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Begum T, Arzmi MH, Khatib A, Uddin ABMH, Aisyah Abdullah M, Rullah K, Mat So'ad SZ, Zulaikha Haspi NF, Nazira Sarian M, Parveen H, Mukhtar S, Ahmed QU. A review on Mitragyna speciosa (Rubiaceae) as a prominent medicinal plant based on ethnobotany, phytochemistry and pharmacological activities. Nat Prod Res 2024:1-17. [PMID: 38923960 DOI: 10.1080/14786419.2024.2371564] [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: 11/10/2023] [Accepted: 06/19/2024] [Indexed: 06/28/2024]
Abstract
Mitragyna speciosa Korth (kratom) is a tropical indigenous tree of Southeast Asia. It is commonly consumed by the people due to its various pharmacological properties. The leaves of this plant are traditionally used for the treatment of several diseases including pain, fever, cough, anxiety, depression, obesity, diarrhoea, wound healing, diabetes, hypertension as well as for the prevention of cancer and improvement of sexual performance. Phytochemical investigations have confirmed the presence of more than forty alkaloids along with the presence of other bioactive secondary metabolites. Among the alkaloids isolated, mitragynine and 7-hydroxymitragynine along with their derivatives have been widely evaluated and reported to possess various pharmacological effects. Hence, the aim of this review is to shed light on the traditional uses of kratom and the scientific studies to justify the folkloric claims and active principles responsible for the various medicinal effects associated with the leaves of this plant. This review highlights the potential benefits and toxicities associated with M. speciosa leaves along with the phytochemistry. Moreover, the existing gaps in the field of M. speciosa study have been identified along with the future directions to further avail the benefits of this plant species.
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Affiliation(s)
- Taslima Begum
- Drug Discovery and Synthetic Chemistry Research Group, Department of Pharmaceutical Chemistry, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
| | - Mohd Hafiz Arzmi
- Department of Fundamental Dental and Medical Sciences, Kulliyyah of Dentistry, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
- Cluster of Cancer Research Initiative IIUM (COCRII), International Islamic University Malaysia, Kuantan, Pahang, Malaysia
- Melbourne Dental School, The University of Melbourne, Victoria, Australia
| | - Alfi Khatib
- Drug Discovery and Synthetic Chemistry Research Group, Department of Pharmaceutical Chemistry, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
| | - A B M Helal Uddin
- Drug Discovery and Synthetic Chemistry Research Group, Department of Pharmaceutical Chemistry, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
| | - Maryam Aisyah Abdullah
- Drug Discovery and Synthetic Chemistry Research Group, Department of Pharmaceutical Chemistry, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
| | - Kamal Rullah
- Drug Discovery and Synthetic Chemistry Research Group, Department of Pharmaceutical Chemistry, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
| | - Siti Zaiton Mat So'ad
- Drug Discovery and Synthetic Chemistry Research Group, Department of Pharmaceutical Chemistry, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
| | - Nur Fatihah Zulaikha Haspi
- Drug Discovery and Synthetic Chemistry Research Group, Department of Pharmaceutical Chemistry, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
| | - Murni Nazira Sarian
- Institute of Systems Biology (INBIOSIS), Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
| | - Humaira Parveen
- Department of Chemistry, Faculty of Science, University of Tabuk, Tabuk, Kingdom of Saudi Arabia
| | - Sayeed Mukhtar
- Department of Chemistry, Faculty of Science, University of Tabuk, Tabuk, Kingdom of Saudi Arabia
| | - Qamar Uddin Ahmed
- Drug Discovery and Synthetic Chemistry Research Group, Department of Pharmaceutical Chemistry, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
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Bowe A, Kerr PL. Endogenous Opioid Activity as the Mechanism of Action for Mitragyna speciosa (Kratom): The Current State of the Evidence. ADVANCES IN NEUROBIOLOGY 2024; 35:287-313. [PMID: 38874729 DOI: 10.1007/978-3-031-45493-6_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
Kratom (Mitragyna speciosa) is a substance derived from botanical compounds native to Southeast Asia. This substance has been cultivated predominantly in Thailand, Malaysia, Vietnam, and Myanmar, where it has historically been used in traditional medicine as a near panacea for several health problems. Such ritualistic use of kratom has been present for centuries; however, recreational use appears to have increased globally, especially in the United States. Pharmacodynamic and pharmacokinetic studies have found that kratom demonstrates a unique parabolic, dose-dependent pattern of effects ranging from stimulation to opioid and analgesic effects. Pharmacological research indicates that kratom is both a mu opioid receptor (μ-OR; MOR) and a kappa opioid receptor (κ-OR; KOR) agonist, which mediates its analgesic effects. Other research suggests that kratom may simultaneously act on dopaminergic and serotonergic receptors, which mediate its stimulant effects. This chapter reviews the literature related to the structural, functional, and cultural characteristics of kratom use. We begin with an overview of current and historical patterns of kratom, followed by a review of data on the pharmacodynamics and pharmacokinetics of kratom thus far.
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MESH Headings
- Mitragyna
- Humans
- Plant Extracts/pharmacology
- Animals
- Receptors, Opioid, kappa/metabolism
- Receptors, Opioid, kappa/agonists
- Analgesics, Opioid/pharmacology
- Analgesics, Opioid/therapeutic use
- Receptors, Opioid, mu/metabolism
- Receptors, Opioid, mu/agonists
- Asia, Southeastern
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Affiliation(s)
- Adina Bowe
- West Virginia University School of Medicine-Charleston, Charleston, WV, USA.
| | - Patrick L Kerr
- West Virginia University School of Medicine-Charleston, Charleston, WV, USA
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Penzak SR, Durham SH, Phillippe HM, Fox BI. Knowledge of Kratom among Alabama Pharmacists. PHARMACY 2023; 12:6. [PMID: 38251400 PMCID: PMC10801507 DOI: 10.3390/pharmacy12010006] [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: 12/07/2023] [Revised: 12/19/2023] [Accepted: 12/28/2023] [Indexed: 01/23/2024] Open
Abstract
Kratom (Mitragyna speciosa) is a botanical substance whose leaves produce stimulant- and opioid-like effects. Kratom use has increased precipitously in the United States (U.S.) over the last decade, yet, in our experience, many pharmacists are unfamiliar with this herb. The purpose of this study was to assess pharmacists' awareness and knowledge of kratom. This cross-sectional study used an online questionnaire to preferentially solicit community pharmacists' knowledge of kratom and collect demographic information. The survey was sent via email to approximately 10,000 pharmacists, targeting those in the state of Alabama, U.S. Data were analyzed using descriptive statistics, and the Chi Square test was used to compare nominal data. A total of 257 participants responded to the survey. Almost 50% of participants had heard of kratom, and 50% had not. Compared to females, males were more likely to have heard of kratom (64% vs. 42%; p = 0.0015), as were pharmacists who worked for an independent pharmacy vs. a chain (61% vs. 41%; p = 0.025). Of the participants who had heard of kratom, only 14% considered themselves knowledgeable or very knowledgeable about the herb, and only 44% knew it was illegal in Alabama. These data indicate a need to further kratom education among community pharmacists in Alabama.
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Affiliation(s)
- Scott R. Penzak
- Department of Pharmacy Practice, Harrison College of Pharmacy, Auburn University, Auburn, AL 36849-5502, USA; (S.H.D.); (H.M.P.)
| | - Spencer H. Durham
- Department of Pharmacy Practice, Harrison College of Pharmacy, Auburn University, Auburn, AL 36849-5502, USA; (S.H.D.); (H.M.P.)
| | - Haley M. Phillippe
- Department of Pharmacy Practice, Harrison College of Pharmacy, Auburn University, Auburn, AL 36849-5502, USA; (S.H.D.); (H.M.P.)
| | - Brent I. Fox
- Department of Health Outcomes and Research Policy, Harrison College of Pharmacy, Auburn University, Auburn, AL 36849-5502, USA;
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Hossain R, Sultana A, Nuinoon M, Noonong K, Tangpong J, Hossain KH, Rahman MA. A Critical Review of the Neuropharmacological Effects of Kratom: An Insight from the Functional Array of Identified Natural Compounds. Molecules 2023; 28:7372. [PMID: 37959790 PMCID: PMC10648626 DOI: 10.3390/molecules28217372] [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: 09/17/2023] [Revised: 10/19/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023] Open
Abstract
Kratom (Mitragyna speciosa Korth. Havil) has been considered a narcotic drug for years, barred by the law in many parts of the world, while extensive research over the past few decades proves its several beneficial effects, some of which are still in ambiguity. In many countries, including Thailand, the indiscriminate use and abuse of kratom have led to the loss of life. Nonetheless, researchers have isolated almost fifty pure compounds from kratom, most of which are alkaloids. The most prevalent compounds, mitragynine and 7-hydroxy mitragynine, are reported to display agonist morphine-like effects on human μ-opioid receptors and antagonists at κ- and δ-opioid receptors with multimodal effects at other central receptors. Mitragynine is also credited to be one of the modulatory molecules for the Keap1-Nrf2 pathway and SOD, CAT, GST, and associated genes' upregulatory cascades, leading it to play a pivotal role in neuroprotective actions while evidently causing neuronal disorders at high doses. Additionally, its anti-inflammatory, antioxidative, antibacterial, and gastroprotective effects are well-cited. In this context, this review focuses on the research gap to resolve ambiguities about the neuronal effects of kratom and demonstrate its prospects as a therapeutic target for neurological disorders associated with other pharmacological effects.
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Affiliation(s)
- Rahni Hossain
- School of Allied Health Sciences, College of Graduate Studies, Walailak University, Nakhon Si Thammarat 80160, Thailand; (R.H.); (M.N.); (K.N.)
- Research Excellence Center for Innovation and Health Product (RECIHP), Walailak University, Nakhon Si Thammarat 80160, Thailand
| | - Abida Sultana
- Department of Biochemistry & Molecular Biology, University of Chittagong, Chittagong 4331, Bangladesh;
| | - Manit Nuinoon
- School of Allied Health Sciences, College of Graduate Studies, Walailak University, Nakhon Si Thammarat 80160, Thailand; (R.H.); (M.N.); (K.N.)
- Hematology and Transfusion Science Research Center, Walailak University, Nakhon Si Thammarat 80160, Thailand
| | - Kunwadee Noonong
- School of Allied Health Sciences, College of Graduate Studies, Walailak University, Nakhon Si Thammarat 80160, Thailand; (R.H.); (M.N.); (K.N.)
- Research Excellence Center for Innovation and Health Product (RECIHP), Walailak University, Nakhon Si Thammarat 80160, Thailand
| | - Jitbanjong Tangpong
- School of Allied Health Sciences, College of Graduate Studies, Walailak University, Nakhon Si Thammarat 80160, Thailand; (R.H.); (M.N.); (K.N.)
- Research Excellence Center for Innovation and Health Product (RECIHP), Walailak University, Nakhon Si Thammarat 80160, Thailand
| | - Kazi Helal Hossain
- Angiogenesis and Brain Development Laboratory, Department of Neurosciences, Huntington Medical Research Institutes (HMRI), Pasadena, CA 91105, USA;
| | - Md Atiar Rahman
- School of Allied Health Sciences, College of Graduate Studies, Walailak University, Nakhon Si Thammarat 80160, Thailand; (R.H.); (M.N.); (K.N.)
- Department of Biochemistry & Molecular Biology, University of Chittagong, Chittagong 4331, Bangladesh;
- Research Excellence Center for Innovation and Health Product (RECIHP), Walailak University, Nakhon Si Thammarat 80160, Thailand
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Ortiz YT, Bilbrey JA, Felix JS, Kienegger EA, Mottinelli M, Mukhopadhyay S, McCurdy CR, McMahon LR, Wilkerson JL. Cannabidiol and mitragynine exhibit differential interactive effects in the attenuation of paclitaxel-induced mechanical allodynia, acute antinociception, and schedule-controlled responding in mice. Pharmacol Rep 2023; 75:937-950. [PMID: 37243887 DOI: 10.1007/s43440-023-00498-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/12/2023] [Accepted: 05/15/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND For many chemotherapy patients peripheral neuropathy is a debilitating side effect. Mitragyna speciosa (kratom) contains the alkaloid mitragynine (MG), which produces analgesia in multiple preclinical pain models. In humans, anecdotal reports suggest cannabidiol (CBD) may enhance kratom-related analgesia. We examined the interactive activity of MG and CBD in a mouse chemotherapy-induced peripheral neuropathy (CIPN) model. We also examined MG + CBD in acute antinociception and schedule-controlled responding assays, as well as examined underlying receptor mechanisms. METHODS Male and female C57BL/6J mice received a cycle of intraperitoneal (ip) paclitaxel injections (cumulative dose 32 mg/kg). The von Frey assay was utilized to assess CIPN allodynia. In paclitaxel-naïve mice, schedule-controlled responding for food was conducted under a fixed ratio (FR)-10, and hot plate antinociception was examined. RESULTS MG dose-relatedly attenuated CIPN allodynia (ED50 102.96 mg/kg, ip), reduced schedule-controlled responding (ED50 46.04 mg/kg, ip), and produced antinociception (ED50 68.83 mg/kg, ip). CBD attenuated allodynia (ED50 85.14 mg/kg, ip) but did not decrease schedule-controlled responding or produce antinociception. Isobolographic analysis revealed 1:1, 3:1 MG + CBD mixture ratios additively attenuated CIPN allodynia. All combinations decreased schedule-controlled responding and produced antinociception. WAY-100635 (serotonin 5-HT1A receptor antagonist) pretreatment (0.01 mg/kg, ip) antagonized CBD anti-allodynia. Naltrexone (pan opioid receptor antagonist) pretreatment (0.032 mg/kg, ip) antagonized MG anti-allodynia and acute antinociception but produced no change in MG-induced decreased schedule-controlled behavior. Yohimbine (α2 receptor antagonist) pretreatment (3.2 mg/kg, ip) antagonized MG anti-allodynia and produced no change in MG-induced acute antinociception or decreased schedule-controlled behavior. CONCLUSIONS Although more optimization is needed, these data suggest CBD combined with MG may be useful as a novel CIPN therapeutic.
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Affiliation(s)
- Yuma T Ortiz
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, USA
- Department of Pharmaceutical Sciences, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center, 1406 S. Coulter., Amarillo, TX, 79106, USA
| | - Joshua A Bilbrey
- College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - Jasmine S Felix
- College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - Erik A Kienegger
- College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - Marco Mottinelli
- Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL, USA
- Department of Chemistry and Chemical Biology, College of Science, Northeastern University, Boston, MA, USA
| | - Sushobhan Mukhopadhyay
- Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - Christopher R McCurdy
- Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - Lance R McMahon
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, USA
- Department of Pharmaceutical Sciences, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center, 1406 S. Coulter., Amarillo, TX, 79106, USA
| | - Jenny L Wilkerson
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, USA.
