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Parikh AC, Jeffery CS, Sandhu Z, Brownlee BP, Queimado L, Mims MM. The effect of cannabinoids on wound healing: A review. Health Sci Rep 2024; 7:e1908. [PMID: 38410495 PMCID: PMC10895075 DOI: 10.1002/hsr2.1908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 11/05/2023] [Accepted: 02/01/2024] [Indexed: 02/28/2024] Open
Abstract
Background and Aims Cannabis and its various derivatives are commonly used for both recreational and medicinal purposes. Cannabinoids have been shown to have anti-inflammatory properties. Inflammation is an important component of wound healing and the effect of cannabinoids on wound healing has become a recent topic of investigation. The objective of this article is to perform a comprehensive review of the literature to summarize the effects of cannabinoids on wound healing of the skin and to guide future avenues of research. Methods A comprehensive literature review was performed to evaluate the effects of cannabinoids on cutaneous wound healing. Results Cannabinoids appear to improve skin wound healing through a variety of mechanisms. This is supported through a variety of in vitro and animal studies. Animal studies suggest application of cannabinoids may improve the healing of postsurgical and chronic wounds. There are few human studies which evaluate the effects of cannabinoids on wound healing and many of these are case series and observational studies. They do suggest cannabinoids may have some benefit. However, definitive conclusions cannot be drawn from them. Conclusion While further human studies are needed, topical application of cannabinoids may be a potential therapeutic option for postsurgical and chronic wounds.
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Affiliation(s)
- Aniruddha C. Parikh
- Departments of Otolaryngology Head and Neck SurgeryThe University of Oklahoma Health Sciences CenterOklahoma CityOklahomaUSA
| | - Christopher S. Jeffery
- Departments of General SurgeryThe University of Oklahoma Health Sciences CenterOklahoma CityOklahomaUSA
| | - Zainab Sandhu
- Departments of Otolaryngology Head and Neck SurgeryThe University of Oklahoma Health Sciences CenterOklahoma CityOklahomaUSA
| | - Benjamin P. Brownlee
- Departments of Otolaryngology Head and Neck SurgeryThe University of Oklahoma Health Sciences CenterOklahoma CityOklahomaUSA
| | - Lurdes Queimado
- Departments of Otolaryngology Head and Neck SurgeryThe University of Oklahoma Health Sciences CenterOklahoma CityOklahomaUSA
- Departments of Cell BiologyThe University of Oklahoma Health Sciences CenterOklahoma CityOklahomaUSA
- Department of Otolaryngology Head and Neck Surgery, TSET Health Promotion Research Center, Stephenson Cancer CenterThe University of Oklahoma Health Sciences CenterOklahoma CityOklahomaUSA
| | - Mark M. Mims
- Departments of Otolaryngology Head and Neck SurgeryThe University of Oklahoma Health Sciences CenterOklahoma CityOklahomaUSA
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2
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Healy CR, Gethin G, Pandit A, Finn DP. Chronic wound-related pain, wound healing and the therapeutic potential of cannabinoids and endocannabinoid system modulation. Biomed Pharmacother 2023; 168:115714. [PMID: 37865988 DOI: 10.1016/j.biopha.2023.115714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 10/09/2023] [Accepted: 10/11/2023] [Indexed: 10/24/2023] Open
Abstract
Chronic wounds represent a significant burden on the individual, and the healthcare system. Individuals with chronic wounds report pain to be the most challenging aspect of living with a chronic wound, with current therapeutic options deemed insufficient. The cutaneous endocannabinoid system is an important regulator of skin homeostasis, with evidence of system dysregulation in several cutaneous disorders. Herein, we describe the cutaneous endocannabinoid system, chronic wound-related pain, and comorbidities, and review preclinical and clinical evidence investigating endocannabinoid system modulation for wound-related pain and wound healing. Based on the current literature, there is some evidence to suggest efficacy of endocannabinoid system modulation for promotion of wound healing, attenuation of cutaneous disorder-related inflammation, and for the management of chronic wound-related pain. However, there is 1) a paucity of preclinical studies using validated models, specific for the study of chronic wound-related pain and 2) a lack of randomised control trials and strong clinical evidence relating to endocannabinoid system modulation for wound-related pain. In conclusion, while there is some limited evidence of benefit of endocannabinoid system modulation in wound healing and wound-related pain management, further research is required to better realise the potential of targeting the endocannabinoid system for these therapeutic applications.
