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Foyzun T, Whiting M, Velasco KK, Jacobsen JC, Connor M, Grimsey NL. Single nucleotide polymorphisms in the cannabinoid CB 2 receptor: Molecular pharmacology and disease associations. Br J Pharmacol 2024; 181:2391-2412. [PMID: 38802979 DOI: 10.1111/bph.16383] [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: 11/30/2023] [Revised: 02/26/2024] [Accepted: 03/09/2024] [Indexed: 05/29/2024] Open
Abstract
Preclinical evidence implicating cannabinoid receptor 2 (CB2) in various diseases has led researchers to question whether CB2 genetics influence aetiology or progression. Associations between conditions and genetic loci are often studied via single nucleotide polymorphism (SNP) prevalence in case versus control populations. In the CNR2 coding exon, ~36 SNPs have high overall population prevalence (minor allele frequencies [MAF] ~37%), including non-synonymous SNP (ns-SNP) rs2501432 encoding CB2 63Q/R. Interspersed are ~27 lower frequency SNPs, four being ns-SNPs. CNR2 introns also harbour numerous SNPs. This review summarises CB2 ns-SNP molecular pharmacology and evaluates evidence from ~70 studies investigating CB2 genetic variants with proposed linkage to disease. Although CNR2 genetic variation has been associated with a wide variety of conditions, including osteoporosis, immune-related disorders, and mental illnesses, further work is required to robustly validate CNR2 disease links and clarify specific mechanisms linking CNR2 genetic variation to disease pathophysiology and potential drug responses.
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Affiliation(s)
- Tahira Foyzun
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - Maddie Whiting
- Department of Pharmacology and Clinical Pharmacology, School of Medical Sciences, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Department of Medicine, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Kate K Velasco
- Department of Pharmacology and Clinical Pharmacology, School of Medical Sciences, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Department of Medicine, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Jessie C Jacobsen
- School of Biological Sciences, Faculty of Science, University of Auckland, Auckland, New Zealand
- Centre for Brain Research, University of Auckland, Auckland, New Zealand
| | - Mark Connor
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - Natasha L Grimsey
- Department of Pharmacology and Clinical Pharmacology, School of Medical Sciences, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Centre for Brain Research, University of Auckland, Auckland, New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, Auckland, New Zealand
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2
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Mahardhika AB, Załuski M, Schoeder CT, Boshta NM, Schabikowski J, Perri F, Łażewska D, Neumann A, Kremers S, Oneto A, Ressemann A, Latacz G, Namasivayam V, Kieć-Kononowicz K, Müller CE. Potent, Selective Agonists for the Cannabinoid-like Orphan G Protein-Coupled Receptor GPR18: A Promising Drug Target for Cancer and Immunity. J Med Chem 2024; 67:9896-9926. [PMID: 38885438 DOI: 10.1021/acs.jmedchem.3c02423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
The human orphan G protein-coupled receptor GPR18, activated by Δ9-tetrahydrocannabinol (THC), constitutes a promising drug target in immunology and cancer. However, studies on GPR18 are hampered by the lack of suitable tool compounds. In the present study, potent and selective GPR18 agonists were developed showing low nanomolar potency at human and mouse GPR18, determined in β-arrestin recruitment assays. Structure-activity relationships were analyzed, and selectivity versus cannabinoid (CB) and CB-like receptors was assessed. Compound 51 (PSB-KK1415, EC50 19.1 nM) was the most potent GPR18 agonist showing at least 25-fold selectivity versus CB receptors. The most selective GPR18 agonist 50 (PSB-KK1445, EC50 45.4 nM) displayed >200-fold selectivity versus both CB receptor subtypes, GPR55, and GPR183. The new GPR18 agonists showed minimal species differences, while THC acted as a weak partial agonist at the mouse receptor. The newly discovered compounds represent the most potent and selective GPR18 agonists reported to date.
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Affiliation(s)
- Andhika B Mahardhika
- Pharmaceutical Institute, Department of Pharmaceutical and Medicinal Chemistry, University of Bonn, An der Immenburg 4, D-53121 Bonn, Germany
- Research Training Group 1873, University of Bonn, 53127 Bonn, Germany
- Research Training Group 2873, University of Bonn, 53121 Bonn, Germany
| | - Michal Załuski
- Department of Technology and Biotechnology of Drugs, Faculty of Pharmacy, Jagiellonian University Medical College, Pl 30-688 Kraków, Poland
| | - Clara T Schoeder
- Pharmaceutical Institute, Department of Pharmaceutical and Medicinal Chemistry, University of Bonn, An der Immenburg 4, D-53121 Bonn, Germany
- Research Training Group 1873, University of Bonn, 53127 Bonn, Germany
| | - Nader M Boshta
- Pharmaceutical Institute, Department of Pharmaceutical and Medicinal Chemistry, University of Bonn, An der Immenburg 4, D-53121 Bonn, Germany
| | - Jakub Schabikowski
- Department of Technology and Biotechnology of Drugs, Faculty of Pharmacy, Jagiellonian University Medical College, Pl 30-688 Kraków, Poland
| | - Filomena Perri
- Pharmaceutical Institute, Department of Pharmaceutical and Medicinal Chemistry, University of Bonn, An der Immenburg 4, D-53121 Bonn, Germany
- Research Training Group 1873, University of Bonn, 53127 Bonn, Germany
| | - Dorota Łażewska
- Department of Technology and Biotechnology of Drugs, Faculty of Pharmacy, Jagiellonian University Medical College, Pl 30-688 Kraków, Poland
| | - Alexander Neumann
- Pharmaceutical Institute, Department of Pharmaceutical and Medicinal Chemistry, University of Bonn, An der Immenburg 4, D-53121 Bonn, Germany
- Research Training Group 1873, University of Bonn, 53127 Bonn, Germany
| | - Sarah Kremers
- Pharmaceutical Institute, Department of Pharmaceutical and Medicinal Chemistry, University of Bonn, An der Immenburg 4, D-53121 Bonn, Germany
| | - Angelo Oneto
- Pharmaceutical Institute, Department of Pharmaceutical and Medicinal Chemistry, University of Bonn, An der Immenburg 4, D-53121 Bonn, Germany
| | - Anastasiia Ressemann
- Pharmaceutical Institute, Department of Pharmaceutical and Medicinal Chemistry, University of Bonn, An der Immenburg 4, D-53121 Bonn, Germany
| | - Gniewomir Latacz
- Department of Technology and Biotechnology of Drugs, Faculty of Pharmacy, Jagiellonian University Medical College, Pl 30-688 Kraków, Poland
| | - Vigneshwaran Namasivayam
- Pharmaceutical Institute, Department of Pharmaceutical and Medicinal Chemistry, University of Bonn, An der Immenburg 4, D-53121 Bonn, Germany
| | - Katarzyna Kieć-Kononowicz
- Department of Technology and Biotechnology of Drugs, Faculty of Pharmacy, Jagiellonian University Medical College, Pl 30-688 Kraków, Poland
| | - Christa E Müller
- Pharmaceutical Institute, Department of Pharmaceutical and Medicinal Chemistry, University of Bonn, An der Immenburg 4, D-53121 Bonn, Germany
- Research Training Group 1873, University of Bonn, 53127 Bonn, Germany
- Research Training Group 2873, University of Bonn, 53121 Bonn, Germany
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3
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Tai W, Arnold JC, Chan HK, Kwok PCL. Spray freeze dried cannabidiol with dipalmitoylphosphatidylcholine (DPPC) for inhalation and solubility enhancement. Int J Pharm 2024; 659:124235. [PMID: 38762165 DOI: 10.1016/j.ijpharm.2024.124235] [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: 03/04/2024] [Revised: 05/15/2024] [Accepted: 05/15/2024] [Indexed: 05/20/2024]
Abstract
Pulmonary delivery is an efficient route of administration to deliver cannabidiol (CBD) due to the high bioavailability and fast onset of action. The major formulation challenge is the poor aqueous solubility of CBD. This study aimed to produce inhalable CBD powders with enhanced solubility and characterise their solid-state properties. CBD was spray freeze dried with mannitol or trehalose dihydrate with and without dipalmitoylphosphatidylcholine (DPPC). All four powders had acceptable yields at > 70 % with porous and spherical particles. The two crystalline mannitol powders contained less residual solvent than both amorphous trehalose ones. The addition of DPPC did not affect the crystallinity and residual solvent level of the powders. Instead, DPPC made the particles more porous, decreased the particle size from 19-23 µm to 11-13 µm, and increased CBD solubility from 0.36 µg/mL to over 2 µg/mL. The two DPPC powders were dispersed from a low resistance RS01 inhaler, showing acceptable aerosol performance with emitted fractions at 91-93 % and fine particle fractions < 5 µm at 34-43 %. These formulations can be used as a platform to deliver CBD and other cannabinoids by inhalation.
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Affiliation(s)
- Waiting Tai
- Advanced Drug Delivery Group, Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, NSW 2006, Australia
| | - Jonathon Carl Arnold
- Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, NSW 2050, Australia; Discipline of Pharmacology, Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, NSW 2006, Australia
| | - Hak-Kim Chan
- Advanced Drug Delivery Group, Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, NSW 2006, Australia
| | - Philip Chi Lip Kwok
- Advanced Drug Delivery Group, Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, NSW 2006, Australia.
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Sparkes E, Markham JW, Boyd R, Udoh M, Gordon R, Zaman H, Walker KA, Dane C, Kevin RC, Santiago MJ, Hibbs DE, Banister SD, Ametovski A, Cairns EA. Synthesis and functional evaluation of proteinogenic amino acid-derived synthetic cannabinoid receptor agonists related to MPP-5F-PICA, MMB-5F-PICA, and MDMB-5F-PICA. RSC Med Chem 2024; 15:2063-2079. [PMID: 38911147 PMCID: PMC11187556 DOI: 10.1039/d3md00758h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 03/29/2024] [Indexed: 06/25/2024] Open
Abstract
Synthetic cannabinoid receptor agonists (SCRAs) comprise the second largest class of new psychoactive substances (NPS), and typically α-amino acid moieties are incorporated as part of their design. Limited investigation has been performed into elucidating structure-activity relationships around commonly used α-amino acid-derived head groups, mainly with valine and tert-leucine-derived compounds previously described. As such, proactive synthesis, characterisation and pharmacological evaluation were performed to explore structure-activity relationships of 15 α-amino acid derivatives, with both the natural isomers and their enantiomers at CB1 and CB2 investigated using a fluorescence-based membrane potential assay. This library was based around the detected SCRAs MPP-5F-PICA, MMB-5F-PICA, and MDMB-5F-PICA, with the latter showing significant receptor activation at CB1 (pEC50 = 8.34 ± 0.05 M; E max = 108 ± 3%) and CB2 (pEC50 = 8.13 ± 0.07 M; E max = 99 ± 2%). Most valine and leucine derivatives were potent and efficacious SCRAs, while smaller derivatives generally showed reduced activity at CB1 and CB2, and larger derivatives also showed reduced activity. SAR trends observed were rationalised via in silico induced fit docking. Overall, while natural enantiomers showed equipotent or greater activity than the unnatural isomers in most cases, this was not universal. As such, a number of these compounds should be monitored as emerging NPS, and various substituents described herein.