- Department of Pharmaceutical Sciences, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center, 1406 S. Coulter., Amarillo, TX, 79106, USA.
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Mat NH, Bakar SNS, Murugaiyah V, Chawarski MC, Hassan Z. Analgesic effects of main indole alkaloid of kratom, mitragynine in acute pain animal model. Behav Brain Res 2023; 439:114251. [PMID: 36503042 DOI: 10.1016/j.bbr.2022.114251] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 09/22/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022]
Abstract
Mitragynine exerts its analgesic effect mainly via opioid receptors activation. Additionally, the effect may be mediated via mitragynine's anti-inflammatory property and non-opioid receptor pain pathways, namely through the TRPV1 receptor. No studies identify hitherto, hence, the current study aimed to investigate the mitragynine's analgesic effect via the anti-inflammatory property, non-opioid receptor (TRPV1) and the effective dose (ED) to alleviate pain. Male and female Sprague Dawley rats were pre-treated intraperitoneally with either mitragynine (1, 5, 10, 13, 15 or 30 mg/kg), vehicle, or indomethacin (1 mg/kg) 30 min before inducing inflammatory pain using acetic acid. The writhes and pain-related withdrawal behaviour occurrence were counted within a 1-h duration. Percentage of writhes inhibition, pain-related withdrawal behaviour aggregate, ED50 and ED95 were determined. The body temperature was recorded and TRPV1 expression in the rats' brains was measured. Mitragynine (except 1 mg/kg) significantly reduced the number of writhes compared with the vehicle administered group. Mitragynine (30 mg/kg) demonstrated 99.5% inhibition of writhing behaviour and low withdrawal behaviour score compared with vehicle and indomethacin and successfully blocked the hypothermia induced by acetic acid. The overall ED50 and ED95 values of mitragynine were 3.62 and 20.84 mg/kg, respectively. The percentage of writhing inhibition and withdrawal behaviour were similar in both genders. Mitragynine (15 and 30 mg/kg) significantly reduced the TRPV1 expression in the brain of the rats. Mitragynine alleviated pain-like behaviour and showed analgesic effects via anti-inflammatory and non-opioid receptor pathways. The findings also suggest that mitragynine might regulate some physiological functions of the rat.
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Affiliation(s)
- Noorul Hamizah Mat
- Centre for Drug Research, Universiti Sains Malaysia, 11800 Penang, Malaysia
| | | | - Vikneswaran Murugaiyah
- Centre for Drug Research, Universiti Sains Malaysia, 11800 Penang, Malaysia; Discipline of Pharmacology, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Penang, Malaysia
| | - Marek C Chawarski
- Departments of Psychiatry and Emergency Medicine, Yale School of Medicine, New Haven, CT, United States
| | - Zurina Hassan
- Centre for Drug Research, Universiti Sains Malaysia, 11800 Penang, Malaysia.
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Veeramohan R, Zamani AI, Azizan KA, Goh HH, Aizat WM, Razak MFA, Yusof NSM, Mansor SM, Baharum SN, Ng CL. Comparative metabolomics analysis reveals alkaloid repertoires in young and mature Mitragyna speciosa (Korth.) Havil. Leaves. PLoS One 2023; 18:e0283147. [PMID: 36943850 PMCID: PMC10030037 DOI: 10.1371/journal.pone.0283147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 03/02/2023] [Indexed: 03/23/2023] Open
Abstract
The fresh leaves of Mitragyna speciosa (Korth.) Havil. have been traditionally consumed for centuries in Southeast Asia for its healing properties. Although the alkaloids of M. speciosa have been studied since the 1920s, comparative and systematic studies of metabolite composition based on different leaf maturity levels are still lacking. This study assessed the secondary metabolite composition in two different leaf stages (young and mature) of M. speciosa, using an untargeted liquid chromatography-electrospray ionisation-time-of-flight-mass spectrometry (LC-ESI-TOF-MS) metabolite profiling. The results revealed 86 putatively annotated metabolite features (RT:m/z value) comprising 63 alkaloids, 10 flavonoids, 6 terpenoids, 3 phenylpropanoids, and 1 of each carboxylic acid, glucoside, phenol, and phenolic aldehyde. The alkaloid features were further categorised into 14 subclasses, i.e., the most abundant class of secondary metabolites identified. As per previous reports, indole alkaloids are the most abundant alkaloid subclass in M. speciosa. The result of multivariate analysis (MVA) using principal component analysis (PCA) showed a clear separation of 92.8% between the young and mature leaf samples, indicating a high variance in metabolite levels between them. Akuammidine, alstonine, tryptamine, and yohimbine were tentatively identified among the many new alkaloids reported in this study, depicting the diverse biological activities of M. speciosa. Besides delving into the knowledge of metabolite distribution in different leaf stages, these findings have extended the current alkaloid repository of M. speciosa for a better understanding of its pharmaceutical potential.
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Affiliation(s)
- Rubashiny Veeramohan
- Institute of Systems Biology, Universiti Kebangsaan Malaysia, UKM Bangi, Selangor, Malaysia
| | - Arief Izzairy Zamani
- Institute of Systems Biology, Universiti Kebangsaan Malaysia, UKM Bangi, Selangor, Malaysia
- Leave a Nest Malaysia Sdn Bhd, Cyberjaya, Selangor, Malaysia
| | - Kamalrul Azlan Azizan
- Institute of Systems Biology, Universiti Kebangsaan Malaysia, UKM Bangi, Selangor, Malaysia
| | - Hoe-Han Goh
- Institute of Systems Biology, Universiti Kebangsaan Malaysia, UKM Bangi, Selangor, Malaysia
| | - Wan Mohd Aizat
- Institute of Systems Biology, Universiti Kebangsaan Malaysia, UKM Bangi, Selangor, Malaysia
| | - Mohd Fauzi Abd Razak
- Institute of Systems Biology, Universiti Kebangsaan Malaysia, UKM Bangi, Selangor, Malaysia
| | | | | | | | - Chyan Leong Ng
- Institute of Systems Biology, Universiti Kebangsaan Malaysia, UKM Bangi, Selangor, Malaysia
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Basheer M, Khudhair Jasim R, Harn GL. Controversial usages of kratom ( Mitragyna speciosa): For good or for evil. World J Pharmacol 2022; 11:16-26. [DOI: 10.5497/wjp.v11.i3.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/04/2022] [Accepted: 11/23/2022] [Indexed: 11/28/2022] Open
Abstract
Kratom (Mitragyna speciosa) is a plant that grows well in tropical climates such as in Southeast Asia. Traditionally, people discovered it possessed a stimulating effect that relieved tiredness. Furthermore, it contains analgesic and medicinal properties for the treatment of pain, diarrhea, muscle discomfort, and blood pressure and to enhance stamina. Nevertheless, long term or regular consumption of kratom leads to addiction. This is because the main alkaloid of kratom, mitragynine, binds to opioid receptors and exerts a euphoric effect similar to that of morphine, which may lead to death. Due to this reason, kratom has been listed as a regulated substance in many countries including the United States, Thailand, Malaysia, Bhutan, Finland, Lithuania, Denmark, Poland, Sweden, Australia, and Myanmar. Usages of kratom carry two pharmacological effects depending on dosage. Low-dose kratom exerts a stimulating effect that refreshes the user. High-dose kratom exerts sedative effects that can lead to addiction similar to that of morphine. Despite the euphoric effect of kratom, the beneficial values of kratom to human health is indisputable. Therefore, a complete banning of kratom may cause a loss to pharmaceutical industry. Rather, a controlled or selective usage of kratom will be a better choice.
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Affiliation(s)
- Murtadha Basheer
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Minden 11800, Penang, Malaysia
| | - Rana Khudhair Jasim
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Minden 11800, Penang, Malaysia
| | - Gam Lay Harn
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Minden 11800, Penang, Malaysia
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Stanciu C, Ahmed S, Gnanasegaram S, Gibson S, Penders T, Grundmann O, McCurdy C. Kratom as an opioid alternative: harm, or harm reduction? A systematic review of literature. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2022; 48:509-528. [PMID: 36001875 DOI: 10.1080/00952990.2022.2111685] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Background: Kratom (Mitragyna speciosa Korth.) products are increasingly endorsed for self-management of multiple ailments, including as opioid substitution. The FDA has expressed that there is no evidence to indicate that this botanical is safe or effective for any medical use.Objective: We systematically review the current state of the literature concerning the impact of kratom and its alkaloids in all paradigms that involve opioids.Methods: A keyword search of online literature databases identified 16 preclinical studies, 25 case reports, and 10 observational studies meeting our pre-selected criteria.Results: All rodent models support alkaloids' action on opioid receptors, translating in their ability to mitigate opioid withdrawal. Some studies found mitragynine (MG) to have less reinforcing properties than morphine, and possessing tolerance-sparing properties when coadministered with morphine. Two studies that assessed 7-hydroxymitragynine (7OHMG) found it to substitute for morphine with potential for tolerance and dependence. Aside from addiction development, case reports outline a variety of confounding toxicities. Ten surveys of users, some conducted with assistance from pro-kratom lobbying organizations, find a high self-reported efficacy as an opioid substitute, with minimal reported adverse effects.Conclusion: With no reported controlled human clinical trials, in the light of rising concerns surrounding kratom's liabilities, there is insufficient evidence to allow any conclusions to be drawn. Case reports and observational studies carry significant bias toward harm and efficacy, respectively. Existing animal studies are heterogeneous in methodology and ultimately findings, with concern for interspecies variability and human translatability. Further research should investigate the safety and efficacy of using kratom alkaloids as opioid substitutes.
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Affiliation(s)
- Cornel Stanciu
- New Hampshire Hospital, Psychiatry at Dartmouth's Geisel School of Medicine, Concord, NH, USA
| | - Saeed Ahmed
- Department of Psychiatry, Rutland Regional Medical Centre, Rutland, VT, USA
| | | | - Stephen Gibson
- Pharmacy Department, New Hampshire Hospital, Concord, NH, USA
| | - Thomas Penders
- Department of Addiction, Brody School of Medicine, East Carolina University, Greenville, NC, USA
| | - Oliver Grundmann
- Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - Christopher McCurdy
- Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL, USA
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Ahmad I, Prabowo WC, Arifuddin M, Fadraersada J, Indriyanti N, Herman H, Purwoko RY, Nainu F, Rahmadi A, Paramita S, Kuncoro H, Mita N, Narsa AC, Prasetya F, Ibrahim A, Rijai L, Alam G, Mun’im A, Dej-adisai S. Mitragyna Species as Pharmacological Agents: From Abuse to Promising Pharmaceutical Products. Life (Basel) 2022; 12:life12020193. [PMID: 35207481 PMCID: PMC8878704 DOI: 10.3390/life12020193] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 01/13/2022] [Indexed: 01/07/2023] Open
Abstract
Mitragyna is a genus belonging to the Rubiaceae family and is a plant endemic to Asia and Africa. Traditionally, the plants of this genus were used by local people to treat some diseases from generation to generation. Mitragyna speciosa (Korth.) Havil. is a controversial plant from this genus, known under the trading name “kratom”, and contains more than 40 different types of alkaloids. Mitragynine and 7-hydroxymitragynine have agonist morphine-like effects on opioid receptors. Globally, Mitragyna plants have high economic value. However, regulations regarding the circulation and use of these commodities vary in several countries around the world. This review article aims to comprehensively examine Mitragyna plants (mainly M. speciosa) as potential pharmacological agents by looking at various aspects of the plants. A literature search was performed and information collected using electronic databases including Scopus, ScienceDirect, PubMed, directory open access journal (DOAJ), and Google Scholar in early 2020 to mid-2021. This narrative review highlights some aspects of this genus, including historical background and botanical origins, habitat, cultivation, its use in traditional medicine, phytochemistry, pharmacology and toxicity, abuse and addiction, legal issues, and the potential of Mitragyna species as pharmaceutical products.
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Affiliation(s)
- Islamudin Ahmad
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Universitas Mulawarman, Samarinda 75119, Indonesia; (M.A.); (J.F.); (N.I.); (N.M.)
- Pharmaceutical Research and Development Laboratory of FARMAKA TROPIS, Faculty of Pharmacy, Universitas Mulawarman, Samarinda 75119, Indonesia; (W.C.P.); (H.H.); (H.K.); (A.C.N.); (F.P.); (A.I.); (L.R.)