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Affiliation(s)
- Catherine R Healy
- Pharmacology and Therapeutics, School of Medicine, University of Galway, Galway City, Ireland; Galway Neuroscience Centre, University of Galway, Galway City, Ireland; Centre for Pain Research, University of Galway, Galway City, Ireland; CÚRAM, SFI Research Centre for Medical Devices, University of Galway, Galway City, Ireland
| | - Georgina Gethin
- CÚRAM, SFI Research Centre for Medical Devices, University of Galway, Galway City, Ireland; School of Nursing and Midwifery, University of Galway, Galway City, Ireland; Alliance for Research and Innovation in Wounds, University of Galway, Galway City, Ireland
| | - Abhay Pandit
- CÚRAM, SFI Research Centre for Medical Devices, University of Galway, Galway City, Ireland
| | - David P Finn
- Pharmacology and Therapeutics, School of Medicine, University of Galway, Galway City, Ireland; Galway Neuroscience Centre, University of Galway, Galway City, Ireland; Centre for Pain Research, University of Galway, Galway City, Ireland; CÚRAM, SFI Research Centre for Medical Devices, University of Galway, Galway City, Ireland.
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3
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Deng Z, Zhao L, Li X, Wang CY, Zhou Y, Li M, Li Y, Fu X. Folium crataegi boosts skin regeneration for burn injury in rats through multiple ways. Biomed Pharmacother 2023; 167:115457. [PMID: 37690389 DOI: 10.1016/j.biopha.2023.115457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/31/2023] [Accepted: 09/05/2023] [Indexed: 09/12/2023] Open
Abstract
Appropriate topical dressings for burn treatments are important to accelerate skin wound recovery and prevent external infections. This study aimed to evaluate the effect and investigate the mechanism of folium crataegi (Crataegus pinnatifida Bge.) for the treatment of burn wounds, as well as to compare the therapeutic effects of aqueous extracts (HLW) and alcoholic extracts (HLE) from folium crataegi. The results demonstrated that both HLW and HLE groups exhibited a higher wound contraction rate than the silver sulfadiazine (SSD) ointment group. Moreover, HLW showed more significant wound repair effects than HLE. HLW significantly increased levels of EGF and FGF-2 in wound tissue, as well as TGF-β1, VEGF, CAT and IL-10 in serum. Folium crataegi extract, especially aqueous extracts, exerted good anti-inflammatory, anti-oxidant and anti-bacterial effects by upregulating the expression of lag3, txn1 and slpi, respectively. Folium crataegi extract significantly inhibits the expression of npas2, a key gene in the circadian rhythm pathway. In conclusion, this research illustrated that the folium crataegi extract, especially aqueous extracts, had better therapeutic effects on skin burns through multiple ways, possibly including a novel mechanism related to circadian rhythm pathway. These findings suggest that folium crataegi could be a valuable source of compounds for enhancing skin regeneration through multiple ways.
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Affiliation(s)
- Zhihong Deng
- Qingdao Academy of Chinese Medical Sciences Shandong University of Traditional Chinese Medicine, Qingdao Key Laboratory of Research in Marine Traditional Chinese Medicine, Qingdao Key Technology Innovation Center of Marine Traditional Chinese Medicine's Deep Development and Industrialization, Qingdao 266114, China; Marine Traditional Chinese Medicine Research Center, Key Laboratory of Marine Traditional Chinese Medicine in Shandong Universities, Shandong Engineering and Technology Research Center on Omics of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250355, China
| | - Lifeng Zhao
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Xiuxue Li
- Qingdao Academy of Chinese Medical Sciences Shandong University of Traditional Chinese Medicine, Qingdao Key Laboratory of Research in Marine Traditional Chinese Medicine, Qingdao Key Technology Innovation Center of Marine Traditional Chinese Medicine's Deep Development and Industrialization, Qingdao 266114, China; Marine Traditional Chinese Medicine Research Center, Key Laboratory of Marine Traditional Chinese Medicine in Shandong Universities, Shandong Engineering and Technology Research Center on Omics of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250355, China.
