabinoid, CB2/metabolism
- Tyrosine 3-Monooxygenase/metabolism
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Affiliation(s)
- Berhanu Geresu
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, Addis Ababa University, 1176 Addis Ababa, Ethiopia
| | - Ana Canseco-Alba
- Department of Biology, William Paterson University, Wayne, NJ 07470, USA
| | - Branden Sanabria
- Department of Biology, William Paterson University, Wayne, NJ 07470, USA
| | - Zhicheng Lin
- Department of Psychiatry, Harvard Medical School, Psychiatric Neurogenomics, Division of Alcohol and Drug Abuse, and Mailman Neuroscience Research Center, McLean Hospital, Belmont, MA 02478, USA
| | - Qing-Rong Liu
- Laboratory of Clinical Investigation, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA
| | - Emmanuel S Onaivi
- Department of Biology, William Paterson University, Wayne, NJ 07470, USA.
| | - Ephrem Engidawork
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, Addis Ababa University, 1176 Addis Ababa, Ethiopia.
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Alsalahi A, Alshawsh MA, Chik Z, Mohamed Z. Effect of Catha edulis (khat) on pancreatic functions in streptozotocin-induced diabetes in male Sprague-Dawley rats. Exp Anim 2018; 67:517-526. [PMID: 29973470 PMCID: PMC6219881 DOI: 10.1538/expanim.18-0057] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
People consume Catha edulis (khat) for its euphoric effect, and type 1
diabetics have claimed that khat could reduce elevated levels of blood sugar. However,
khat has been suggested to provoke diabetes mellitus through destruction of pancreatic
β-cells. This study investigated the effect of an ethanolic khat extract on pancreatic
functions in type 1 diabetes (T1DM)-induced male Sprague-Dawley rats and to assess its
in vitro cytotoxicity in rat pancreatic β-cells (RIN-14B). T1DM was
induced in a total of 20 rats with a single intraperitoneal injection of 75 mg/kg of
streptozotocin. The rats were distributed into four groups (n=5): the diabetic control, 8
IU insulin-treated, 200 mg/kg khat-treated, and 400 mg/kg khat-treated groups. Another 5
rats were included as a nondiabetic control. Body weight, fasting blood sugar, and caloric
intake were recorded weekly. Four weeks after treatment, the rats were sacrificed, and
blood was collected for insulin, lipid profile, total protein, amylase, and lipase
analysis, while pancreases were harvested for histopathology. In vitro,
khat exerted moderate cytotoxicity against RIN-14B cells after 24 and 48 h but
demonstrated greater inhibition against RIN-14B cells after 72 h. Neither 200 mg/kg nor
400 mg/kg of khat produced any significant reduction in blood sugar; however, 200 mg/kg
khat extract provoked more destruction of pancreatic β-cells as compared with the diabetic
control. Ultimately, neither 200 mg/kg nor 400 mg/kg of khat extract could produce a
hypoglycemic effect in T1DM-induced rats. However, 200 mg/kg of khat caused greater
destruction of pancreatic β-cells, implying that khat may cause a direct cytotoxic effect
on pancreatic β-cells in vitro.
