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Lindner T, Schmidl D, Peschorn L, Pai V, Popa-Cherecheanu A, Chua J, Schmetterer L, Garhöfer G. Therapeutic Potential of Cannabinoids in Glaucoma. Pharmaceuticals (Basel) 2023; 16:1149. [PMID: 37631064 PMCID: PMC10460067 DOI: 10.3390/ph16081149] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 08/07/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
Glaucoma is a leading cause of irreversible blindness worldwide. To date, intraocular pressure (IOP) is the only modifiable risk factor in glaucoma treatment, but even in treated patients, the disease can progress. Cannabinoids, which have been known to lower IOP since the 1970s, have been shown to have beneficial effects in glaucoma patients beyond their IOP-lowering properties. In addition to the classical cannabinoid receptors CB1 and CB2, knowledge of non-classical cannabinoid receptors and the endocannabinoid system has increased in recent years. In particular, the CB2 receptor has been shown to mediate anti-inflammatory, anti-apoptotic, and neuroprotective properties, which may represent a promising therapeutic target for neuroprotection in glaucoma patients. Due to their vasodilatory effects, cannabinoids improve blood flow to the optic nerve head, which may suggest a vasoprotective potential and counteract the altered blood flow observed in glaucoma patients. The aim of this review was to assess the available evidence on the effects and therapeutic potential of cannabinoids in glaucoma patients. The pharmacological mechanisms underlying the effects of cannabinoids on IOP, neuroprotection, and ocular hemodynamics have been discussed.
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Affiliation(s)
- Theresa Lindner
- Department of Clinical Pharmacology, Medical University Vienna, 1090 Vienna, Austria; (T.L.); (D.S.); (L.P.); (V.P.); (L.S.)
| | - Doreen Schmidl
- Department of Clinical Pharmacology, Medical University Vienna, 1090 Vienna, Austria; (T.L.); (D.S.); (L.P.); (V.P.); (L.S.)
| | - Laura Peschorn
- Department of Clinical Pharmacology, Medical University Vienna, 1090 Vienna, Austria; (T.L.); (D.S.); (L.P.); (V.P.); (L.S.)
| | - Viktoria Pai
- Department of Clinical Pharmacology, Medical University Vienna, 1090 Vienna, Austria; (T.L.); (D.S.); (L.P.); (V.P.); (L.S.)
| | - Alina Popa-Cherecheanu
- Department of Ophthalmology, Emergency University Hospital, 050098 Bucharest, Romania;
- Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Jacqueline Chua
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore 169856, Singapore;
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Leopold Schmetterer
- Department of Clinical Pharmacology, Medical University Vienna, 1090 Vienna, Austria; (T.L.); (D.S.); (L.P.); (V.P.); (L.S.)
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore 169856, Singapore;
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore 169857, Singapore
- SERI-NTU Advanced Ocular Engineering (STANCE), Nanyang Technological University, Singapore 639798, Singapore
- School of Chemistry, Chemical Engineering and Biotechnology, Nanyang Technological University, Singapore 637459, Singapore
- Center for Medical Physics and Biomedical Engineering, Medical University Vienna, 1090 Vienna, Austria
- Institute of Molecular and Clinical Ophthalmology, 4031 Basel, Switzerland
| | - Gerhard Garhöfer
- Department of Clinical Pharmacology, Medical University Vienna, 1090 Vienna, Austria; (T.L.); (D.S.); (L.P.); (V.P.); (L.S.)
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2
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Roy P, Dennis DG, Eschbach MD, Anand SD, Xu F, Maturano J, Hellman J, Sarlah D, Das A. Metabolites of Cannabigerol Generated by Human Cytochrome P450s Are Bioactive. Biochemistry 2022; 61:2398-2408. [PMID: 36223199 DOI: 10.1021/acs.biochem.2c00383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The phytocannabinoid cannabigerol (CBG) is the central biosynthetic precursor to many cannabinoids, including Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD). Though the use of CBG has recently witnessed a widespread surge because of its beneficial health effects and lack of psychoactivity, its metabolism by human cytochrome P450s is largely unknown. Herein, we describe comprehensive in vitro and in vivo cytochrome P450 (CYP)-mediated metabolic studies of CBG, ranging from liquid chromatography tandem mass spectrometry-based primary metabolic site determination, synthetic validation, and kinetic behavior using targeted mass spectrometry. These investigations revealed that cyclo-CBG, a recently isolated phytocannabinoid, is the major metabolite that is rapidly formed by selected human cytochrome P450s (CYP2J2, CYP3A4, CYP2D6, CYP2C8, and CYP2C9). Additionally, in vivo studies with mice administered with CBG supported these studies, where cyclo-CBG is the major metabolite as well. Spectroscopic binding studies along with docking and modeling of the CBG molecule near the heme in the active site of P450s confirmed these observations, pointing at the preferred site selectivity of CBG metabolism at the prenyl chain over other positions. Importantly, we found out that CBG and its oxidized CBG metabolites reduced inflammation in BV2 microglial cells stimulated with LPS. Overall, combining enzymological studies, mass spectrometry, and chemical synthesis, we showcase that CBG is rapidly metabolized by human P450s to form oxidized metabolites that are bioactive.
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Affiliation(s)
- Pritam Roy
- Department of Comparative Biosciences, Center for Biophysics and Quantitative Biology, Beckman Institute for Advanced Science and Technology, Department of Bioengineering, Neuroscience program, University of Illinois Urbana-Champaign, Urbana, Illinois 61801, United States.,School of Chemistry and Biochemistry, Georgia Institute of Technology, Atlanta, Georgia 30332, United States
| | - David G Dennis
- Roger Adams Laboratory, Department of Chemistry, University of Illinois, Urbana, Illinois 61801, United States.,Cancer Center at Illinois, University of Illinois, Urbana, Illinois 61801, United States
| | - Mark D Eschbach
- Department of Comparative Biosciences, Center for Biophysics and Quantitative Biology, Beckman Institute for Advanced Science and Technology, Department of Bioengineering, Neuroscience program, University of Illinois Urbana-Champaign, Urbana, Illinois 61801, United States.,School of Chemistry and Biochemistry, Georgia Institute of Technology, Atlanta, Georgia 30332, United States
| | - Shravanthi D Anand
- Department of Comparative Biosciences, Center for Biophysics and Quantitative Biology, Beckman Institute for Advanced Science and Technology, Department of Bioengineering, Neuroscience program, University of Illinois Urbana-Champaign, Urbana, Illinois 61801, United States.,School of Chemistry and Biochemistry, Georgia Institute of Technology, Atlanta, Georgia 30332, United States
| | - Fengyun Xu
- Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, California 94143, United States
| | - Jonathan Maturano
- Roger Adams Laboratory, Department of Chemistry, University of Illinois, Urbana, Illinois 61801, United States.,Cancer Center at Illinois, University of Illinois, Urbana, Illinois 61801, United States
| | - Judith Hellman
- Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, California 94143, United States
| | - David Sarlah
- Roger Adams Laboratory, Department of Chemistry, University of Illinois, Urbana, Illinois 61801, United States.,Cancer Center at Illinois, University of Illinois, Urbana, Illinois 61801, United States
| | - Aditi Das
- Department of Comparative Biosciences, Center for Biophysics and Quantitative Biology, Beckman Institute for Advanced Science and Technology, Department of Bioengineering, Neuroscience program, University of Illinois Urbana-Champaign, Urbana, Illinois 61801, United States.,School of Chemistry and Biochemistry, Georgia Institute of Technology, Atlanta, Georgia 30332, United States.,Cancer Center at Illinois, University of Illinois, Urbana, Illinois 61801, United States
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CB 1R, CB 2R and TRPV1 expression and modulation in in vivo, animal glaucoma models: A systematic review. Biomed Pharmacother 2022; 150:112981. [PMID: 35468582 DOI: 10.1016/j.biopha.2022.112981] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 04/06/2022] [Accepted: 04/14/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The endocannabinoid system (ECS) is a complex biological regulatory system. Its expression and functionality have been widely investigated in ocular tissues. Recent data have reported its modulation to be valid in determining an ocular hypotensive and a neuroprotective effect in preclinical animal models of glaucoma. AIM This study aimed to explore the available literature on cannabinoid receptor 1 (CB1R), cannabinoid receptor 2 (CB2R), and transient receptor potential vanilloid 1 (TRPV1) expression in the trabecular meshwork (TM), ciliary body (CB), and retina as well as their ocular hypotensive and neuroprotective effects in preclinical, in vivo, animal glaucoma models. MATERIALS AND METHODS The study adhered to both PRISMA and SYRCLE guidelines. Sixty-nine full-length articles were included in the final analysis. RESULTS Preclinical studies indicated a widespread distribution of CB1R, CB2R, and TRPV1 in the TM, CB, and retina, although receptor-, age-, and species-dependent differences were observed. CB1R and CB2R modulation have been shown to exert ocular hypotensive effects in preclinical models via the regulation of inflow and outflow pathways. Retinal cell neuroprotection has been achieved in several experimental models, mediated by agonists and antagonists of CB1R, CB2R, and TRPV1. DISCUSSION Despite the growing body of preclinical data regarding the expression and modulation of ECS in ocular tissues, the mechanisms responsible for the hypotensive and neuroprotective efficacy exerted by this system remain largely elusive. Research on this topic is advocated to further substantiate the hypothesis that the ECS is a new potential therapeutic target in the context of glaucoma.