- Correspondence:
| | - Wisnu Cahyo Prabowo
- Pharmaceutical Research and Development Laboratory of FARMAKA TROPIS, Faculty of Pharmacy, Universitas Mulawarman, Samarinda 75119, Indonesia; (W.C.P.); (H.H.); (H.K.); (A.C.N.); (F.P.); (A.I.); (L.R.)
| | - Muhammad Arifuddin
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Universitas Mulawarman, Samarinda 75119, Indonesia; (M.A.); (J.F.); (N.I.); (N.M.)
| | - Jaka Fadraersada
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Universitas Mulawarman, Samarinda 75119, Indonesia; (M.A.); (J.F.); (N.I.); (N.M.)
| | - Niken Indriyanti
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Universitas Mulawarman, Samarinda 75119, Indonesia; (M.A.); (J.F.); (N.I.); (N.M.)
| | - Herman Herman
- Pharmaceutical Research and Development Laboratory of FARMAKA TROPIS, Faculty of Pharmacy, Universitas Mulawarman, Samarinda 75119, Indonesia; (W.C.P.); (H.H.); (H.K.); (A.C.N.); (F.P.); (A.I.); (L.R.)
| | | | - Firzan Nainu
- Faculty of Pharmacy, Hasanuddin University, Makassar 90245, Indonesia; (F.N.); (G.A.)
| | - Anton Rahmadi
- Department of Agricultural Product Technology, Faculty of Agriculture, Universitas Mulawarman, Samarinda 75119, Indonesia;
| | - Swandari Paramita
- Research Center of Natural Products from Tropical Rainforest (PUI-PT OKTAL), Department of Community Medicine, Faculty of Medicine, Universitas Mulawarman, Samarinda 75119, Indonesia;
| | - Hadi Kuncoro
- Pharmaceutical Research and Development Laboratory of FARMAKA TROPIS, Faculty of Pharmacy, Universitas Mulawarman, Samarinda 75119, Indonesia; (W.C.P.); (H.H.); (H.K.); (A.C.N.); (F.P.); (A.I.); (L.R.)
| | - Nur Mita
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Universitas Mulawarman, Samarinda 75119, Indonesia; (M.A.); (J.F.); (N.I.); (N.M.)
| | - Angga Cipta Narsa
- Pharmaceutical Research and Development Laboratory of FARMAKA TROPIS, Faculty of Pharmacy, Universitas Mulawarman, Samarinda 75119, Indonesia; (W.C.P.); (H.H.); (H.K.); (A.C.N.); (F.P.); (A.I.); (L.R.)
| | - Fajar Prasetya
- Pharmaceutical Research and Development Laboratory of FARMAKA TROPIS, Faculty of Pharmacy, Universitas Mulawarman, Samarinda 75119, Indonesia; (W.C.P.); (H.H.); (H.K.); (A.C.N.); (F.P.); (A.I.); (L.R.)
| | - Arsyik Ibrahim
- Pharmaceutical Research and Development Laboratory of FARMAKA TROPIS, Faculty of Pharmacy, Universitas Mulawarman, Samarinda 75119, Indonesia; (W.C.P.); (H.H.); (H.K.); (A.C.N.); (F.P.); (A.I.); (L.R.)
| | - Laode Rijai
- Pharmaceutical Research and Development Laboratory of FARMAKA TROPIS, Faculty of Pharmacy, Universitas Mulawarman, Samarinda 75119, Indonesia; (W.C.P.); (H.H.); (H.K.); (A.C.N.); (F.P.); (A.I.); (L.R.)
| | - Gemini Alam
- Faculty of Pharmacy, Hasanuddin University, Makassar 90245, Indonesia; (F.N.); (G.A.)
| | - Abdul Mun’im
- Laboratory of Pharmacognosy-Phytochemistry, Faculty of Pharmacy, Universitas Indonesia, Depok 16424, Indonesia;
| | - Sukanya Dej-adisai
- Department of Pharmacognosy and Pharmaceutical Botany, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hat-Yai, Songkhla 90110, Thailand;
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11
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Hiranita T, Obeng S, Sharma A, Wilkerson JL, McCurdy CR, McMahon LR. In vitro and in vivo pharmacology of kratom. ADVANCES IN PHARMACOLOGY (SAN DIEGO, CALIF.) 2021; 93:35-76. [PMID: 35341571 DOI: 10.1016/bs.apha.2021.10.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Kratom products have been historically and anecdotally used in south Asian countries for centuries to manage pain and opioid withdrawal. The use of kratom products has dramatically increased in the United States. More than 45 kratom alkaloids have been isolated, yet the overall pharmacology of the individual alkaloids is still not well characterized. The purpose of this chapter is to summarize in vitro and in vivo opioid activities of the primary kratom alkaloid mitragynine and its more potent metabolite 7-hydroxymitragynine. Following are experimental procedures described to characterize opioid receptor activity; receptor binding and functional assays, antinociceptive assays, operant conditioning assays, and respiratory plethysmography. The capacity of kratom alkaloids to confer tolerance and physical dependence as well as their pharmacokinetic properties are also summarized. The data reviewed here suggest that kratom products and mitragynine possess low efficacy agonist activity at the mu-opioid receptor in vivo. In addition, kratom products and mitragynine have been demonstrated to antagonize the effects of high efficacy mu-opioid agonists. The data further suggest that 7-hydroxymitragynine formed in vivo by metabolism of mitragynine may be minimally involved in the overall behavioral profile of mitragynine and kratom, whereas 7-hydroxymitragynine itself, at sufficiently high doses administered exogenously, shares many of the same abuse- and dependence-related behavioral effects associated with traditional opioid agonists. The apparent low efficacy of kratom products and mitragynine at mu-opioid receptors supports the development of these ligands as effective and potentially safe medications for opioid use disorder.
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Affiliation(s)
- Takato Hiranita
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, United States
| | - Samuel Obeng
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, United States; Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL, United States
| | - Abhisheak Sharma
- Department of Pharmaceutics, College of Pharmacy, University of Florida, Gainesville, FL, United States; Translational Drug Development Core, Clinical and Translational Sciences Institute, College of Pharmacy, University of Florida, Gainesville, FL, United States
| | - Jenny L Wilkerson
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, United States
| | - Christopher R McCurdy
- Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL, United States; Department of Pharmaceutics, College of Pharmacy, University of Florida, Gainesville, FL, United States; Translational Drug Development Core, Clinical and Translational Sciences Institute, College of Pharmacy, University of Florida, Gainesville, FL, United States
| | - Lance R McMahon
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, United States.
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12
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Hartley C, Bulloch M, Penzak SR. Clinical Pharmacology of the Dietary Supplement, Kratom (Mitragyna speciosa). J Clin Pharmacol 2021; 62:577-593. [PMID: 34775626 DOI: 10.1002/jcph.2001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 11/05/2021] [Indexed: 11/10/2022]
Abstract
Kratom (Mitragyna speciosa) consists of over 40 alkaloids with two of them, mitragynine (MG) and 7-OH-mitragynine (7-OH-MG) being the main psychoactive compounds. MG and 7-OH-MG each target opioid receptors and have been referred to as atypical opioids. They exert their pharmacologic effects on the μ, δ, and κ opioid receptors. In addition, they affect adrenergic, serotonergic, and dopaminergic pathways. Kratom has been touted as an inexpensive, legal alternative to standard opioid replacement therapy such as methadone and buprenorphine. Other uses for kratom include chronic pain, attaining a "legal high," and numerous CNS disorders including anxiety depression and post-traumatic stress disorder (PTSD). Kratom induces analgesia and mild euphoria with a lower risk of respiratory depression or adverse central nervous system effects compared to traditional opioid medications. Nonetheless, kratom has been associated with both physical and psychological dependence with some individuals experiencing classic opioid withdrawal symptoms upon abrupt cessation. Kratom use has been linked to serious adverse effects including liver toxicity, seizures, and death. These risks are often compounded by poly-substance abuse. Further, kratom may potentiate the toxicity of coadministered medications through modulation of cytochrome P450, P-glycoprotein, and uridine diphosphate glucuronosyltransferase enzymes (UGDT). In 2016 the U.S. Drug Enforcement Administration (DEA) took steps to classify kratom as a federal schedule 1 medication; however, due to public resistance, this plan was set aside. Until studies are conducted that define kratom's role in treating opioid withdrawal and/or other CNS conditions, kratom will likely remain available as a dietary supplement for the foreseeable future. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Chad Hartley
- Department of Pharmacy Practice, Harrison School of Pharmacy, Auburn University, Auburn, Alabama, 36849, United States
| | - Marilyn Bulloch
- Department of Pharmacy Practice, Harrison School of Pharmacy, Auburn University, Auburn, Alabama, 36849, United States
| | - Scott R Penzak
- Department of Pharmacy Practice, Harrison School of Pharmacy, Auburn University, Auburn, Alabama, 36849, United States
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13
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Hassan R, Sreenivasan S, Müller CP, Hassan Z. Methadone, Buprenorphine, and Clonidine Attenuate Mitragynine Withdrawal in Rats. Front Pharmacol 2021; 12:708019. [PMID: 34322028 PMCID: PMC8311127 DOI: 10.3389/fphar.2021.708019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 06/29/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Kratom or Mitragyna speciosa Korth has been widely used to relieve the severity of opioid withdrawal in natural settings. However, several studies have reported that kratom may by itself cause dependence following chronic consumption. Yet, there is currently no formal treatment for kratom dependence. Mitragynine, is the major psychoactive alkaloid in kratom. Chronic mitragynine treatment can cause addiction-like symptoms in rodent models including withdrawal behaviour. In this study we assessed whether the prescription drugs, methadone, buprenorphine and clonidine, could mitigate mitragynine withdrawal effects. In order to assess treatment safety, we also evaluated hematological, biochemical and histopathological treatment effects. Methods: We induced mitragynine withdrawal behaviour in a chronic treatment paradigm in rats. Methadone (1.0 mg/kg), buprenorphine (0.8 mg/kg) and clonidine (0.1 mg/kg) were i.p. administered over four days during mitragynine withdrawal. These treatments were stopped and withdrawal sign assessment continued. Thereafter, toxicological profiles of the treatments were evaluated in the blood and in organs. Results: Chronic mitragynine treatment caused significant withdrawal behaviour lasting at least 5 days. Methadone, buprenorphine, as well as clonidine treatments significantly attenuated these withdrawal signs. No major effects on blood or organ toxicity were observed. Conclusion: These data suggest that the already available prescription medications methadone, buprenorphine, and clonidine are capable to alleviate mitragynine withdrawal signs rats. This may suggest them as treatment options also for problematic mitragynine/kratom use in humans.
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Affiliation(s)
- Rahimah Hassan
- Centre for Drug Research, Universiti Sains Malaysia, Minden, Malaysia
| | - Sasidharan Sreenivasan
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia, Minden, Malaysia
| | - Christian P Müller
- Centre for Drug Research, Universiti Sains Malaysia, Minden, Malaysia.,Section of Addiction Medicine, Department of Psychiatry and Psychotherapy, University Clinic, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Zurina Hassan
- Centre for Drug Research, Universiti Sains Malaysia, Minden, Malaysia.,Addiction Behaviour and Neuroplasticity Laboratory, National Neuroscience Institute, Singapore, Singapore
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14
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Kratom pharmacology: Clues from planarians exposed to mitragynine. Physiol Behav 2021; 239:113499. [PMID: 34146575 DOI: 10.1016/j.physbeh.2021.113499] [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] [Received: 01/25/2021] [Revised: 05/12/2021] [Accepted: 06/12/2021] [Indexed: 11/21/2022]
Abstract
Mitragynine (MG), the most prevalent bioactive alkaloid in kratom, displays nanomolar affinity for µ, κ and δ opioid receptors and produces opioid-dependent antinociception and dependence in rats. Here, using a battery of behavioral assays, we investigated MG effects in planarians. Acute MG exposure (< 100 μM) did not affect planarian motility or environmental preference, but reduced motility was detected during abstinence from chronic MG (1, 10 μM). MG (10 μM) produced place conditioning effects that were reduced by naltrexone (10 μΜ). These results suggest that MG produces opioid-sensitive reinforcing effects in planarians and MG pharmacology is conserved across different species.
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15
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Obeng S, Wilkerson JL, León F, Reeves ME, Restrepo LF, Gamez-Jimenez LR, Patel A, Pennington AE, Taylor VA, Ho NP, Braun T, Fortner JD, Crowley ML, Williamson MR, Pallares VLC, Mottinelli M, Lopera-Londoño C, McCurdy CR, McMahon LR, Hiranita T. Pharmacological Comparison of Mitragynine and 7-Hydroxymitragynine: In Vitro Affinity and Efficacy for μ-Opioid Receptor and Opioid-Like Behavioral Effects in Rats. J Pharmacol Exp Ther 2020; 376:410-427. [PMID: 33384303 DOI: 10.1124/jpet.120.000189] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 12/28/2020] [Indexed: 01/30/2023] Open
Abstract
Relationships between µ-opioid receptor (MOR) efficacy and effects of mitragynine and 7-hydroxymitragynine are not fully established. We assessed in vitro binding affinity and efficacy and discriminative stimulus effects together with antinociception in rats. The binding affinities of mitragynine and 7-hydroxymitragynine at MOR (Ki values 77.9 and 709 nM, respectively) were higher than their binding affinities at κ-opioid receptor (KOR) or δ-opioid receptor (DOR). [35S]guanosine 5'-O-[γ-thio]triphosphate stimulation at MOR demonstrated that mitragynine was an antagonist, whereas 7-hydroxymitragynine was a partial agonist (Emax = 41.3%). In separate groups of rats discriminating either morphine (3.2 mg/kg) or mitragynine (32 mg/kg), mitragynine produced a maximum of 72.3% morphine-lever responding, and morphine produced a maximum of 65.4% mitragynine-lever responding. Other MOR agonists produced high percentages of drug-lever responding in the morphine and mitragynine discrimination assays: 7-hydroxymitragynine (99.7% and 98.1%, respectively), fentanyl (99.7% and 80.1%, respectively), buprenorphine (99.8% and 79.4%, respectively), and nalbuphine (99.4% and 98.3%, respectively). In the morphine and mitragynine discrimination assays, the KOR agonist U69,593 produced maximums of 72.3% and 22.3%, respectively, and the DOR agonist SNC 80 produced maximums of 34.3% and 23.0%, respectively. 7-Hydroxymitragynine produced antinociception; mitragynine did not. Naltrexone antagonized all of the effects of morphine and 7-hydroxymitragynine; naltrexone antagonized the discriminative stimulus effects of mitragynine but not its rate-decreasing effects. Mitragynine increased the potency of the morphine discrimination yet decreased morphine antinociception. Here we illustrate striking differences in MOR efficacy, with mitragynine having less than 7-hydroxymitragynine. SIGNIFICANCE STATEMENT: At human µ-opioid receptor (MOR) in vitro, mitragynine has low affinity and is an antagonist, whereas 7-hydroxymitragynine has 9-fold higher affinity than mitragynine and is an MOR partial agonist. In rats, intraperitoneal mitragynine exhibits a complex pharmacology including MOR agonism; 7-hydroxymitragynine has higher MOR potency and efficacy than mitragynine. These results are consistent with 7-hydroxymitragynine being a highly selective MOR agonist and with mitragynine having a complex pharmacology that combines low efficacy MOR agonism with activity at nonopioid receptors.
