Estrogenic effects of marijuana smoke condensate and cannabinoid compounds

The marijuana, cannabinoids, and female reproductive system

The marijuana is considered as widely used recreational illicit drug that has become popular among women of reproductive age. It is believed that the marijuana use may have negative impacts on the female fertility. However, the exact mechanisms of its reproductive toxicity remain unclear. The studies suggest that the exogenous cannabinoids may interfere with endocannabinoid system and disrupt hypothalamic-pituitary-ovary axis. Consequently, it impacts the female fertility by disruption of normal secretion of ovarian sex hormones and menstrual cycles. However, other studies have shown that medical marijuana is useful analgesic agent for pain management. But, given that the wide range of cannabinoids side effects are reported, it seems that caution should be taken in the recreational use of these substances. In summary, this article aimed to review the possible impacts of marijuana and its derivatives on the main female reproductive organs and embryonic growth and development.

Marijuana Is Associated With a Hormonal Imbalance Among Several Habits Related to Male Infertility: A Retrospective Study

Marijuana is one of the most consumed drugs worldwide. There is increasing evidence of an association between marijuana and male infertility. This study intends to assess the repercussion of marijuana smoking and other habits (sedentary lifestyle, alcohol, and tobacco use) in the testicular function of infertile men seeking andrological evaluation. A retrospective study was performed using medical records data of men aged 18-59 years from 2009 to 2017. Complete semen analyses, sperm functional tests, SHBG, and hormonal levels, testosterone-to-estradiol ratio (T/E2), and testis volume were evaluated. Exclusion criteria included cryptorchidism, infertility caused by genetic or infectious diseases, and cancer. A multiple linear regression analysis was performed to investigate which habit could predict certain parameters using the software SPSS 23.0 (P < 0.05). In a sample of 153 men, semen parameters, testosterone levels, and testis volume were not significantly influenced. Marijuana use had the broader hormonal changes since it influences estradiol (P = 0.000; B = -11.616), prolactin (P = 0.000; B = 3.211), SHBG levels (P = 0.017; B = 7.489), and T/E2 (P = 0.004; B = 14.030). Sedentary lifestyle (P = 0.028; B = 1.279) and tobacco smoking (P = 0.031; B = -2.401) influenced the prolactin levels. Marijuana is associated with hormonal imbalance in this infertile cohort by lowering estradiol levels and inhibiting aromatase function.

The Complex Interplay between Endocannabinoid System and the Estrogen System in Central Nervous System and Periphery

The endocannabinoid system (ECS) is a lipid cell signaling system involved in the physiology and homeostasis of the brain and peripheral tissues. Synaptic plasticity, neuroendocrine functions, reproduction, and immune response among others all require the activity of functional ECS, with the onset of disease in case of ECS impairment. Estrogens, classically considered as female steroid hormones, regulate growth, differentiation, and many other functions in a broad range of target tissues and both sexes through the activation of nuclear and membrane estrogen receptors (ERs), which leads to genomic and non-genomic cell responses. Since ECS function overlaps or integrates with many other cell signaling systems, this review aims at updating the knowledge about the possible crosstalk between ECS and estrogen system (ES) at both central and peripheral level, with focuses on the central nervous system, reproduction, and cancer.

A critical review on the detection, occurrence, fate, toxicity, and removal of cannabinoids in the water system and the environment

Cannabinoids are a group of organic compounds found in cannabis. Δ⁹-tetrahydrocannabinol (THC) and cannabidiol (CBD), the two major constituents of cannabinoids, and their metabolites are contaminants of emerging concern due to the limited information on their environmental impacts. As well, their releases to the water systems and environment are expected to increase due to recent legalization. Solid-phase extraction is the most common technique for the extraction and pre-concentration of cannabinoids in water samples as well as a clean-up step after the extraction of cannabinoids from solid samples. Liquid chromatography coupled with mass spectrometry is the most common technique used for the analysis of cannabinoids. THC and its metabolites have been detected in wastewater, surface water, and drinking water. In particular, 11-nor-9-carboxy-Δ⁹-tetrahydrocannabinol (THC-COOH) has been detected at concentrations up to 2590 and 169 ng L^-1 in untreated and treated wastewater, respectively, 79.9 ng L^-1 in surface water, and 1 ng L^-1 in drinking water. High removal of cannabinoids has been observed in wastewater treatment plants; this is likely a result of adsorption due to the low aqueous solubility of cannabinoids. Based on the estrogenicity and cytotoxicity studies and modelling, it has been predicted that THC and THC-COOH pose moderate risk for adverse impact on the environment. While chlorination and photo-oxidation have been shown to be effective in the removal of THC-COOH, they also produce by-products that are potentially more toxic than regulated disinfection by-products. The potential of indirect exposure to cannabinoids and their metabolites through recreational water is of great interest. As cannabinoids and especially their by-products may have adverse impacts on the environment and public health, more studies on their occurrence in various types of water and environmental systems, as well as on their environmental toxicity, would be required to accurately assess their impact on the environment and public health.