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Mosaed S, Smith AK, Liu JHK, Minckler DS, Fitzgerald RL, Grelotti D, Sones E, Weinreb RN, Marcotte TD. The Relationship Between Plasma Tetrahydrocannabinol Levels and Intraocular Pressure in Healthy Adult Subjects. Front Med (Lausanne) 2022; 8:736792. [PMID: 35111768 PMCID: PMC8801518 DOI: 10.3389/fmed.2021.736792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 12/24/2021] [Indexed: 11/13/2022] Open
Abstract
BackgroundΔ9-tetrahydrocannabinol (THC) has been shown to decreased intraocular pressure (IOP). This project aims to define the relationship between plasma THC levels and IOP in healthy adult subjects.MethodsEleven healthy subjects received a single dose of inhaled cannabis that was self-administered in negative pressure rooms. Measurements of IOP and plasma THC levels were taken at baseline and every 30 min for 1 h and afterwards every hour for 4 h. IOP reduction and percent change in IOP over time were calculated. Linear regression models were used to measure the relationship between IOP and plasma THC levels. Two line linear regression models with F-tests were used to detect change points in the regression. Then, Pearson correlations were computed based on the change point.ResultsTwenty-two eyes met inclusion criteria. The average peak percentage decrease in IOP was 16% at 60 min. Percent IOP reduction as well as total IOP reduction demonstrated a negative correlation with THC plasma levels showing r-values of −0.81 and −0.70, respectively. F-tests revealed a change point in the regression for plasma levels >20 ng/ml. For levels >20 ng/ml, the correlation coefficients changed significantly with r-values of 0.21 and 0.29 (p < 0.01).ConclusionPlasma THC levels are significantly correlated with IOP reduction up to plasma levels of 20 ng/ml. Plasma levels >20 ng/ml were not correlated with further decrease in IOP. More research is needed to determine the efficacy of THC in reducing IOP for eyes with ocular hypertension and glaucoma.
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Affiliation(s)
- Sameh Mosaed
- Gavin Herbert Eye Institute, University of California, Irvine, Irvine, CA, United States
- Irvine School of Medicine, University of California, Irvine, Irvine, CA, United States
| | - Andrew K. Smith
- Gavin Herbert Eye Institute, University of California, Irvine, Irvine, CA, United States
- Irvine School of Medicine, University of California, Irvine, Irvine, CA, United States
- *Correspondence: Andrew K. Smith
| | - John H. K. Liu
- Viterbi Family Department of Ophthalmology, University of California, San Diego, San Diego, CA, United States
| | - Donald S. Minckler
- Irvine School of Medicine, University of California, Irvine, Irvine, CA, United States
| | - Robert L. Fitzgerald
- Department of Pathology, University of California, San Diego, San Diego, CA, United States
| | - David Grelotti
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - Emily Sones
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - Robert N. Weinreb
- Viterbi Family Department of Ophthalmology, University of California, San Diego, San Diego, CA, United States
| | - Thomas D. Marcotte
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
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5
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Mosaed S, Liu JHK, Minckler DS, Fitzgerald RL, Grelotti D, Sones E, Shiels CR, Weinreb RN, Marcotte TD. The Effect of Inhaled Cannabis on Intraocular Pressure in Healthy Adult Subjects. Ophthalmology 2021. [DOI: 10.17925/opht.2021.15.1.33] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Cannabinoids in Glaucoma Patients: The Never-Ending Story. J Clin Med 2020; 9:jcm9123978. [PMID: 33302608 PMCID: PMC7763320 DOI: 10.3390/jcm9123978] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 11/26/2020] [Accepted: 12/04/2020] [Indexed: 12/18/2022] Open
Abstract
Glaucoma is one of the principal causes of irreversible blindness worldwide. Yet, intraocular pressure (IOP) is the main modifiable risk factor for disease progression. In the never-ending challenge to develop new and effective drugs, several molecules have been tested as anti-glaucoma agents thanks to their pressure-lowering capabilities. Among these molecules, the cannabinoids have been investigated as possible anti-glaucoma drugs since the early 1970s. Cannabinoids are a large class of chemical compounds that exploit their effects by interaction with cannabinoid receptors 1 and 2. These receptors are widely expressed in the human retina where they may influence important functions such as photo-transduction, amacrine cell network maintenance, and IOP regulation. Therefore, in past years several studies have been conducted in order to assess the IOP lowering effects of cannabinoids. PRISMA guidelines have been used to perform a literature search on Pubmed and Scopus aiming to investigate the mechanism of IOP lowering effects and the potential benefits of orally administered, inhaled, topical, and intravenous cannabinoids in the treatment of glaucoma patients.
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Balendra SI, Zollet P, Cisa Asinari Di Gresy E Casasca G, Cordeiro MF. Personalized approaches for the management of glaucoma. EXPERT REVIEW OF PRECISION MEDICINE AND DRUG DEVELOPMENT 2020. [DOI: 10.1080/23808993.2020.1756770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Shiama Indu Balendra
- The Western Eye Hospital, Imperial College Healthcare NHS Trust (ICHNT), London, UK
- The Imperial College Ophthalmic Research Group (ICORG), Imperial College, London, UK
- Glaucoma and Retinal Neurodegeneration Group, Department of Visual Neuroscience, UCL Institute of Ophthalmology, London, UK
| | - Piero Zollet
- The Imperial College Ophthalmic Research Group (ICORG), Imperial College, London, UK
- Department of Ophthalmology, University Vita-Salute San Raffaele, San Raffaele Scientific Institute, Milan, Italy
| | - Gloria Cisa Asinari Di Gresy E Casasca
- The Imperial College Ophthalmic Research Group (ICORG), Imperial College, London, UK
- Department of Ophthalmology, University Vita-Salute San Raffaele, San Raffaele Scientific Institute, Milan, Italy
| | - Maria Francesca Cordeiro
- The Western Eye Hospital, Imperial College Healthcare NHS Trust (ICHNT), London, UK
- The Imperial College Ophthalmic Research Group (ICORG), Imperial College, London, UK
- Glaucoma and Retinal Neurodegeneration Group, Department of Visual Neuroscience, UCL Institute of Ophthalmology, London, UK
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8
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Challenges and Opportunities in Preclinical Research of Synthetic Cannabinoids for Pain Therapy. ACTA ACUST UNITED AC 2020; 56:medicina56010024. [PMID: 31936616 PMCID: PMC7023162 DOI: 10.3390/medicina56010024] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 01/05/2020] [Accepted: 01/07/2020] [Indexed: 12/13/2022]
Abstract
Cannabis has been used in pain management since 2900 BC. In the 20th century, synthetic cannabinoids began to emerge, thus opening the way for improved efficacy. The search for new forms of synthetic cannabinoids continues and, as such, the aim of this review is to provide a comprehensive tool for the research and development of this promising class of drugs. Methods for the in vitro assessment of cytotoxic, mutagenic or developmental effects are presented, followed by the main in vivo pain models used in cannabis research and the results yielded by different types of administration (systemic versus intrathecal versus inhalation). Animal models designed for assessing side-effects and long-term uses are also discussed. In the second part of this review, pharmacokinetic and pharmacodynamic studies of synthetic cannabinoid biodistribution, together with liquid chromatography–mass spectrometric identification of synthetic cannabinoids in biological fluids from rodents to humans are presented. Last, but not least, different strategies for improving the solubility and physicochemical stability of synthetic cannabinoids and their potential impact on pain management are discussed. In conclusion, synthetic cannabinoids are one of the most promising classes of drugs in pain medicine, and preclinical research should focus on identifying new and improved alternatives for a better clinical and preclinical outcome.