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Affiliation(s)
- Eric Sparkes
- Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney 94 Mallett St, Building M02F, Camperdown Sydney NSW 2050 Australia
- School of Chemistry, Faculty of Science, The University of Sydney NSW 2050 Australia
| | - Jack W Markham
- Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney 94 Mallett St, Building M02F, Camperdown Sydney NSW 2050 Australia
- School of Chemistry, Faculty of Science, The University of Sydney NSW 2050 Australia
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney NSW 2050 Australia
| | - Rochelle Boyd
- Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney 94 Mallett St, Building M02F, Camperdown Sydney NSW 2050 Australia
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney NSW 2050 Australia
| | - Michael Udoh
- Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney 94 Mallett St, Building M02F, Camperdown Sydney NSW 2050 Australia
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney NSW 2050 Australia
| | - Rebecca Gordon
- Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney 94 Mallett St, Building M02F, Camperdown Sydney NSW 2050 Australia
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney NSW 2050 Australia
| | - Humayra Zaman
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University Sydney NSW 2109 Australia
| | - Katelyn A Walker
- Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney 94 Mallett St, Building M02F, Camperdown Sydney NSW 2050 Australia
- School of Psychology, Faculty of Science, The University of Sydney NSW 2050 Australia
| | - Chianna Dane
- School of Chemistry, Faculty of Science, The University of Sydney NSW 2050 Australia
| | - Richard C Kevin
- Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney 94 Mallett St, Building M02F, Camperdown Sydney NSW 2050 Australia
- Department of Clinical Pharmacology and Toxicology, St Vincent's Hospital Sydney Sydney NSW 2010 Australia
- School of Clinical Medicine, The University of New South Wales Sydney NSW 2052 Australia
| | - Marina J Santiago
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University Sydney NSW 2109 Australia
| | - David E Hibbs
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney NSW 2050 Australia
| | - Samuel D Banister
- Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney 94 Mallett St, Building M02F, Camperdown Sydney NSW 2050 Australia
- School of Chemistry, Faculty of Science, The University of Sydney NSW 2050 Australia
| | - Adam Ametovski
- Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney 94 Mallett St, Building M02F, Camperdown Sydney NSW 2050 Australia
- School of Chemistry, Faculty of Science, The University of Sydney NSW 2050 Australia
| | - Elizabeth A Cairns
- Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney 94 Mallett St, Building M02F, Camperdown Sydney NSW 2050 Australia
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney NSW 2050 Australia
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5
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McCartney D, Irwin C, Bawa Z, Palmer B, Sahinovic A, Delang N, Cox GR, Desbrow B, Lau NS, McGregor IS. The Effect of Cannabidiol on Subjective Responses to Endurance Exercise: A Randomised Controlled Trial. SPORTS MEDICINE - OPEN 2024; 10:61. [PMID: 38782848 PMCID: PMC11116295 DOI: 10.1186/s40798-024-00727-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 05/14/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Exercise is known to improve health. However, it can be unpleasant, often inducing negative feelings, or 'affect'. Cannabidiol (CBD), a non-intoxicating constituent of the cannabis plant, has been reported to enhance the subjective experience of exercise; specifically, in trained individuals performing fixed-intensity endurance activity. Here, we investigated the effects of CBD on subjective responses to exercise under more ecologically valid conditions; namely, in recreationally active individuals performing self-paced endurance activity. METHODS A randomised, double-blind, placebo-controlled, crossover trial was conducted at Griffith University between July 17 and August 28, 2023. Griffith University students studying sports nutrition were invited to take part, with eligible volunteers ≥ 18 years of age and able to perform endurance exercise. Participants ingested placebo or 150 mg CBD in two soft-gel capsules 90 min before completing a self-paced 25-lap (10 km) run around an outdoor athletics track (400 m, synthetic). The primary outcomes were affective valence during exercise, assessed on completion of laps 6, 12, 18 and 24 using the 'Feelings Scale', and positive and negative affect, assessed at baseline, pre-run and post-run using the 'Positive and Negative Affect Schedule'. Exercise enjoyment, motivation and self-efficacy, the core features of the 'runner's high' (i.e., euphoria, pain, anxiety, sedation), perceived exertion and run time were also assessed. RESULTS Fifty-two participants were randomised and 51 were included in the final sample (n = 22 female; 22 [21-25] years). Exercise induced negative affect (i.e., at the time of undertaking) and increased pain. CBD did not counteract either response. In fact, CBD had no significant effects on any of the outcomes measured. In contrast, exercise, once completed, increased positive affect, and decreased negative affect and anxiety. CONCLUSIONS CBD (150 mg, oral) does not appear to enhance the subjective experience of self-paced endurance exercise in recreationally active individuals. Nor, however, does it appear to compromise it. These findings suggest that CBD use is safe under exercise conditions and unlikely to impede physical activity participation. Our study also reaffirms the powerful mood-enhancing effects of exercise. TRIAL REGISTRATION Registered with the Australian New Zealand Clinical Trials Registry ( www.anzctr.org.au ) on May 31, 2023 (Trial ID: ACTRN12623000593639).
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Affiliation(s)
- Danielle McCartney
- Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, Sydney, NSW, Australia.
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia.
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia.
- The University of Sydney, 94 Mallett Street, Camperdown, NSW, 2050, Australia.
| | - Christopher Irwin
- School of Health Sciences and Social Work, Griffith University, Gold Coast, QLD, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Zeeta Bawa
- Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, Sydney, NSW, Australia
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
- Sydney Pharmacy School, The University of Sydney, Sydney, NSW, Australia
| | - Blake Palmer
- School of Health Sciences and Social Work, Griffith University, Gold Coast, QLD, Australia
| | - Ayshe Sahinovic
- Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, Sydney, NSW, Australia
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Nathan Delang
- School of Health Sciences and Social Work, Griffith University, Gold Coast, QLD, Australia
| | - Gregory R Cox
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
| | - Ben Desbrow
- School of Health Sciences and Social Work, Griffith University, Gold Coast, QLD, Australia
| | - Namson S Lau
- The Boden Initiative, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Iain S McGregor
- Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, Sydney, NSW, Australia
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
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6
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Ramirez G, Tesfatsion TT, Docampo-Palacios ML, Cruces I, Hellmann AJ, Okhovat A, Pittiglio MK, Ray KP, Cruces W. Ultrasonic or Microwave Modified Continuous Flow Chemistry for the Synthesis of Tetrahydrocannabinol: Observing Effects of Various Solvents and Acids. ACS OMEGA 2024; 9:13191-13199. [PMID: 38524441 PMCID: PMC10956408 DOI: 10.1021/acsomega.3c09794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/22/2024] [Accepted: 02/26/2024] [Indexed: 03/26/2024]
Abstract
Synthesizing tetrahydrocannabinol is a lengthy process with minimal yields and little applicability on an industrial scale. To close the gap between bench chemistry and industry process chemistry, this paper introduces a small-scale flow chemistry method that utilizes a microwave or ultrasonic medium to produce major tetrahydrocannabinol isomers. This process produces excellent yields and minimal side products, which leads to more efficient large-scale production of the desired cannabinoids.
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Affiliation(s)
| | | | - Maite L. Docampo-Palacios
- Colorado Chromatography
Laboratories, 10505 S.
Progress Way Unit 105, Parker, Colorado 80134, United States
| | - Ivan Cruces
- Colorado Chromatography
Laboratories, 10505 S.
Progress Way Unit 105, Parker, Colorado 80134, United States
| | - Adam J. Hellmann
- Colorado Chromatography
Laboratories, 10505 S.
Progress Way Unit 105, Parker, Colorado 80134, United States
| | - Alex Okhovat
- Colorado Chromatography
Laboratories, 10505 S.
Progress Way Unit 105, Parker, Colorado 80134, United States
| | - Monica K. Pittiglio
- Colorado Chromatography
Laboratories, 10505 S.
Progress Way Unit 105, Parker, Colorado 80134, United States
| | - Kyle P. Ray
- Colorado Chromatography
Laboratories, 10505 S.
Progress Way Unit 105, Parker, Colorado 80134, United States
| | - Westley Cruces
- Colorado Chromatography
Laboratories, 10505 S.
Progress Way Unit 105, Parker, Colorado 80134, United States
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7
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Tagsold D, Toni I, Trollmann R, Woelfle J, Gravou-Apostolatou C. The Use of Cannabinoids in Pediatric Palliative Care-A Retrospective Single-Center Analysis. CHILDREN (BASEL, SWITZERLAND) 2024; 11:234. [PMID: 38397346 PMCID: PMC10887187 DOI: 10.3390/children11020234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 02/05/2024] [Accepted: 02/09/2024] [Indexed: 02/25/2024]
Abstract
This data analysis aimed to systematically analyze a pediatric patient population with a life-limiting disease who were administered cannabinoids. It was a retrospective single-center analysis of patients under supervision of the specialized outpatient pediatric palliative care (SOPPC) team at the Department of Pediatrics and Adolescent Medicine of the Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU). Thirty-one patients with a primary diagnosis of neuropediatric, oncologic, metabolic, and cardiologic categories were included. The indications we identified were spasticity, pain, restlessness, anxiety, loss of appetite, epilepsy, and paresis. Certain aspects of quality of life were improved for 20 of 31 patients (64.5%). For nine patients (29%), no improvement was detected. No conclusions could be drawn for two patients (6.5%). Adverse events were reported for six of the thirty-one patients (19.4%). These were graded as mild, including symptoms such as restlessness, nausea, and behavioral issues. We detected no clinically relevant interactions with other medications. We collected fundamental data on the use of cannabinoids by pediatric palliative patients. Cannabinoids are now frequently administered in pediatric palliative care. They seem to be safe to use and should be considered an add-on therapy for other drug regimens.
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Affiliation(s)
| | | | | | | | - Chara Gravou-Apostolatou
- Department of Pediatrics and Adolescent Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (D.T.)
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8
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Al-Khazaleh AK, Zhou X, Bhuyan DJ, Münch GW, Al-Dalabeeh EA, Jaye K, Chang D. The Neurotherapeutic Arsenal in Cannabis sativa: Insights into Anti-Neuroinflammatory and Neuroprotective Activity and Potential Entourage Effects. Molecules 2024; 29:410. [PMID: 38257323 PMCID: PMC10821245 DOI: 10.3390/molecules29020410] [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: 12/12/2023] [Revised: 01/09/2024] [Accepted: 01/12/2024] [Indexed: 01/24/2024] Open
Abstract
Cannabis, renowned for its historical medicinal use, harbours various bioactive compounds-cannabinoids, terpenes, and flavonoids. While major cannabinoids like delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) have received extensive scrutiny for their pharmacological properties, emerging evidence underscores the collaborative interactions among these constituents, suggesting a collective therapeutic potential. This comprehensive review explores the intricate relationships and synergies between cannabinoids, terpenes, and flavonoids in cannabis. Cannabinoids, pivotal in cannabis's bioactivity, exhibit well-documented analgesic, anti-inflammatory, and neuroprotective effects. Terpenes, aromatic compounds imbuing distinct flavours, not only contribute to cannabis's sensory profile but also modulate cannabinoid effects through diverse molecular mechanisms. Flavonoids, another cannabis component, demonstrate anti-inflammatory, antioxidant, and neuroprotective properties, particularly relevant to neuroinflammation. The entourage hypothesis posits that combined cannabinoid, terpene, and flavonoid action yields synergistic or additive effects, surpassing individual compound efficacy. Recognizing the nuanced interactions is crucial for unravelling cannabis's complete therapeutic potential. Tailoring treatments based on the holistic composition of cannabis strains allows optimization of therapeutic outcomes while minimizing potential side effects. This review underscores the imperative to delve into the intricate roles of cannabinoids, terpenes, and flavonoids, offering promising prospects for innovative therapeutic interventions and advocating continued research to unlock cannabis's full therapeutic potential within the realm of natural plant-based medicine.
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Affiliation(s)
- Ahmad K. Al-Khazaleh
- NICM Health Research Institute, Western Sydney University, Penrith, NSW 2751, Australia; (X.Z.); (D.J.B.); (G.W.M.); (K.J.)
| | - Xian Zhou
- NICM Health Research Institute, Western Sydney University, Penrith, NSW 2751, Australia; (X.Z.); (D.J.B.); (G.W.M.); (K.J.)
| | - Deep Jyoti Bhuyan
- NICM Health Research Institute, Western Sydney University, Penrith, NSW 2751, Australia; (X.Z.); (D.J.B.); (G.W.M.); (K.J.)
- School of Science, Western Sydney University, Penrith, NSW 2751, Australia
| | - Gerald W. Münch
- NICM Health Research Institute, Western Sydney University, Penrith, NSW 2751, Australia; (X.Z.); (D.J.B.); (G.W.M.); (K.J.)
- Pharmacology Unit, School of Medicine, Western Sydney University, Penrith, NSW 2751, Australia
| | - Elaf Adel Al-Dalabeeh
- Department of Biological Sciences, School of Science, University of Jordan, Amman 11942, Jordan;
| | - Kayla Jaye
- NICM Health Research Institute, Western Sydney University, Penrith, NSW 2751, Australia; (X.Z.); (D.J.B.); (G.W.M.); (K.J.)
| | - Dennis Chang
- NICM Health Research Institute, Western Sydney University, Penrith, NSW 2751, Australia; (X.Z.); (D.J.B.); (G.W.M.); (K.J.)
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9
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Motamedy S, Soltani B, Kameshki H, Kermani AA, Amleshi RS, Nazeri M, Shabani M. The Therapeutic Potential and Molecular Mechanisms Underlying the Neuroprotective Effects of Sativex ® - A Cannabis-derived Spray. Mini Rev Med Chem 2024; 24:1427-1448. [PMID: 38318827 DOI: 10.2174/0113895575285934240123110158] [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: 11/16/2023] [Revised: 12/29/2023] [Accepted: 01/05/2024] [Indexed: 02/07/2024]
Abstract
Sativex is a cannabis-based medicine that comes in the form of an oromucosal spray. It contains equal amounts of Δ9-tetrahydrocannabinol and cannabidiol, two compounds derived from cannabis plants. Sativex has been shown to have positive effects on symptoms of amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), and sleep disorders. It also has analgesic, antiinflammatory, antitumoral, and neuroprotective properties, which make it a potential treatment option for other neurological disorders. The article reviews the results of recent preclinical and clinical studies that support the therapeutic potential of Sativex and the molecular mechanisms behind its neuroprotective benefits in various neurological disorders. The article also discusses the possible advantages and disadvantages of using Sativex as a neurotherapeutic agent, such as its safety, efficacy, availability, and legal status.