| | - Chang-Yun Wang
- Key Laboratory of Marine Drugs, the Ministry of Education of China, School of Medicine and Pharmacy, Ocean University of China, Qingdao 266003, China; Laboratory for Marine Drugs and Bioproducts, Qingdao National Laboratory for Marine Science and Technology, Qingdao 266237, China
| | - Yue Zhou
- Key Laboratory of Marine Drugs, the Ministry of Education of China, School of Medicine and Pharmacy, Ocean University of China, Qingdao 266003, China; Laboratory for Marine Drugs and Bioproducts, Qingdao National Laboratory for Marine Science and Technology, Qingdao 266237, China
| | - Mengfei Li
- Qingdao Academy of Chinese Medical Sciences Shandong University of Traditional Chinese Medicine, Qingdao Key Laboratory of Research in Marine Traditional Chinese Medicine, Qingdao Key Technology Innovation Center of Marine Traditional Chinese Medicine's Deep Development and Industrialization, Qingdao 266114, China; Marine Traditional Chinese Medicine Research Center, Key Laboratory of Marine Traditional Chinese Medicine in Shandong Universities, Shandong Engineering and Technology Research Center on Omics of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250355, China
| | - Yingfei Li
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing 100700, China.
| | - Xianjun Fu
- Qingdao Academy of Chinese Medical Sciences Shandong University of Traditional Chinese Medicine, Qingdao Key Laboratory of Research in Marine Traditional Chinese Medicine, Qingdao Key Technology Innovation Center of Marine Traditional Chinese Medicine's Deep Development and Industrialization, Qingdao 266114, China; Marine Traditional Chinese Medicine Research Center, Key Laboratory of Marine Traditional Chinese Medicine in Shandong Universities, Shandong Engineering and Technology Research Center on Omics of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250355, China.
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4
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Saraiva MM, Campelo MDS, Câmara Neto JF, Lima ABN, Silva GDA, Dias ATDFF, Ricardo NMPS, Kaplan DL, Ribeiro MENP. Alginate/polyvinyl alcohol films for wound healing: Advantages and challenges. J Biomed Mater Res B Appl Biomater 2023; 111:220-233. [PMID: 35959858 DOI: 10.1002/jbm.b.35146] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 07/08/2022] [Accepted: 07/25/2022] [Indexed: 11/06/2022]
Abstract
The skin is the largest organ in the human body and its physical integrity must be maintained for body homeostasis and to prevent the entry of pathogenic microorganisms. Sodium alginate (SA) and polyvinyl alcohol (PVA) are two polymers widely used in films for wound dressing applications. Furthermore, blends between SA and PVA improve physical, mechanical and biological properties of the final wound healing material when compared to the individual polymers. Different drugs have been incorporated into SA/PVA-based films to improve wound healing activity. It is noteworthy that SA/PVA films can be crosslinked with Ca2+ or other agents, which improves physicochemical and biological properties. Thus, SA/PVA associations are promising for the biomedical field, as a potential alternative for wound treatment. This review focuses on the main techniques for obtaining SA/PVA films, their physical-chemical characterization, drug incorporation, and the advantages and challenges of these films for wound healing.