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Garai S, Kulkarni PM, Schaffer PC, Leo LM, Brandt AL, Zagzoog A, Black T, Lin X, Hurst DP, Janero DR, Abood ME, Zimmowitch A, Straiker A, Pertwee RG, Kelly M, Szczesniak AM, Denovan-Wright EM, Mackie K, Hohmann AG, Reggio PH, Laprairie RB, Thakur GA. Application of Fluorine- and Nitrogen-Walk Approaches: Defining the Structural and Functional Diversity of 2-Phenylindole Class of Cannabinoid 1 Receptor Positive Allosteric Modulators. J Med Chem 2020; 63:542-568. [PMID: 31756109 DOI: 10.1021/acs.jmedchem.9b01142] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Cannabinoid 1 receptor (CB1R) allosteric ligands hold a far-reaching therapeutic promise. We report the application of fluoro- and nitrogen-walk approaches to enhance the drug-like properties of GAT211, a prototype CB1R allosteric agonist-positive allosteric modulator (ago-PAM). Several analogs exhibited improved functional potency (cAMP, β-arrestin 2), metabolic stability, and aqueous solubility. Two key analogs, GAT591 (6r) and GAT593 (6s), exhibited augmented allosteric-agonist and PAM activities in neuronal cultures, improved metabolic stability, and enhanced orthosteric agonist binding (CP55,940). Both analogs also exhibited good analgesic potency in the CFA inflammatory-pain model with longer duration of action over GAT211 while being devoid of adverse cannabimimetic effects. Another analog, GAT592 (9j), exhibited moderate ago-PAM potency and improved aqueous solubility with therapeutic reduction of intraocular pressure in murine glaucoma models. The SAR findings and the enhanced allosteric activity in this class of allosteric modulators were accounted for in our recently developed computational model for CB1R allosteric activation and positive allosteric modulation.
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Affiliation(s)
- Sumanta Garai
- Department of Pharmaceutical Sciences, School of Pharmacy, Bouvé College of Health Sciences , Northeastern University , Boston , Massachusetts 02115 , United States
| | - Pushkar M Kulkarni
- Department of Pharmaceutical Sciences, School of Pharmacy, Bouvé College of Health Sciences , Northeastern University , Boston , Massachusetts 02115 , United States
| | - Peter C Schaffer
- Department of Pharmaceutical Sciences, School of Pharmacy, Bouvé College of Health Sciences , Northeastern University , Boston , Massachusetts 02115 , United States
| | - Luciana M Leo
- Center for Substance Abuse Research, Lewis Katz School of Medicine , Temple University , Philadelphia , Pennsylvania 19140 , United States
| | - Asher L Brandt
- College of Pharmacy and Nutrition , University of Saskatchewan , 104 Clinic Pl , Saskatoon , SK S7N2Z4 , Canada
| | - Ayat Zagzoog
- College of Pharmacy and Nutrition , University of Saskatchewan , 104 Clinic Pl , Saskatoon , SK S7N2Z4 , Canada
| | - Tallan Black
- College of Pharmacy and Nutrition , University of Saskatchewan , 104 Clinic Pl , Saskatoon , SK S7N2Z4 , Canada
| | - Xiaoyan Lin
- Program in Neuroscience, Psychological and Brain Sciences, and Gill Center for Biomolecular Science , Indiana University , Bloomington , Indiana 47405 , United States
| | - Dow P Hurst
- Center for Drug Discovery , University of North Carolina Greensboro , Greensboro , North Carolina 27402 , United States
| | - David R Janero
- Department of Pharmaceutical Sciences, Bouvé College of Health Sciences, Department of Chemistry and Chemical Biology, College of Science, and Health Sciences Entrepreneurs , Northeastern University , Boston , Massachusetts 02115 , United States
| | - Mary E Abood
- Center for Substance Abuse Research, Lewis Katz School of Medicine , Temple University , Philadelphia , Pennsylvania 19140 , United States
| | - Anaelle Zimmowitch
- Program in Neuroscience, Psychological and Brain Sciences, and Gill Center for Biomolecular Science , Indiana University , Bloomington , Indiana 47405 , United States
| | - Alex Straiker
- Program in Neuroscience, Psychological and Brain Sciences, and Gill Center for Biomolecular Science , Indiana University , Bloomington , Indiana 47405 , United States
| | - Roger G Pertwee
- School of Medicine, Medical Sciences and Nutrition, Institute of Medical Sciences , University of Aberdeen , Aberdeen AB25 2ZD , Scotland, U.K
| | - Melanie Kelly
- Department of Pharmacology, Faculty of Medicine , Dalhousie University , 5850 College St , Halifax , NS , B3H4R2 , Canada
| | - Anna-Maria Szczesniak
- Department of Pharmacology, Faculty of Medicine , Dalhousie University , 5850 College St , Halifax , NS , B3H4R2 , Canada
| | - Eileen M Denovan-Wright
- Department of Pharmacology, Faculty of Medicine , Dalhousie University , 5850 College St , Halifax , NS , B3H4R2 , Canada
| | - Ken Mackie
- Program in Neuroscience, Psychological and Brain Sciences, and Gill Center for Biomolecular Science , Indiana University , Bloomington , Indiana 47405 , United States
| | - Andrea G Hohmann
- Program in Neuroscience, Psychological and Brain Sciences, and Gill Center for Biomolecular Science , Indiana University , Bloomington , Indiana 47405 , United States
| | - Patricia H Reggio
- Center for Drug Discovery , University of North Carolina Greensboro , Greensboro , North Carolina 27402 , United States
| | - Robert B Laprairie
- College of Pharmacy and Nutrition , University of Saskatchewan , 104 Clinic Pl , Saskatoon , SK S7N2Z4 , Canada.,Department of Pharmacology, Faculty of Medicine , Dalhousie University , 5850 College St , Halifax , NS , B3H4R2 , Canada
| | - Ganesh A Thakur
- Department of Pharmaceutical Sciences, School of Pharmacy, Bouvé College of Health Sciences , Northeastern University , Boston , Massachusetts 02115 , United States
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Guglielmi P, Carradori S, Campestre C, Poce G. Novel therapies for glaucoma: a patent review (2013-2019). Expert Opin Ther Pat 2019; 29:769-780. [DOI: 10.1080/13543776.2019.1653279] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Paolo Guglielmi
- Department of Chemistry and Technologies of Drugs, Sapienza University of Rome, Rome, Italy
| | - Simone Carradori
- Department of Pharmacy, University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy
| | - Cristina Campestre
- Department of Pharmacy, University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy
| | - Giovanna Poce
- Department of Chemistry and Technologies of Drugs, Sapienza University of Rome, Rome, Italy
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11
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Lax P, Kutsyr O, Esquiva G, Altavilla C, Maneu V, Cuenca N. Cannabinoid-mediated retinal rescue correlates with improved circadian parameters in retinal dystrophic rats. Exp Eye Res 2019; 180:192-199. [DOI: 10.1016/j.exer.2018.12.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 11/13/2018] [Accepted: 12/30/2018] [Indexed: 11/15/2022]
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12
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Spadoni G, Bedini A, Furiassi L, Mari M, Mor M, Scalvini L, Lodola A, Ghidini A, Lucini V, Dugnani S, Scaglione F, Piomelli D, Jung KM, Supuran CT, Lucarini L, Durante M, Sgambellone S, Masini E, Rivara S. Identification of Bivalent Ligands with Melatonin Receptor Agonist and Fatty Acid Amide Hydrolase (FAAH) Inhibitory Activity That Exhibit Ocular Hypotensive Effect in the Rabbit. J Med Chem 2018; 61:7902-7916. [DOI: 10.1021/acs.jmedchem.8b00893] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- Gilberto Spadoni
- Dipartimento di Scienze Biomolecolari, Università degli Studi di Urbino “Carlo Bo”, Piazza Rinascimento 6, I-61029 Urbino, Italy
| | - Annalida Bedini
- Dipartimento di Scienze Biomolecolari, Università degli Studi di Urbino “Carlo Bo”, Piazza Rinascimento 6, I-61029 Urbino, Italy
| | - Lucia Furiassi
- Dipartimento di Scienze Biomolecolari, Università degli Studi di Urbino “Carlo Bo”, Piazza Rinascimento 6, I-61029 Urbino, Italy
| | - Michele Mari
- Dipartimento di Scienze Biomolecolari, Università degli Studi di Urbino “Carlo Bo”, Piazza Rinascimento 6, I-61029 Urbino, Italy
| | - Marco Mor
- Dipartimento di Scienze degli Alimenti e del Farmaco, Università degli Studi di Parma, Parco Area delle Scienze 27/A I-43124 Parma, Italy
| | - Laura Scalvini
- Dipartimento di Scienze degli Alimenti e del Farmaco, Università degli Studi di Parma, Parco Area delle Scienze 27/A I-43124 Parma, Italy
| | - Alessio Lodola
- Dipartimento di Scienze degli Alimenti e del Farmaco, Università degli Studi di Parma, Parco Area delle Scienze 27/A I-43124 Parma, Italy