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Affiliation(s)
- Sina Motamedy
- Neuroscience Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran
| | - Bahareh Soltani
- Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Halimeh Kameshki
- Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Reza Saboori Amleshi
- Neuroscience Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran
| | - Masoud Nazeri
- Department of Anesthesiology, Friedrich-Alexander-University Erlangen-Nuremberg, University Hospital Erlangen, Krankenhausstraße 12, 91054 Erlangen, Germany
| | - Mohammad Shabani
- Neuroscience Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran
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10
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Rogers CI, Pacanowski CR. The relationship between cannabis and anorexia nervosa: a scoping review. J Eat Disord 2023; 11:186. [PMID: 37858278 PMCID: PMC10585887 DOI: 10.1186/s40337-023-00887-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 09/11/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Relapse rates in Anorexia Nervosa (AN) remain high, warranting exploration of further treatments. Cannabinoid agonists are of interest as they have shown successful outcomes in the treatment of associated conditions, such as post-traumatic stress disorder. This scoping review explores the endocannabinoid system (ECS), benefits/harms/null effects of cannabinoid treatment, and harms of cannabis use in AN. METHODS PubMed, PsycINFO, Cochrane, and Web of Science were searched for studies published between 2010 and August 2023, with human participants that explored the ECS, cannabinoid treatment, or cannabis use, and included 1 or more keywords for both cannabis and AN in the title and or abstract. Reports describing secondary anorexia, reports not available in English, grey literature, reports combining data from AN with other conditions, and reports only reporting the prevalence of cannabis abuse/dependence were excluded. Data were extracted from 17 reports (n = 15 studies). For the ECS, outcomes included genetics such as allele expression related to the ECS, cannabinoid receptor availability, and circulating levels of endocannabinoids. For benefits/harms/null effects of cannabinoid treatment, outcomes included changes in weight, eating disorder (ED) symptoms, physical activity (PA), and hormones. For harms of cannabis use, outcomes included genetics related to cannabis use disorder and associations between cannabis use and ED symptoms. RESULTS Eight studies (n = 8 reports) found abnormalities in the ECS in AN including expression of related alleles, genotypes, and haplotypes, availability of cannabinoid receptors, and levels of endocannabinoids. Three studies (n = 5 reports) found benefits/harms/null effects of cannabinoid treatment. Benefits included weight gain, improved ED symptoms and reduced PA, while null effects included no changes in weight or ED symptoms, and harms included increased PA and lowered adipose hormones. Four studies (n = 4 reports) expanded upon harms of cannabis use, including genetic predispositions to cannabis use disorder, and compensatory behaviors related to cannabis use. CONCLUSION Limited evidence suggests that abnormalities in the ECS in AN may render cannabis a potential treatment for weight restoration and associated symptoms. Future research may wish to investigate individualized dosing approaches to maximize beneficial effects while minimizing harms. Level II Evidence: Scoping Review.
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Affiliation(s)
- Chloe I Rogers
- Department of Health Behavior and Nutrition Sciences, University of Delaware, Newark, Delaware, USA.
| | - Carly R Pacanowski
- Department of Health Behavior and Nutrition Sciences, University of Delaware, Newark, Delaware, USA
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11
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Pelgrim TAD, Ramaekers JG, Wall MB, Freeman TP, Bossong MG. Acute effects of Δ9-tetrahydrocannabinol (THC) on resting state connectivity networks and impact of COMT genotype: A multi-site pharmacological fMRI study. Drug Alcohol Depend 2023; 251:110925. [PMID: 37598453 DOI: 10.1016/j.drugalcdep.2023.110925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 07/28/2023] [Accepted: 07/30/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND Cannabis produces various acute psychotropic effects, with marked individual differences. Cannabis use is a risk factor for developing psychotic disorders. The main component responsible for these effects is Δ9-tetrahydrocannabinol (THC). Here we investigated the neural basis of acute THC effects and its modulation by catechol-methyl-transferase (COMT) Val158Met genotype. METHODS Resting state functional MRI data of healthy occasional cannabis users were combined and re-analyzed from three double-blind, placebo-controlled, within-subject pharmacological functional magnetic resonance imaging studies (total N=87). Functional connectivity after placebo and THC was compared in three functional networks (salience, executive and default mode network) and a network implicated in psychosis (the hippocampus-midbrain-striatum network). COMT genotype modulation of subjective effects and connectivity was examined. RESULTS THC reduced connectivity in the salience network, specifically from the right insula to both the left insula and anterior cingulate cortex. We found a trend towards decreased connectivity in the hippocampus-midbrain-striatum network after THC. COMT genotype modulated subjective effects of THC, with strongest dysphoric reactions in Met/Met individuals. In addition, reduced connectivity after THC was demonstrated in the hippocampus-midbrain-striatum network of Met/Met individuals only. CONCLUSIONS In this large multisite study we found that THC robustly decreases connectivity in the salience network, involved in processing awareness and salient information. Connectivity changes in the hippocampus-midbrain-striatum network may reflect the acute psychotic-like effects of THC. COMT genotype modulation of THC's impact on subjective effects and functional connectivity provides further evidence for involvement of prefrontal dopamine levels in the acute effects of cannabis.
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Affiliation(s)
- Teuntje A D Pelgrim
- Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands; Department of Psychiatry, Parnassia Psychiatric Institute, Amsterdam, the Netherlands
| | - Johannes G Ramaekers
- Department of Neuropsychology & Psychopharmacology, Maastricht University, Maastricht, the Netherlands
| | - Matthew B Wall
- Invicro London, Hammersmith Hospital, London, UK; Faculty of Medicine, Imperial College London, London, UK; Clinical Psychopharmacology Unit, University College London, London, UK
| | - Tom P Freeman
- Addiction and Mental Health Group (AIM), University of Bath, Bath, UK
| | - Matthijs G Bossong
- Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands.
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12
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Walton-Raaby M, Floen T, García-Díez G, Mora-Diez N. Calculating the Aqueous pK a of Phenols: Predictions for Antioxidants and Cannabinoids. Antioxidants (Basel) 2023; 12:1420. [PMID: 37507958 PMCID: PMC10376140 DOI: 10.3390/antiox12071420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/30/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
We aim to develop a theoretical methodology for the accurate aqueous pKa prediction of structurally complex phenolic antioxidants and cannabinoids. In this study, five functionals (M06-2X, B3LYP, BHandHLYP, PBE0, and TPSS) and two solvent models (SMD and PCM) were combined with the 6-311++G(d,p) basis set to predict pKa values for twenty structurally simple phenols. None of the direct calculations produced good results. However, the correlations between the calculated Gibbs energy difference of each acid and its conjugate base, ΔGaq(BA)°=ΔGaqA-°-ΔGaq(HA)°, and the experimental aqueous pKa values had superior predictive accuracy, which was also tested relative to an independent set of ten molecules of which six were structurally complex phenols. New correlations were built with twenty-seven phenols (including the phenols with experimental pKa values from the test set), which were used to make predictions. The best correlation equations used the PCM method and produced mean absolute errors of 0.26-0.27 pKa units and R2 values of 0.957-0.960. The average range of predictions for the potential antioxidants (cannabinoids) was 0.15 (0.25) pKa units, which indicates good agreement between our methodologies. The new correlation equations could be used to make pKa predictions for other phenols in water and potentially in other solvents where they might be more soluble.
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Affiliation(s)
- Max Walton-Raaby
- Department of Chemistry, Thompson Rivers University, Kamloops, BC V2C 0C8, Canada
- Department of Chemistry, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Tyler Floen
- Department of Chemistry, Thompson Rivers University, Kamloops, BC V2C 0C8, Canada
| | | | - Nelaine Mora-Diez
- Department of Chemistry, Thompson Rivers University, Kamloops, BC V2C 0C8, Canada
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13
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Persia D, Mangiavacchi F, Marcotullio MC, Rosati O. Cannabinoids as multifaceted compounds. PHYTOCHEMISTRY 2023; 212:113718. [PMID: 37196772 DOI: 10.1016/j.phytochem.2023.113718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 04/25/2023] [Accepted: 05/09/2023] [Indexed: 05/19/2023]
Abstract
Since ancient times, Cannabis and its preparations have found various applications such as for medical, recreational and industrial purposes. Subsequently the 1930s, legislation in many countries has restricted its use due to its psychotropic properties. More recently, the discovery of endocannabinoid system, including new receptors, ligands, and mediators, its role in maintaining the homeostasis of the human body and the possible implication in various physiological and pathophysiological processes has also been understood. Based on this evidence, researchers were able to develop new therapeutic targets for the treatment of various pathological disorders. For this purpose, Cannabis and cannabinoids were subjected for the evaluation of their pharmacological activities. The renewed interest in the medical use of cannabis for its potential therapeutic application has prompted legislators to take action to regulate the safe use of cannabis and products containing cannabinoids. However, each country has an enormous heterogeneity in the regulation of laws. Here, we are pleased to show a general and prevailing overview of the findings regarding cannabinoids and the multiple research fields such as chemistry, phytochemistry, pharmacology and analytics in which they are involved.
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Affiliation(s)
- Diana Persia
- Department of Pharmaceutical Sciences, Via Del Liceo, 1 - Università Degli Studi di Perugia, 06123, Perugia, Italy
| | - Francesca Mangiavacchi
- Department of Pharmaceutical Sciences, Via Del Liceo, 1 - Università Degli Studi di Perugia, 06123, Perugia, Italy; Current Address: Department of Chemistry 'Ugo Schiff', Via Della Lastruccia, 16 - Università Degli Studi di Firenze, 50019, Sesto Fiorentino, Italy
| | - Maria Carla Marcotullio
- Department of Pharmaceutical Sciences, Via Del Liceo, 1 - Università Degli Studi di Perugia, 06123, Perugia, Italy
| | - Ornelio Rosati
- Department of Pharmaceutical Sciences, Via Del Liceo, 1 - Università Degli Studi di Perugia, 06123, Perugia, Italy.
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14
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Alvarez LD, Alves NRC. Molecular determinants of tetrahydrocannabinol binding to the glycine receptor. Proteins 2023; 91:400-411. [PMID: 36271319 DOI: 10.1002/prot.26438] [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: 08/02/2022] [Revised: 10/04/2022] [Accepted: 10/18/2022] [Indexed: 02/03/2023]
Abstract
The recognition of Cannabis as a source of new compounds suitable for medical use has attracted strong interest from the scientific community in its research, and substantial progress has accumulated regarding cannabinoids' activity; however, a thorough description of their molecular mechanisms of action remains a task to complete. Highlighting their complex pharmacology, the list of cannabinoids' interactors has vastly expanded beyond the canonical cannabinoid receptors. Among those, we have focused our study on the glycine receptor (GlyR), an ion channel involved in the modulation of nervous system responses, including, to our interest, sensitivity to peripheral pain. Here, we report the use of computational methods to investigate possible binding modes between the GlyR and Δ9 -tetrahydrocannabinol (THC). After obtaining a first pose for the THC binding from a biased molecular docking simulation and subsequently evaluating it by molecular dynamic simulations, we found a dynamic system with an identifiable representative binding mode characterized by the specific interaction with two transmembrane residues (Phe293 and Ser296). Complementarily, we assessed the role of membrane cholesterol in this interaction and positively established its relevance for THC binding to GlyR. Lastly, the use of restrained molecular dynamics simulations allowed us to refine the description of the binding mode and of the cholesterol effect. Altogether, our findings contribute to the current knowledge about the GlyR-THC mode of binding and propose a new starting point for future research on how cannabinoids in general, and THC in particular, modulate pain perception in view of its possible clinical applications.