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Affiliation(s)
- Matheus Morais Saraiva
- Department of Organic and Inorganic Chemistry, Sciences Center, Laboratory of Polymers and Materials Innovation, Federal University of Ceará, Fortaleza, Brazil
| | - Matheus da Silva Campelo
- Department of Organic and Inorganic Chemistry, Sciences Center, Laboratory of Polymers and Materials Innovation, Federal University of Ceará, Fortaleza, Brazil
| | - João Francisco Câmara Neto
- Department of Organic and Inorganic Chemistry, Sciences Center, Laboratory of Polymers and Materials Innovation, Federal University of Ceará, Fortaleza, Brazil
| | - Ana Beatriz Nogueira Lima
- Department of Organic and Inorganic Chemistry, Sciences Center, Laboratory of Polymers and Materials Innovation, Federal University of Ceará, Fortaleza, Brazil
| | - George de Almeida Silva
- Department of Organic and Inorganic Chemistry, Sciences Center, Laboratory of Polymers and Materials Innovation, Federal University of Ceará, Fortaleza, Brazil
| | - Andre Tavares de Freitas Figueredo Dias
- Department of Organic and Inorganic Chemistry, Sciences Center, Laboratory of Polymers and Materials Innovation, Federal University of Ceará, Fortaleza, Brazil
| | - Nágila Maria Pontes Silva Ricardo
- Department of Organic and Inorganic Chemistry, Sciences Center, Laboratory of Polymers and Materials Innovation, Federal University of Ceará, Fortaleza, Brazil
| | - David L Kaplan
- Department of Biomedical Engineering, Tufts University, Medford, Massachusetts, USA
| | - Maria Elenir Nobre Pinho Ribeiro
- Department of Organic and Inorganic Chemistry, Sciences Center, Laboratory of Polymers and Materials Innovation, Federal University of Ceará, Fortaleza, Brazil
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5
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Chen D, Tang H, Jiang H, Sun L, Zhao W, Qian F. ACPA Alleviates Bleomycin-Induced Pulmonary Fibrosis by Inhibiting TGF-β-Smad2/3 Signaling-Mediated Lung Fibroblast Activation. Front Pharmacol 2022; 13:835979. [PMID: 35355726 PMCID: PMC8959577 DOI: 10.3389/fphar.2022.835979] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 01/31/2022] [Indexed: 01/06/2023] Open
Abstract
Pulmonary fibrosis is a group of life-threatening diseases with limited therapeutic options. The involvement of cannabinoid type 1 receptors (CB1R) has been indicated in fibrotic diseases, but whether or not the activation of CB1R can be a benefit for fibrosis treatment is controversial. In this study, we investigated the effects of arachidonoylcyclopropylamide (ACPA), as a selective CB1R agonist, on bleomycin (BLM)-induced pulmonary fibrosis. We showed that ACPA treatment significantly improved the survival rate of BLM-treated mice, alleviated BLM-induced pulmonary fibrosis, and inhibited the expressions of extracellular matrix (ECM) markers, such as collagen, fibronectin, and α-SMA. The enhanced expressions of ECM markers in transforming growth factor-beta (TGF-β)-challenged primary lung fibroblasts isolated from mouse lung tissues were inhibited by ACPA treatment in a dose-dependent manner, and the fibroblast migration triggered by TGF-β was dose-dependently diminished after ACPA administration. Moreover, the increased mRNA levels of CB1R were observed in both lung fibroblasts of BLM-induced fibrotic mice in vivo and TGF-β-challenged primary lung fibroblasts in vitro. CB1R-specific agonist ACPA significantly diminished the activation of TGF-β–Smad2/3 signaling, i.e., the levels of p-Smad2 and p-Smad3, and decreased the expressions of downstream effector proteins including slug and snail, which regulate ECM production, in TGF-β-challenged primary lung fibroblasts. Collectively, these findings demonstrated that CB1R-specific agonist ACPA exhibited antifibrotic efficacy in both in vitro and in vivo models of pulmonary fibrosis, revealing a novel anti-fibrosis approach to fibroblast-selective inhibition of TGF-β-Smad2/3 signaling by targeting CB1R.