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Affiliation(s)
- Abdulsamad Alsalahi
- Department of Pharmacology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Mohammed A Alshawsh
- Department of Pharmacology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Zamri Chik
- Department of Pharmacology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Zahurin Mohamed
- Department of Pharmacology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
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Engidawork E. Pharmacological and Toxicological Effects of Catha edulis F. (Khat). Phytother Res 2017; 31:1019-1028. [PMID: 28557133 DOI: 10.1002/ptr.5832] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 04/19/2017] [Accepted: 04/20/2017] [Indexed: 01/02/2023]
Abstract
Khat chewing is deeply rooted in the culture and tradition of communities in khat belt countries, and its consumption is spread to other countries through the suitcase trade. The aim of this article is to review current knowledge on the chemistry, social, pharmacology and toxicology of khat and its use. Khat produces effect invariably in every system, which is harmful or beneficial in some instances. Harmful effects are observed in heavy users, although firm evidence is lacking. Chewing khat acutely elicits states of euphoria, which is followed by low mood. Khat contains alkaloids with psychostimulant properties, but the effect cannot be totally explained by these alkaloids. It is also not clear whether the effect produced in some organs like liver could be attributed to khat or pesticides sprayed during farming. Although the evidence indicates that khat has adverse effects in most organs, our understanding of the complex interaction between use and effect is incomplete, and causal relationships have not yet been described. Moreover, khat has positioned itself well in the social, economic and political arena. Thus, a multidisciplinary research is required to understand the different dimensions and come up with ways that maximize the benefit while minimizing the risk. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Ephrem Engidawork
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, P.O Box 1176, Addis Ababa, Ethiopia
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Geresu B, Onaivi E, Engidawork E. Behavioral evidence for the interaction between cannabinoids and Catha edulis F. (Khat) in mice. Brain Res 2016; 1648:333-338. [PMID: 27502029 DOI: 10.1016/j.brainres.2016.08.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 07/29/2016] [Accepted: 08/04/2016] [Indexed: 11/18/2022]
Abstract
Several studies have shown the existence of an interaction between the endocannabinoid system and some drugs of abuse, such as opioids, nicotine, alcohol, and cocaine. For instance, the endocannabinoid system has long been known to play a role in the underlying mechanisms of drug reward and dependence. The aim of this study was to evaluate the possible existence of an interaction between the endocannabinoid system and khat after acute administration. Behavioral interactions of khat extract with cannabinoids were assessed. To this effect, mice were randomly divided into different groups (vehicle, khat extract, khat and WIN55,212-2, a cannabinoid agonist, khat extract and cannabinoid antagonists, AM251 & AM630) and their behavioral responses were evaluated in activity monitor, elevated plus maze and Y-maze tests. These tests were used to determine changes in locomotor activity, anxiety-like behavior, and working memory. Khat and WIN55,212-2 demonstrated differential responses in these tests, but co-administration of these agents invariably increased the measured parameters, which were reversed by the cannabinoid receptor antagonists used. The data collectively indicate that there is an interaction between khat and the endocannabinoid system, which most likely involves the cannabinoid receptors or a common mechanism separately activated by the two agents.
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Affiliation(s)
- Berhanu Geresu
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Emmanuel Onaivi
- Department of Biology, College of Science and Health, William Paterson University, USA
| | - Ephrem Engidawork
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, Addis Ababa University, Addis Ababa, Ethiopia
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Alsalahi A, Alshawsh MA, Mohamed R, Alyousefi NA, Alshagga MA, Shwter AN, Al-Maqtari A, Ahmed RH, Mohamed Z. Conflicting reports on the role of the glycemic effect of Catha edulis (Khat): A systematic review and meta-analysis. JOURNAL OF ETHNOPHARMACOLOGY 2016; 186:30-43. [PMID: 27025406 DOI: 10.1016/j.jep.2016.03.045] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Revised: 03/03/2016] [Accepted: 03/18/2016] [Indexed: 06/05/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Traditionally, the leaves of Catha edulis Forsskal (Khat) are consumed by the people of Yemen primarily for its recreational effect, and secondarily, for achieving certain tasks. Additionally, Yemeni diabetics chew such leaves in the belief that this can control their elevated blood glucose level. AIMS This review focuses on outlining the findings of studies that have been conducted to display the glycemic effect of Catha edulis, while trying to balance it with findings of the association of its chewing with the development of type 2 diabetes mellitus (DM). MATERIALS AND METHODS The search strategy adopted was based on a comprehensive research in Medline, PubMed, Web of Science, JSTOR, Scopus and Cochrane for articles, proceeding abstracts and theses to identify complete reports written in the English language about the glycemic effect of Catha edulis in humans and animals from 1976 to 2016. In addition, bibliographies were also reviewed to find additional reports not otherwise published. Thirty seven records were identified of which, 25 eligible studies were included in the meta-analysis using blood glucose as an outcome