| | - Andrea Ghidini
- Dipartimento di Scienze degli Alimenti e del Farmaco, Università degli Studi di Parma, Parco Area delle Scienze 27/A I-43124 Parma, Italy
| | - Valeria Lucini
- Dipartimento di Oncologia ed Emato-Oncologia, Università degli Studi di Milano, Via Vanvitelli 32, I-20129 Milano, Italy
| | - Silvana Dugnani
- Dipartimento di Oncologia ed Emato-Oncologia, Università degli Studi di Milano, Via Vanvitelli 32, I-20129 Milano, Italy
| | - Francesco Scaglione
- Dipartimento di Oncologia ed Emato-Oncologia, Università degli Studi di Milano, Via Vanvitelli 32, I-20129 Milano, Italy
| | - Daniele Piomelli
- Dipartimento di Scienze degli Alimenti e del Farmaco, Università degli Studi di Parma, Parco Area delle Scienze 27/A I-43124 Parma, Italy
- Department of Anatomy and Neurobiology, School of Medicine, University of California, Irvine, California 92697, United States
| | - Kwang-Mook Jung
- Department of Anatomy and Neurobiology, School of Medicine, University of California, Irvine, California 92697, United States
| | - Claudiu T. Supuran
- Dipartimento NEUROFARBA, Sezione di Scienze Farmaceutiche e Nutraceutiche, Università degli Studi di Firenze, via Ugo Shiff 6, I-50019 Sesto Fiorentino (FI), Italy
| | - Laura Lucarini
- Dipartimento NEUROFARBA, Sezione di Farmacologia e Tossicologia, Università degli Studi di Firenze, Viale G. Pieraccini 6, I-50019 Firenze, Italy
| | - Mariaconcetta Durante
- Dipartimento NEUROFARBA, Sezione di Farmacologia e Tossicologia, Università degli Studi di Firenze, Viale G. Pieraccini 6, I-50019 Firenze, Italy
| | - Silvia Sgambellone
- Dipartimento NEUROFARBA, Sezione di Farmacologia e Tossicologia, Università degli Studi di Firenze, Viale G. Pieraccini 6, I-50019 Firenze, Italy
| | - Emanuela Masini
- Dipartimento NEUROFARBA, Sezione di Farmacologia e Tossicologia, Università degli Studi di Firenze, Viale G. Pieraccini 6, I-50019 Firenze, Italy
| | - Silvia Rivara
- Dipartimento di Scienze degli Alimenti e del Farmaco, Università degli Studi di Parma, Parco Area delle Scienze 27/A I-43124 Parma, Italy
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13
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Maurya N, Velmurugan BK. Therapeutic applications of cannabinoids. Chem Biol Interact 2018; 293:77-88. [PMID: 30040916 DOI: 10.1016/j.cbi.2018.07.018] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 07/10/2018] [Accepted: 07/20/2018] [Indexed: 12/12/2022]
Abstract
The psychoactive property of cannabinoids is well known and there has been a continuous controversy regarding the usage of these compounds for therapeutic purposes all over the world. Their use for medical and research purposes are restricted in various countries. However, their utility as medications should not be overshadowed by its negative physiological activities. This review article is focused on the therapeutic potential and applications of phytocannabinoids and endocannabinoids. We further highlights their mode of action, overall effects on physiology, various in vitro and in vivo studies that have been done so far and the extent to which these compounds can be useful in different disease conditions such as cancer, Alzheimer's disease, multiple sclerosis, pain, inflammation, glaucoma and many others. Thus, this work is an attempt to make the readers understand the positive implications of these compounds and indicates the significant developments of utilizing cannabinoids as therapeutic agents.
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Affiliation(s)
- Nancy Maurya
- School of Biotechnology, Rajiv Gandhi Proudyogiki Vishwavidyalaya, Bhopal, India
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14
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Efficacy of Timolol 0.1% Gel and a Prostaglandin Analog in an Unfixed Combination Compared to the Corresponding Fixed Combinations. Eur J Ophthalmol 2018; 23:683-689. [PMID: 23640513 DOI: 10.5301/ejo.5000292] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To investigate the intraocular pressure (IOP) reduction with prostaglandin analogs (PGAs)-timolol fixed combinations versus the unfixed combination of the same PGAs and timolol 0.1% in gel-forming carbomer. METHODS Patients with primary open-angle glaucoma (POAG) receiving for at least 4 weeks the fixed combinations of PGA-timolol, administered once a day in the evening (0.005% latanoprost with 0.5% timolol, 0.004% travoprost with 0.5% timolol, 0.03% bimatoprost with 0.5% timolol) were switched to an unfixed combination of the same PGA (once a day in the evening) with timolol 0.1% in gel-forming carbomer (once a day in the morning) for at least 4 weeks. The primary endpoint was to compare efficacy of fixed vs unfixed combinations in lowering IOP. The effects of both regimens on short-term IOP fluctuations were also assessed. RESULTS A total of 32 patients (64 eyes) fulfilled inclusion criteria: 17 patients received latanoprost-timolol fixed combination, 9 travoprost-timolol fixed combination, 6 bimatoprost-timolol fixed combination. For all considered time periods each unfixed combination induced an IOP reduction significantly higher than the corresponding fixed combination (paired t test: p<0.05 in all measurements). The diurnal IOP reduction was significantly higher during the unfixed combinations (p<0.001). Unfixed combinations significantly decreased IOP diurnal fluctuations and increased the percentage of patients with daily IOP fluctuation ≤2 mm Hg. CONCLUSIONS In this pilot study, PGA and timolol seems to be more effective in POAG treatment when administered as unfixed combinations, reducing both IOP and daily fluctuations. The once a day timolol 0.1% gel-forming carbomer may be a valuable option in PGA-timolol unfixed combination regimen.
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15
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Neuroprotective agents in the management of glaucoma. Eye (Lond) 2018; 32:938-945. [PMID: 29472700 PMCID: PMC5944652 DOI: 10.1038/s41433-018-0050-2] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 01/22/2018] [Accepted: 01/25/2018] [Indexed: 01/05/2023] Open
Abstract
Glaucoma is an optic neuropathy, specifically a neurodegenerative disease characterized by loss of retinal ganglion cells (RGCs) and their axons. The pathogenesis of RGC loss in glaucoma remains incompletely understood and a broad range of possible mechanisms have been implicated. Clinical evidence indicates that lowering intraocular pressure (IOP) does not prevent progression in all patients; therefore, risk factors other than those related to IOP are involved in the disease. The need for alternative, non-IOP-lowering treatments focused at preventing progression, that is, neuroprotectants, has become of interest to both the patient and the physician. Experimental evidence accumulated during the past two decades lend a great deal of support to molecules endowed with neuroprotective features. However, translation to the clinic of the latter drugs results unsuccessful mostly because of the lack of reliable in vivo measure of retinal damage, thus hampering the good therapeutic potential of neuroprotective agents given alone or as adjuvant therapy to IOP-lowering agents. Further research effort is needed to better understand the mechanisms involved in glaucoma and the means to translate into clinic neuroprotective drugs.
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16
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Rizzo MI, Greco A, De Virgilio A, Gallo A, Taverniti L, Fusconi M, Conte M, Pagliuca G, Turchetta R, de Vincentiis M. Glaucoma: recent advances in the involvement of autoimmunity. Immunol Res 2018; 65:207-217. [PMID: 27475096 DOI: 10.1007/s12026-016-8837-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Glaucomatous optic neuropathy is the most commonly acquired optic neuropathy encountered in clinical practice. It is the second leading cause of blindness globally, after cataracts, but it presents a greater public health challenge than cataracts, because the blindness it causes is irreversible. It has pathogenesis still largely unknown and no established cure. Alterations in serum antibody profiles, upregulation, and downregulation have been described, but it still remains elusive if the autoantibodies seen in glaucoma are an epiphenomenon or causative. Hypertension, diabetes, and hearing disorders also are associated. This review is a glaucoma update with focus about the recent advances in the last 15 years.