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Affiliation(s)
- Dongxin Chen
- Engineering Research Center of Cell and Therapeutic Antibody, Ministry of Education, School of Pharmacy, Shanghai Jiao Tong University, Shanghai, China
| | - Huirong Tang
- Engineering Research Center of Cell and Therapeutic Antibody, Ministry of Education, School of Pharmacy, Shanghai Jiao Tong University, Shanghai, China
| | - Hongchao Jiang
- Engineering Research Center of Cell and Therapeutic Antibody, Ministry of Education, School of Pharmacy, Shanghai Jiao Tong University, Shanghai, China
| | - Lei Sun
- Engineering Research Center of Cell and Therapeutic Antibody, Ministry of Education, School of Pharmacy, Shanghai Jiao Tong University, Shanghai, China
| | - Wenjuan Zhao
- Engineering Research Center of Cell and Therapeutic Antibody, Ministry of Education, School of Pharmacy, Shanghai Jiao Tong University, Shanghai, China
| | - Feng Qian
- Engineering Research Center of Cell and Therapeutic Antibody, Ministry of Education, School of Pharmacy, Shanghai Jiao Tong University, Shanghai, China.,Anhui Province Key Laboratory of Translational Cancer Research, Bengbu Medical College, Bengbu, China
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6
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Eid BG, Alhakamy NA, Fahmy UA, Ahmed OAA, Md S, Abdel-Naim AB, Caruso G, Caraci F. Melittin and diclofenac synergistically promote wound healing in a pathway involving TGF-β1. Pharmacol Res 2022; 175:105993. [PMID: 34801680 DOI: 10.1016/j.phrs.2021.105993] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/17/2021] [Accepted: 11/17/2021] [Indexed: 12/23/2022]
Abstract
A dysregulation of the wound healing process can lead to the development of various intractable ulcers or excessive scar formation. Therefore it is essential to identify novel pharmacological strategies to promote wound healing and restore the mechanical integrity of injured tissue. The goal of the present study was to formulate a nano-complex containing melittin (MEL) and diclofenac (DCL) with the aim to evaluate their synergism and preclinical efficacy in an in vivo model of acute wound. After its preparation and characterization, the therapeutic potential of the combined nano-complexes was evaluated. MEL-DCL nano-complexes exhibited better regenerated epithelium, keratinization, epidermal proliferation, and granulation tissue formation, which in turn showed better wound healing activity compared to MEL, DCL, or positive control. The nano-complexes also showed significantly enhanced antioxidant activity. Treatment of wounded skin with MEL-DCL nano-complexes showed significant reduction of interleukin-6 (IL-6), IL-1β, and tumor necrosis factor-α (TNF-α) pro-inflammatory markers that was paralleled by a substantial increase in mRNA expression levels of collagen, type I, alpha 1 (Col1A1) and collagen, type IV, alpha 1 (Col4A1), and hydroxyproline content as compared to individual drugs. Additionally, MEL-DCL nano-complexes were able to significantly increase hypoxia-inducible factor 1-alpha (HIF-1α) and transforming growth factor beta 1 (TGF-β1) proteins expression compared to single drugs or negative control group. SB431542, a selective inhibitor of type-1 TGF-β receptor, significantly prevented in our in vitro assay the wound healing process induced by the MEL-DCL nano-complexes, suggesting a key role of TGF-β1 in the wound closure. In conclusion, the nano-complex of MEL-DCL represents a novel pharmacological tool that can be topically applied to improve wound healing.
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Affiliation(s)
- Basma G Eid
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Nabil A Alhakamy
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia; Advanced Drug Delivery Research Group, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia; Center of Excellence for Drug Research and Pharmaceutical Industries, King Abdulaziz University, Jeddah 21589, Saudi Arabia; Scientific chair "Mohamed Saeed Tamer Chair for Pharmaceutical industries", King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Usama A Fahmy
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Osama A A Ahmed
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia; Advanced Drug Delivery Research Group, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia; Center of Excellence for Drug Research and Pharmaceutical Industries, King Abdulaziz University, Jeddah 21589, Saudi Arabia; Scientific chair "Mohamed Saeed Tamer Chair for Pharmaceutical industries", King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Shadab Md
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Ashraf B Abdel-Naim
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Giuseppe Caruso
- Department of Drug and Health Sciences, University of Catania, 95125 Catania, Italy.
| | - Filippo Caraci
- Department of Drug and Health Sciences, University of Catania, 95125 Catania, Italy; Oasi Research Institute-IRCCS, 94018 Troina, Italy.