measurement. Studies were divided into four subgroups according to the experimental model, namely; non-diabetic animals, diabetic animals, non-diabetic humans and diabetic humans. The pooled mean difference (MD) of blood glucose between experimental and control were calculated using random effects model of the weighted mean difference of blood glucose with 95% confidence interval (CI). Heterogeneity between studies was tested using I(2) statistic and a value of P<0.05 was considered to indicate statistical significance. RESULTS The scientific reports in the literature prevailed that the glycemic effect of Catha edulis were greatly conflicting with the majority of studies indicating that Catha edulis has a mild hypoglycemic effect. However, the meta-analysis indicted that the overall result showed an insignificant reduction in blood glucose (MD=-9.70, 95% CI: -22.17 to 2.76, P=0.13, with high heterogeneity between subgroups, I(2)=88.2%, P<0.0001). In addition, pooled mean difference of blood glucose of non-diabetic animals, diabetic animals and non-diabetic humans showed an insignificant reduction in blood glucose (MD=-18.55, 95% CI: -39.55 to 2.50, P<0.08, MD=-52.13%, 95% CI: -108.24 to 3.99, P=0.07 and MD=-2.71%, 95% CI: -19.19 to -13.77, P=0.75) respectively. Conversely, a significant elevation in the pooled mean difference of blood glucose in diabetic humans was indicated (MD=67.18, 95% CI: 36.93-97.43, P<0.0001). The conflict shown in the glycemic effect of Catha edulis is thought to be cultivar-related, while demographic and epidemiological reports suggested that chewing Catha edulis might be a predisposing factor contributing to the development of type 2 DM. CONCLUSION It was difficult to draw a meaningful conclusion from both the systematic and the meta-analysis with respect to the glycemic effect of Catha edulis since the meta-analysis results were insignificant with high heterogeneity among subgroups and are greatly conflicting. The variation is most likely due to unadjusted experimental factors or is related to Catha edulis itself, such as the differences in the phytochemical composition. Therefore, it is highly recommended that further studies of the glycemic effect of the cultivar of Catha edulis being studied should come with the identification and quantification of phytochemical content so that a meaningful assessment can be made with regard to its hypoglycemic properties. In addition, well-controlled clinical studies should be conducted to confirm whether or not chewing Catha edulis is associated with the development of type 2 DM, since this would be a source of concern seeing that the plant is widely consumed in certain populations.
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Affiliation(s)
- Abdulsamad Alsalahi
- Department of Pharmacology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Mohammed A Alshawsh
- Department of Pharmacology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
| | - Rosmawati Mohamed
- Department of Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Naelah A Alyousefi
- Department of Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Mustafa Ahmed Alshagga
- Department of Pharmacology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Abdrabuh N Shwter
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Ali Al-Maqtari
- Faculty of Dentistry, University of Malaya, Kuala Lumpur, 50603 Kuala Lumpur, Malaysia
| | - Radwan H Ahmed
- Department of Molecular Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Zahurin Mohamed
- Department of Pharmacology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
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Bogale T, Engidawork E, Yisma E. Subchronic oral administration of crude khat extract (Catha edulis forsk) induces schizophernic-like symptoms in mice. Altern Ther Health Med 2016; 16:153. [PMID: 27245332 PMCID: PMC4896131 DOI: 10.1186/s12906-016-1145-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 05/27/2016] [Indexed: 11/24/2022]
Abstract
Background Chewing fresh leaves of the khat plant (Catha edulis forsk) is a deep rooted and widespread habit in East Africa and the Middle East. Although a body of knowledge exists about the adverse effects of khat on health, data are sparse with regard to the consequences of long-term khat chewing in resulting schizophrenic like symptoms. Methods A crude extract of khat at different doses (100 mg/kg (K (khat)100), 200 mg/kg (K200) and 400 mg/kg (K400)) were administered for experimental group of mice whereas standard (ketamine (KT) 10 mg/kg- positive controls (KT10)) and vehicle (2 % v/v Tween-80 in distilled water – negative control groups (CON)) were administered for control groups of mice daily for two months to evaluate subchronic oral administration of crude khat extract to induce schizophrenic-like symptoms in mice. Mice were subjected to a battery of behavioural tests and parameters like locomotor activity, total time spent in social interaction and level of cognition among different groups of mice were measured and analyzed. Results Khat at all doses significantly increased (p < 0.001) the mean locomotor activity score of mice compared to CON. However, the mean locomotor activity score of mice treated with khat was significantly lower (p < 0.001) compared to the mean locomotor activity score of KT10 mice (p < 0.001). The mean total time score (in seconds) spent in social interaction, mean total time score (in seconds) spent in sniffing and following the partner was significantly higher (p < 0.001) in CON groups of mice compared to khat and ketamine treated groups. Moreover, in spatial memory task, the mean latency score (in seconds) to find the platform of khat and ketamine treated mice was significantly higher (p < 0.05) when compared to CON. Conclusions Subchronic oral administration of khat showed an enhanced locomotor activity, reduced social interaction and impaired cognitive function, which demonstrated that long-term use of khat is associated with schizophernic-like symptoms.