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Affiliation(s)
- Maria Ida Rizzo
- ENT Section, Department Organs of Sense, University of Rome "La Sapienza", Viale del Policlinico 155, 00100, Rome, Italy.,Department of Surgical Science, University of Rome "La Sapienza", Viale del Policlinico 155, 00100, Rome, Italy
| | - Antonio Greco
- Department of Surgical Science, University of Rome "La Sapienza", Viale del Policlinico 155, 00100, Rome, Italy
| | - Armando De Virgilio
- ENT Section, Department Organs of Sense, University of Rome "La Sapienza", Viale del Policlinico 155, 00100, Rome, Italy. .,Department of Surgical Science, University of Rome "La Sapienza", Viale del Policlinico 155, 00100, Rome, Italy.
| | - Andrea Gallo
- Otorhinolaryngology Section, Department of Medico-Surgical Sciences and Biotechnologies, ''Sapienza'' University of Rome, Corso della Repubblica, 79, 04100, Latina, LT, Italy
| | - Luciano Taverniti
- Ophthalmology Section, Department Organs of Sense, University of Rome "La Sapienza", Viale del Policlinico 155, 00100, Rome, Italy
| | - Massimo Fusconi
- ENT Section, Department Organs of Sense, University of Rome "La Sapienza", Viale del Policlinico 155, 00100, Rome, Italy
| | - Michela Conte
- ENT Section, Department Organs of Sense, University of Rome "La Sapienza", Viale del Policlinico 155, 00100, Rome, Italy
| | - Giulio Pagliuca
- Otorhinolaryngology Section, Department of Medico-Surgical Sciences and Biotechnologies, ''Sapienza'' University of Rome, Corso della Repubblica, 79, 04100, Latina, LT, Italy
| | - Rosaria Turchetta
- ENT Section, Department Organs of Sense, University of Rome "La Sapienza", Viale del Policlinico 155, 00100, Rome, Italy
| | - Marco de Vincentiis
- ENT Section, Department Organs of Sense, University of Rome "La Sapienza", Viale del Policlinico 155, 00100, Rome, Italy
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17
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Cairns EA, Toguri JT, Porter RF, Szczesniak AM, Kelly MEM. Seeing over the horizon - targeting the endocannabinoid system for the treatment of ocular disease. J Basic Clin Physiol Pharmacol 2017; 27:253-65. [PMID: 26565550 DOI: 10.1515/jbcpp-2015-0065] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 09/25/2015] [Indexed: 01/09/2023]
Abstract
The observation that marijuana reduces intraocular pressure was made by Hepler and Frank in the 1970s. Since then, there has been a significant body of work investigating cannabinoids for their potential use as therapeutics. To date, no endocannabinoid system (ECS)-modulating drug has been approved for clinical use in the eye; however, recent advances in our understanding of the ECS, as well as new pharmacological tools, has renewed interest in the development of ocular ECS-based therapeutics. This review summarizes the current state-of-affairs for the use of ECS-modulating drugs for the treatment of glaucoma and ocular inflammatory and ischemic disease.
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18
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The arguments for and against cannabinoids application in glaucomatous retinopathy. Biomed Pharmacother 2016; 86:620-627. [PMID: 28027538 DOI: 10.1016/j.biopha.2016.11.106] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Revised: 11/21/2016] [Accepted: 11/27/2016] [Indexed: 01/22/2023] Open
Abstract
Glaucoma represents several optic neuropathies leading to irreversible blindness through progressive retinal ganglion cell (RGC) loss. Reduction of intraocular pressure (IOP) is known as the only modifiable factor in the treatment of this disorder. Application of exogenous cannabinoids to lower IOP has attracted attention of scientists as potential agents for the treatment of glaucoma. Accordingly, neuroprotective effect of these agents has been recently described through modulation of endocannabinoid system in the eye. In the present work, pertinent information regarding ocular endocannabinoid system, mechanism of exogenous cannabinoids interaction with the ocular endocannabinoid system to reduce IOP, and neuroprotection property of cannabinoids will be discussed according to current scientific literature. In addition to experimental studies, bioavailability of cannabinoids, clinical surveys, and adverse effects of application of cannabinoids in glaucoma will be reviewed.
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19
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Emerging Concepts in Glaucoma and Review of the Literature. Am J Med 2016; 129:1000.e7-1000.e13. [PMID: 27125182 DOI: 10.1016/j.amjmed.2016.03.038] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Revised: 03/09/2016] [Accepted: 03/10/2016] [Indexed: 01/04/2023]
Abstract
Glaucoma is the most commonly acquired optic neuropathy. It represents a public health challenge because it causes an irreversible blindness. Emerging evidence indicates that the pathogenesis of glaucoma depends on several interacting pathogenetic mechanisms, which include mechanical effects by an increased intraocular pressure, decreased neutrophine-supply, hypoxia, excitotoxicity, oxidative stress, and the involvement of autoimmune processes. In particular, alterations in serum antibody profiles have been described. However, it is still unclear whether the autoantibodies seen in glaucoma are an epiphenomenon or causative. Oxidative stress appears to be a critical factor in the neurodestructive consequences of mitochondrial dysfunction, glial activation response, and uncontrolled activity of the immune system during glaucomatous neurodegeneration. In addition, hearing loss has been identified in association with glaucoma. A higher prevalence of antiphosphatidylserine antibodies of the immunoglobulin G class was seen in normal-tension glaucoma patients with hearing loss in comparison with normal-tension glaucoma patients with normacusis. This finding suggests a similar pathological pathway as a sign for generalized disease.
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20
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Nucci C, Russo R, Martucci A, Giannini C, Garaci F, Floris R, Bagetta G, Morrone LA. New strategies for neuroprotection in glaucoma, a disease that affects the central nervous system. Eur J Pharmacol 2016; 787:119-26. [DOI: 10.1016/j.ejphar.2016.04.030] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 03/23/2016] [Accepted: 04/14/2016] [Indexed: 01/30/2023]
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Cairns EA, Baldridge WH, Kelly MEM. The Endocannabinoid System as a Therapeutic Target in Glaucoma. Neural Plast 2016; 2016:9364091. [PMID: 26881140 PMCID: PMC4737462 DOI: 10.1155/2016/9364091] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 11/10/2015] [Indexed: 11/17/2022] Open
Abstract
Glaucoma is an irreversible blinding eye disease which produces progressive retinal ganglion cell (RGC) loss. Intraocular pressure (IOP) is currently the only modifiable risk factor, and lowering IOP results in reduced risk of progression of the disorder. The endocannabinoid system (ECS) has attracted considerable attention as a potential target for the treatment of glaucoma, largely due to the observed IOP lowering effects seen after administration of exogenous cannabinoids. However, recent evidence has suggested that modulation of the ECS may also be neuroprotective. This paper will review the use of cannabinoids in glaucoma, presenting pertinent information regarding the pathophysiology of glaucoma and how alterations in cannabinoid signalling may contribute to glaucoma pathology. Additionally, the mechanisms and potential for the use of cannabinoids and other novel agents that target the endocannabinoid system in the treatment of glaucoma will be discussed.
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Affiliation(s)
- Elizabeth A. Cairns
- Department of Pharmacology, Dalhousie University, Halifax, NS, Canada B3H 4R2
| | - William H. Baldridge
- Department of Medical Neuroscience, Dalhousie University, Halifax, NS, Canada B3H 4R2
- Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, NS, Canada B3H 4R2
| | - Melanie E. M. Kelly
- Department of Pharmacology, Dalhousie University, Halifax, NS, Canada B3H 4R2
- Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, NS, Canada B3H 4R2
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22
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Morrone LA, Rombolà L, Corasaniti MT, Bagetta G, Nucci C, Russo R. Natural compounds and retinal ganglion cell neuroprotection. PROGRESS IN BRAIN RESEARCH 2015; 220:257-81. [PMID: 26497795 DOI: 10.1016/bs.pbr.2015.05.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Glaucoma, the second leading cause of blindness in the world, is a chronic optic neuropathy often associated with increased intraocular pressure and characterized by progressive retinal ganglion cell (RGC) axons degeneration and death leading to typical optic nerve head damage and distinctive visual field defects. Although the pathogenesis of glaucoma is still largely unknown, it is hypothesized that RCGs become damaged through various insults/mechanisms, including ischemia, oxidative stress, excitotoxicity, defective axonal transport, trophic factor withdrawal, and neuroinflammation. In this review, we summarize the potential benefits of several natural compounds for RGCs neuroprotection.