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Affiliation(s)
- Lautaro D Alvarez
- Facultad de Ciencias Exactas y Naturales, Departamento de Química Biológica, Universidad de Buenos Aires, Buenos Aires, Argentina.,CONICET-Universidad de Buenos Aires, UMYMFOR, Buenos Aires, Argentina
| | - N R Carina Alves
- Facultad de Ciencias Exactas y Naturales, Departamento de Química Biológica, Universidad de Buenos Aires, Buenos Aires, Argentina.,CONICET-Universidad de Buenos Aires, IFIBYNE, Buenos Aires, Argentina
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15
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Mahardhika AB, Ressemann A, Kremers SE, Gregório Castanheira MS, Schoeder CT, Müller CE, Pillaiyar T. Design, synthesis, and structure-activity relationships of diindolylmethane derivatives as cannabinoid CB 2 receptor agonists. Arch Pharm (Weinheim) 2023; 356:e2200493. [PMID: 36437108 DOI: 10.1002/ardp.202200493] [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: 09/19/2022] [Revised: 10/31/2022] [Accepted: 11/03/2022] [Indexed: 11/29/2022]
Abstract
3,3'-Diindolylmethane (DIM), a natural product-derived compound formed upon ingestion of cruciferous vegetables, was recently described to act as a partial agonist of the anti-inflammatory cannabinoid (CB) receptor subtype CB2 . In the present study, we synthesized and evaluated a series of DIM derivatives and determined their affinities for human CB receptor subtypes in radioligand binding studies. Potent compounds were additionally evaluated in functional cAMP accumulation and β-arrestin recruitment assays. Small substituents in the 4-position of both indole rings of DIM were beneficial for high CB2 receptor affinity and efficacy. Di-(4-cyano-1H-indol-3-yl)methane (46, PSB-19837, EC50 : cAMP, 0.0144 µM, 95% efficacy compared to the full standard agonist CP55,940; β-arrestin, 0.0149 µM, 67% efficacy) was the most potent CB2 receptor agonist of the present series. Di-(4-bromo-1H-indol-3-yl)methane (44, PSB-19571) showed higher potency in β-arrestin (EC50 0.0450 µM, 61% efficacy) than in cAMP accumulation assays (EC50 0.509 µM, 85% efficacy) while 3-((1H-indol-3-yl)methyl)-4-methyl-1H-indole (149, PSB-18691) displayed a 19-fold bias for the G protein pathway (EC50 : cAMP, 0.0652 µM; β-arrestin, 1.08 µM). DIM and its analogs act as allosteric CB2 receptor agonists. These potent CB2 receptor agonists have potential as novel drugs for the treatment of inflammatory diseases.
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Affiliation(s)
- Andhika B Mahardhika
- Department of Pharmaceutical & Medicinal Chemistry, PharmaCenter Bonn, Pharmaceutical Institute, University of Bonn, Bonn, Germany.,Research Training Group 1873, University of Bonn, Bonn, Germany
| | - Anastasiia Ressemann
- Department of Pharmaceutical & Medicinal Chemistry, PharmaCenter Bonn, Pharmaceutical Institute, University of Bonn, Bonn, Germany
| | - Sarah E Kremers
- Department of Pharmaceutical & Medicinal Chemistry, PharmaCenter Bonn, Pharmaceutical Institute, University of Bonn, Bonn, Germany
| | - Mariana S Gregório Castanheira
- Department of Pharmaceutical & Medicinal Chemistry, PharmaCenter Bonn, Pharmaceutical Institute, University of Bonn, Bonn, Germany
| | - Clara T Schoeder
- Department of Pharmaceutical & Medicinal Chemistry, PharmaCenter Bonn, Pharmaceutical Institute, University of Bonn, Bonn, Germany.,Research Training Group 1873, University of Bonn, Bonn, Germany
| | - Christa E Müller
- Department of Pharmaceutical & Medicinal Chemistry, PharmaCenter Bonn, Pharmaceutical Institute, University of Bonn, Bonn, Germany.,Research Training Group 1873, University of Bonn, Bonn, Germany
| | - Thanigaimalai Pillaiyar
- Department of Pharmaceutical & Medicinal Chemistry, PharmaCenter Bonn, Pharmaceutical Institute, University of Bonn, Bonn, Germany.,Pharmaceutical/Medicinal Chemistry and Tübingen Center for Academic Drug Discovery, Institute of Pharmacy, Eberhard Karls University, Tübingen, Germany
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16
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Reddy TS, Zomer R, Mantri N. Nanoformulations as a strategy to overcome the delivery limitations of cannabinoids. Phytother Res 2023; 37:1526-1538. [PMID: 36748949 DOI: 10.1002/ptr.7742] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 11/22/2022] [Accepted: 11/28/2022] [Indexed: 02/08/2023]
Abstract
Medical cannabis has received significant interest in recent years due to its promising benefits in the management of pain, anxiety, depression and neurological and movement disorders. Specifically, the major phytocannabinoids derived from the cannabis plant such as (-) trans-Δ9 -tetrahydrocannabinol (THC) and cannabidiol (CBD), have been shown to be responsible for the pharmacological and therapeutic properties. Recently, these phytocannabinoids have also attracted special attention in cancer treatment due to their well-known palliative benefits in chemotherapy-induced nausea, vomiting, pain and loss of appetite along with their anticancer activities. Despite the enormous pharmacological benefits, the low aqueous solubility, high instability (susceptibility to extensive first pass metabolism) and poor systemic bioavailability restrict their utilization at clinical perspective. Therefore, drug delivery strategies based on nanotechnology are emerging to improve pharmacokinetic profile and bioavailability of cannabinoids as well as enhance their targeted delivery. Here, we critically review the nano-formulation systems engineered for overcoming the delivery limitations of native phytocannabinoids including polymeric and lipid-based nanoparticles (lipid nano capsules (LNCs), nanostructured lipid carriers (NLCs), nanoemulsions (NE) and self-emulsifying drug delivery systems (SEDDS)), ethosomes and cyclodextrins as well as their therapeutic applications.
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Affiliation(s)
- T Srinivasa Reddy
- The Pangenomics Group, Biosciences and Food Technology, School of Science, RMIT University, Melbourne, Victoria, Australia
| | - Roby Zomer
- MGC Pharmaceuticals Limited, West Perth, Western Australia, Australia
| | - Nitin Mantri
- The Pangenomics Group, Biosciences and Food Technology, School of Science, RMIT University, Melbourne, Victoria, Australia.,The UWA Institute of Agriculture, The University of Western Australia, Perth, Western Australia, Australia
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17
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Patil N, Chandel V, Rana A, Jain M, Kaushik P. Investigation of Cannabis sativa Phytochemicals as Anti-Alzheimer's Agents: An In Silico Study. PLANTS (BASEL, SWITZERLAND) 2023; 12:510. [PMID: 36771595 PMCID: PMC9919841 DOI: 10.3390/plants12030510] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 05/27/2023]
Abstract
Cannabis sativa is a medicinal plant that has been known for years and is used as an Ayurvedic medicine. This plant has great potential in treating various types of brain diseases. Phytochemicals present in this plant act as antioxidants by maintaining synaptic plasticity and preventing neuronal loss. Cannabidiol (CBD) and Tetrahydrocannabinol (THC) are both beneficial in treating Alzheimer's disease by increasing the solubility of Aβ42 amyloid and Tau aggregation. Apart from these therapeutic effects, there are certain unknown functions of these phytochemicals in Alzheimer's disease that we want to elucidate through this study. In this research, our approach is to analyze the effect of phytochemicals in Cannabis sativa on multiple culprit enzymes in Alzheimer's disease, such as AChE (Acetylcholinesterase), BChE (Butyrylcholinesterase), γ-secretase, and BACE-1. In this study, the compounds were selected by Lipinski's rule, ADMET, and ProTox based on toxicity. Molecular docking between the selected compounds (THCV, Cannabinol C2, and Cannabidiorcol) and enzymes mentioned above was obtained by various software programs including AutoDock Vina 4.2, AutoDock, and iGEMDOCK. In comparison to Donepezil (BA = -8.4 kcal/mol, Ki = 1.46 mM), Rivastigmine (BA = -7.0 kcal/mol, Ki = 0.02 mM), and Galantamine (BA = -7.1, Ki = 2.1 mM), Cannabidiorcol (BA = -9.4 kcal/mol, Ki = 4.61 mM) shows significant inhibition of AChE. On the other hand, Cannabinol C2 (BA = -9.2 kcal/mol, Ki = 4.32 mM) significantly inhibits Butyrylcholinesterase (BuChE) in comparison to Memantine (BA = -6.8 kcal/mol, Ki = 0.54 mM). This study sheds new light and opens new avenues for elucidating the role of bioactive compounds present in Cannabis sativa in treating Alzheimer's disease.
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Affiliation(s)
- Nil Patil
- Department of Life Sciences, Parul Institute of Applied Sciences, Parul University, Vadodara 391760, Gujarat, India
- Laboratory 209, Cell & Developmental Biology Laboratory, Centre of Research for Development, Parul University, Vadodara 391760, Gujarat, India
| | - Vaishnavi Chandel
- Department of Life Sciences, Parul Institute of Applied Sciences, Parul University, Vadodara 391760, Gujarat, India
| | - Aarzu Rana
- Department of Life Sciences, Parul Institute of Applied Sciences, Parul University, Vadodara 391760, Gujarat, India
| | - Mukul Jain
- Department of Life Sciences, Parul Institute of Applied Sciences, Parul University, Vadodara 391760, Gujarat, India
- Laboratory 209, Cell & Developmental Biology Laboratory, Centre of Research for Development, Parul University, Vadodara 391760, Gujarat, India
| | - Prashant Kaushik
- Instituto de Conservacióny Mejora de la Agrodiversidad Valenciana, Universitat Politècnica de València, 46022 Valencia, Spain
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18
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Laws JS, Smid SD. Evaluating Cannabis sativa L.'s neuroprotection potential: From bench to bedside. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2022; 107:154485. [PMID: 36209703 DOI: 10.1016/j.phymed.2022.154485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 09/09/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Neurodegenerative diseases and dementia pose a global health challenge in an aging population, exemplified by the increasing incidence and prevalence of its most common form, Alzheimer's disease. Although several approved treatments exist for Alzheimer's disease, they only afford transient symptomatic improvements and are not considered disease-modifying. The psychoactive properties of Cannabis sativa L. have been recognized for thousands of years and now with burgeoning access to medicinal formulations globally, research has turned to re-evaluate cannabis and its myriad phytochemicals as a potential treatment and adjunctive agent for neurodegenerative diseases. PURPOSE This review evaluated the neuroprotective potential of C. sativa's active constituents for potential therapeutic use in dementia and Alzheimer's disease, based on published studies demonstrating efficacy in experimental preclinical settings associated with neurodegeneration. STUDY DESIGN Relevant information on the neuroprotective potential of the C. sativa's phytoconstituents in preclinical studies (in vitro, in vivo) were included. The collated information on C. sativa's component bioactivity was organized for therapeutic applications against neurodegenerative diseases. METHODS The therapeutic use of C. sativa related to Alzheimer's disease relative to known phytocannabinoids and other phytochemical constituents were derived from online databases, including PubMed, Elsevier, The Plant List (TPL, www.theplantlist.org), Science Direct, as well as relevant information on the known pharmacological actions of the listed phytochemicals. RESULTS Numerous C. sativa -prevalent phytochemicals were evidenced in the body of literature as having efficacy in the treatment of neurodegenerative conditions exemplified by Alzheimer's disease. Several phytocannabinoids, terpenes and select flavonoids demonstrated neuroprotection through a myriad of cellular and molecular pathways, including cannabinoid receptor-mediated, antioxidant and direct anti-aggregatory actions against the pathological toxic hallmark protein in Alzheimer's disease, amyloid β. CONCLUSIONS These findings provide strong evidence for a role of cannabis constituents, individually or in combination, as potential neuroprotectants timely to the emergent use of medicinal cannabis as a novel treatment for neurodegenerative diseases. Future randomized and controlled clinical studies are required to substantiate the bioactivities of phytocannabinoids and terpenes and their likely synergies.
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Affiliation(s)
- John Staton Laws
- Discipline of Pharmacology, School of Biomedicine, Faculty of Health and Medical Sciences, The University of Adelaide, South Australia, Australia
| | - Scott D Smid
- Discipline of Pharmacology, School of Biomedicine, Faculty of Health and Medical Sciences, The University of Adelaide, South Australia, Australia.
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19
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Velzeboer R, Malas A, Boerkoel P, Cullen K, Hawkins M, Roesler J, Lai WWK. Cannabis dosing and administration for sleep: a systematic review. Sleep 2022; 45:6701617. [PMID: 36107800 DOI: 10.1093/sleep/zsac218] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 09/01/2022] [Indexed: 01/31/2023] Open
Abstract
STUDY OBJECTIVES As cannabis is increasingly used to treat sleep disorders, we performed a systematic review to examine the effects of cannabis on sleep and to guide cannabis prescribers in their recommendations to patients, specifically focusing on dosing. METHODS We searched EMBASE, Medline, and Web of Science and identified 4550 studies for screening. Five hundred sixty-eight studies were selected for full-text review and 31 were included for analysis. Study results were considered positive based on improvements in sleep architecture or subjective sleep quality. Bias in randomized controlled trials was assessed using Cochrane Risk of Bias tool 2.0. RESULTS Sleep improvements were seen in 7 out of 19 randomized studies and in 7 out of 12 uncontrolled trials. There were no significant differences between the effects of tetrahydrocannabinol and cannabidiol. Cannabis showed most promise at improving sleep in patients with pain-related disorders, as compared to those with neurologic, psychiatric, or sleep disorders, and showed no significant effects on healthy participants' sleep. While subjective improvements in sleep quality were often observed, diagnostic testing showed no improvements in sleep architecture. Adverse events included headaches, sedation, and dizziness, and occurred more frequently at higher doses, though no serious adverse events were observed. CONCLUSION High-quality evidence to support cannabis use for sleep remains limited. Heterogeneity in cannabis types, doses, timing of administration, and sleep outcome measures limit the ability to make specific dosing recommendations.