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7
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Abstract
Cannabis sativa L. plant is currently attracting increasing interest in cosmetics and dermatology. In this review, the biologically active compounds of hemp are discussed. Particularly the complex interactions of cannabinoids with the endocannabinoid system of the skin to treat various conditions (such as acne, allergic contact dermatitis, melanoma, and psoriasis) with clinical data. Moreover, the properties of some cannabinoids make them candidates as cosmetic actives for certain skin types. Hemp seed oil and its minor bioactive compounds such as terpenes, flavonoids, carotenoids, and phytosterols are also discussed for their added value in cosmetic formulation.
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8
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Correia-Sá I, Carvalho C, A Machado V, Carvalho S, Serrão P, Marques M, Vieira-Coelho MA. Targeting cannabinoid receptor 2 (CB2) limits collagen production-An in vitro study in a primary culture of human fibroblasts. Fundam Clin Pharmacol 2021; 36:89-99. [PMID: 34259358 DOI: 10.1111/fcp.12716] [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: 02/15/2021] [Accepted: 07/09/2021] [Indexed: 11/28/2022]
Abstract
Previous studies showed that cannabinoid 2 (CB2) receptor is involved in skin inflammation, fibrogenesis and re-epithelialization in mice, indicating that this receptor may be implicated in wound healing. Thus, topical use of cannabinoids may have a role in local fibrotic and wound healing diseases such as scars or keloids. We investigate the effect of the CB2 selective receptor agonist (6aR,10aR)-3-(1,1-Dimethylbutyl)-6a,7,10,10a-tetrahydro-6,6,9-trimethyl-6H-dibenzo[b,d]pyran (JWH133) and the CB2 selective receptor antagonist (6-Iodo-2-methyl-1-[2-(4-morpholinyl)ethyl]-1H-indol-3-yl)(4-methoxyphenyl)-methanone (AM630), on primary cultures of human fibroblasts. Primary cultures of adult human fibroblasts were obtained from abdominal human skin samples. Fibroblasts pretreated with JWH133 and/or AM630 were stimulated with TGF-β (10 ng/ml). Fibroblast activation into myofibroblasts was quantified by the expression of alpha-smooth muscle actin (α-SMA) using Immunocytochemistry and Western Blot assays. Collagen content was quantified with the Sirius red staining assay. Upon human fibroblasts stimulation with TGF-β, a significant increase on α-SMA and CB2 receptor expression was observed. In these cells, JWH133 decreased α-SMA expression and collagen content. However, this effect was not observed in resting human fibroblasts. AM630 decreased α-SMA expression and collagen content in both resting and activated fibroblasts. This effect was time- and concentration-dependent with an IC50 value of 11 μM. The CB2 receptor appears to be involved in fibroblast repair during skin wound healing in humans, as TGF-β increases CB2 receptor expression and JWH133 produces an anti-fibrotic effect in human fibroblasts. AM630 also showed an anti-fibrotic effect hypothesizing that other cannabinoid receptors, such as TRPV, may be involved in this response.