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Affiliation(s)
- Luigi Antonio Morrone
- Department of Pharmacy and Health and Nutritional Sciences, Section of Preclinical and Translational Pharmacology, University of Calabria, Arcavacata di Rende, Italy; University Consortium for Adaptive Disorders and Head Pain (UCHAD), Section of Neuropharmacology of Normal and Pathological Neuronal Plasticity, University of Calabria, Arcavacata di Rende, Italy.
| | - Laura Rombolà
- Department of Pharmacy and Health and Nutritional Sciences, Section of Preclinical and Translational Pharmacology, University of Calabria, Arcavacata di Rende, Italy
| | | | - Giacinto Bagetta
- Department of Pharmacy and Health and Nutritional Sciences, Section of Preclinical and Translational Pharmacology, University of Calabria, Arcavacata di Rende, Italy; University Consortium for Adaptive Disorders and Head Pain (UCHAD), Section of Neuropharmacology of Normal and Pathological Neuronal Plasticity, University of Calabria, Arcavacata di Rende, Italy
| | - Carlo Nucci
- Ophthalmology Unit, Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy
| | - Rossella Russo
- Department of Pharmacy and Health and Nutritional Sciences, Section of Preclinical and Translational Pharmacology, University of Calabria, Arcavacata di Rende, Italy
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Belendiuk KA, Baldini LL, Bonn-Miller MO. Narrative review of the safety and efficacy of marijuana for the treatment of commonly state-approved medical and psychiatric disorders. Addict Sci Clin Pract 2015; 10:10. [PMID: 25896576 PMCID: PMC4636852 DOI: 10.1186/s13722-015-0032-7] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 04/15/2015] [Indexed: 02/08/2023] Open
Abstract
The present investigation aimed to provide an objective narrative review of the existing literature pertaining to the benefits and harms of marijuana use for the treatment of the most common medical and psychological conditions for which it has been allowed at the state level. Common medical conditions for which marijuana is allowed (i.e., those conditions shared by at least 80 percent of medical marijuana states) were identified as: Alzheimer’s disease, amyotrophic lateral sclerosis, cachexia/wasting syndrome, cancer, Crohn’s disease, epilepsy and seizures, glaucoma, hepatitis C virus, human immunodeficiency virus/acquired immunodeficiency syndrome, multiple sclerosis and muscle spasticity, severe and chronic pain, and severe nausea. Post-traumatic stress disorder was also included in the review, as it is the sole psychological disorder for which medical marijuana has been allowed. Studies for this narrative review were included based on a literature search in PsycINFO, MEDLINE, and Google Scholar. Findings indicate that, for the majority of these conditions, there is insufficient evidence to support the recommendation of medical marijuana at this time. A significant amount of rigorous research is needed to definitively ascertain the potential implications of marijuana for these conditions. It is important for such work to not only examine the effects of smoked marijuana preparations, but also to compare its safety, tolerability, and efficacy in relation to existing pharmacological treatments.
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Affiliation(s)
- Katherine A Belendiuk
- Institute of Human Development, University of California, 1121 Tolman Hall #1690, Berkeley, CA, 94720, USA.
| | - Lisa L Baldini
- Palo Alto University, 1791 Arastradero Road, Palo Alto, CA, 94304, USA.
| | - Marcel O Bonn-Miller
- Center of Excellence in Substance Abuse Treatment and Education, Philadelphia VA Medical Center, 3900 Woodland Avenue, Philadelphia, PA, 19104, USA. .,Center for Innovation to Implementation and National Center for PTSD, VA Palo Alto Health Care System, 795 Willow Road (152-MPD), Menlo Park, CA, 94025, USA. .,Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3440 Market Street, Philadelphia, PA, 19104, USA.
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24
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Wentz SM, Kim NJ, Wang J, Amireskandari A, Siesky B, Harris A. Novel therapies for open-angle glaucoma. F1000PRIME REPORTS 2014; 6:102. [PMID: 25580256 PMCID: PMC4229725 DOI: 10.12703/p6-102] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Open-angle glaucoma is a multifactorial optic neuropathy characterized by progressive loss of retinal ganglion cells and their axons. It is an irreversible disease with no established cure. The only currently approved treatment is aimed at lowering intraocular pressure, the most significant risk factor known to date. However, it is now clear that there are other risk factors involved in glaucoma's pathophysiology. To achieve future improvements in glaucoma management, new approaches to therapies and novel targets must be developed. Such therapies may include new tissue targets for lowering intraocular pressure, molecules influencing ocular hemodynamics, and treatments providing neuroprotection of retinal ganglion cells. Furthermore, novel drug delivery systems are in development that may improve patient compliance, increase bioavailability, and decrease adverse side effects.
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25
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26
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Krishnan G, Chatterjee N. Endocannabinoids affect innate immunity of Muller glia during HIV-1 Tat cytotoxicity. Mol Cell Neurosci 2014; 59:10-23. [DOI: 10.1016/j.mcn.2014.01.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Revised: 12/20/2013] [Accepted: 01/03/2014] [Indexed: 01/14/2023] Open
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27
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Martucci A, Cesareo M, Napoli D, Sorge RP, Ricci F, Mancino R, Nucci C. Evaluation of pupillary response to light in patients with glaucoma: a study using computerized pupillometry. Int Ophthalmol 2014; 34:1241-7. [PMID: 24550056 DOI: 10.1007/s10792-014-9920-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 02/03/2014] [Indexed: 12/30/2022]
Abstract
The aim of this study was to evaluate pupillary response to light stimulation in patients with different stages of glaucoma using computerized pupillometry. We conducted a retrospective study on a group of 44 glaucoma patients who had undergone complete ophthalmological examination, visual field test (Humphrey SITA Standard 24-2) and monocular dynamic pupillometry (MonCV3 Metrovision). Eyes were classified into stages of glaucoma according to visual field damage using the Glaucoma Staging System 2. A group of 18 healthy subjects, homogeneous for age and sex with glaucoma patients, was used as a control. The following parameters were considered-latency and duration of contraction and dilatation; initial, minimum, maximum, and mean pupil diameter; amplitude of contraction; contraction and dilatation speed; and percent pupil contraction (PPC). PPC and pupil contraction speed and minimum diameter showed covariate correlation with the stages of glaucoma. The control group significantly differed from the stage 3 group in terms of PPC and from the stage 4 group in terms of minimum diameter. There were significant differences between the stage 5 group and stage 1, 2, 3 and control groups. Ordinal logistic regression showed a correlation between pupil contraction speed, minimum diameter, PPC, initial diameter and the stage of glaucoma. The study showed that glaucoma damage is associated with altered values of pupillary response to light. This event may be the consequence of the progressive loss of retinal ganglion cells and their axons induced by glaucoma.
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Affiliation(s)
- Alessio Martucci
- Ophthalmology Unit, Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy
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28
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The fatty acid amide hydrolase inhibitor, URB597, promotes retinal ganglion cell neuroprotection in a rat model of optic nerve axotomy. Neuropharmacology 2013; 72:116-25. [DOI: 10.1016/j.neuropharm.2013.04.018] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2012] [Revised: 04/11/2013] [Accepted: 04/12/2013] [Indexed: 11/19/2022]
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29
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Romano MR, Lograno MD. Signaling cross-talk between cannabinoid and muscarinic systems actives Rho-kinase and increases the contractile responses of the bovine ciliary muscle. Eur J Pharmacol 2013; 702:174-9. [PMID: 23396229 DOI: 10.1016/j.ejphar.2013.01.053] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2012] [Revised: 01/02/2013] [Accepted: 01/29/2013] [Indexed: 11/16/2022]
Abstract
The aim of the present study was to evaluate the role of a possible interaction between cannabinoid and muscarinic systems, both widely expressed in the ocular structure and involved in the control of bovine ciliary muscle contractility and intraocular pressure modulation. The ciliary muscle strips isolated by bovine eyes were exposed cumulatively to anandamide in the presence and in the absence of carbachol (5 nM), in a miograph system for isometric recording. The experiments were also conducted in the presence of AM251 (100 nM), 4-DAMP (100 nM), Pertussis toxin (500 ng/ml), U73122 (0.1 and 1 μM), chelerythrine (1 and 10 μM) and Y27632 (1 and 10 μM). Contractile responses were expressed as the percentage of 10 μM carbachol-induced contraction. The anandamide-induced contraction on bovine ciliary muscle strips was enhanced by the previous stimulation of Gq-protein-coupled muscarinic M3 receptors with carbachol. The contractile response to anandamide plus carbachol was affected by different inhibitors such as Pertussis toxin, phospholipase C, protein kinase C and Rho-kinase. The key results of the present study show that sequential activation of muscarinic M3 receptors and cannabinoid CB1 receptors produce synergistic contractile effects of the bovine ciliary muscle by involving the activation of Rho-kinase and protein kinase C.
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Affiliation(s)
- Maria Rosaria Romano
- Department of Pharmacy - Science of Drug, Section of Pharmacology and Toxicology, University of Bari Aldo Moro, Bari, Italy.