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Affiliation(s)
- Samuel Obeng
- Departments of Pharmacodynamics (S.O., J.L.W., M.E.R., L.F.R., L.R.G.-J., A.P., A.E.P., V.A.T., N.P.H., T.B., M.R.W., V.L.C.P., L.R.M., T.H.) and Medicinal Chemistry (S.O., F.L., J.D.F., M.L.C., M.M., C.L.-L., C.R.M.), and Translational Drug Development Core, Clinical and Translational Sciences Institutes (C.R.M.), College of Pharmacy, University of Florida, Gainesville, Florida
| | - Jenny L Wilkerson
- Departments of Pharmacodynamics (S.O., J.L.W., M.E.R., L.F.R., L.R.G.-J., A.P., A.E.P., V.A.T., N.P.H., T.B., M.R.W., V.L.C.P., L.R.M., T.H.) and Medicinal Chemistry (S.O., F.L., J.D.F., M.L.C., M.M., C.L.-L., C.R.M.), and Translational Drug Development Core, Clinical and Translational Sciences Institutes (C.R.M.), College of Pharmacy, University of Florida, Gainesville, Florida
| | - Francisco León
- Departments of Pharmacodynamics (S.O., J.L.W., M.E.R., L.F.R., L.R.G.-J., A.P., A.E.P., V.A.T., N.P.H., T.B., M.R.W., V.L.C.P., L.R.M., T.H.) and Medicinal Chemistry (S.O., F.L., J.D.F., M.L.C., M.M., C.L.-L., C.R.M.), and Translational Drug Development Core, Clinical and Translational Sciences Institutes (C.R.M.), College of Pharmacy, University of Florida, Gainesville, Florida
| | - Morgan E Reeves
- Departments of Pharmacodynamics (S.O., J.L.W., M.E.R., L.F.R., L.R.G.-J., A.P., A.E.P., V.A.T., N.P.H., T.B., M.R.W., V.L.C.P., L.R.M., T.H.) and Medicinal Chemistry (S.O., F.L., J.D.F., M.L.C., M.M., C.L.-L., C.R.M.), and Translational Drug Development Core, Clinical and Translational Sciences Institutes (C.R.M.), College of Pharmacy, University of Florida, Gainesville, Florida
| | - Luis F Restrepo
- Departments of Pharmacodynamics (S.O., J.L.W., M.E.R., L.F.R., L.R.G.-J., A.P., A.E.P., V.A.T., N.P.H., T.B., M.R.W., V.L.C.P., L.R.M., T.H.) and Medicinal Chemistry (S.O., F.L., J.D.F., M.L.C., M.M., C.L.-L., C.R.M.), and Translational Drug Development Core, Clinical and Translational Sciences Institutes (C.R.M.), College of Pharmacy, University of Florida, Gainesville, Florida
| | - Lea R Gamez-Jimenez
- Departments of Pharmacodynamics (S.O., J.L.W., M.E.R., L.F.R., L.R.G.-J., A.P., A.E.P., V.A.T., N.P.H., T.B., M.R.W., V.L.C.P., L.R.M., T.H.) and Medicinal Chemistry (S.O., F.L., J.D.F., M.L.C., M.M., C.L.-L., C.R.M.), and Translational Drug Development Core, Clinical and Translational Sciences Institutes (C.R.M.), College of Pharmacy, University of Florida, Gainesville, Florida
| | - Avi Patel
- Departments of Pharmacodynamics (S.O., J.L.W., M.E.R., L.F.R., L.R.G.-J., A.P., A.E.P., V.A.T., N.P.H., T.B., M.R.W., V.L.C.P., L.R.M., T.H.) and Medicinal Chemistry (S.O., F.L., J.D.F., M.L.C., M.M., C.L.-L., C.R.M.), and Translational Drug Development Core, Clinical and Translational Sciences Institutes (C.R.M.), College of Pharmacy, University of Florida, Gainesville, Florida
| | - Anna E Pennington
- Departments of Pharmacodynamics (S.O., J.L.W., M.E.R., L.F.R., L.R.G.-J., A.P., A.E.P., V.A.T., N.P.H., T.B., M.R.W., V.L.C.P., L.R.M., T.H.) and Medicinal Chemistry (S.O., F.L., J.D.F., M.L.C., M.M., C.L.-L., C.R.M.), and Translational Drug Development Core, Clinical and Translational Sciences Institutes (C.R.M.), College of Pharmacy, University of Florida, Gainesville, Florida
| | - Victoria A Taylor
- Departments of Pharmacodynamics (S.O., J.L.W., M.E.R., L.F.R., L.R.G.-J., A.P., A.E.P., V.A.T., N.P.H., T.B., M.R.W., V.L.C.P., L.R.M., T.H.) and Medicinal Chemistry (S.O., F.L., J.D.F., M.L.C., M.M., C.L.-L., C.R.M.), and Translational Drug Development Core, Clinical and Translational Sciences Institutes (C.R.M.), College of Pharmacy, University of Florida, Gainesville, Florida
| | - Nicholas P Ho
- Departments of Pharmacodynamics (S.O., J.L.W., M.E.R., L.F.R., L.R.G.-J., A.P., A.E.P., V.A.T., N.P.H., T.B., M.R.W., V.L.C.P., L.R.M., T.H.) and Medicinal Chemistry (S.O., F.L., J.D.F., M.L.C., M.M., C.L.-L., C.R.M.), and Translational Drug Development Core, Clinical and Translational Sciences Institutes (C.R.M.), College of Pharmacy, University of Florida, Gainesville, Florida
| | - Tobias Braun
- Departments of Pharmacodynamics (S.O., J.L.W., M.E.R., L.F.R., L.R.G.-J., A.P., A.E.P., V.A.T., N.P.H., T.B., M.R.W., V.L.C.P., L.R.M., T.H.) and Medicinal Chemistry (S.O., F.L., J.D.F., M.L.C., M.M., C.L.-L., C.R.M.), and Translational Drug Development Core, Clinical and Translational Sciences Institutes (C.R.M.), College of Pharmacy, University of Florida, Gainesville, Florida
| | - John D Fortner
- Departments of Pharmacodynamics (S.O., J.L.W., M.E.R., L.F.R., L.R.G.-J., A.P., A.E.P., V.A.T., N.P.H., T.B., M.R.W., V.L.C.P., L.R.M., T.H.) and Medicinal Chemistry (S.O., F.L., J.D.F., M.L.C., M.M., C.L.-L., C.R.M.), and Translational Drug Development Core, Clinical and Translational Sciences Institutes (C.R.M.), College of Pharmacy, University of Florida, Gainesville, Florida
| | - Morgan L Crowley
- Departments of Pharmacodynamics (S.O., J.L.W., M.E.R., L.F.R., L.R.G.-J., A.P., A.E.P., V.A.T., N.P.H., T.B., M.R.W., V.L.C.P., L.R.M., T.H.) and Medicinal Chemistry (S.O., F.L., J.D.F., M.L.C., M.M., C.L.-L., C.R.M.), and Translational Drug Development Core, Clinical and Translational Sciences Institutes (C.R.M.), College of Pharmacy, University of Florida, Gainesville, Florida
| | - Morgan R Williamson
- Departments of Pharmacodynamics (S.O., J.L.W., M.E.R., L.F.R., L.R.G.-J., A.P., A.E.P., V.A.T., N.P.H., T.B., M.R.W., V.L.C.P., L.R.M., T.H.) and Medicinal Chemistry (S.O., F.L., J.D.F., M.L.C., M.M., C.L.-L., C.R.M.), and Translational Drug Development Core, Clinical and Translational Sciences Institutes (C.R.M.), College of Pharmacy, University of Florida, Gainesville, Florida
| | - Victoria L C Pallares
- Departments of Pharmacodynamics (S.O., J.L.W., M.E.R., L.F.R., L.R.G.-J., A.P., A.E.P., V.A.T., N.P.H., T.B., M.R.W., V.L.C.P., L.R.M., T.H.) and Medicinal Chemistry (S.O., F.L., J.D.F., M.L.C., M.M., C.L.-L., C.R.M.), and Translational Drug Development Core, Clinical and Translational Sciences Institutes (C.R.M.), College of Pharmacy, University of Florida, Gainesville, Florida
| | - Marco Mottinelli
- Departments of Pharmacodynamics (S.O., J.L.W., M.E.R., L.F.R., L.R.G.-J., A.P., A.E.P., V.A.T., N.P.H., T.B., M.R.W., V.L.C.P., L.R.M., T.H.) and Medicinal Chemistry (S.O., F.L., J.D.F., M.L.C., M.M., C.L.-L., C.R.M.), and Translational Drug Development Core, Clinical and Translational Sciences Institutes (C.R.M.), College of Pharmacy, University of Florida, Gainesville, Florida
| | - Carolina Lopera-Londoño
- Departments of Pharmacodynamics (S.O., J.L.W., M.E.R., L.F.R., L.R.G.-J., A.P., A.E.P., V.A.T., N.P.H., T.B., M.R.W., V.L.C.P., L.R.M., T.H.) and Medicinal Chemistry (S.O., F.L., J.D.F., M.L.C., M.M., C.L.-L., C.R.M.), and Translational Drug Development Core, Clinical and Translational Sciences Institutes (C.R.M.), College of Pharmacy, University of Florida, Gainesville, Florida
| | - Christopher R McCurdy
- Departments of Pharmacodynamics (S.O., J.L.W., M.E.R., L.F.R., L.R.G.-J., A.P., A.E.P., V.A.T., N.P.H., T.B., M.R.W., V.L.C.P., L.R.M., T.H.) and Medicinal Chemistry (S.O., F.L., J.D.F., M.L.C., M.M., C.L.-L., C.R.M.), and Translational Drug Development Core, Clinical and Translational Sciences Institutes (C.R.M.), College of Pharmacy, University of Florida, Gainesville, Florida
| | - Lance R McMahon
- Departments of Pharmacodynamics (S.O., J.L.W., M.E.R., L.F.R., L.R.G.-J., A.P., A.E.P., V.A.T., N.P.H., T.B., M.R.W., V.L.C.P., L.R.M., T.H.) and Medicinal Chemistry (S.O., F.L., J.D.F., M.L.C., M.M., C.L.-L., C.R.M.), and Translational Drug Development Core, Clinical and Translational Sciences Institutes (C.R.M.), College of Pharmacy, University of Florida, Gainesville, Florida
| | - Takato Hiranita
- Departments of Pharmacodynamics (S.O., J.L.W., M.E.R., L.F.R., L.R.G.-J., A.P., A.E.P., V.A.T., N.P.H., T.B., M.R.W., V.L.C.P., L.R.M., T.H.) and Medicinal Chemistry (S.O., F.L., J.D.F., M.L.C., M.M., C.L.-L., C.R.M.), and Translational Drug Development Core, Clinical and Translational Sciences Institutes (C.R.M.), College of Pharmacy, University of Florida, Gainesville, Florida
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16
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Ya K, Methaneethorn J, Tran QB, Trakulsrichai S, Wananukul W, Lohitnavy M. Development of a Physiologically Based Pharmacokinetic Model of Mitragynine, Psychoactive Alkaloid in Kratom ( Mitragyna Speciosa Korth.), In Rats and Humans. J Psychoactive Drugs 2020; 53:127-139. [PMID: 34003732 DOI: 10.1080/02791072.2020.1849877] [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: 10/22/2022]
Abstract
Mitragynine is a major psychoactive alkaloid in leaves of kratom (Mitragyna speciosa Korth.). To understand its disposition in organs, this study aimed to develop a physiologically based pharmacokinetic (PBPK) model that predicts mitragynine concentrations in plasma and organ of interests in rats and humans. The PBPK model consisted of six organ compartments (i.e. lung, brain, liver, fat, slowly perfused tissues, and rapidly perfused tissue). From systematic searching, three pharmacokinetic studies of mitragynine (two studies in rats and 1 study in humans) were retrieved from the literature. Berkeley Madonna Software (version 8.3.18) was used for model development and model simulation. The developed PBPK model consisted of biologically relevant features following involvement of (i) breast cancer-resistant protein (BCRP) in brain, (ii) a hepatic cytochrome P450 3A4 (CYP3A4)-mediated metabolism in the liver, and (iii) a diffusion-limited transport in fat. The simulations adequately describe simulated and observed data in the two species with different dosing regimens. PBPK models of mitragynine in rats and humans were successfully developed. The models may be used to guide optimal mitragynine dosing regimens.
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Affiliation(s)
- Kimheang Ya
- Center of Excellence for Environmental Health & Toxicology, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.,Pharmacokinetic Research Unit, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand
| | - Janthima Methaneethorn
- Center of Excellence for Environmental Health & Toxicology, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.,Pharmacokinetic Research Unit, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.,Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand
| | - Quoc Ba Tran
- Center for Advanced Chemistry, Institute of Research and Development, Duy Tan University, Da Nang, Vietnam.,Faculty of Environmental and Chemical Engineering, Duy Tan University, Da Nang, Vietnam
| | - Satariya Trakulsrichai
- Department of Emergency Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Salaya, Thailand.,Ramathibodi Poison Center, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Salaya, Thailand
| | - Winai Wananukul
- Ramathibodi Poison Center, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Salaya, Thailand.,Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Salaya, Thailand
| | - Manupat Lohitnavy
- Center of Excellence for Environmental Health & Toxicology, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.,Pharmacokinetic Research Unit, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.,Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand
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17
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Lee MJ, Ramanathan S, Mansor SM, Tan SC. Development of an ELISA for detection of mitragynine and its metabolites in human urine. Anal Biochem 2020; 599:113733. [PMID: 32302607 DOI: 10.1016/j.ab.2020.113733] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 04/07/2020] [Accepted: 04/08/2020] [Indexed: 10/24/2022]
Abstract
An enzyme-linked immunosorbent assay for detection of mitragynine, other closely related Kratom alkaloids and metabolites was developed using polyclonal antibodies. Mitragynine was conjugated to a carrier protein, cationized-bovine serum albumin using Mannich reaction. The synthesized antigen was injected into rabbits to elicit specific polyclonal antibodies against mitragynine. An enzyme conjugate was synthesized for evaluating its performance with the antibodies produced. The assay had an IC50 of 7.3 ng/mL with a limit of detection of 15 ng/mL for mitragynine. Antibody produced have high affinity for mitragynine (100%), other closely related Kratom alkaloids such as paynantheine (54%), speciociliatine (63%), 7α-hydroxy-7H-mitragynine (83%) and cross-reacted with metabolites 9-O-demethyl mitragynine (79%), 16-carboxy mitragynine (103%), 9-O-demethyl mitragynine sulfate (263%), 9-O-demethyl mitragynine glucuronide (60%), 16-carboxy mitragynine glucuronide (60%), 9-O-demethyl-16-carboxy mitragynine sulfate (270%) and 17-O-demethyl-16,17-dihydro mitragynine glucuronide (34%). It showed cross-reactivity less than 0.01% to reserpine, codeine, morphine, caffeine, methadone, amphetamine, and cocaine. Ten-fold dilution urine was used in the assay to reduce the matrix effects. The recovery ranged from 83% to 112% with variation coefficients in intraday and interday less than 8% and 6%, respectively. The ELISA turned out to be a convenient tool to diagnose mitragynine, other closely related Kratom alkaloids and metabolites in human urine samples.