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Affiliation(s)
- Inês Correia-Sá
- Department of Plastic, Reconstructive and Aesthetic Surgery and Burn Unit, Faculty of Medicine, University of Porto and Centro Hospitalar São João, Porto, Portugal.,Department of Biomedicine-Pharmacology and Therapeutics Unit, Faculty of Medicine, University of Oporto, Porto, Portugal
| | - Cláudia Carvalho
- Department of Biomedicine-Pharmacology and Therapeutics Unit, Faculty of Medicine, University of Oporto, Porto, Portugal
| | - Vera A Machado
- Department of Biomedicine-Pharmacology and Therapeutics Unit, Faculty of Medicine, University of Oporto, Porto, Portugal
| | - Sofia Carvalho
- Department of Biomedicine-Pharmacology and Therapeutics Unit, Faculty of Medicine, University of Oporto, Porto, Portugal
| | - Paula Serrão
- Department of Biomedicine-Pharmacology and Therapeutics Unit, Faculty of Medicine, University of Oporto, Porto, Portugal
| | - Marisa Marques
- Department of Plastic, Reconstructive and Aesthetic Surgery and Burn Unit, Faculty of Medicine, University of Porto and Centro Hospitalar São João, Porto, Portugal
| | - Maria A Vieira-Coelho
- Department of Biomedicine-Pharmacology and Therapeutics Unit, Faculty of Medicine, University of Oporto, Porto, Portugal
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9
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Maida V, Shi RB, Fazzari FGT, Zomparelli L. Topical cannabis-based medicines - A novel adjuvant treatment for venous leg ulcers: An open-label trial. Exp Dermatol 2021; 30:1258-1267. [PMID: 34013652 DOI: 10.1111/exd.14395] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 05/06/2021] [Accepted: 05/07/2021] [Indexed: 12/25/2022]
Abstract
Venous leg ulcers are highly prevalent lower limb integumentary wounds that remain challenging to heal despite the use of evidence-based compression therapies. A multitude of adjuvant treatments has been studied but none have demonstrated enough efficacy to gain adoption into treatment guidelines. Global attention on Cannabis-Based Therapies is increasing and has been driven by quantum scientific advancements in the understanding of the endocannabinoid signalling system. Topical Cannabis-Based Medicines represent a novel treatment paradigm for venous leg ulcers in terms of promoting wound closure. Fourteen complex patients with sixteen recalcitrant leg ulcers were treated with Topical Cannabis-Based Medicines in conjunction with compression bandaging, every second day, to both wound bed and peri-wound tissues. The cohort had a mean age of 75.8 years and was medically complex as reflected by a mean M3 multimorbidity index score of 2.94 and a mean Palliative Performance Scale score of 67.1%. Complete wound closure, defined as being fully epithelialized, was achieved among 11 patients (79%) and 13 wounds (81%) within a median of 34 days. All three remaining patients demonstrated progressive healing trends but were lost to follow-up. The treatments were well tolerated, and no significant adverse reactions were experienced. The rapid wound closure of previously non-healing venous leg ulcers among elderly and highly complex patients suggests that Topical Cannabis-Based Medicines may become effective adjuvants in conjunction with compression therapy. This may also indicate that they may have an even broader role within integumentary and wound management. Therefore, this treatment paradigm warrants being subjected to controlled trials.
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Affiliation(s)
- Vincent Maida
- Division of Palliative Care, University of Toronto, Toronto, ON, Canada.,Division of Supportive & Palliative Care, William Osler Health System, Toronto, ON, Canada
| | - Runjie Bill Shi
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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10
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Kong HE, Pollack BP, Blalock TW. Cannabinoids in dermatologic surgery. J Am Acad Dermatol 2021; 85:1565-1570. [PMID: 33422628 DOI: 10.1016/j.jaad.2021.01.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 12/31/2020] [Accepted: 01/05/2021] [Indexed: 01/10/2023]
Abstract
Though known as a medicinal herb for centuries, the recent legalization of cannabinoids across many states has ushered in a new era where cannabinoids have become a popular treatment option among clinicians and patients alike. Cannabinoids have demonstrated efficacy in wound healing, reducing inflammation, ameliorating pain, and have shown potential as an antitumor agent. As a result, cannabinoids have been rapidly woven into the fabric of modern medicine. However, the utility of cannabinoids in dermatologic surgery has not been explored to date. In this article, we review the current literature to discuss the potential impact of cannabinoid use in dermatologic surgery.