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Affiliation(s)
- Rob Velzeboer
- Clinical Research, Tranq Sleep Care , Kelowna, British Columbia, Canada
| | - Adeeb Malas
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Pierre Boerkoel
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Katie Cullen
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michelle Hawkins
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jordanna Roesler
- Department of Dermatology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Wayne Wei-Ku Lai
- Medical Director, Tranq Sleep Care, Kelowna, British Columbia, Canada.,Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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20
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Sparkes E, Boyd R, Chen S, Markham JW, Luo JL, Foyzun T, Zaman H, Fletcher C, Ellison R, McGregor IS, Santiago MJ, Lai F, Gerona RR, Connor M, Hibbs DE, Cairns EA, Glass M, Ametovski A, Banister SD. Synthesis and pharmacological evaluation of newly detected synthetic cannabinoid receptor agonists AB-4CN-BUTICA, MMB-4CN-BUTINACA, MDMB-4F-BUTICA, MDMB-4F-BUTINACA and their analogs. Front Psychiatry 2022; 13:1010501. [PMID: 36245876 PMCID: PMC9558907 DOI: 10.3389/fpsyt.2022.1010501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 08/24/2022] [Indexed: 11/13/2022] Open
Abstract
Synthetic cannabinoid receptor agonists (SCRAs) continue to make up a significant portion new psychoactive substances (NPS) detected and seized worldwide. Due to their often potent activation of central cannabinoid receptors in vivo, use of SCRAs can result in severe intoxication, in addition to other adverse health effects. Recent detections of AB-4CN-BUTICA, MMB-4CN-BUTINACA, MDMB-4F-BUTICA and MDMB-4F-BUTINACA mark a continuation in the appearance of SCRAs bearing novel tail substituents. The proactive characterization campaign described here has facilitated the detection of several new SCRAs in toxicological case work. Here we detail the synthesis, characterization, and pharmacological evaluation of recently detected SCRAs, as well as a systematic library of 32 compounds bearing head, tail, and core group combinations likely to appear in future. In vitro radioligand binding assays revealed most compounds showed moderate to high affinity at both CB1 (pK i = < 5 to 8.89 ± 0.09 M) and CB2 (pK i = 5.49 ± 0.03 to 9.92 ± 0.09 M) receptors. In vitro functional evaluation using a fluorescence-based membrane potential assay showed that most compounds were sub-micromolar to sub-nanomolar agonists at CB1 (pEC50 = < 5 to 9.48 ± 0.14 M) and CB2 (pEC50 = 5.92 ± 0.16 to 8.64 ± 0.15 M) receptors. An in silico receptor-ligand docking approach was utilized to rationalize binding trends for CB2 with respect to the tail substituent, and indicated that rigidity in this region (i.e., 4-cyanobutyl) was detrimental to affinity.
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Affiliation(s)
- Eric Sparkes
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
- Faculty of Science, School of Chemistry, The University of Sydney, Sydney, NSW, Australia
| | - Rochelle Boyd
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
- Faculty of Science, School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Shuli Chen
- Department of Pharmacology and Toxicology, University of Otago, Dunedin, New Zealand
| | - Jack W. Markham
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
- Faculty of Science, School of Chemistry, The University of Sydney, Sydney, NSW, Australia
- Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Sydney, NSW, Australia
| | - Jia Lin Luo
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
- Faculty of Science, School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Tahira Foyzun
- Macquarie Medical School, Macquarie University, Sydney, NSW, Australia
| | - Humayra Zaman
- Macquarie Medical School, Macquarie University, Sydney, NSW, Australia
| | - Charlotte Fletcher
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
- Faculty of Science, School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Ross Ellison
- Clinical Toxicology and Environmental Biomonitoring Laboratory, University of California, San Francisco, San Francisco, CA, United States
| | - Iain S. McGregor
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
- Faculty of Science, School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | | | - Felcia Lai
- Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Sydney, NSW, Australia
| | - Roy R. Gerona
- Clinical Toxicology and Environmental Biomonitoring Laboratory, University of California, San Francisco, San Francisco, CA, United States
| | - Mark Connor
- Macquarie Medical School, Macquarie University, Sydney, NSW, Australia
| | - David E. Hibbs
- Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Sydney, NSW, Australia
| | - Elizabeth A. Cairns
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
- Faculty of Science, School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Michelle Glass
- Department of Pharmacology and Toxicology, University of Otago, Dunedin, New Zealand
| | - Adam Ametovski
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
- Faculty of Science, School of Chemistry, The University of Sydney, Sydney, NSW, Australia
| | - Samuel D. Banister
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
- Faculty of Science, School of Chemistry, The University of Sydney, Sydney, NSW, Australia
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A New Lactam from Cannabis sativa. Chem Nat Compd 2022. [DOI: 10.1007/s10600-022-03750-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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22
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Zhou C, Assareh N, Arnold JC. The Cannabis Constituent Cannabigerol Does Not Disrupt Fear Memory Processes or Stress-Induced Anxiety in Mice. Cannabis Cannabinoid Res 2022; 7:294-303. [PMID: 34182770 PMCID: PMC9225414 DOI: 10.1089/can.2021.0027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Introduction: Medicinal cannabis has proliferated around the world and there is increasing interest in the therapeutic potential of individual plant-derived cannabinoids (phytocannabinoids). Preclinical evidence suggests the phytocannabinoid cannabigerol (CBG) could be useful in treating brain disorders, including stress and anxiety-related disorders. In this study, we aimed to explore whether CBG disrupts various contextually conditioned fear memory processes and trauma-induced anxiety-related behavior in a mouse model of post-traumatic stress disorder (PTSD). Materials and Methods: All mice underwent contextual fear conditioning. CBG was administered between 1 and 60 mg/kg intraperitoneally (i.p.). We first assessed the effects of repeated CBG exposure on long-term fear memories. We also examined whether acute CBG affected various fear memory processes, namely expression, acquisition, consolidation, and reconsolidation of conditioned fear. Finally, the effect of acute CBG administration on stress-induced anxiety in the light/dark test was assessed. Results: Repeated CBG exposure did not affect long-term conditioned fear that was observed 24 days after the conditioning session. Moreover, acute CBG administration did not influence the acquisition, consolidation, reconsolidation, or expression of contextually conditioned fear. Acute CBG treatment also did not affect stress-induced anxiety-related behaviors in the light/dark test. Conclusions: CBG was ineffective in disrupting long-term fear memories, various conditioned fear memory processes, or stress-induced anxiety-related behavior in mice. These preclinical data suggest CBG may have limited scope in the treatment of PTSD and stress-related anxiety.
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Affiliation(s)
- Cilla Zhou
- Brain and Mind Centre, The University of Sydney, Sydney, Australia.,Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, Sydney, Australia.,Discipline of Pharmacology, Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Neda Assareh
- Brain and Mind Centre, The University of Sydney, Sydney, Australia.,Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, Sydney, Australia
| | - Jonathon C. Arnold
- Brain and Mind Centre, The University of Sydney, Sydney, Australia.,Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, Sydney, Australia.,Discipline of Pharmacology, Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Address correspondence to: Jonathon C. Arnold, PhD, Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, University of Sydney, 94 Mallett Street, Camperdown 2050, New South Wales, Australia,
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23
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MacPhail SL, Bedoya-Pérez MA, Cohen R, Kotsirilos V, McGregor IS, Cairns EA. Medicinal Cannabis Prescribing in Australia: An Analysis of Trends Over the First Five Years. Front Pharmacol 2022; 13:885655. [PMID: 35620292 PMCID: PMC9127064 DOI: 10.3389/fphar.2022.885655] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 03/31/2022] [Indexed: 11/13/2022] Open
Abstract
A regulatory framework allowing legal access to medicinal cannabis (MC) products has operated in Australia since November 2016. MC prescribing by healthcare practitioners (HCPs) is primarily conducted through the Special Access Scheme - Category B (SAS-B) pathway, through which prescribers apply to the Therapeutic Goods Administration (TGA–the federal regulator) for approval to prescribe a category of product to an individual patient suffering from a specific indication. The dataset collected by the TGA provides a unique opportunity to examine MC prescribing trends over time in the Australian population. Here we analysed this TGA SAS-B dataset since inception with respect to age, gender, product type (e.g., oil, flower, etc.), CBD content, indication treated, and prescriber location. Results are presented descriptively as well as being analysed using non-linear regression models. Relationship between variables were explored via correspondence analyses. Indications were classified with reference to the International Statistical Classification of Diseases and Related Health Problems (10th Revision). As of 31 August 2021, a total of 159,665 SAS-B approvals had been issued for MC products, 82.4% of were since January 2020. Leading indications for approvals were for pain, anxiety, and sleep disorders. Oil products were the most popular product type, while CBD-dominant products (≥98% CBD) accounted for 25.1% of total approvals. Approvals for flower products increased markedly during 2020–2021, as did approvals involving younger age groups (18–31 years old), male patients, and non-CBD dominant products. A disproportionate number of SAS-B MC applications (around 50%) came from HCPs in the state of Queensland. Associations between patient gender and age and/or indication with product type were found. For example, approvals for oil products were commonly associated with approvals for pain. While, overall prescribing increased dramatically over the last 2 years of analysis, stabilization of approval numbers is evident for some indications, such as pain. Current prescribing practices do not always reflect provided TGA guidance documents for MC prescribing. While acknowledging some limitations around the SAS-B dataset, it provides a unique and valuable resource with which to better understand current prescribing practices and utilisation of MC products within Australia.