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Affiliation(s)
- Mei Jin Lee
- Institute for Research in Molecular Medicine (INFORMM), Main Campus, Universiti Sains Malaysia, 11800, Penang, Malaysia.
| | - Surash Ramanathan
- Centre for Drug Research (CDR), Main Campus, Universiti Sains Malaysia, 11800, Penang, Malaysia
| | - Sharif Mahsufi Mansor
- Centre for Drug Research (CDR), Main Campus, Universiti Sains Malaysia, 11800, Penang, Malaysia
| | - Soo Choon Tan
- Institute for Research in Molecular Medicine (INFORMM), Main Campus, Universiti Sains Malaysia, 11800, Penang, Malaysia
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18
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Ismail I, Wahab S, Sidi H, Das S, Lin LJ, Razali R. Kratom and Future Treatment for the Opioid Addiction and Chronic Pain: Periculo Beneficium? Curr Drug Targets 2020; 20:166-172. [PMID: 28443503 DOI: 10.2174/1389450118666170425154120] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 04/13/2017] [Accepted: 04/13/2017] [Indexed: 12/17/2022]
Abstract
Kratom (Mitragyna speciosa), a naturally existing plant found in South-East Asia, is traditionally used as a herb to help elevate a person's energy and also to treat numerous medical ailments. Other than the analgesic property, kratom has been used as an agent to overcome opioid withdrawal as it contains natural alkaloids, i.e. mitragynine, 7-hydroxymitragynine, and MGM-9, which has agonist affinity on the opioid receptors, including mu (µ) and kappa (κ). The role of neural reward pathways linked to µ-opioid receptors and both dopaminergic and gamma-Aminobutyric acid (GABA)-ergic interneurons that express µ-opioid receptors were deliberated. However, kratom has been reported to be abused together with other illicit substances with high risk of potential addiction. There are also anecdotes of adverse effects and toxicity of kratom, i.e. tremor, fatigue, seizure, and death. Different countries have distinctive regulation and policy on the plantation and use of this plant when most of the countries banned the use of it because of its addiction problems and side effects. The aim of this review is to highlight on the potential use of kratom, unique 'herbs" as a substitution therapy for chronic pain and opioid addiction, based on the neurobiological perspective of pain and the underlying mechanism of actions of drug addiction.
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Affiliation(s)
- Ismaliza Ismail
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Suzaily Wahab
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Hatta Sidi
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Srijit Das
- Department of Anatomy, Universiti Kebangsaan Malaysia Medical Centre, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Loo Jiann Lin
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Rosdinom Razali
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, 56000 Cheras, Kuala Lumpur, Malaysia
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19
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Ramachandram DS, Damodaran T, Zainal H, Murugaiyah V, Ramanathan S. Pharmacokinetics and pharmacodynamics of mitragynine, the principle alkaloid of Mitragyna speciosa: present knowledge and future directions in perspective of pain. J Basic Clin Physiol Pharmacol 2019; 31:jbcpp-2019-0138. [PMID: 31665120 DOI: 10.1515/jbcpp-2019-0138] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 08/15/2019] [Indexed: 06/10/2023]
Abstract
Mitragyna speciosa, commonly known as Ketum or Biak in Malaysia and Kratom in Thailand, is a native plant to Southeast Asia and has various pharmacological benefits. Mitragynine (MG) is the principal alkaloid found in the leaves of Mitragyna speciosa and has been reported to be responsible for the plant's therapeutic actions. Traditionally, local communities use Kratom preparations for relief from different types of pain. The potential analgesic effects of MG using rodent models have been reported in literatures. We have reviewed the published analgesic and pharmacokinetic studies and all of these findings showed the routes of drug administration, doses employed, and type of vehicles used to solubilize the drug, varied considerably; hence this posted difficulties in predicting the drug's pharmacokinetic-response relationship. A rational approach is warranted for accurate prediction of dose-response relationship; as this is essential for the development of MG as an alternative medicinal drug for pain management. PKPD modeling would serve as a better method to understand the dose-response relationship in future MG preclinical and clinical studies.
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Affiliation(s)
| | | | - Hadzliana Zainal
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | | | - Surash Ramanathan
- Centre for Drug Research, Universiti Sains Malaysia, Penang, Malaysia
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20
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Hassan Z, Suhaimi FW, Ramanathan S, Ling KH, Effendy MA, Müller CP, Dringenberg HC. Mitragynine (Kratom) impairs spatial learning and hippocampal synaptic transmission in rats. J Psychopharmacol 2019; 33:908-918. [PMID: 31081443 DOI: 10.1177/0269881119844186] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Mitragynine is the major alkaloid of Mitragyna speciosa (Korth.) or Kratom, a psychoactive plant widely abused in Southeast Asia. While addictive effects of the substance are emerging, adverse cognitive effects of this drug and neuropharmacological actions are insufficiently understood. AIMS In the present study, we investigated the effects of mitragynine on spatial learning and synaptic transmission in the CA1 region of the hippocampus. METHODS Male Sprague Dawley rats received daily (for 12 days) training sessions in the Morris water maze, with each session followed by treatment either with mitragynine (1, 5, or 10 mg/kg; intraperitoneally), morphine (5 mg/kg; intraperitoneally) or a vehicle. In the second experiment, we recorded field excitatory postsynaptic potentials in the hippocampal CA1 area in anesthetized rats and assessed the effects of mitragynine on baseline synaptic transmission, paired-pulse facilitation, and long-term potentiation. Gene expression of major memory- and addiction-related genes was investigated and the effects of mitragynine on Ca2+ influx was also examined in cultured primary neurons from E16-E18 rats. RESULTS/OUTCOMES Escape latency results indicate that animals treated with mitragynine displayed a slower rate of acquisition as compared to their control counterparts. Further, mitragynine treatment significantly reduced the amplitude of baseline (i.e. non-potentiated) field excitatory postsynaptic potentials and resulted in a minor suppression of long-term potentiation in CA1. Bdnf and αCaMKII mRNA expressions in the brain were not affected and Ca2+ influx elicited by glutamate application was inhibited in neurons pre-treated with mitragynine. CONCLUSIONS/INTERPRETATION These data suggest that high doses of mitragynine (5 and 10 mg/kg) cause memory deficits, possibly via inhibition of Ca2+ influx and disruption of hippocampal synaptic transmission and long-term potentiation induction.
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Affiliation(s)
- Zurina Hassan
- 1 Centre for Drug Research, Universiti Sains Malaysia, Penang, Malaysia
| | - Farah W Suhaimi
- 1 Centre for Drug Research, Universiti Sains Malaysia, Penang, Malaysia
| | - Surash Ramanathan
- 1 Centre for Drug Research, Universiti Sains Malaysia, Penang, Malaysia
| | - King-Hwa Ling
- 2 Department of Biomedical Science, Universiti Putra Malaysia, Selangor, Malaysia
| | - Mohamad A Effendy
- 1 Centre for Drug Research, Universiti Sains Malaysia, Penang, Malaysia
| | - Christian P Müller
- 3 Department of Psychiatry and Psychotherapy, Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen, Germany
| | - Hans C Dringenberg
- 4 Department of Psychology and Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
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21
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Meireles V, Rosado T, Barroso M, Soares S, Gonçalves J, Luís Â, Caramelo D, Simão AY, Fernández N, Duarte AP, Gallardo E. Mitragyna speciosa: Clinical, Toxicological Aspects and Analysis in Biological and Non-Biological Samples. MEDICINES 2019; 6:medicines6010035. [PMID: 30836609 PMCID: PMC6473843 DOI: 10.3390/medicines6010035] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 02/24/2019] [Accepted: 02/27/2019] [Indexed: 02/07/2023]
Abstract
The abuse of psychotropic substances is a well-known phenomenon, and many of them are usually associated with ancestral traditions and home remedies. This is the case of Mitragyna speciosa (kratom), a tropical tree used to improve work performance and to withstand great heat. According to several published studies, the main reasons for kratom consumption involve improving sexual performance and endurance, but also social and recreational uses for the feeling of happiness and euphoria; it is also used for medical purposes as a pain reliever, and in the treatment of diarrhea, fever, diabetes, and hypertension. However, this plant has gained more popularity amongst young people over the last years. Since it is available on the internet for purchase, its use is now widely as a drug of abuse, namely as a new psychoactive substance, being a cheaper alternative to opioids that does not require medical prescription in most countries. According to internet surveys by the European Monitoring Centre for Drugs and Drug Addiction in 2008 and 2011, kratom was one of the most widely supplied new psychoactive substances. The composition of kratom is complex; in fact, more than 40 different alkaloids have been identified in Mitragyna speciosa so far, the major constituent being mitragynine, which is exclusive to this plant. Besides mitragynine, alkaloids such as corynantheidine and 7-hydroxamitragynine also present pharmacological effects, a feature that may be attributed to the remaining constituents as well. The main goal of this review is not only to understand the origin, chemistry, consumption, and analytical methodologies for analysis and mechanism of action, but also the use of secondary metabolites of kratom as therapeutic drugs and the assessment of potential risks associated with its consumption, in order to aid health professionals, toxicologists, and police authorities in cases where this plant is present.
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Affiliation(s)
- Vânia Meireles
- Centro de Investigação em Ciências da Saúde, Faculdade de Ciências da Saúde da Universidade da Beira Interior (CICS-UBI), 6200-506 Covilhã, Portugal.
| | - Tiago Rosado
- Centro de Investigação em Ciências da Saúde, Faculdade de Ciências da Saúde da Universidade da Beira Interior (CICS-UBI), 6200-506 Covilhã, Portugal.
| | - Mário Barroso
- Serviço de Química e Toxicologia Forenses, Instituto de Medicina Legal e Ciências Forenses-Delegação do Sul, 1169-201 Lisboa, Portugal.
| | - Sofia Soares
- Centro de Investigação em Ciências da Saúde, Faculdade de Ciências da Saúde da Universidade da Beira Interior (CICS-UBI), 6200-506 Covilhã, Portugal.
| | - Joana Gonçalves
- Centro de Investigação em Ciências da Saúde, Faculdade de Ciências da Saúde da Universidade da Beira Interior (CICS-UBI), 6200-506 Covilhã, Portugal.
| | - Ângelo Luís
- Centro de Investigação em Ciências da Saúde, Faculdade de Ciências da Saúde da Universidade da Beira Interior (CICS-UBI), 6200-506 Covilhã, Portugal.
| | - Débora Caramelo
- Centro de Investigação em Ciências da Saúde, Faculdade de Ciências da Saúde da Universidade da Beira Interior (CICS-UBI), 6200-506 Covilhã, Portugal.
| | - Ana Y Simão
- Centro de Investigação em Ciências da Saúde, Faculdade de Ciências da Saúde da Universidade da Beira Interior (CICS-UBI), 6200-506 Covilhã, Portugal.
| | - Nicolás Fernández
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Cátedra de Toxicología y Química Legal, Laboratorio de Asesoramiento Toxicológico Analítico (CENATOXA). Junín 956 7mo piso. Ciudad Autónoma de Buenos Aires (CABA), Buenos Aires C1113AAD, Argentina.
| | - Ana Paula Duarte
- Centro de Investigação em Ciências da Saúde, Faculdade de Ciências da Saúde da Universidade da Beira Interior (CICS-UBI), 6200-506 Covilhã, Portugal.
| | - Eugenia Gallardo
- Centro de Investigação em Ciências da Saúde, Faculdade de Ciências da Saúde da Universidade da Beira Interior (CICS-UBI), 6200-506 Covilhã, Portugal.
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Chemical constituents and nitric oxide inhibitory activity of supercritical carbon dioxide extracts from Mitragyna speciosa leaves. ARAB J CHEM 2019. [DOI: 10.1016/j.arabjc.2016.09.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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23
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Eldridge WB, Foster C, Wyble L. Neonatal Abstinence Syndrome Due to Maternal Kratom Use. Pediatrics 2018; 142:peds.2018-1839. [PMID: 30404789 DOI: 10.1542/peds.2018-1839] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/09/2018] [Indexed: 12/17/2022] Open
Abstract
Neonatal abstinence syndrome (NAS) is increasing in incidence and most commonly associated with maternal opioid use during pregnancy. Nonopioid alternatives to treat opioid dependence are highly sought after in the country's current opioid epidemic. Whether Kratom, a legal, widely available herbal supplement, should be classified as an opioid is contentious. Although the US Food and Drug Administration has recently addressed this controversy, Kratom continues to be marketed as a nonopioid remedy for opioid withdrawal. Its use is increasing in the United States. We describe an infant with NAS born to a mother with daily Kratom tea ingestion to self-treat opioid dependence. Pediatricians and parents should be aware of the risk of NAS due to Kratom use during pregnancy.
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Edosuyi O, Igbe I, Iniaghe LO. Antinociceptive and antioxidant activities of Hunteria umbellata stem bark: possible role of the serotonergic, opioidergic and dopaminergic pathways. ACTA ACUST UNITED AC 2018; 15:/j/jcim.ahead-of-print/jcim-2017-0099/jcim-2017-0099.xml. [DOI: 10.1515/jcim-2017-0099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 09/21/2017] [Indexed: 01/09/2023]
Abstract
AbstractBackground(HU) (K. Schum) is used in ethnomedicine for the management of pain, diabetes mellitus and dysmenorrhoea. This study evaluated the analgesic and antioxidant activities of aqueous extract of HU stem bark and the possible mechanism(s) of action.MethodsThe antinociceptive effect of HU was evaluated using acetic acid mouse writhing, tail flick, hot plate and formalin-induced paw licking models. To establish the possible mechanism(s) of action of HU, separate group of animals were pretreated with naloxone (1 mg/kg, i.p.), atropine (1 mg/kg, i.p.), haloperidol (0.1 mg/kg, i.p.), ondansetron (1 mg/kg, i.p.) and phenoxybenzamine (0.1 mg/kg, i.p.), 15 min before HU. TheResultsThe extract at 150 and 300 mg/kg, significantly (pConclusionsResults obtained in this study suggest the involvement of serotonergic, opioidergic and dopaminergic pathways in the analgesic effect of HU stem bark, in addition to its potent antioxidant potential.