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Kassim S, Dalsania A, Nordgren J, Klein A, Hulbert J. Before the ban--an exploratory study of a local khat market in East London, U.K. Harm Reduct J 2015; 12:19. [PMID: 26066043 PMCID: PMC4465728 DOI: 10.1186/s12954-015-0048-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 05/13/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Khat is a green leaf with amphetamine-like effects. It is primarily used among people in Africa, the Middle East and in the diaspora communities from these countries. Prior to the prohibition of khat in the UK on 24 June 2014, there was almost no information available on key aspects of the local khat market. METHODS A cross-sectional study was conducted in 2012 using snowball sampling, Privileged Access Interviewing and area mapping in order to identify khat sale establishments. Data was collected via face-to-face interviews using mixed methods for data collection. This included information about the establishments selling khat, khat pricing and its use among different ethnic minority groups, in addition to the potential sale of khat to children and risk assessment (e.g., use of pesticides on khat). RESULTS Five out of seven sellers identified agreed to participate. Sellers described their khat sale establishments as 'community centres' which included, for example, a restaurant basement. The sellers' history of selling khat ranged between 1-15 years and khat's sale took place between 2pm-10pm. Miraa (e.g., Lara) from Kenya was the most popularly used khat variety, sold in pre-wrapped bundles of approximately 250 g costing £3 each and delivered four days a week. Harari (e.g., Owdi) from Ethiopia was sold in 200 g, 400 g and 1 kg bundles, priced between £5 and £20 and delivered two days a week. The primary benefit of khat use was reported to be social interaction. The customers were predominantly adult males of Somali origin. Most sellers claimed a self-imposed ban on sales to children under 18 years old. Khat bundles had no labelling describing variety or weight and sellers had no knowledge of the use of pesticides on khat and did not advertise the risks associated with khat use. CONCLUSIONS Khat selling establishments were businesses that did not adhere to trade standards regulations (e.g., labelling khat bundles). They claimed to provide a community service (facilitating social interaction) to their predominately Somali customers. Without a better understanding of the dynamics of the khat market there is a risk that both health and social needs of the vulnerable populations involved in the market continue to go unaddressed. Future research should track changes in the now illicit khat market in order to evaluate the social and public health implications following the recent changes to the current U.K. regulatory environment regarding khat.
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Affiliation(s)
- Saba Kassim
- Queen Mary, University of London, Barts and The London School of Medicine and Dentistry, Institute of Dentistry, 4 Newark Street, London, E1 2AT, UK.
| | - Asha Dalsania
- Queen Mary, University of London, Barts and The London School of Medicine and Dentistry, Institute of Dentistry, 4 Newark Street, London, E1 2AT, UK.
| | - Johan Nordgren
- Department of Social Work, Malmö University, Malmö, Sweden.
| | - Axel Klein
- Project Office with Egmont, Institute for International Relations, Brussels, Belgium.
| | - Josh Hulbert
- Drugscience, the Independent Scientific Committee on Drugs, London, UK.