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Affiliation(s)
- Sara L MacPhail
- The Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, Sydney, NSW, Australia.,School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Miguel A Bedoya-Pérez
- The Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, Sydney, NSW, Australia.,School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Rhys Cohen
- School of Social Sciences, Department of Sociology, Macquarie University, Sydney, NSW, Australia.,Cannabis Consulting Australia, Sydney, NSW, Australia
| | - Vicki Kotsirilos
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia
| | - Iain S McGregor
- The Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, Sydney, NSW, Australia.,School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Elizabeth A Cairns
- The Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, Sydney, NSW, Australia.,School of Psychology, The University of Sydney, Sydney, NSW, Australia
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24
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Filippini G, Minozzi S, Borrelli F, Cinquini M, Dwan K. Cannabis and cannabinoids for symptomatic treatment for people with multiple sclerosis. Cochrane Database Syst Rev 2022; 5:CD013444. [PMID: 35510826 PMCID: PMC9069991 DOI: 10.1002/14651858.cd013444.pub2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Spasticity and chronic neuropathic pain are common and serious symptoms in people with multiple sclerosis (MS). These symptoms increase with disease progression and lead to worsening disability, impaired activities of daily living and quality of life. Anti-spasticity medications and analgesics are of limited benefit or poorly tolerated. Cannabinoids may reduce spasticity and pain in people with MS. Demand for symptomatic treatment with cannabinoids is high. A thorough understanding of the current body of evidence regarding benefits and harms of these drugs is required. OBJECTIVES To assess benefit and harms of cannabinoids, including synthetic, or herbal and plant-derived cannabinoids, for reducing symptoms for adults with MS. SEARCH METHODS We searched the following databases from inception to December 2021: MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL, the Cochrane Library), CINAHL (EBSCO host), LILACS, the Physiotherapy Evidence Database (PEDro), the World Health Organisation International Clinical Trials Registry Platform, the US National Institutes of Health clinical trial register, the European Union Clinical Trials Register, the International Association for Cannabinoid Medicines databank. We hand searched citation lists of included studies and relevant reviews. SELECTION CRITERIA We included randomised parallel or cross-over trials (RCTs) evaluating any cannabinoid (including herbal Cannabis, Cannabis flowers, plant-based cannabinoids, or synthetic cannabinoids) irrespective of dose, route, frequency, or duration of use for adults with MS. DATA COLLECTION AND ANALYSIS We followed standard Cochrane methodology. To assess bias in included studies, we used the Cochrane Risk of bias 2 tool for parallel RCTs and crossover trials. We rated the certainty of evidence using the GRADE approach for the following outcomes: reduction of 30% in the spasticity Numeric Rating Scale, pain relief of 50% or greater in the Numeric Rating Scale-Pain Intensity, much or very much improvement in the Patient Global Impression of Change (PGIC), Health-Related Quality of Life (HRQoL), withdrawals due to adverse events (AEs) (tolerability), serious adverse events (SAEs), nervous system disorders, psychiatric disorders, physical dependence. MAIN RESULTS We included 25 RCTs with 3763 participants of whom 2290 received cannabinoids. Age ranged from 18 to 60 years, and between 50% and 88% participants across the studies were female. The included studies were 3 to 48 weeks long and compared nabiximols, an oromucosal spray with a plant derived equal (1:1) combination of tetrahydrocannabinol (THC) and cannabidiol (CBD) (13 studies), synthetic cannabinoids mimicking THC (7 studies), an oral THC extract of Cannabis sativa (2 studies), inhaled herbal Cannabis (1 study) against placebo. One study compared dronabinol, THC extract of Cannabis sativa and placebo, one compared inhaled herbal Cannabis, dronabinol and placebo. We identified eight ongoing studies. Critical outcomes • Spasticity: nabiximols probably increases the number of people who report an important reduction of perceived severity of spasticity compared with placebo (odds ratio (OR) 2.51, 95% confidence interval (CI) 1.56 to 4.04; 5 RCTs, 1143 participants; I2 = 67%; moderate-certainty evidence). The absolute effect was 216 more people (95% CI 99 more to 332 more) per 1000 reporting benefit with cannabinoids than with placebo. • Chronic neuropathic pain: we found only one small trial that measured the number of participants reporting substantial pain relief with a synthetic cannabinoid compared with placebo (OR 4.23, 95% CI 1.11 to 16.17; 1 study, 48 participants; very low-certainty evidence). We are uncertain whether cannabinoids reduce chronic neuropathic pain intensity. • Treatment discontinuation due to AEs: cannabinoids may increase slightly the number of participants who discontinue treatment compared with placebo (OR 2.41, 95% CI 1.51 to 3.84; 21 studies, 3110 participants; I² = 17%; low-certainty evidence); the absolute effect is 39 more people (95% CI 15 more to 76 more) per 1000 people. Important outcomes • PGIC: cannabinoids probably increase the number of people who report 'very much' or 'much' improvement in health status compared with placebo (OR 1.80, 95% CI 1.37 to 2.36; 8 studies, 1215 participants; I² = 0%; moderate-certainty evidence). The absolute effect is 113 more people (95% CI 57 more to 175 more) per 1000 people reporting improvement. • HRQoL: cannabinoids may have little to no effect on HRQoL (SMD -0.08, 95% CI -0.17 to 0.02; 8 studies, 1942 participants; I2 = 0%; low-certainty evidence); • SAEs: cannabinoids may result in little to no difference in the number of participants who have SAEs compared with placebo (OR 1.38, 95% CI 0.96 to 1.99; 20 studies, 3124 participants; I² = 0%; low-certainty evidence); • AEs of the nervous system: cannabinoids may increase nervous system disorders compared with placebo (OR 2.61, 95% CI 1.53 to 4.44; 7 studies, 1154 participants; I² = 63%; low-certainty evidence); • Psychiatric disorders: cannabinoids may increase psychiatric disorders compared with placebo (OR 1.94, 95% CI 1.31 to 2.88; 6 studies, 1122 participants; I² = 0%; low-certainty evidence); • Drug tolerance: the evidence is very uncertain about the effect of cannabinoids on drug tolerance (OR 3.07, 95% CI 0.12 to 75.95; 2 studies, 458 participants; very low-certainty evidence). AUTHORS' CONCLUSIONS Compared with placebo, nabiximols probably reduces the severity of spasticity in the short-term in people with MS. We are uncertain about the effect on chronic neurological pain and health-related quality of life. Cannabinoids may increase slightly treatment discontinuation due to AEs, nervous system and psychiatric disorders compared with placebo. We are uncertain about the effect on drug tolerance. The overall certainty of evidence is limited by short-term duration of the included studies.
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Affiliation(s)
- Graziella Filippini
- Scientific Director's Office, Carlo Besta Foundation and Neurological Institute, Milan, Italy
| | - Silvia Minozzi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Francesca Borrelli
- Department of Pharmacy, School of Medicine and Surgery, University of Naples 'Federico II', Naples, Italy
| | - Michela Cinquini
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Kerry Dwan
- Review Production and Quality Unit, Editorial & Methods Department, Cochrane Central Executive, London, UK
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25
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Markham J, Sparkes E, Boyd R, Chen S, Manning JJ, Finlay D, Lai F, McGregor E, Maloney CJ, Gerona RR, Connor M, McGregor IS, Hibbs DE, Glass M, Kevin RC, Banister SD. Defining Steric Requirements at CB 1 and CB 2 Cannabinoid Receptors Using Synthetic Cannabinoid Receptor Agonists 5F-AB-PINACA, 5F-ADB-PINACA, PX-1, PX-2, NNL-1, and Their Analogues. ACS Chem Neurosci 2022; 13:1281-1295. [PMID: 35404067 DOI: 10.1021/acschemneuro.2c00034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Synthetic cannabinoid receptor agonists (SCRAs) are a diverse class of new psychoactive substances (NPS). They commonly comprise N-alkylated indole, indazole, or 7-azaindole scaffolds with amide-linked pendant amino acid groups. To explore the contribution of the amino acid side chain to the cannabinoid pharmacology of SCRA NPS, a systematic library of side chain-modified SCRAs was prepared based on the recent detections of amino acid derivatives 17 (5F-AB-PINACA), 18 (5F-ADB-PINACA), 15 (PX-1), 19 (PX-2), and 20 (NNL-1). In vitro binding affinities and functional activities at cannabinoid type 1 and 2 receptors (CB1 and CB2, respectively) were determined for all the library members using radioligand competition experiments and a fluorescence-based membrane potential assay. Binding affinities and functional activities varied widely across compounds (Ki = 0.32 to >10 000 nM, EC50 = 0.24-1259 nM), with several clear structure-activity relationships (SARs) emerging. Affinity and potency at CB1 changed as a function of the heterocyclic core (indazole > indole > 7-azaindole) and the pendant amino acid side chain (tert-butyl > iso-propyl > iso-butyl > benzyl > ethyl > methyl > hydrogen). Ensemble docking at CB1 revealed a clear steric basis for observed SAR trends. Interestingly, although 15 (PX-1) and 19 (PX-2) have been detected in recreational drug markets, they failed to induce centrally CB1-mediated effects (e.g., hypothermia) in mice using radiobiotelemetry. Together, these data provide insights regarding structural contributions to the cannabimimetic profiles of 17 (5F-AB-PINACA), 18 (5F-ADB-PINACA), 15 (PX-1), 19 (PX-2), 20 (NNL-1), and other SCRA NPS.
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Affiliation(s)
- Jack Markham
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney 2050, New South Wales, Australia
- School of Chemistry, The University of Sydney, Sydney 2006, New South Wales, Australia
| | - Eric Sparkes
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney 2050, New South Wales, Australia
- School of Chemistry, The University of Sydney, Sydney 2006, New South Wales, Australia
| | - Rochelle Boyd
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney 2050, New South Wales, Australia
- School of Chemistry, The University of Sydney, Sydney 2006, New South Wales, Australia
| | - Shuli Chen
- Department of Pharmacology and Toxicology, University of Otago, Dunedin 9016, New Zealand
| | - Jamie J. Manning
- Department of Pharmacology and Toxicology, University of Otago, Dunedin 9016, New Zealand
| | - David Finlay
- Department of Pharmacology and Toxicology, University of Otago, Dunedin 9016, New Zealand
| | - Felcia Lai
- School of Pharmacy, The University of Sydney, Sydney 2006, New South Wales, Australia
| | - Eila McGregor
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney 2050, New South Wales, Australia
- School of Psychology, The University of Sydney, Sydney 2005, New South Wales, Australia
| | - Callan J. Maloney
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney 2050, New South Wales, Australia
- School of Chemistry, The University of Sydney, Sydney 2006, New South Wales, Australia
| | - Roy R. Gerona
- Clinical Toxicology and Environmental Biomonitoring Laboratory, University of California, San Francisco, California 94143, United States
| | - Mark Connor
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney 2109, New South Wales, Australia
| | - Iain S. McGregor
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney 2050, New South Wales, Australia
- School of Psychology, The University of Sydney, Sydney 2005, New South Wales, Australia
| | - David E. Hibbs
- School of Pharmacy, The University of Sydney, Sydney 2006, New South Wales, Australia
| | - Michelle Glass
- Department of Pharmacology and Toxicology, University of Otago, Dunedin 9016, New Zealand
| | - Richard C. Kevin
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney 2050, New South Wales, Australia
- School of Pharmacy, The University of Sydney, Sydney 2006, New South Wales, Australia
| | - Samuel D. Banister
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney 2050, New South Wales, Australia
- School of Chemistry, The University of Sydney, Sydney 2006, New South Wales, Australia
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26
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Glatfelter GC, Partilla JS, Baumann MH. Structure-activity relationships for 5F-MDMB-PICA and its 5F-pentylindole analogs to induce cannabinoid-like effects in mice. Neuropsychopharmacology 2022; 47:924-932. [PMID: 34802041 PMCID: PMC8882184 DOI: 10.1038/s41386-021-01227-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 10/21/2021] [Accepted: 10/26/2021] [Indexed: 01/08/2023]
Abstract
Synthetic cannabinoid receptor agonists (SCRAs) are an evolving class of new psychoactive substances found on recreational drug markets worldwide. The indole-containing compound, 5F-MDMB-PICA, is a popular SCRA associated with serious medical consequences, including overdose and hospitalizations. In vitro studies reveal that 5F-MDMB-PICA is a potent agonist at cannabinoid type 1 receptors (CB1), but little information exists regarding in vivo pharmacology of the drug. To this end, we examined the in vitro and in vivo cannabinoid-like effects produced by 5F-MDMB-PICA and related 5F-pentylindole analogs with differing composition of the head group moiety (i.e., 5F-NNEI, 5F-SDB-006, 5F-CUMYL-PICA, 5F-MMB-PICA). In mouse brain membranes, 5F-MDMB-PICA and its analogs inhibited binding to [3H]rimonabant-labeled CB1 and displayed agonist actions in [35S]GTPγS functional assays. 5F-MDMB-PICA exhibited the highest CB1 affinity (Ki = 1.24 nM) and functional potency (EC50 = 1.46 nM), but head group composition markedly influenced activity in both assays. For example, the 3,3-dimethylbutanoate (5F-MDMB-PICA) and cumyl (5F-CUMYL-PICA) head groups engendered high CB1 affinity and potency, whereas a benzyl (5F-SDB-006) head group did not. In C57BL/6J mice, all 5F-pentylindole SCRAs produced dose- and time-dependent hypothermia, catalepsy, and analgesia that were reversed by rimonabant, indicating CB1 involvement. In vitro Ki and EC50 values were positively correlated with in vivo ED50 potency estimates. Our findings demonstrate that 5F-MDMB-PICA is a potent SCRA, and subtle alterations to head group composition can have profound influence on pharmacological effects at CB1. Importantly, measures of CB1 binding and efficacy in mouse brain tissue seem to accurately predict in vivo drug potency in this species.
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Affiliation(s)
- Grant C. Glatfelter
- grid.420090.f0000 0004 0533 7147Designer Drug Research Unit (DDRU), National Institute on Drug Abuse (NIDA), Intramural Research Program (IRP), Baltimore, MD USA
| | - John S. Partilla
- grid.420090.f0000 0004 0533 7147Designer Drug Research Unit (DDRU), National Institute on Drug Abuse (NIDA), Intramural Research Program (IRP), Baltimore, MD USA
| | - Michael H. Baumann
- grid.420090.f0000 0004 0533 7147Designer Drug Research Unit (DDRU), National Institute on Drug Abuse (NIDA), Intramural Research Program (IRP), Baltimore, MD USA
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27
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Affiliation(s)
- Margaret Haney
- Division on Substance Use Disorders, Department of Psychiatry, Columbia University Irving Medical Center, and New York State Psychiatric Institute, New York
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28
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Walsh KB, McKinney AE, Holmes AE. Minor Cannabinoids: Biosynthesis, Molecular Pharmacology and Potential Therapeutic Uses. Front Pharmacol 2021; 12:777804. [PMID: 34916950 PMCID: PMC8669157 DOI: 10.3389/fphar.2021.777804] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 11/08/2021] [Indexed: 11/29/2022] Open
Abstract
The medicinal use of Cannabis sativa L. can be traced back thousands of years to ancient China and Egypt. While marijuana has recently shown promise in managing chronic pain and nausea, scientific investigation of cannabis has been restricted due its classification as a schedule 1 controlled substance. A major breakthrough in understanding the pharmacology of cannabis came with the isolation and characterization of the phytocannabinoids trans-Δ9-tetrahydrocannabinol (Δ9-THC) and cannabidiol (CBD). This was followed by the cloning of the cannabinoid CB1 and CB2 receptors in the 1990s and the subsequent discovery of the endocannabinoid system. In addition to the major phytocannabinoids, Δ9-THC and CBD, cannabis produces over 120 other cannabinoids that are referred to as minor and/or rare cannabinoids. These cannabinoids are produced in smaller amounts in the plant and are derived along with Δ9-THC and CBD from the parent cannabinoid cannabigerolic acid (CBGA). While our current knowledge of minor cannabinoid pharmacology is incomplete, studies demonstrate that they act as agonists and antagonists at multiple targets including CB1 and CB2 receptors, transient receptor potential (TRP) channels, peroxisome proliferator-activated receptors (PPARs), serotonin 5-HT1a receptors and others. The resulting activation of multiple cell signaling pathways, combined with their putative synergistic activity, provides a mechanistic basis for their therapeutic actions. Initial clinical reports suggest that these cannabinoids may have potential benefits in the treatment of neuropathic pain, neurodegenerative diseases, epilepsy, cancer and skin disorders. This review focuses on the molecular pharmacology of the minor cannabinoids and highlights some important therapeutic uses of the compounds.