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30
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Hudson BD, Beazley M, Szczesniak AM, Straiker A, Kelly MEM. Indirect sympatholytic actions at β-adrenoceptors account for the ocular hypotensive actions of cannabinoid receptor agonists. J Pharmacol Exp Ther 2011; 339:757-67. [PMID: 21885619 PMCID: PMC11047145 DOI: 10.1124/jpet.111.185769] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Accepted: 08/22/2011] [Indexed: 01/27/2023] Open
Abstract
Intraocular pressure (IOP) is the primary risk factor for glaucoma, a blinding eye disease. Cannabinoid agonists have long been known to decrease IOP, suggesting they may be useful in glaucoma treatment. However, the specific mechanism by which cannabinoids generate this ocular hypotensive effect remains unknown. The current evidence suggests the cannabinoids reduce IOP through actions at cannabinoid 1 (CB(1)) receptors within the eye, and adrenergic receptors (ARs) may also contribute to this action of cannabinoids. Considering this, the present study aimed to elucidate the mechanism behind the ocular hypotensive properties of cannabinoids through the use of mice genetically lacking either cannabinoid receptors or βARs. Cannabinoid agonists, βAR antagonists, and βAR agonists decreased IOP in wild-type mice and CB(2)(-/-) mice. In contrast, none of these compounds were found to reduce IOP in βAR(-/-) or CB(1)(-/-) mice. Desensitization of the βARs and depletion of catecholamines in wild-type mice also eliminated the ability of the cannabinoid agonist (R)-(+)-[2,3-dihydro-5-methyl-3-(4-morpholinylmethyl)pyrrolo[1,2,3-de]-1,4-benzoxazin-6-yl]-1-naphthalenylmethanone mesylate (WIN 55,212-2) to reduce IOP, strongly implicating a role for both βARs and catecholamines in the ocular hypotensive properties of cannabinoids. Finally, CB(1) receptors were shown to colocalize with tyrosine hydroxylase, a marker for adrenergic neurons. Taken together, these findings suggest that βARs are required for the ocular hypotensive properties of cannabinoids, and cannabinoids reduce IOP by acting as indirect sympatholytics and inhibiting norepinephrine release within the eye.
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Affiliation(s)
- Brian D Hudson
- Department of Pharmacology, Sir Charles Tupper Building, Dalhousie University, 5850 College St. Halifax, NS, Canada B3H1X5
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Szczesniak AM, Maor Y, Robertson H, Hung O, Kelly MEM. Nonpsychotropic cannabinoids, abnormal cannabidiol and canabigerol-dimethyl heptyl, act at novel cannabinoid receptors to reduce intraocular pressure. J Ocul Pharmacol Ther 2011; 27:427-35. [PMID: 21770780 DOI: 10.1089/jop.2011.0041] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The objective of our study was to examine the pharmacology of the intraocular pressure (IOP)-lowering actions of the behaviorally inactive cannabinoids, abnormal cannabidiol (abn-CBD), and a cannabigerol analog, cannabigerol-dimethyl heptyl (CBG-DMH), in comparison to that of the nonselective cannabinoid 1 receptor (CB(1)R) and CB(2)R agonist, WIN55,212-2, in Brown Norway rats. The IOP was measured noninvasively using a hand-held tonometer in nonanesthetized animals. The IOP measurements were taken every 15 min for a period of 2 h after drug administration. All drugs were administered via intraperitoneal (i.p.) injections, and abn-CBD and CBG-DMH were also given topically. Both abn-CBD and CBG-DMH reduced IOP when administrated i.p. at doses of ≥2.5 mg/kg or topically at concentrations of 1%-2%. The IOP-lowering effects of abn-CBD and CBG-DMH were reduced by i.p. administration of O-1918 (2.5 mg/kg), a selective antagonist of the abn-CBD-sensitive cannabinoid-related receptor (CBx), but were unaffected by the CB(1)R antagonist, AM251 (2.5 mg/kg), or the CB(2)R antagonist, AM630 (2.5 mg/kg). In contrast, the IOP-lowering action of WIN55,212-2 was completely blocked by the CB(1)R-selective antagonist, AM251, and was unaffected by the CBx receptor antagonist, O-1918. However, similar to the nonpsychotropic cannabinoids, the ocular hypotensive actions of WIN55,212-2 were also insensitive to block by the CB(2)R antagonist, AM630. Consistent with this, the selective CB(2)R agonist, HU-308 (2 mg/kg) failed to reduce IOP in Brown Norway rats. Concurrent application of a dose of WIN55,212-2 that was subthreshold to reduce IOP (0.25 mg/kg), together with a topical dose of either abn-CBD (0.5%) or CBG-DMH (0.25%), respectively, potentiated the ocular hypotensive effect of either compound applied alone. This study demonstrates that the atypical cannabinoid, abn-CBD, and the cannabigerol analog, CBG-DMH, decrease IOP in the normotensive Brown Norway rat eye independent of CB(1)R or CB(2)R activation, via activation of CBx receptors. The enhanced decrease in IOP seen after coapplication of the CB(1)R agonist, WIN55,212-2, together with either abn-CBD or CBG-DMH, respectively, further suggests that the ocular pharmacodynamics of abn-CBD and CBG-DMH are mediated by receptor targets distinct from CB(1)R. These results indicate that both CBG-DMH and abn-CBD have the potential for further investigation as novel ocular hypotensive cannabinoids devoid of CB(1)R-mediated side-effects.
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Abstract
The endocannabinoid (ECB) system has been found throughout the central nervous system and modulates cell excitability in various forms of short-term plasticity. ECBs and their receptors have also been localized to all retinal cells, and cannabinoid receptor activation has been shown to alter voltage-dependent conductances in several different retinal cell types, suggesting a possible role for cannabinoids in retinal processing. Their effects on synaptic transmission in the mammalian retina, however, have not been previously investigated. Here, we show that exogenous cannabinoids alter spontaneous synaptic transmission onto retinal ganglion cells (RGCs). Using whole-cell voltage-clamp recordings in whole-mount retinas, we measured spontaneous postsynaptic currents (SPSCs) in RGCs in adult and young (P14-P21) mice. We found that the addition of an exogenous cannabinoid agonist, WIN55212-2 (5 μM), caused a significant reversible reduction in the frequency of SPSCs. This change, however, did not alter the kinetics of the SPSCs, indicating a presynaptic locus of action. Using blockers to isolate inhibitory or excitatory currents, we found that cannabinoids significantly reduced the release probability of both GABA and glutamate, respectively. While the addition of cannabinoids reduced the frequency of both GABAergic and glutamatergic SPSCs in both young and adult mice, we found that the largest effect was on GABA-mediated currents in young mice. These results suggest that the ECB system may potentially be involved in the modulation of signal transmission in the retina. Furthermore, they suggest that it might play a role in the developmental maturation of synaptic circuits, and that exogenous cannabinoids are likely able to disrupt retinal processing and consequently alter vision.
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Pinar-Sueiro S, Rodríguez-Puertas R, Vecino E. [Cannabinoid applications in glaucoma]. ACTA ACUST UNITED AC 2011; 86:16-23. [PMID: 21414525 DOI: 10.1016/j.oftal.2010.11.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2010] [Revised: 11/08/2010] [Accepted: 11/10/2010] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Glaucoma is a slowly progressive optic neuropathy that is one of the leading causes of legal blindness throughout the world. Currently there is a limited group of topical drugs for the medical treatment of glaucoma is currently limited, and research needs to be focused on new therapeutic horizons, such as the potential usefulness of the cannabinoid agonists for the treatment of glaucoma. AIM To review the current scientific literature related to the beneficial effects derived from the different ways of administration of cannabinoids indicated for the glaucomatous optic neuropathy. DEVELOPMENT Cannabinoid receptors have shown an intense expression in ocular tissues implicated in the regulation of the intraocular pressure, as well as inner layers of the retina. Through activation of CB1 and CB1 specific receptors and through other still unknown pathways, the cannabinoid agonists have shown both a clear hypotensive, as well as an experimentally proved neuroprotective effect on retinal ganglion cells. CONCLUSIONS Some cannabinoid agonists (WIN 55212-2, anandamide) have demonstrated, in experimental studies, to act as «ideal drugs» in the management of glaucoma, as they have been shown to have good tolerability after topical application, efficiently reduce intraocular pressure, and behave as neuroprotectors on retinal ganglion cells. Further studies as regards the safety and clinical assays must be carried out in order to examine the effectiveness of these drugs for the treatment of glaucoma in our daily clinical practice.