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Fu H, Shi K, Hu G, Yang Y, Kuang Q, Lu L, Zhang L, Chen W, Dong M, Chen Y, He Q. Tumor-Targeted Paclitaxel Delivery and Enhanced Penetration Using TAT-Decorated Liposomes Comprising Redox-Responsive Poly(Ethylene Glycol). J Pharm Sci 2015; 104:1160-73. [DOI: 10.1002/jps.24291] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 10/25/2014] [Accepted: 11/06/2014] [Indexed: 12/27/2022]
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Shewamene Z, Engidawork E. Subacute administration of crude khat (Catha edulis F.) extract induces mild to moderate nephrotoxicity in rats. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 14:66. [PMID: 24555719 PMCID: PMC3933508 DOI: 10.1186/1472-6882-14-66] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Accepted: 02/18/2014] [Indexed: 12/13/2022]
Abstract
BACKGROUND Although various studies have been conducted to shed light on the pharmacological actions of khat, little or no data are available regarding khat's effect on the renal redox system. The aim of this study was therefore to investigate the potential of nephrotoxicity associated with khat exposure in rats. METHODS Sprague Dawely rats were randomly assigned into eight experimental groups. Animals were treated with Tween80, gentamicin 100 mg/kg and khat at various doses (100, 200 and 400 mg/kg) alone or in combination with gentamicin for ten days. The animals were then sacrificed to obtain blood and renal tissues for subsequent analysis. Renal markers, including creatinine, blood urea nitrogen, antioxidant enzymes as well as markers for lipid peroxidation were determined using established protocols. In addition, histopathological changes were evaluated with hematoxilin and-eosin staining technique. RESULTS Lower and moderate doses of khat did not alter the measured parameters compared to controls. By contrast, higher dose (400 mg/kg) of khat not only increased levels of serum creatinine and blood urea nitrogen (p < 0.001) but also levels of malondialdehyde (p < 0.01). Moreover, 400 mg/kg of khat significantly decreased enzymatic activities of superoxide dismutase (p < 0.01) and catalase (p < 0.001). When khat was administered with gentamicin, it was again the higher dose that significantly accentuated gentamicin-induced alterations in the renal system. CONCLUSIONS Khat treatment at high dose is demonstrated to induce mild to moderate renal damage. Moreover, it creates synergy when combined with nephrotoxic drugs such as gentamicin.
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Affiliation(s)
- Zewdneh Shewamene
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, Addis Ababa University, P.O, Box 1176, Addis Ababa, Ethiopia
| | - Ephrem Engidawork
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, Addis Ababa University, P.O, Box 1176, Addis Ababa, Ethiopia
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Al Suwaidi J, Ali WM, Aleryani SL. Cardiovascular complications of Khat. Clin Chim Acta 2013; 419:11-4. [PMID: 23370046 DOI: 10.1016/j.cca.2013.01.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Revised: 01/17/2013] [Accepted: 01/21/2013] [Indexed: 10/27/2022]
Abstract
This article reviews current knowledge in khat (cathinone) research and its health impacts and toxicity in the cardiac system of khat chewers based on current evidence. The authors describe the process by which khat is postulated to induce multiple cardiac abnormalities by illustrating multiple case reports as described from around the world. The role of free radicals in inducing cardiac disease is also discussed. Future research areas are proposed to enhance our understanding of the mode of action of this toxicological drug.
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Affiliation(s)
- Jassim Al Suwaidi
- Department of Adult Cardiology, Heart Hospital, Hamad Medical Corporation (HMC), Doha, Qatar
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Toxicological Features of Catha edulis (Khat) on Livers and Kidneys of Male and Female Sprague-Dawley Rats: A Subchronic Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012; 2012:829401. [PMID: 23259000 PMCID: PMC3522130 DOI: 10.1155/2012/829401] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Revised: 10/15/2012] [Accepted: 10/22/2012] [Indexed: 11/18/2022]
Abstract
Hepato- and nephrotoxicity of Khat consumption (Catha edulis Forskal) have been evoked. Therefore, this study was conducted to evaluate such possible hepatorenal toxicity in female and male Sprague-Dawley rats (SD rats) focusing primarily on liver and kidney. In addition, female and male rats were investigated separately. Accordingly, forty-eight SD-rats (100–120 g) were distributed randomly into four groups of males and female (n = 12). Normal controls (NCs) received distilled water, whereas test groups received 500 mg/kg (low dose (LD)), 1000 mg/kg (medium dose (MD)), or 2000 mg/kg (high dose (HD)) of crude extract of Catha edulis orally for 4 weeks. Then, physical, biochemical, hematological, and histological parameters were analyzed. Results in Khat-fed rats showed hepatic enlargement, abnormal findings in serum aspartate aminotransferase (AST), and alkaline phosphatase (ALP) of male and female SD-rats and serum albumin (A) and serum creatinine (Cr) of female as compared to controls. In addition, histopathological abnormalities confirmed hepatic and renal toxicities of Khat that were related to heavy Khat consumption. In summary, Khat could be associated with hepatic hypertrophy and hepatotoxicity in male and female SD-rats and nephrotoxicity only in female SD-rats.
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