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Affiliation(s)
- Kenneth B Walsh
- Department of Pharmacology, Physiology and Neuroscience, School of Medicine, University of South Carolina, Columbia, SC, United States
| | - Amanda E McKinney
- Institute for Human and Planetary Health, Crete, NE, United States.,School of Integrative Learning, Doane University, Crete, NE, United States
| | - Andrea E Holmes
- School of Integrative Learning, Doane University, Crete, NE, United States.,Precision Plant Molecules, Denver, CO, United States
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McCartney D, Arkell TR, Irwin C, Kevin RC, McGregor IS. Are blood and oral fluid Δ 9-tetrahydrocannabinol (THC) and metabolite concentrations related to impairment? A meta-regression analysis. Neurosci Biobehav Rev 2021; 134:104433. [PMID: 34767878 DOI: 10.1016/j.neubiorev.2021.11.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/29/2021] [Accepted: 11/05/2021] [Indexed: 12/17/2022]
Abstract
Blood and oral fluid Δ9-tetrahydrocannabinol (THC) concentrations are often used to identify cannabis-impaired drivers. We used meta-analytic techniques to characterise the relationships between biomarkers of cannabis use, subjective intoxication, and impairment of driving and driving-related cognitive skills. Twenty-eight publications and 822 driving-related outcomes were reviewed. Each outcome was measured in concert with one or more biomarkers of cannabis/THC use and/or subjective intoxication. Higher blood THC and 11-OH-THC concentrations, oral fluid THC concentrations and subjective ratings of intoxication were associated with greater impairment in 'other' (mostly occasional) cannabis users (p's<0.05). Blood 11-COOH-THC concentrations were associated with impairment after inhaling, but not orally ingesting, cannabis/THC. However t these 'biomarker-performance' relationships (R) were only very weak (blood THCpost-ingestion: -0.08; blood THCpost-inhalation: -0.10; blood 11-OH-THCpost-ingestion: -0.13), weak (blood 11-OH-THCpost-inhalation: -0.24; oral fluid THCpost-inhalation: -0.36; subjective intoxication: -0.29) or moderate (blood 11-COOH-THCpost-inhalation: -0.43) in strength. No significant biomarker-performance relationships were observed in 'regular' (weekly or more often) cannabis users (p's>0.10), although the analyses were less robust. Blood and oral fluid THC concentrations are relatively poor indicators of cannabis/THC-induced impairment.
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Affiliation(s)
- Danielle McCartney
- The University of Sydney, Lambert Initiative for Cannabinoid Therapeutics, Sydney, New South Wales, Australia; The University of Sydney, Brain and Mind Centre, Sydney, New South Wales, Australia; The University of Sydney, Faculty of Science, School of Psychology, Sydney, New South Wales, Australia.
| | - Thomas R Arkell
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Christopher Irwin
- Menzies Health Institute Queensland and School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
| | - Richard C Kevin
- The University of Sydney, Lambert Initiative for Cannabinoid Therapeutics, Sydney, New South Wales, Australia; The University of Sydney, Brain and Mind Centre, Sydney, New South Wales, Australia; The University of Sydney, Faculty of Science, School of Psychology, Sydney, New South Wales, Australia
| | - Iain S McGregor
- The University of Sydney, Lambert Initiative for Cannabinoid Therapeutics, Sydney, New South Wales, Australia; The University of Sydney, Brain and Mind Centre, Sydney, New South Wales, Australia; The University of Sydney, Faculty of Science, School of Psychology, Sydney, New South Wales, Australia
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Ametovski A, Cairns EA, Grafinger KE, Cannaert A, Deventer MH, Chen S, Wu X, Shepperson CE, Lai F, Ellison R, Gerona R, Blakey K, Kevin R, McGregor IS, Hibbs DE, Glass M, Stove C, Auwärter V, Banister SD. NNL-3: A Synthetic Intermediate or a New Class of Hydroxybenzotriazole Esters with Cannabinoid Receptor Activity? ACS Chem Neurosci 2021; 12:4020-4036. [PMID: 34676751 DOI: 10.1021/acschemneuro.1c00348] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Synthetic cannabinoid receptor agonists (SCRAs) remain a prolific class of new psychoactive substances (NPS) and continue to expand rapidly. Despite the recent identification of hydroxybenzotriazole (HOBt) containing SCRAs in synthetic cannabis samples, there is currently no information regarding the pharmacological profile of these NPS with respect to human CB1 and CB2 receptors. In the current study, a series consisting of seven HOBt indole-, indazole-, and 7-azaindole-carboxylates bearing a range of N-alkyl substituents were synthesized and pharmacologically evaluated. Competitive binding assays at CB1 and CB2 demonstrated that all analogues except a 2-methyl-substituted derivative had low affinity for CB1 (Ki = 3.80-43.7 μM) and CB2 (Ki = 2.75-18.2 μM). A fluorometric functional assay revealed that 2-methylindole- and indole-derived HOBt carboxylates were potent and efficacious agonists of CB1 (EC50 = 12.0 and 63.7 nM; Emax = 118 and 120%) and CB2 (EC50 = 10.9 and 321 nM; Emax = 91 and 126%). All other analogues incorporating indazole and 7-azaindole cores and bearing a range of N1-substituents showed relatively low potency for CB1 and CB2. Additionally, a reporter assay monitoring β-arrestin 2 (βarr2) recruitment to the receptor revealed that the 2-methylindole example was the most potent and efficacious at CB1 (EC50 = 131 nM; Emax = 724%) and the most potent at CB2 (EC50 = 38.2 nM; Emax = 51%). As with the membrane potential assay, the indazole and other indole HOBt carboxylates were considerably less potent at both receptors, and analogues comprising a 7-azaindole core showed little activity. Taken together, these data suggest that NNL-3 demonstrates little CB1 receptor activity and is unlikely to be psychoactive in humans. NNL-3 is likely an unintended SCRA manufacturing byproduct. However, the synthesis of NNL-3 analogues proved simple and general, and some of these showed potent cannabimetic profiles in vitro, indicating that HOBt esters of this type may represent an emerging class of SCRA NPS.
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Affiliation(s)
- Adam Ametovski
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050, Australia
- School of Chemistry, The University of Sydney, Sydney, NSW 2006, Australia
| | - Elizabeth A. Cairns
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050, Australia
- School of Psychology, The University of Sydney, Sydney, NSW 2006, Australia
| | - Katharina Elisabeth Grafinger
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, 79104 Freiburg, Germany
| | - Annelies Cannaert
- Laboratory of Toxicology, Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, 9000 Ghent, Belgium
| | - Marie H. Deventer
- Laboratory of Toxicology, Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, 9000 Ghent, Belgium
| | - Shuli Chen
- Department of Pharmacology and Toxicology, University of Otago, Dunedin 9016, New Zealand
| | - Xinyi Wu
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050, Australia
- School of Chemistry, The University of Sydney, Sydney, NSW 2006, Australia
| | - Caitlin E. Shepperson
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050, Australia
- School of Chemistry, The University of Sydney, Sydney, NSW 2006, Australia
| | - Felcia Lai
- Faculty of Pharmacy, The University of Sydney, Sydney, New South Wales 2050, Australia
| | - Ross Ellison
- Clinical Toxicology and Environmental Biomonitoring Laboratory, University of California, San Francisco, California 94143, United States
| | - Roy Gerona
- Clinical Toxicology and Environmental Biomonitoring Laboratory, University of California, San Francisco, California 94143, United States
| | - Karen Blakey
- Illicit Drug Group, Forensic Chemistry, QHFSS, Queensland Health, Coopers Plains, Brisbane, QLD 4108, Australia
| | - Richard Kevin
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050, Australia
- School of Psychology, The University of Sydney, Sydney, NSW 2006, Australia
| | - Iain S. McGregor
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050, Australia
- School of Psychology, The University of Sydney, Sydney, NSW 2006, Australia
| | - David E. Hibbs
- Faculty of Pharmacy, The University of Sydney, Sydney, New South Wales 2050, Australia
| | - Michelle Glass
- Department of Pharmacology and Toxicology, University of Otago, Dunedin 9016, New Zealand
| | - Christophe Stove
- Laboratory of Toxicology, Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, 9000 Ghent, Belgium
| | - Volker Auwärter
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, 79104 Freiburg, Germany
| | - Samuel D. Banister
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050, Australia
- School of Chemistry, The University of Sydney, Sydney, NSW 2006, Australia
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McCartney D, Kevin RC, Suraev AS, Irwin C, Grunstein RR, Hoyos CM, McGregor IS. Orally administered cannabidiol does not produce false-positive tests for Δ 9 -tetrahydrocannabinol on the Securetec DrugWipe® 5S or Dräger DrugTest® 5000. Drug Test Anal 2021; 14:137-143. [PMID: 34412166 PMCID: PMC9292716 DOI: 10.1002/dta.3153] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/21/2021] [Accepted: 08/16/2021] [Indexed: 11/25/2022]
Abstract
Many jurisdictions use point‐of‐collection (POC) oral fluid testing devices to identify driving under the influence of cannabis, indexed by the presence of Δ9‐tetrahydrocannabinol (THC), an intoxicating cannabinoid, in oral fluid. Although the use of the non‐intoxicating cannabinoid, cannabidiol (CBD), is not prohibited among drivers, it is unclear whether these devices can reliably distinguish between CBD and THC, which have similar chemical structures. This study determined whether orally administered CBD produces false‐positive tests for THC on standard, POC oral fluid testing devices. In a randomised, double‐blind, crossover design, healthy participants (n = 17) completed four treatment sessions involving the administration of either placebo or 15‐, 300‐ or 1500‐mg pure CBD in a high‐fat dietary supplement. Oral fluid was sampled, and the DrugWipe®‐5S (DW‐5S; 10 ng·ml−1 THC cut‐off) and Drug Test® 5000 (DT5000; 10 ng·mL−1 THC cut‐off) devices administered, at baseline (pretreatment) and ~20‐, ~145‐ and ~185‐min posttreatment. Oral fluid cannabinoid concentrations were measured using ultra‐high performance liquid chromatography–tandem mass spectrometry. Median (interquartile range [IQR]) oral fluid CBD concentrations were highest at ~20 min, quantified as 0.4 (6.0), 15.8 (41.6) and 167 (233) ng·ml−1 on the 15‐, 300‐ and 1500‐mg CBD treatments, respectively. THC, cannabinol and cannabigerol were not detected in any samples. A total of 259 DW‐5S and 256 DT5000 tests were successfully completed, and no THC‐positive tests were observed. Orally administered CBD does not appear to produce false‐positive (or true‐positive) tests for THC on the DW‐5S and DT5000. The likelihood of an individual who is using a CBD (only) oral formulation being falsely accused of DUIC therefore appears low.