Cannabidiol (CBD) but not tetrahydrocannabinol (THC) dysregulate in vitro decidualization of human endometrial stromal cells by disruption of estrogen signaling

Decidualization, which comprises proliferation and differentiation of endometrial stromal cells (ESCs), is essential for the establishment of a receptive endometrium and pregnancy to occur. A deregulation of decidualization has been associated with miscarriage, infertility and other pregnancy-related disorders. The role of estradiol (E₂) on decidualization has already been shown, since it regulates proliferation of ESCs and expression of progesterone receptor. In this study, we investigated the effects of phytocannabinoids, tetrahydrocannabinol (THC) and cannabidiol (CBD), in proliferation and differentiation of ESCs, as well as, in E₂ metabolism/signaling. We found that CBD, but not THC, inhibits ESCs differentiation. We also show that CBD prevents the increase on transcript levels of CYP19A1 gene and the elevation of E₂ levels that are observed in differentiating ESCs. Moreover, we found that CBD presents anti-aromatase activity. In overall, we highlight a novel effect of CBD on human endometrial differentiation, which may lead to infertility problems.

Changes in IGF-I, urinary free cortisol and adipokines during dronabinol therapy in anorexia nervosa: Results from a randomised, controlled trial

OBJECTIVE

Anorexia nervosa (AN) is characterised by complex neuroendocrine disturbances due to severe underweight, physical hyperactivity and purging behaviour. Cannabinoid agonists are used to palliate cachexia of various causes, but their interactions with the hormonal systems that are involved in energy metabolism have not been previously described in humans. Therefore we found it of interest to assess interactions between the synthetic cannabinoid agonist dronabinol and insulin-like growth factor I (IGF-I), urinary free cortisol (UFC) and adipokines in patients with chronic AN.

DESIGN

This was a prospective, double-blind randomised crossover study, conducted at a specialised care centre for eating disorders. The results are based on twenty-four adult women with chronic AN, who completed the study. The participants received dronabinol (oral capsules, 5mg daily) and matching placebo over four weeks, separated by a four-week washout period. Bioactive IGF was determined by a cell-based bioassay, whereas total IGF-I, IGFBP-2 and -3 and the two adipokines leptin and adiponectines were measured by immunoassays. The UFC excretion was determined by mass spectrometry.

RESULTS

As previously reported, dronabinol treatment caused a small, yet significant increase in BMI as compared to placebo (+0.23 kg/m(2); P = 0.04). This modest weight gain predicted a corresponding increase in bioactive IGF-I, while the amount of daily energy expenditure due to physical activity had a comparable but opposite effect. Nevertheless, neither IGF-I, bioactive IGF nor the IGFBPs levels changed significantly during dronabinol intervention as compared to placebo. Adiponectin also remained unaffected by the weight gain, whereas plasma leptin showed a transient increase at three weeks (P < 0.05). UFC levels were decreased during dronabinol intervention.

CONCLUSION

Our results showed that low-dosage therapy with the synthetic cannabinoid agonist dronabinol affected neither the concentration nor the activity of the circulating IGF-system in women with severe and chronic AN. However, our results suggest that such treatment may alleviate the increased hypothalamic-pituitary-adrenal axis activity seen in these patients.

Marijuana, phytocannabinoids, the endocannabinoid system, and male fertility

Marijuana has the highest consumption rate among all of the illicit drugs used in the USA, and its popularity as both a recreational and medicinal drug is increasing especially among men of reproductive age. Male factor infertility is on the increase, and the exposure to the cannabinoid compounds released by marijuana could be a contributing cause. The endocannabinoid system (ECS) is deeply involved in the complex regulation of male reproduction through the endogenous release of endocannabinoids and binding to cannabinoid receptors. Disturbing the delicate balance of the ECS due to marijuana use can negatively impact reproductive potential. Various in vivo and in vitro studies have reported on the empirical role that marijuana plays in disrupting the hypothalamus-pituitary-gonadal axis, spermatogenesis, and sperm function such as motility, capacitation, and the acrosome reaction. In this review, we highlight the latest evidence regarding the effect of marijuana use on male fertility and also provide a detailed insight into the ECS and its significance in the male reproductive system.

It's not your mother's marijuana: effects on maternal-fetal health and the developing child

Pro-marijuana advocacy efforts exemplified by the "medical" marijuana movement, coupled with the absence of conspicuous public health messages about the potential dangers of marijuana use during pregnancy, could lead to greater use of today's more potent marijuana, which could have significant short- and long-term consequences. This article reviews the current literature regarding the effects of prenatal marijuana use on the pregnant woman and her offspring.