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Affiliation(s)
- S Pinar-Sueiro
- Departamento de Biología Celular e Histología, Grupo de Oftalmo-Biología Experimental (GOBE), Facultad de Medicina, Universidad del País Vasco (UPV/EHU), Leioa, Vizcaya, España
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Chang Z, Okamoto K, Tashiro A, Bereiter DA. Ultraviolet irradiation of the eye and Fos-positive neurons induced in trigeminal brainstem after intravitreal or ocular surface transient receptor potential vanilloid 1 activation. Neuroscience 2010; 170:678-85. [PMID: 20643195 DOI: 10.1016/j.neuroscience.2010.07.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2010] [Revised: 07/08/2010] [Accepted: 07/09/2010] [Indexed: 10/19/2022]
Abstract
The interior structures of the eye are well supplied by the trigeminal nerve; however, the function of these afferent fibers is not well defined. The aim of this study was to use c-fos like immunohistochemistry (Fos-LI) to map the trigeminal brainstem complex after intravitreal microinjection or ocular surface application of capsaicin, a selective transient receptor potential vanilloid 1 (TRPV1) agonist in male rats under barbiturate anesthesia. The effect of ocular inflammation on Fos-LI was tested 2 or 7 days after UV irradiation of the eye. In non-inflamed controls, intravitreal capsaicin produced peaks of Fos-LI at the trigeminal subnucleus interpolaris/caudalis (Vi/Vcvl) transition and in superficial laminae at the caudalis/upper cervical cord (Vc/C1) junction regions. At the Vc/C1 junction intravitreal capsaicin induced Fos-LI in a dose-dependent manner, while at the Vi/Vcvl transition responses were similar after vehicle or capsaicin injections. Two days, but not 7 days, after UV irradiation intravitreal and ocular surface capsaicin-evoked Fos-LI at the Vc/C1 junction and nucleus tractus solitarius (NTS) were markedly enhanced, whereas the responses at the Vi/Vcvl transition were not different from non-inflamed controls. More than 80% of trigeminal ganglion neurons labeled after intravitreal microinjection of Fluorogold also expressed immunoreactivity for the TRPV1 receptor. These findings suggested that most intraocular trigeminal sensory nerves serve as nociceptors. The similar pattern and magnitude of Fos-LI after capsaicin suggested that TRPV1-responsive trigeminal nerves that supply intraocular and ocular surface tissues form a unified integrative circuit in the caudal brainstem. Intensity coding of capsaicin concentration and facilitation of Fos-LI expression after UV irradiation strongly supported the hypothesis that the Vc/C1 junction was critical for nociceptive processing related to ocular pain, whereas the Vi/Vcvl transition region likely served other functions in ocular homeostasis under naïve and inflamed conditions.
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Affiliation(s)
- Z Chang
- Department of Diagnostic and Biological Sciences, University of Minnesota School of Dentistry, 18-214 Moos Tower, 515 Delaware Street South East, Minneapolis, MN 55455, USA.
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Lai TYY, Chen LJ, Yam GHF, Tham CCY, Pang CP. Development of novel drugs for ocular diseases: possibilities for individualized therapy. Per Med 2010; 7:371-386. [DOI: 10.2217/pme.10.25] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
In clinical ophthalmology, new and old drug regimens are available for the treatment of major eye diseases, including potentially blinding conditions, such as glaucoma, and various macular diseases. In glaucoma, therapeutic treatment mainly deals with control of intraocular pressure at low levels but the clinical courses of patients can be very variable. Very often, specific drug combinations and dosages have to be formulated for individual glaucoma patients. In neovascular age-related macular degeneration, choroidal neovascularization can lead to progressive and irreversible visual impairment if not treated early. In recent years, clinical trials using photodynamic therapy with verteporfin and various anti-VEGF antibodies, such as ranibizumab and bevacizumab, have enhanced the treatment outcomes of neovascular age-related macular degeneration. In diabetic macular edema, intravitreal triamcinolone acetonide and anti-VEGF therapy are effective in some patients. Again, responses to treatment are not uniform in all macular patients. Traditional herbal medicine has long been known to play a role in the practice of personalized formulations in Asia. Potential preventive and therapeutic effects have been claimed in individual eye patients. Meanwhile, advanced technologies in molecular biology have led to identification of genes associated with many eye diseases and development of the concept of individual medicine, in which the genotype of a person can be used as a basis for disease prediction or prophylactic treatments. Moreover, pharmacogenomic studies have demonstrated the association of various genotypes or haplotypes with responses to drug therapies, providing hope for tailormade personalized treatments. The combination of genotypic information with clinical features for the prescription of treatment modes in eye diseases is under vigorous research.
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Affiliation(s)
- Timothy YY Lai
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, 147K Argyle Street, Kowloon, Hong Kong
| | - Li Jia Chen
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, 147K Argyle Street, Kowloon, Hong Kong
| | - Gary HF Yam
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, 147K Argyle Street, Kowloon, Hong Kong
| | - Clement CY Tham
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, 147K Argyle Street, Kowloon, Hong Kong
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López-Ortíz M, Herrera-Solís A, Luviano-Jardón A, Reyes-Prieto N, Castillo I, Monsalvo I, Demare P, Méndez-Díaz M, Regla I, Prospéro-García O. Chemoenzymatic synthesis and cannabinoid activity of a new diazabicyclic amide of phenylacetylricinoleic acid. Bioorg Med Chem Lett 2010; 20:3231-4. [PMID: 20457524 DOI: 10.1016/j.bmcl.2010.04.074] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2010] [Revised: 04/14/2010] [Accepted: 04/16/2010] [Indexed: 12/15/2022]
Abstract
Endocannabinoids (eCBs) are endogenous neuromodulators of synaptic transmission. Their dysfunction may cause debilitating disorders of diverse clinical manifestation. For example, drug addiction, lack of sex desire, eating disorders, such as anorexia or bulimia and dyssomnias. eCBs also participate in the regulation of core temperature and pain perception. In this context, it is important to recognize the utility of cannabinoid receptor 1 (CB1R) agonists, natural as Delta(9)-tetrahydrocannabinol (THC) or synthetic as Nabilone as useful drugs to alleviate this kind of patients' suffering. Therefore, we have developed a new drug, (R,Z)-18-((1S,4S)-5-methyl-2,5-diazabicyclo[2.2.1]heptan-2-yl)-18-oxooctadec-9-en-7-yl phenylacetate (PhAR-DBH-Me), that appears to bind and activate the CB1R. This diazabicyclic amide was synthesized from phenylacetylricinoleic acid and (1S,4S)-2,5-diazabicyclo[2.2.1]heptane. To test its cannabinergic properties we evaluated its effects on core temperature, pain perception, and the sleep-waking cycle of rats. Results indicate that 20 and 40mg/kg of PhAR-DBH-Me readily reduced core temperature and increased pain perception threshold. In addition, 20mg/kg increased REM sleep in otherwise normal rats. All these effects were prevented or attenuated by AM251, a CB1R antagonist. Place preference conditioning studies indicated that this molecule does not produce rewarding effects. These results strongly support that PhAR-DBH-Me possesses cannabinoid activity without the reinforcement effects.
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Affiliation(s)
- Manuel López-Ortíz
- Facultad de Estudios Superiores Zaragoza, Universidad Nacional Autónoma de México, Batalla del 5 de Mayo y Fuerte de Loreto, Iztapalapa 09230, Mexico, D.F., Mexico
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Smid SD. Role of prostaglandins and specific place in therapy of bimatoprost in the treatment of elevated intraocular pressure and ocular hypertension: A closer look at the agonist properties of bimatoprost and the prostamides. Clin Ophthalmol 2009; 3:663-70. [PMID: 20054414 PMCID: PMC2801635 DOI: 10.2147/opth.s6337] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2009] [Indexed: 11/23/2022] Open
Abstract
Bimatoprost is the only representative of a novel class of prostaglandin ethanolamide (prostamide) compounds used therapeutically as an efficacious treatment for glaucoma. The pathways through which bimatoprost works to improve uveoscleral outflow to relieve elevated intraocular pressure are similar to those of the conventional prostaglandins used in glaucoma therapy, with some evidence of a preferential action at the trabecular meshwork. The pharmacology of bimatoprost is however, unclear. Pharmacological evidence supports a specific and distinct receptor-mediated agonist activity of bimatoprost at ‘prostamide’ receptors, which is selective to the prostamides as a class. However, other studies have reported either activity of bimatoprost at additional prostanoid and nonprostanoid receptors, or a conversion of bimatoprost to metabolites with agonist activity at prostaglandin FP receptors in the human eye. The formation of endogenous prostamides has been demonstrated in vivo, by a novel pathway involving the cyclooxygenase-2-mediated conversion of endogenous cannabinoid (endocannabinoid) substrates. Irrespective of the pharmacology of bimatoprost and the prostamides in general, further studies are needed to determine the biological role and biochemical pathology of prostamides in the human eye, particularly in glaucoma. Such studies may improve our understanding of uveoscleral flow and may offer new treatments for controlling intraocular pressure.
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Affiliation(s)
- Scott D Smid
- Discipline of Pharmacology, School of Medical Sciences, Faculty of Health Sciences, University of Adelaide, Adelaide, SA, Australia.
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