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Lee MJ, Ramanathan S, Mansor SM, Yeong KY, Tan SC. Method validation in quantitative analysis of phase I and phase II metabolites of mitragynine in human urine using liquid chromatography-tandem mass spectrometry. Anal Biochem 2017; 543:146-161. [PMID: 29248503 DOI: 10.1016/j.ab.2017.12.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Revised: 11/30/2017] [Accepted: 12/13/2017] [Indexed: 11/17/2022]
Abstract
A method using solid phase extraction and liquid chromatography-tandem mass spectrometry to quantitatively detect mitragynine, 16-carboxy mitragynine, and 9-O-demethyl mitragynine in human urine samples was developed and validated. The relevant metabolites were identified using multiple reaction monitoring in positive ionization mode using nalorphine as an internal standard. The method was validated for accuracy, precision, recovery, linearity, and lower limit of quantitation. The intra- and inter-day accuracy and precision were found in the range of 83.6-117.5% with coefficient of variation less than 13%. The percentage of recovery for mitragynine, 16-carboxy mitragynine, and 9-O-demethyl mitragynine was within the range of 80.1-118.9%. The lower limit of quantification was 1 ng/mL for mitragynine, 2 ng/mL for 16-carboxy mitragynine, and 50 ng/mL for 9-O-demethyl mitragynine. The developed method was reproducible, high precision and accuracy with good linearity and recovery for mitragynine, 16-carboxy mitragynine, and 9-O-demethyl mitragynine in human urine.
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Affiliation(s)
- Mei Jin Lee
- Institute for Research in Molecular Medicine (INFORMM), Main Campus, Universiti Sains Malaysia, 11800, Penang, Malaysia.
| | - Surash Ramanathan
- Centre for Drug Research (CDR), Main Campus, Universiti Sains Malaysia, 11800, Penang, Malaysia
| | - Sharif Mahsufi Mansor
- Centre for Drug Research (CDR), Main Campus, Universiti Sains Malaysia, 11800, Penang, Malaysia
| | - Keng Yoon Yeong
- Institute for Research in Molecular Medicine (INFORMM), Main Campus, Universiti Sains Malaysia, 11800, Penang, Malaysia; School of Science, Monash University Malaysia Campus, Jalan Lagoon Selatan, Bandar Sunway, 47500, Selangor, Malaysia
| | - Soo Choon Tan
- Institute for Research in Molecular Medicine (INFORMM), Main Campus, Universiti Sains Malaysia, 11800, Penang, Malaysia.
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Cheaha D, Reakkamnuan C, Nukitram J, Chittrakarn S, Phukpattaranont P, Keawpradub N, Kumarnsit E. Effects of alkaloid-rich extract from Mitragyna speciosa (Korth.) Havil. on naloxone-precipitated morphine withdrawal symptoms and local field potential in the nucleus accumbens of mice. JOURNAL OF ETHNOPHARMACOLOGY 2017; 208:129-137. [PMID: 28687506 DOI: 10.1016/j.jep.2017.07.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 07/04/2017] [Accepted: 07/04/2017] [Indexed: 06/07/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Mitragyna speciosa (Korth.) Havil. (M. speciosa) is among the most well-known plants used in ethnic practice of Southeast Asia. It has gained increasing attention as a plant with potential to substitute morphine in addiction treatment program. However, its action on the central nervous system is controversial. AIM OF THE STUDY This study investigated the effects of M. speciosa alkaloid extract on naloxone-precipitated morphine withdrawal and neural signaling in the nucleus accumbens (NAc, brain reward center) of mice. MATERIALS AND METHODS The effects of M. speciosa alkaloid extract and mitragynine, a pure major constituent, on naloxone-precipitated morphine withdrawal were examined. Male Swiss Albino (ICR) mice were rendered dependent on morphine before injection with naloxone, a nonspecific opioid antagonist, to induce morphine withdrawal symptoms. The intensity of naloxone-precipitated morphine withdrawal was assessed from jumping behavior and diarrhea induced during a period of morphine withdrawal. To test possible addictive effect of M. speciosa alkaloid extract, mice were implanted with intracranial electrode into the NAc for local field potential (LFP) recording. Following M. speciosa alkaloid extract (80mg/kg) and morphine (15mg/kg) treatment, LFP power spectra and spontaneous motor activity were analyzed in comparison to control levels. RESULTS One-way ANOVA and multiple comparisons revealed that M. speciosa alkaloid extract (80 and 100mg/kg) significantly decreased the number of jumping behavior induced by morphine withdrawal whereas mitragynine did not. Additionally, M. speciosa alkaloid extract significantly decreased dry and wet fecal excretions induced by morphine withdrawal. LFP analysis revealed that morphine significantly decreased alpha (9.7-12Hz) and increased low gamma (30.3-44.9Hz) and high gamma (60.5-95.7Hz) powers in the NAc whereas M. speciosa alkaloid extract did not. Spontaneous motor activity was significantly increased by morphine but not M. speciosa alkaloid extract. CONCLUSIONS Taken together, M. speciosa alkaloid extract, but not mitragynine, attenuated the severity of naloxone-precipitated morphine withdrawal symptoms. Neural signaling in the NAc and spontaneous motor activity were sensitive to morphine but not M. speciosa alkaloid extract. Therefore, treatment with the M. speciosa alkaloid extract may be useful for opiate addiction treatment program.
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Affiliation(s)
- Dania Cheaha
- Department of Biology, Faculty of Science, Prince of Songkla University, Hatyai, Songkhla 90112, Thailand; Research Unit for EEG Biomarkers of Neuronal Diseases, Faculty of Science, Prince of Songkla University, Hatyai, Songkhla 90112, Thailand
| | - Chayaporn Reakkamnuan
- Department of Physiology, Faculty of Science, Prince of Songkla University, Hatyai, Songkhla 90112, Thailand; Research Unit for EEG Biomarkers of Neuronal Diseases, Faculty of Science, Prince of Songkla University, Hatyai, Songkhla 90112, Thailand
| | - Jakkrit Nukitram
- Department of Biology, Faculty of Science, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Somsmorn Chittrakarn
- Department of Pharmacology, Faculty of Science, Prince of Songkla University, Hatyai, Songkhla 90112, Thailand
| | | | - Niwat Keawpradub
- Department of Pharmacognosy and Pharmaceutical Botany, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hatyai, Songkhla 90112, Thailand
| | - Ekkasit Kumarnsit
- Department of Physiology, Faculty of Science, Prince of Songkla University, Hatyai, Songkhla 90112, Thailand; Research Unit for EEG Biomarkers of Neuronal Diseases, Faculty of Science, Prince of Songkla University, Hatyai, Songkhla 90112, Thailand.
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Yusoff NH, Mansor SM, Müller CP, Hassan Z. Opioid receptors mediate the acquisition, but not the expression of mitragynine-induced conditioned place preference in rats. Behav Brain Res 2017; 332:1-6. [DOI: 10.1016/j.bbr.2017.05.059] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 05/22/2017] [Accepted: 05/24/2017] [Indexed: 02/05/2023]
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Feng LY, Battulga A, Han E, Chung H, Li JH. New psychoactive substances of natural origin: A brief review. J Food Drug Anal 2017; 25:461-471. [PMID: 28911631 PMCID: PMC9328809 DOI: 10.1016/j.jfda.2017.04.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 03/16/2017] [Accepted: 04/04/2017] [Indexed: 12/17/2022] Open
Abstract
Plant-based drugs of abuse are as old as recorded human history. Although traditional addictive substances, such as opium, cannabis and coca, have been controlled by the United Nations anti-drug conventions, many, if not most, natural plants with addictive or abuse liability remain elusive. Therefore, the United Nations Office on Drugs and Crime (UNODC) has warned the emerging threat from new psychoactive substances (NPS), which are mostly derived or modified from the constituents of natural origin. For example, synthetic cannabinoids and synthetic cathinones are derived from the cannabis and khat plant, respectively. In this review, we briefly discussed the chemistry, pharmacology and toxicology of five common NPS of natural origin, i.e., khat, kratom, salvia, magic mushroom and mandrake. Through the review, we hope that professionals and general public alike can pay more attention to the potential problems caused by natural NPS, and suitable control measures will be taken.
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Affiliation(s)
- Ling-Yi Feng
- Ph.D. Program in Toxicology, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Altansuvd Battulga
- School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Eunyoung Han
- College of Pharmacy, Duksung Women's University, Seoul, South Korea
| | - Heesun Chung
- Graduate School of Analytical Science and Technology, Chungnam National University, Daejeon, South Korea.
| | - Jih-Heng Li
- Ph.D. Program in Toxicology, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan; School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
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Brown PN, Lund JA, Murch SJ. A botanical, phytochemical and ethnomedicinal review of the genus Mitragyna korth: Implications for products sold as kratom. JOURNAL OF ETHNOPHARMACOLOGY 2017; 202:302-325. [PMID: 28330725 DOI: 10.1016/j.jep.2017.03.020] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Revised: 03/14/2017] [Accepted: 03/15/2017] [Indexed: 06/06/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE The genus Mitragyna (Rubiacaeae) has been traditionally used in parts of Africa, Asia and Oceania. In recent years, there has been increased interest in species of Mitragyna with the introduction of products to western markets and regulatory uncertainty. AIM OF THE STUDY This paper reviewed the traditional ethnomedicinal uses of leaves for species belonging to the genus Mitragyna with reference to the botany and known chemistry in order to highlight areas of interest for products currently being sold as kratom. MATERIALS AND METHODS A literature search was conducted using Web of Science, Google Scholar, the Royal Museum for Central Africa, Internet Archive, Hathi Trust, and Biodiversity Heritage Library search engines in the spring of 2015, fall of 2016 and winter of 2017 to document uses of bark, leaf and root material. RESULTS Leaves of M. speciosa (kratom) had the most common documented ethnomedicinal uses as an opium substitute or remedy for addiction. Other species of Mitragyna were reportedly used for treating pain, however the mode of preparation was most often cited as topical application. Other uses of Mitragyna included treatment of fever, skin infections, and as a mild anxiolytic. CONCLUSIONS Mitragyna species have been used medicinally in various parts of the world and that there is significant traditional evidence of use. Modern products that include formulations as topical application of liniments, balms or tinctures may provide effective alternatives for treatment of certain types of pains. Future research is required to establish safety and toxicology limits, medicinal chemistry parameters and the potential for different physiological responses among varying genetic populations to support regulatory requirements for Mitragyna spp.
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Affiliation(s)
- Paula N Brown
- Natural Health Products and Food Research Group, British Columbia Institute of Technology, 4355 Mathissi Place, Burnaby, British Columbia, Canada V5G 4S8; Department of Biology, University of British Columbia, 3247 University Way, Kelowna, British Columbia, Canada V1V 1V7
| | - Jensen A Lund
- Natural Health Products and Food Research Group, British Columbia Institute of Technology, 4355 Mathissi Place, Burnaby, British Columbia, Canada V5G 4S8; Department of Chemistry, University of British Columbia, 3247 University Way, Kelowna, British Columbia, Canada V1V 1V7
| | - Susan J Murch
- Department of Chemistry, University of British Columbia, 3247 University Way, Kelowna, British Columbia, Canada V1V 1V7.
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Hassan Z, Bosch OG, Singh D, Narayanan S, Kasinather BV, Seifritz E, Kornhuber J, Quednow BB, Müller CP. Novel Psychoactive Substances-Recent Progress on Neuropharmacological Mechanisms of Action for Selected Drugs. Front Psychiatry 2017; 8:152. [PMID: 28868040 PMCID: PMC5563308 DOI: 10.3389/fpsyt.2017.00152] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 08/02/2017] [Indexed: 12/15/2022] Open
Abstract
A feature of human culture is that we can learn to consume chemical compounds, derived from natural plants or synthetic fabrication, for their psychoactive effects. These drugs change the mental state and/or the behavioral performance of an individual and can be instrumentalized for various purposes. After the emergence of a novel psychoactive substance (NPS) and a period of experimental consumption, personal and medical benefits and harm potential of the NPS can be estimated on evidence base. This may lead to a legal classification of the NPS, which may range from limited medical use, controlled availability up to a complete ban of the drug form publically accepted use. With these measures, however, a drug does not disappear, but frequently continues to be used, which eventually allows an even better estimate of the drug's properties. Thus, only in rare cases, there is a final verdict that is no more questioned. Instead, the view on a drug can change from tolerable to harmful but may also involve the new establishment of a desired medical application to a previously harmful drug. Here, we provide a summary review on a number of NPS for which the neuropharmacological evaluation has made important progress in recent years. They include mitragynine ("Kratom"), synthetic cannabinoids (e.g., "Spice"), dimethyltryptamine and novel serotonergic hallucinogens, the cathinones mephedrone and methylone, ketamine and novel dissociative drugs, γ-hydroxybutyrate, γ-butyrolactone, and 1,4-butanediol. This review shows not only emerging harm potentials but also some potential medical applications.
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Affiliation(s)
- Zurina Hassan
- Centre for Drug Research, Universiti Sains Malaysia, Minden, Malaysia
| | - Oliver G Bosch
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Darshan Singh
- Centre for Drug Research, Universiti Sains Malaysia, Minden, Malaysia
| | - Suresh Narayanan
- School of Social Sciences, Universiti Sains Malaysia, Minden, Malaysia
| | | | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, University Hospital, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Boris B Quednow
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Christian P Müller
- Department of Psychiatry and Psychotherapy, University Hospital, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
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Limsuwanchote S, Putalun W, Keawpradub N, Tanaka H, Morimoto S, Wungsintaweekul J. Anti-mitragynine monoclonal antibody-based ELISA for determination of alkaloids in the kratom cocktail. Forensic Toxicol 2016. [DOI: 10.1007/s11419-016-0332-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pantano F, Tittarelli R, Mannocchi G, Zaami S, Ricci S, Giorgetti R, Terranova D, Busardò FP, Marinelli E. Hepatotoxicity Induced by "the 3Ks": Kava, Kratom and Khat. Int J Mol Sci 2016; 17:580. [PMID: 27092496 PMCID: PMC4849036 DOI: 10.3390/ijms17040580] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 02/18/2016] [Accepted: 04/11/2016] [Indexed: 12/23/2022] Open
Abstract
The 3Ks (kava, kratom and khat) are herbals that can potentially induce liver injuries. On the one hand, growing controversial data have been reported about the hepatotoxicity of kratom, while, on the other hand, even though kava and khat hepatotoxicity has been investigated, the hepatotoxic effects are still not clear. Chronic recreational use of kratom has been associated with rare instances of acute liver injury. Several studies and case reports have suggested that khat is hepatotoxic, leading to deranged liver enzymes and also histopathological evidence of acute hepatocellular degeneration. Numerous reports of severe hepatotoxicity potentially induced by kava have also been highlighted, both in the USA and Europe. The aim of this review is to focus on the different patterns and the mechanisms of hepatotoxicity induced by “the 3Ks”, while trying to clarify the numerous aspects that still need to be addressed.