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Affiliation(s)
- Ha Eun Kong
- Emory University School of Medicine, Atlanta, Georgia
| | - Brian P Pollack
- Emory University School of Medicine, Atlanta, Georgia; Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia; Department of Pathology, Emory University School of Medicine, Atlanta, Georgia; Winship Cancer Institute of Emory University School of Medicine, Atlanta, Georgia; Atlanta VA Health System, Decatur, Georgia
| | - Travis W Blalock
- Emory University School of Medicine, Atlanta, Georgia; Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia; Winship Cancer Institute of Emory University School of Medicine, Atlanta, Georgia; Atlanta VA Health System, Decatur, Georgia.
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11
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Correia-Sá IB, Carvalho CM, Serrão PV, Machado VA, Carvalho SO, Marques M, Vieira-Coelho MA. AM251, a cannabinoid receptor 1 antagonist, prevents human fibroblasts differentiation and collagen deposition induced by TGF-β - An in vitro study. Eur J Pharmacol 2020; 892:173738. [PMID: 33220269 DOI: 10.1016/j.ejphar.2020.173738] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 11/01/2020] [Accepted: 11/04/2020] [Indexed: 10/22/2022]
Abstract
Previous studies showed that cannabinoid 1 receptor (CB1) is linked with skin fibrosis and scar tissue formation in mice. Therefore, the topical use of cannabinoids may have a role in the prevention or treatment of local fibrotic and wound healing diseases as hypertrophic scars or keloids. In this study, we asked whether CB1 activation or inactivation would change fibroblast differentiation into myofibroblast and collagen deposition in skin human fibroblast. Primary cultures of adult human fibroblasts were obtained from abdominal human skin. Cells were stimulated with transforming growth factor-beta (TGF-β, 10ng/ml) and treated with a CB1 selective agonist (arachidonyl-2-chloroethylamide, ACEA 1 μM) and an antagonist (AM251 1, 5 and 10 μM). Alpha-smooth muscle actin (α-SMA) was quantified using Immunocytochemistry and Western Blot. Collagen was quantified with Sirius Red staining assay. Significance was assessed by One-way ANOVA. P < 0.05 was considered significant. TGF-β significantly increases α-SMA expression. ACEA 1 μM significantly increases collagen deposition but does not change α-SMA expression. AM251 10 μM added in the absence and the presence of ACEA reduces α-SMA expression and collagen content in TGF-β treated cells. AM251 shows a concentration-dependent effect over collagen deposition with a pIC50 of 5.5 (4.6-6.4). TGF-β significantly increases CB1 receptor expression. CB1 inactivation with AM251 prevents fibroblasts differentiation and collagen deposition, induced by TGF-β in human fibroblasts. The outcome supports that CB1 is a molecular target for wound healing disorders and in vivo and pre-clinical studies should be implemented to clarify this premise.
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Affiliation(s)
- Inês B Correia-Sá
- Department of Plastic, Reconstructive and Aesthetic Surgery and Burn Unit, Faculty of Medicine, University of Porto and Centro Hospitalar São João, EPE, Porto, Portugal; Department of Biomedicine - Pharmacology and Therapeutics Unit, Faculty of Medicine, University of Oporto, Porto, Portugal.
| | - Cláudia M Carvalho
- Department of Biomedicine - Pharmacology and Therapeutics Unit, Faculty of Medicine, University of Oporto, Porto, Portugal
| | - Paula V Serrão
- Department of Biomedicine - Pharmacology and Therapeutics Unit, Faculty of Medicine, University of Oporto, Porto, Portugal
| | - Vera A Machado
- Department of Biomedicine - Pharmacology and Therapeutics Unit, Faculty of Medicine, University of Oporto, Porto, Portugal
| | - Sofia O Carvalho
- Department of Biomedicine - Pharmacology and Therapeutics Unit, Faculty of Medicine, University of Oporto, Porto, Portugal
| | - Marisa Marques
- Department of Plastic, Reconstructive and Aesthetic Surgery and Burn Unit, Faculty of Medicine, University of Porto and Centro Hospitalar São João, EPE, Porto, Portugal
| | - Maria A Vieira-Coelho
- Department of Biomedicine - Pharmacology and Therapeutics Unit, Faculty of Medicine, University of Oporto, Porto, Portugal
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