A global toxicogenomic analysis investigating the mechanistic differences between tobacco and marijuana smoke condensates in vitro

Like tobacco smoking, habitual marijuana smoking causes numerous adverse pulmonary effects. However, the mechanisms of action involved, especially as compared to tobacco smoke, are still unclear. To uncover putative modes of action, this study employed a toxicogenomics approach to compare the toxicological pathways perturbed following exposure to marijuana and tobacco smoke condensate in vitro. Condensates of mainstream smoke from hand-rolled tobacco and marijuana cigarettes were similarly prepared using identical smoking conditions. Murine lung epithelial cells were exposed to low, medium and high concentrations of the smoke condensates for 6h. RNA was extracted immediately or after a 4h recovery period and hybridized to mouse whole genome microarrays. Tobacco smoke condensate (TSC) exposure was associated with changes in xenobiotic metabolism, oxidative stress, inflammation, and DNA damage response. These same pathways were also significantly affected following marijuana smoke condensate (MSC) exposure. Although the effects of the condensates were largely similar, dose-response analysis indicates that the MSC is substantially more potent than TSC. In addition, steroid biosynthesis, apoptosis, and inflammation pathways were more significantly affected following MSC exposure, whereas M phase cell cycle pathways were more significantly affected following TSC exposure. MSC exposure also appeared to elicit more severe oxidative stress than TSC exposure, which may account for the greater cytotoxicity of MSC. This study shows that in general MSC impacts many of the same molecular processes as TSC. However, subtle pathway differences can provide insight into the differential toxicities of the two complex mixtures.

Estrogenic effects and their action mechanism of the major active components of party pill drugs

Benzylpiperazine (BZP) and trifluoromethylphenylpiperazine (TFMPP) are commonly used constituents of party pill drugs. They are reported to induce psychoactive effects such as euphoria and provide effects similar with other illicit drugs such as methylenedioxymethamphetamine (MDMA). A great deal of evidence has proven that party pills, as alternatives for MDMA, exert harmful effects on users. However, their toxicological effects have not been fully understood and endocrine disruptive effects are still unknown. In this study, we identified estrogenic effects of BZP and TFMPP by using in vitro and in vivo assays. BZP and TFMPP stimulated cell proliferation in a dose-dependent manner, while co-treatment with tamoxifen and BZP or TFMPP showed a decrease of E(2)-induced cell proliferation. In an estrogen sensitive reporter gene assay, BZP and TFMPP significantly increased transcriptional activities of party pill drugs. In addition, ER-related genes, PR and pS2, were significantly stimulated by BZP and TFMPP. These results indicated that BZP and TFMPP could have estrogenic activities related to the ER-mediated pathway. Unlike the in vitro assay results, BZP and TFMPP did not show significant effects on weight increase in a rodent uterotrophic assay. However, further studies would be necessary to verify the estrogenic activities of BZP and TFMPP by a chronic exposure animal study.

Association of marijuana use and the incidence of testicular germ cell tumors

BACKGROUND

The incidence of testicular germ cell tumors (TGCTs) has been increasing the past 4 to 6 decades; however, exposures that account for this rise have not been identified. Marijuana use also grew during the same period, and it has been established that chronic marijuana use produces adverse effects on the human endocrine and reproductive systems. In this study, the authors tested the hypothesis that marijuana use is a risk factor for TGCT.

METHODS

A population-based, case-control study of 369 men ages 18 to 44 years who were diagnosed with TGCT from January 1999 through January 2006 was conducted in King, Pierce and Snohomish Counties in Washington State. The responses of these men to questions on their lifetime marijuana use were compared with the responses of 979 age-matched controls who resided in the same 3 counties during the case diagnosis period.

RESULTS

Men with a TGCT were more likely to be current marijuana smokers at the reference date compared with controls (odds ratio [OR], 1.7; 95% confidence interval [95% CI], 1.1-2.5). In analyses according to histologic type, most of the association between current marijuana use and TGCT was observed in men who had nonseminomas/mixed histology tumors (current use: OR, 2.3; 95% CI, 1.3-4.0). Age at first use among current users (age<18 years [OR, 2.8] vs age>or=18 years [OR, 1.3]) and frequency of use (daily or weekly [OR, 3.0] vs less than once per week [OR, 1.8]) appeared to modify the risk.

CONCLUSIONS

An association was observed between marijuana use and the occurrence of nonseminoma TGCTs. Additional studies of TGCTs will be needed to test this hypothesis, including molecular analyses of cannabinoid receptors and endocannabinoid signaling, which may provide clues regarding the biologic mechanisms of TGCTs.

Cannabis smoke condensate I: the effect of different preparation methods on tetrahydrocannabinol levels

Cannabis sativa contains more than 400 known compounds, of which the terpene chemicals, called cannabinoids, are unique to this species. The cannabinoids, which occur as the corresponding acids in the plant material, are the major psychoactive components in this species. The compounds are decarboxylated from the inactive acidic form into the active form by means of smoking. Previous research has made use of the tobacco industry's standard method and adaptations thereof to produce a cannabis smoke condensate. In this study the method of smoke production, which includes the puff frequency, puff length, and puff volume, was tested and the concentration of the major cannabinoid, Delta(9)-tetrahydrocannabinol (THC), and the amount of by-products produced under the different conditions were quantified. This study aimed at combining the existing methodology and at providing quantitative results on the influence of the preparation method on the concentration of THC in the smoke. The results indicate that the method of smoke production influences the amount of THC produced (e.g., longer puff length yielding a higher amount of THC). The THC concentration in the smoke condensate varied between 22.17 mg/g of cannabis and 54.00 mg/g, while the amount of by-products produced varied between 25.57 mg/g and 107.40 mg/g.