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Affiliation(s)
- Flaminia Pantano
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy.
| | - Roberta Tittarelli
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy.
| | - Giulio Mannocchi
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy.
| | - Simona Zaami
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy.
| | - Serafino Ricci
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy.
| | - Raffaele Giorgetti
- Section of Legal Medicine, Università Politecnica delle Marche, 60121 Ancona, Italy.
| | - Daniela Terranova
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy.
| | - Francesco P Busardò
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy.
| | - Enrico Marinelli
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy.
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Saingam D, Assanangkornchai S, Geater AF, Lerkiatbundit S. Factor Analytical Investigation of Krathom (Mitragyna speciosaKorth.) Withdrawal Syndrome in Thailand. J Psychoactive Drugs 2016; 48:76-85. [DOI: 10.1080/02791072.2016.1156791] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Suhaimi FW, Yusoff NHM, Hassan R, Mansor SM, Navaratnam V, Müller CP, Hassan Z. Neurobiology of Kratom and its main alkaloid mitragynine. Brain Res Bull 2016; 126:29-40. [PMID: 27018165 DOI: 10.1016/j.brainresbull.2016.03.015] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 03/22/2016] [Accepted: 03/23/2016] [Indexed: 12/17/2022]
Abstract
Kratom or its main alkaloid, mitragynine is derived from the plant Mitragyna speciosa Korth which is indigenous to Southeast Asian countries. This substance has become widely available in other countries like Europe and United States due to its opium- and coca-like effects. In this article, we have reviewed available reports on mitragynine and other M. speciosa extracts. M. speciosa has been proven to have a rewarding effect and is effective in alleviating the morphine and ethanol withdrawal effects. However, studies in human revealed that prolonged consumption of this plant led to dependence and tolerance while cessation caused a series of aversive withdrawal symptoms. Findings also showed that M. speciosa extracts possess antinociceptive, anti-inflammatory, anti-depressant, and muscle relaxant properties. Available evidence further supports the adverse effects of M. speciosa preparations, mitragynine on cognition. Pharmacological activities are mainly mediated via opioid receptors as well as neuronal Ca2+ channels, expression of cAMP and CREB protein and via descending monoaminergic system. Physicochemical properties of mitragynine have been documented which may further explain the variation in pharmacological responses. In summary, current researchs on its main indole alkaloid, mitragynine suggest both therapeutic and addictive potential but further research on its molecular effects is needed.
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Affiliation(s)
- Farah W Suhaimi
- Centre for Drug Research, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia
| | - Nurul H M Yusoff
- Centre for Drug Research, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia
| | - Rahimah Hassan
- Centre for Drug Research, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia
| | - Sharif M Mansor
- Centre for Drug Research, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia
| | | | - Christian P Müller
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-University Erlangen-Nuremberg, Schwabachanlage 6, 91054 Erlangen, Germany
| | - Zurina Hassan
- Centre for Drug Research, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia.
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Swogger MT, Hart E, Erowid F, Erowid E, Trabold N, Yee K, Parkhurst KA, Priddy BM, Walsh Z. Experiences of Kratom Users: A Qualitative Analysis. J Psychoactive Drugs 2015; 47:360-7. [DOI: 10.1080/02791072.2015.1096434] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Singh D, Müller CP, Vicknasingam BK, Mansor SM. Social Functioning of Kratom (Mitragyna speciosa) Users in Malaysia. J Psychoactive Drugs 2015; 47:125-31. [PMID: 25950592 DOI: 10.1080/02791072.2015.1012610] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Kratom (Mitragyna speciosa) is an indigenous plant known for its traditional medicinal use, and for its addiction potential, in Southeast Asia. In recent years, kratom and its major alkaloid, mitragynine, spread worldwide with largely unknown effects on behavior and mental health. Recent studies show that kratom use can lead to dependence and that mitragynine works as an addictive drug in animal studies. Nevertheless, kratom preparations were also suggested as a less harmful substitute in opiate withdrawal. Potential side-effects of prolonged kratom use, however, are currently unclear. The aim of this study was to investigate the social functioning of regular kratom users in Malaysia. A cross-sectional survey was carried out in three northern states of Peninsular Malaysia investigating 293 regular kratom consumers using the Addiction Severity Index in a snowball sampling technique. Findings showed that regular kratom users do not experience major impairments in their social functioning, despite being dependent on kratom for prolonged periods. Our findings suggest that chronic kratom administration does not significantly impair social functioning of users in a natural context in Malaysia.
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Affiliation(s)
- Darshan Singh
- a Research Scientist, Centre for Drug Research , Universiti Sains Malaysia , Minden , Penang , Malaysia
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Discriminative stimulus properties of mitragynine (kratom) in rats. Psychopharmacology (Berl) 2015; 232:2227-38. [PMID: 25616583 DOI: 10.1007/s00213-015-3866-5] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 12/17/2014] [Indexed: 12/17/2022]
Abstract
RATIONALE Mitragynine (MG) is the primary active alkaloid extracted from the leaves of Mitragyna speciosa or kratom and exhibits pharmacological activities mediated by opioid receptors. The plant has been traditionally used for its opium and psychostimulant-like effects to increase work efficiency or as a substitute in the self-treatment of opiate addiction. OBJECTIVES The present study was performed to investigate the discriminative stimulus effects of MG in rats. The pharmacological mechanism of MG action and its derivative, 7-hydroxymitragynine (7-HMG) with a specific focus on opioid receptor involvement was examined in rats trained to discriminate morphine from vehicle. In order to study the dual actions of MG, the effect of cocaine substitution to the MG discriminative stimulus was also performed in MG-trained rats. METHODS Male Sprague Dawley rats were trained to discriminate MG from vehicle in a two-lever drug discrimination procedure under a tandem variable-interval (VI 60') fixed-ratio (FR 10) schedule of food reinforcement. RESULTS Rats acquired the MG discrimination (15.0 mg/kg, i.p.) which was similar to the acquisition of morphine discrimination (5.0 mg/kg, i.p.) in another group of rats. MG substituted fully to the morphine discriminative stimulus in a dose-dependent manner, suggesting pharmacological similarities between the two drugs. The administration of 7-HMG derivative in 3.0 mg/kg (i.p.) dose engendered full generalisation to the morphine discriminative stimulus. In addition, the MG stimulus also partially generalised to cocaine (10.0 mg/kg, i.p.) stimulus. CONCLUSION The present study demonstrates that the discriminative stimulus effect of MG possesses both opioid- and psychostimulant-like subjective effects.
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Saidin NA, Holmes E, Takayama H, Gooderham NJ. The cellular toxicology of mitragynine, the dominant alkaloid of the narcotic-like herb, Mitragyna speciosa Korth. Toxicol Res (Camb) 2015. [DOI: 10.1039/c5tx00113g] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The cytotoxicity of mitragynine, the dominant alkaloid of the narcotic-like herb, Mitragyna speciosa Korth (Kratom) involves cell cycle arrest, apoptosis and opiate receptors.
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Affiliation(s)
- Nor Aini Saidin
- Computational and Systems Medicine
- Faculty of Medicine
- Imperial College London
- UK
| | - Elaine Holmes
- Computational and Systems Medicine
- Faculty of Medicine
- Imperial College London
- UK
| | | | - Nigel J. Gooderham
- Computational and Systems Medicine
- Faculty of Medicine
- Imperial College London
- UK
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Development of indirect competitive ELISA for quantification of mitragynine in Kratom (Mitragyna speciosa (Roxb.) Korth.). Forensic Sci Int 2014; 244:70-7. [PMID: 25216455 DOI: 10.1016/j.forsciint.2014.08.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Revised: 08/08/2014] [Accepted: 08/12/2014] [Indexed: 11/20/2022]
Abstract
Monoclonal antibody (MAb) against mitragynine (MG), an analgesic alkaloid from Kratom leaves (Mitragyna speciosa), was produced. MG was coupled to carrier proteins employing either 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide/N-hydroxysuccinimide (EDC/NHS), a zero-length cross linker or a 5-carbon length glutaraldehyde cross linker. To confirm the immunogenicity, the hapten numbers were determined using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS). Preparation of the MAb was accomplished by the electrofusion method. Hybridoma 1A6 that was constructed from the fusion between splenocytes of EDC/NHS conjugate immunized mice and SP2/0-Ag14 myeloma cells was selected, cloned twice and expanded. The cross-reactivities (CRs) of this MAb 1A6 with a series of indole alkaloids were 30.54%, 24.83% and 8.63% for speciogynine, paynantheine and mitraciliatine, respectively. Using this MAb, an indirect competitive enzyme-linked immunosorbent assay (icELISA) was developed with a measurement range of 32.92-250 μg/mL. Quantitative analysis of the MG contents in plant samples by icELISA correlated well with the standard high performance liquid chromatography method (R(2)=0.994). The MAb against mitragynine provided a tool for detection of MG in Kratom preparations.
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Saingam D, Assanangkornchai S, Geater AF, Lerkiatbundit S. Validation of Krathom (Mitragyna speciosaKorth.) Dependence Scale (KDS): A Dependence Screen for Internationally Emerging Psychoactive Substance. Subst Abus 2014; 35:276-83. [DOI: 10.1080/08897077.2014.924464] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Hazim AI, Ramanathan S, Parthasarathy S, Muzaimi M, Mansor SM. Anxiolytic-like effects of mitragynine in the open-field and elevated plus-maze tests in rats. J Physiol Sci 2014; 64:161-9. [PMID: 24464759 PMCID: PMC10717818 DOI: 10.1007/s12576-014-0304-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Accepted: 01/08/2014] [Indexed: 01/13/2023]
Abstract
The effects of mitragynine on anxiety-related behaviours in the open-field and elevated plus-maze tests were evaluated. Male Sprague-Dawley rats were orally treated with mitragynine (10, 20 and 40 mg/kg) or diazepam (10 mg/kg) 60 min before behavioural testing. Mitragynine doses used in this study were selected on the basis of approximately human equivalent doses with reference to our previous literature reports. Acute administration of mitragynine (10, 20 and 40 mg/kg) or diazepam (10 mg/kg) increased central zone and open arms exploration in the open-field and elevated plus-maze tests respectively. These anxiolytic-like effects of mitragynine were effectively antagonized by intraperitoneal administration of naloxone (2 mg/kg), flumazenil (10 mg/kg), sulpiride (0.5 mg/kg) or SCH 23390 (0.02 mg/kg) 15 min before mitragynine treatments. These findings reveal that the acute administration of mitragynine produces anxiolytic-like effects and this could be possibly attributed to the interactions among opioidergic, GABAergic and dopaminergic systems in brain regions involved in anxiety.
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Affiliation(s)
- Ammar Imad Hazim
- Centre for Drug Research, Universiti Sains Malaysia, 11800, Penang, Malaysia,
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Matsumoto K, Narita M, Muramatsu N, Nakayama T, Misawa K, Kitajima M, Tashima K, Devi LA, Suzuki T, Takayama H, Horie S. Orally active opioid μ/δ dual agonist MGM-16, a derivative of the indole alkaloid mitragynine, exhibits potent antiallodynic effect on neuropathic pain in mice. J Pharmacol Exp Ther 2014; 348:383-92. [PMID: 24345467 PMCID: PMC6067406 DOI: 10.1124/jpet.113.208108] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 12/09/2013] [Indexed: 01/09/2023] Open
Abstract
(E)-Methyl 2-((2S,3S,7aS,12bS)-3-ethyl-7a-hydroxy-8-methoxy-1,2,3,4,6,7,7a,12b-octahydroindolo[2,3-a]quinolizin-2-yl)-3-methoxyacrylate (7-hydroxymitragynine), a main active constituent of the traditional herbal medicine Mitragyna speciosa, is an indole alkaloid that is structurally different from morphine. 7-Hydroxymitragynine induces a potent antinociceptive effect on mouse acute pain through μ-opioid receptors. In this study, we developed dual-acting μ- and δ-opioid agonists MGM-15 and MGM-16 from 7-hydroxymitragynine for the treatment of acute and chronic pain. MGM-16 showed a higher potency than that of 7-hydroxymitragynine and MGM-15 in in vitro and in vivo assays. MGM-16 exhibited a high affinity for μ- and δ-opioid receptors, with K(i) values of 2.1 and 7.0 nM, respectively. MGM-16 showed μ- and δ-opioid full agonistic effects in a guanosine 5'-O-(3-[(35)S]thiotriphosphate) binding assay and in a functional test using electrically elicited guinea pig ileum and mouse vas deferens contractions. Systemic administration of MGM-16 produced antinociceptive effects in a mouse acute pain model and antiallodynic effects in a chronic pain model. The antinociceptive effect of MGM-16 was approximately 240 times more potent than that of morphine in a mouse tail-flick test, and its antiallodynic effect was approximately 100 times more potent than that of gabapentin in partial sciatic nerve-ligated mice, especially with oral administration. The antinociceptive effect of MGM-16 was completely and partially blocked by the μ-selective antagonist β-funaltrexamine hydrochloride (β-FNA) and by the δ-selective antagonist naltrindole, respectively, in a tail-flick test. The antiallodynic effect of MGM-16 was completely blocked by β-FNA and naltrindole in a neuropathic pain model. These findings suggest that MGM-16 could become a class of a compound with potential therapeutic utility for treating neuropathic pain.
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MESH Headings
- Administration, Oral
- Animals
- CHO Cells
- Cricetinae
- Cricetulus
- Hyperalgesia/drug therapy
- Hyperalgesia/physiopathology
- Ileum/drug effects
- Ileum/physiopathology
- Injections, Subcutaneous
- Male
- Mice
- Muscle Contraction
- Muscle, Smooth/drug effects
- Muscle, Smooth/physiology
- Neuralgia/drug therapy
- Neuralgia/physiopathology
- Physical Stimulation
- Rabbits
- Radioligand Assay
- Receptors, Opioid, delta/agonists
- Receptors, Opioid, delta/antagonists & inhibitors
- Receptors, Opioid, mu/agonists
- Receptors, Opioid, mu/antagonists & inhibitors
- Sciatic Neuropathy/drug therapy
- Sciatic Neuropathy/physiopathology
- Secologanin Tryptamine Alkaloids/chemistry
- Secologanin Tryptamine Alkaloids/pharmacology
- Secologanin Tryptamine Alkaloids/therapeutic use
- Stereoisomerism
- Touch
- Vas Deferens/drug effects
- Vas Deferens/physiopathology
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Affiliation(s)
- Kenjiro Matsumoto
- Laboratory of Pharmacology, Faculty of Pharmaceutical Sciences, Josai International University, Chiba, Japan (K.Ma., N.M., K.T., S.H.); Department of Toxicology (K.Ma., M.N., T.S.) and Department of Pharmacology (K.Ma., M.N.), Hoshi University School of Pharmacy and Pharmaceutical Sciences, Tokyo, Japan; Department of Molecular Structure and Biological Function, Graduate School of Pharmaceutical Sciences, Chiba University, Chiba, Japan (T.N., K.Mi., M.K., H.T.); and Department of Pharmacology and Systems Therapeutics, Mount Sinai School of Medicine, New York, New York (L.A.D.)
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Sufka KJ, Loria MJ, Lewellyn K, Zjawiony JK, Ali Z, Abe N, Khan IA. The effect of Salvia divinorum and Mitragyna speciosa extracts, fraction and major constituents on place aversion and place preference in rats. JOURNAL OF ETHNOPHARMACOLOGY 2013; 151:361-364. [PMID: 24212071 DOI: 10.1016/j.jep.2013.10.059] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 10/22/2013] [Accepted: 10/23/2013] [Indexed: 06/02/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Consumer use of botanicals has increased despite, in many instances, the paucity of research demonstrating efficacy or identifying liabilities. This research employed the place preference/aversion paradigm to characterize the psychoactive properties of Salvia divinorum extract (10, 30, 100mg/kg), salvinorin A (0.1, 0.3, 1.0mg/kg), Mitragyna speciosa MeOH extract (50, 100, 300 mg/kg), Mitragyna speciosa alkaloid-enriched fraction (12.5, 25, 75 mg/kg) and mitragynine (5, 10, 30 mg/kg) in rats. MATERIAL AND METHODS Following apparatus habituation and baseline preference scores, male Sprague-Dawley rats were given eight counter-balanced drug versus vehicle conditioning trials followed by a preference test conducted under drug-free states. S(+)-amphetamine (1mg/kg) served as the positive control (in Exp. 2) and haloperidol (0.8, 1.0mg/kg) served as the negative control in both studies. RESULTS Rats displayed place aversion to both Salvia divinorum and salvinorin A that exceeded that of haloperidol. Rats showed place preference to mitragynine that was similar to that of S(+)-amphetamine. This CPP effect was much less pronounced with the Mitragyna speciosa extract and its fraction. CONCLUSIONS These findings suggest that both botanicals possess liabilities, albeit somewhat different, that warrant caution in their use.
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Affiliation(s)
- Kenneth J Sufka
- Department of Psychology, University of Mississippi, University, MS 38677, USA; Department of Pharmacology, University of Mississippi, University, MS 38677, USA; Research Institute of Pharmaceutical Science, University of Mississippi, University, MS 38677, USA.
| | - Melissa J Loria
- Department of Psychology, University of Mississippi, University, MS 38677, USA
| | - Kevin Lewellyn
- Department of Pharmacognosy, University of Mississippi, University, MS 38677, USA
| | - Jordan K Zjawiony
- Department of Pharmacognosy, University of Mississippi, University, MS 38677, USA; Research Institute of Pharmaceutical Science, University of Mississippi, University, MS 38677, USA
| | - Zulfiqar Ali
- National Center for Natural Product Research, University of Mississippi, University, MS 38677, USA
| | - Naohito Abe
- National Center for Natural Product Research, University of Mississippi, University, MS 38677, USA
| | - Ikhlas A Khan
- Department of Pharmacognosy, University of Mississippi, University, MS 38677, USA; Research Institute of Pharmaceutical Science, University of Mississippi, University, MS 38677, USA; National Center for Natural Product Research, University of Mississippi, University, MS 38677, USA
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Vuppala PK, Jamalapuram S, Furr EB, McCurdy CR, Avery BA. Development and validation of a UPLC-MS/MS method for the determination of 7-hydroxymitragynine, a μ-opioid agonist, in rat plasma and its application to a pharmacokinetic study. Biomed Chromatogr 2013; 27:1726-32. [PMID: 23893615 DOI: 10.1002/bmc.2986] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2013] [Revised: 05/29/2013] [Accepted: 05/29/2013] [Indexed: 11/11/2022]
Abstract
A simple, sensitive and specific ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method was developed and validated to determine the concentrations of 7-hydroxymitragynine in rat plasma. Following a single-step liquid-liquid extraction of plasma samples using chloroform, 7-hydroxymitragynine and the internal standard (tryptoline) were separated on an Acquity UPLC(TM) BEH C18 (1.7 µm, 2.1 × 50 mm) column using an isocratic elution at a flow rate of 0.2 mL/min. The mobile phase consisted of 0.1% acetic acid in water and 0.1% acetic acid in acetonitrile (10:90, v/v). The run time was 2.5 min. The analysis was carried out under the multiple reaction-monitoring mode using positive electrospray ionization. Protonated ions [M + H](+) and their respective product ions were monitored at the following transitions: 415 → 190 for 7-hydroxymitragynine and 173 → 144 for the internal standard. The calibration curve was linear over the range of 10-4000 ng/mL (r(2) = 0.999) with a lower limit of quantification of 10 ng/mL. The extraction recoveries ranged from 62.0 to 67.3% at concentrations of 20, 600 and 3200 ng/mL). Intra- and inter-day assay precisions (relative standard deviation) were <15% and the accuracy was within 96.5-104.0%. This validated method was successfully applied to quantify 7-hydroxymitragynine in rat plasma following intravenous administration.
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Affiliation(s)
- Pradeep K Vuppala
- Department of Pharmaceutics, School of Pharmacy, The University of Mississippi, University, MS, 38677, USA
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Sabetghadam A, Ramanathan S, Sasidharan S, Mansor SM. Subchronic exposure to mitragynine, the principal alkaloid of Mitragyna speciosa, in rats. JOURNAL OF ETHNOPHARMACOLOGY 2013; 146:815-823. [PMID: 23422336 DOI: 10.1016/j.jep.2013.02.008] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Revised: 02/06/2013] [Accepted: 02/08/2013] [Indexed: 06/01/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Mitragyna speciosa is a popular medicinal plant in Southeast Asia which is commonly used for its morphine-like effects. Although the analgesic properties of Mitragyna speciosa and its ability to ameliorate withdrawal signs after abrupt cessation of opioid abuse are well known, information about the long-term safety of the plant's active compounds is lacking. In this work, we evaluated the effects of sub-chronic exposure to mitragynine, the principal alkaloid of Mitragyna speciosa leaves in rats. MATERIALS AND METHODS Male and female Sprague-Dawley rats received three doses of mitragynine (1, 10, 100mg/kg, p.o) for 28 days respectively. Food intake and relative body weight were measured during the experiment. After completion of drug treatment biochemical, hematological, and histological analyses were performed. RESULTS No mortality was observed in any of the treatment groups. The groups of rats treated with the lower and intermediate doses showed no toxic effects during the study. However, the relative body weight of the group of female rats treated with the 100mg/kg dose was decreased significantly. Food intake also tended to decrease in the same group. Only relative liver weight increased after treatment with the high dose of mitragynine (100mg/ kg) in both the male and female treatment groups of rats. Biochemical and hematological parameters were also altered especially in high dose treatment group which corresponds to the histopathological changes. CONCLUSIONS The study demonstrated that mitragynine is relatively safe at lower sub-chronic doses (1-10mg/kg) but exhibited toxicity at a highest dose (sub-chronic 28 days: 100mg/kg). This was confirmed by liver, kidney, and brain histopathological changes, as well as hematological and biochemical changes.
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Affiliation(s)
- Azadeh Sabetghadam
- Centre for Drug Research, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia
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Lim EL, Seah TC, Koe XF, Wahab HA, Adenan MI, Jamil MFA, Majid MIA, Tan ML. In vitro evaluation of cytochrome P450 induction and the inhibition potential of mitragynine, a stimulant alkaloid. Toxicol In Vitro 2012; 27:812-24. [PMID: 23274770 DOI: 10.1016/j.tiv.2012.12.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2012] [Revised: 12/04/2012] [Accepted: 12/13/2012] [Indexed: 12/17/2022]
Abstract
CYP450 enzymes are key determinants in drug toxicities, reduced pharmacological effect and adverse drug reactions. Mitragynine, an euphoric compound was evaluated for its effects on the expression of mRNAs encoding CYP1A2, CYP2D6 and CYP3A4 and protein expression and resultant enzymatic activity. The mRNA and protein expression of CYP450 isoforms were carried out using an optimized multiplex qRT-PCR assay and Western blot analysis. CYP1A2 and CYP3A4 enzyme activities were evaluated using P450-Glo™ assays. The effects of mitragynine on human CYP3A4 protein expression were determined using an optimized hCYP3A4-HepG2 cell-based assay. An in silico computational method to predict the binding conformation of mitragynine to the active site of the CYP3A4 enzyme was performed and further validated using in vitro CYP3A4 inhibition assays. Mitragynine was found to induce mRNA and protein expression of CYP1A2. For the highest concentration of 25 μM, induction of mRNA was approximately 70% that of the positive control and was consistent with the increased CYP1A2 enzymatic activity. Thus, mitragynine is a significant in vitro CYP1A2 inducer. However, it appeared to be a weak CYP3A4 inducer at the transcriptional level and a weak CYP3A4 enzyme inhibitor. It is therefore, unlikely to have any significant clinical effects on CYP3A4 activity.
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Affiliation(s)
- Ee Lin Lim
- Malaysian Institute of Pharmaceuticals & Nutraceuticals, Ministry of Science, Technology & Innovation (MOSTI), Pulau Pinang, Malaysia
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Hassan Z, Muzaimi M, Navaratnam V, Yusoff NHM, Suhaimi FW, Vadivelu R, Vicknasingam BK, Amato D, von Hörsten S, Ismail NIW, Jayabalan N, Hazim AI, Mansor SM, Müller CP. From Kratom to mitragynine and its derivatives: physiological and behavioural effects related to use, abuse, and addiction. Neurosci Biobehav Rev 2012. [PMID: 23206666 DOI: 10.1016/j.neubiorev.2012.11.012] [Citation(s) in RCA: 216] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Kratom (or Ketum) is a psychoactive plant preparation used in Southeast Asia. It is derived from the plant Mitragyna speciosa Korth. Kratom as well as its main alkaloid, mitragynine, currently spreads around the world. Thus, addiction potential and adverse health consequences are becoming an important issue for health authorities. Here we reviewed the available evidence and identified future research needs. It was found that mitragynine and M. speciosa preparations are systematically consumed with rather well defined instrumentalization goals, e.g. to enhance tolerance for hard work or as a substitute in the self-treatment of opiate addiction. There is also evidence from experimental animal models supporting analgesic, muscle relaxant, anti-inflammatory as well as strong anorectic effects. In humans, regular consumption may escalate, lead to tolerance and may yield aversive withdrawal effects. Mitragynine and its derivatives actions in the central nervous system involve μ-opioid receptors, neuronal Ca²⁺ channels and descending monoaminergic projections. Altogether, available data currently suggest both, a therapeutic as well as an abuse potential.
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Affiliation(s)
- Zurina Hassan
- Centre for Drug Research, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia
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Sabetghadam A, Navaratnam V, Mansor SM. Dose-Response Relationship, Acute Toxicity, and Therapeutic Index between the Alkaloid Extract ofMitragyna speciosaand Its Main Active Compound Mitragynine in Mice. Drug Dev Res 2012. [DOI: 10.1002/ddr.21052] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Azadeh Sabetghadam
- Centre for Drug Research; Universiti Sains Malaysia; P. Pinang; 11800; Malaysia
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Shamima AR, Fakurazi S, Hidayat MT, Hairuszah I, Moklas MAM, Arulselvan P. Antinociceptive action of isolated mitragynine from Mitragyna Speciosa through activation of opioid receptor system. Int J Mol Sci 2012; 13:11427-11442. [PMID: 23109863 PMCID: PMC3472755 DOI: 10.3390/ijms130911427] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Revised: 08/27/2012] [Accepted: 08/27/2012] [Indexed: 12/02/2022] Open
Abstract
Cannabinoids and opioids systems share numerous pharmacological properties and antinociception is one of them. Previous findings have shown that mitragynine (MG), a major indole alkaloid found in Mitragyna speciosa (MS) can exert its antinociceptive effects through the opioids system. In the present study, the action of MG was investigated as the antinociceptive agent acting on Cannabinoid receptor type 1 (CB1) and effects on the opioids receptor. The latency time was recorded until the mice showed pain responses such as shaking, licking or jumping and the duration of latency was measured for 2 h at every 15 min interval by hot plate analysis. To investigate the beneficial effects of MG as antinociceptive agent, it was administered intraperitoneally 15 min prior to pain induction with a single dosage (3, 10, 15, 30, and 35 mg/kg b.wt). In this investigation, 35 mg/kg of MG showed significant increase in the latency time and this dosage was used in the antagonist receptor study. The treated groups were administered with AM251 (cannabinoid receptor-1 antagonist), naloxone (non-selective opioid antagonist), naltrindole (δ-opioid antagonist) naloxonazine (μ1-receptor antagonist) and norbinaltorpimine (κ-opioid antagonist) respectively, prior to administration of MG (35 mg/kg). The results showed that the antinociceptive effect of MG was not antagonized by AM251; naloxone and naltrindole were effectively blocked; and norbinaltorpimine partially blocked the antinociceptive effect of MG. Naloxonazine did inhibit the effect of MG, but it was not statistically significant. These results demonstrate that CB1 does not directly have a role in the antinociceptive action of MG where the effect was observed with the activation of opioid receptor.
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Affiliation(s)
- Abdul Rahman Shamima
- Faculty of Pharmacy, Cyberjaya University College of Medical Sciences, 63000 Cyberjaya, Selangor, Malaysia; E-Mail:
| | - Sharida Fakurazi
- Faculty of Medicine and Health Sciences, Department of Human Anatomy, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia; E-Mails: (M.T.H.); (M.A.M.M.)
- Institute of Bioscience, Laboratory of Vaccines and Immunotherapeutics, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia; E-Mail:
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +603-8947-2331; Fax: +603-8942-2341
| | - Mohamad Taufik Hidayat
- Faculty of Medicine and Health Sciences, Department of Human Anatomy, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia; E-Mails: (M.T.H.); (M.A.M.M.)
| | - Ithnin Hairuszah
- Faculty of Medicine and Health Sciences, Department of Pathology, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia; E-Mail:
| | - Mohamad Aris Mohd Moklas
- Faculty of Medicine and Health Sciences, Department of Human Anatomy, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia; E-Mails: (M.T.H.); (M.A.M.M.)
| | - Palanisamy Arulselvan
- Institute of Bioscience, Laboratory of Vaccines and Immunotherapeutics, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia; E-Mail:
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