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Affiliation(s)
- Danielle McCartney
- Lambert Initiative for Cannabinoid Therapeutics, University of Sydney, Sydney, New South Wales, Australia.,Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia.,Faculty of Science, School of Psychology, University of Sydney, Sydney, New South Wales, Australia.,Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Richard C Kevin
- Lambert Initiative for Cannabinoid Therapeutics, University of Sydney, Sydney, New South Wales, Australia.,Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia.,Faculty of Science, School of Psychology, University of Sydney, Sydney, New South Wales, Australia
| | - Anastasia S Suraev
- Lambert Initiative for Cannabinoid Therapeutics, University of Sydney, Sydney, New South Wales, Australia.,Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia.,Faculty of Science, School of Psychology, University of Sydney, Sydney, New South Wales, Australia.,Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Christopher Irwin
- Menzies Health Institute Queensland, School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
| | - Ronald R Grunstein
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia.,Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, Central Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Camilla M Hoyos
- Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia.,Faculty of Science, School of Psychology, University of Sydney, Sydney, New South Wales, Australia.,Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Iain S McGregor
- Lambert Initiative for Cannabinoid Therapeutics, University of Sydney, Sydney, New South Wales, Australia.,Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia.,Faculty of Science, School of Psychology, University of Sydney, Sydney, New South Wales, Australia
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32
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Brown JD, Rivera Rivera KJ, Hernandez LYC, Doenges MR, Auchey I, Pham T, Goodin AJ. Natural and Synthetic Cannabinoids: Pharmacology, Uses, Adverse Drug Events, and Drug Interactions. J Clin Pharmacol 2021; 61 Suppl 2:S37-S52. [PMID: 34396558 DOI: 10.1002/jcph.1871] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 04/01/2021] [Indexed: 01/15/2023]
Abstract
The purpose of this narrative review is to describe the current use environment of both natural and synthetic cannabinoids while providing context for cannabinoid chemistry and pharmacology. In addition to a long history of recreational and nonmedical use, natural cannabinoids are increasingly used as prescription products, through medical cannabis programs, and as consumer health products. Despite anecdotal safety evidence, cannabis and cannabinoids are pharmacologically complex and pose risks for adverse drug events and drug-drug interactions. Synthetic cannabinoids, particularly agonists of cannabinoid receptors, are more potent than natural cannabinoids and can lead to more severe reactions and medical emergencies. This review provides a summary of approved uses and an overview of mechanisms of action for adverse drug events with natural and synthetic cannabinoids. Clinical considerations for special populations that may be at heightened risk for drug-drug interactions and adverse drug events while using natural or synthetic cannabinoids are examined, and recommendations are provided.
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Affiliation(s)
- Joshua D Brown
- Center for Drug Evaluation & Safety, University of Florida, Gainesville, Florida, USA.,Consortium for Medical Marijuana Clinical Outcomes Research, University of Florida, Gainesville, Florida, USA.,Department of Pharmaceutical Outcomes & Policy, University of Florida College of Pharmacy, Gainesville, Florida, USA
| | | | | | - Matthew R Doenges
- University of Florida College of Pharmacy, Gainesville, Florida, USA
| | - India Auchey
- University of Florida College of Pharmacy, Gainesville, Florida, USA
| | - Thanh Pham
- University of Florida College of Pharmacy, Gainesville, Florida, USA
| | - Amie J Goodin
- Center for Drug Evaluation & Safety, University of Florida, Gainesville, Florida, USA.,Consortium for Medical Marijuana Clinical Outcomes Research, University of Florida, Gainesville, Florida, USA.,Department of Pharmaceutical Outcomes & Policy, University of Florida College of Pharmacy, Gainesville, Florida, USA
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33
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'Synthetic cannabis': A dangerous misnomer. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 98:103396. [PMID: 34343944 DOI: 10.1016/j.drugpo.2021.103396] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 11/23/2022]
Abstract
The term 'synthetic cannabis' has been widely used in public discourse to refer to a group of cannabinoid receptor agonists. In this paper we detail the characteristics of these drugs, and present the case that the term is a misnomer. We describe the pharmacodynamics of these drugs, their epidemiology, mechanisms of action, physiological effects and how these differ substantially from delta-9-tetrahydrocannabinol (THC). We argue that not only is the term a misnomer, but it is one with negative clinical and public health implications. Rather, the substances referred to as 'synthetic cannabis' in public discourse should instead be referred to consistently as synthetic cannabinoid receptor agonists (SCRAs), a drug class distinct from plant-derived cannabinoids. SCRAs have greater potency and efficacy, and psychostimulant-like properties. While such terminology may be used in the scientific community, it is not widely used amongst the media, general public, people who use these drugs or may potentially do so. A new terminology has the potential to reduce the confusion and harms that result from the misnomer 'synthetic cannabis'. The constant evolution of this distinct drug class necessitates a range of distinct policy responses relating to terminology, harm reduction, epidemiology, treatment, and legal status.
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34
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Anderson LL, Etchart MG, Bahceci D, Golembiewski TA, Arnold JC. Cannabis constituents interact at the drug efflux pump BCRP to markedly increase plasma cannabidiolic acid concentrations. Sci Rep 2021; 11:14948. [PMID: 34294753 PMCID: PMC8298633 DOI: 10.1038/s41598-021-94212-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 06/25/2021] [Indexed: 12/19/2022] Open
Abstract
Cannabis is a complex mixture of hundreds of bioactive molecules. This provides the potential for pharmacological interactions between cannabis constituents, a phenomenon referred to as “the entourage effect” by the medicinal cannabis community. We hypothesize that pharmacokinetic interactions between cannabis constituents could substantially alter systemic cannabinoid concentrations. To address this hypothesis we compared pharmacokinetic parameters of cannabinoids administered orally in a cannabis extract to those administered as individual cannabinoids at equivalent doses in mice. Astonishingly, plasma cannabidiolic acid (CBDA) concentrations were 14-times higher following administration in the cannabis extract than when administered as a single molecule. In vitro transwell assays identified CBDA as a substrate of the drug efflux transporter breast cancer resistance protein (BCRP), and that cannabigerol and Δ9-tetrahydrocannabinol inhibited the BCRP-mediated transport of CBDA. Such a cannabinoid-cannabinoid interaction at BCRP transporters located in the intestine would inhibit efflux of CBDA, thus resulting in increased plasma concentrations. Our results suggest that cannabis extracts provide a natural vehicle to substantially enhance plasma CBDA concentrations. Moreover, CBDA might have a more significant contribution to the pharmacological effects of orally administered cannabis extracts than previously thought.
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Affiliation(s)
- Lyndsey L Anderson
- Brain and Mind Centre, Discipline of Pharmacology, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, 94 Mallett St, Camperdown, NSW, 2050, Australia
| | - Maia G Etchart
- Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, 94 Mallett St, Camperdown, NSW, 2050, Australia
| | - Dilara Bahceci
- Brain and Mind Centre, Discipline of Pharmacology, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Taliesin A Golembiewski
- Brain and Mind Centre, Discipline of Pharmacology, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Jonathon C Arnold
- Brain and Mind Centre, Discipline of Pharmacology, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia. .,Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, 94 Mallett St, Camperdown, NSW, 2050, Australia.
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35
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Day JI, Grotjahn S, Senaweera S, Koenig B, Weaver Iii JD. Defluorodearomatization: A Photocatalytic Birch-Like Reduction That Enables C-C Bond Formation and Provides Access to Unnatural Cannabinoids. J Org Chem 2021; 86:7928-7945. [PMID: 34076434 PMCID: PMC8716186 DOI: 10.1021/acs.joc.1c00169] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Within the framework of discovery chemistry, polyfluorination remains a synthetic challenge despite its ability to provide useful characteristics, such as a reduction in the number of hydrogen bond donors and metabolic stability. Coupling a reversal of this methodology with photocatalysis has been demonstrated to allow the rapid synthesis of previously difficult or impossible targets by starting with fluorines everywhere and selectively removing or functionalizing them. Herein, we demonstrate a novel method to synthesize 1,4-cyclohexadienes through a dearomative photocatalytic C-C coupling reaction. This allows for access to materials that are orthogonal to the selectivity of the Birch reaction and are more functional-group-tolerant. The reaction also allows the efficient synthesis of polyfluorinated cannabinoids. While the yields are modest, the access to the new chemical space provided by the reaction is unprecedented by any means. The trifluorinated analog of THC, 1-deoxy-1,2,4-trifluoro-THC, is synthesized, demonstrating the importance of discovery chemistry and the ability to explore otherwise unknown structure-activity relationships.
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Affiliation(s)
- Jon I Day
- Department of Chemistry, Oklahoma State University, 107 Physical Science, 74078 Stillwater, Oklahoma, United States
| | - Sascha Grotjahn
- Institut für Organische Chemie, Universität Regensburg, Universitätstrasse 31, 93053 Regensburg, Germany
| | - Sameera Senaweera
- Center for Drug Design, College of Pharmacy, University of Minnesota, 7-158 Phillips Wangensteen Building, 516 Delaware Street SE, Minneapolis, Minnesota 55455, United States
| | - Burkhard Koenig
- Institut für Organische Chemie, Universität Regensburg, Universitätstrasse 31, 93053 Regensburg, Germany
| | - Jimmie D Weaver Iii
- Department of Chemistry, Oklahoma State University, 107 Physical Science, 74078 Stillwater, Oklahoma, United States
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36
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Rosager EV, Møller C, Sjögren M. Treatment studies with cannabinoids in anorexia nervosa: a systematic review. Eat Weight Disord 2021; 26:407-415. [PMID: 32240516 DOI: 10.1007/s40519-020-00891-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 03/14/2020] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Anorexia nervosa (AN) is a psychiatric disorder with a high mortality and unknown etiology, and effective treatment is lacking. For decades, cannabis has been known to cause physical effects on the human body, including increasing appetite, which may be beneficial in the treatment of AN. OBJECTIVE To systematically review the literature for evidence of an effect of cannabinoids on (1) weight gain, and (2) other outcomes, in AN. METHOD A systematic review was done using three databases Embase, PubMed and Psychinfo. The review was registered in PROSPERO with ID number CRD42019141293 and was done according to PRISMA guidelines. RESULTS There were 1288 studies identified and after thorough review and exclusion of copies, 4 studies met the inclusion criteria. Three studies used the same AN population and utilized data from one original study, leaving only two original studies. Both of these were Randomized Controlled Trials that explored the effects of delta-9-tetrahydrocannabinol (Δ9-THC) or dronabinol in AN, whereof one study was properly designed and powered and showed a weight increase of an added 1 kg over 4 weeks over placebo. DISCUSSION AND CONCLUSION There are few studies and the level of evidence is low. The only properly designed, low bias and highly powered study found a weight increasing effect of dronabinol in AN, while the other, using Δ9-THC at a high dose, found no effect and where the dose may have counteracted the weight gaining effects due to adverse events. More research on cannabinoids in anorexia nervosa is warranted, especially its effects on psychopathology. LEVEL OF EVIDENCE Level I, systematic review.
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Affiliation(s)
- Emilie Vangsgaard Rosager
- Mental Health Center Ballerup, Copenhagen University, Institute for Clinical Medicine, Maglevaenget 32, 2750, Ballerup, Denmark
| | - Christian Møller
- Mental Health Center Ballerup, Copenhagen University, Institute for Clinical Medicine, Maglevaenget 32, 2750, Ballerup, Denmark
| | - Magnus Sjögren
- Mental Health Center Ballerup, Copenhagen University, Institute for Clinical Medicine, Maglevaenget 32, 2750, Ballerup, Denmark.
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37
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Cannabis use and posttraumatic stress disorder comorbidity: Epidemiology, biology and the potential for novel treatment approaches. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2021; 157:143-193. [PMID: 33648669 DOI: 10.1016/bs.irn.2020.09.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Cannabis use is increasing among some demographics in the United States and is tightly linked to anxiety, trauma, and stress reactivity at the epidemiological and biological level. Stress-coping motives are highly cited reasons for cannabis use. However, with increased cannabis use comes the increased susceptibility for cannabis use disorder (CUD). Indeed, CUD is highly comorbid with posttraumatic stress disorder (PTSD). Importantly, endogenous cannabinoid signaling systems play a key role in the regulation of stress reactivity and anxiety regulation, and preclinical data suggest deficiencies in this signaling system could contribute to the development of stress-related psychopathology. Furthermore, endocannabinoid deficiency states, either pre-existing or induced by trauma exposure, could provide explanatory insights into the high rates of comorbid cannabis use in patients with PTSD. Here we review clinical and preclinical literature related to the cannabis use-PTSD comorbidity, the role of endocannabinoids in the regulation of stress reactivity, and potential therapeutic implications of recent work in this area.
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38
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Cannaert A, Sparkes E, Pike E, Luo JL, Fang A, Kevin RC, Ellison R, Gerona R, Banister SD, Stove CP. Synthesis and in Vitro Cannabinoid Receptor 1 Activity of Recently Detected Synthetic Cannabinoids 4F-MDMB-BICA, 5F-MPP-PICA, MMB-4en-PICA, CUMYL-CBMICA, ADB-BINACA, APP-BINACA, 4F-MDMB-BINACA, MDMB-4en-PINACA, A-CHMINACA, 5F-AB-P7AICA, 5F-MDMB-P7AICA, and 5F-AP7AICA. ACS Chem Neurosci 2020; 11:4434-4446. [PMID: 33253529 DOI: 10.1021/acschemneuro.0c00644] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Synthetic cannabinoid receptor agonists (SCRAs) are an evolving class of new psychoactive substances (NPS) with structurally diverse compounds emerging each year. Due to the rapid pace at which these drugs enter the market, there is often little or nil information regarding the pharmacology of these substances despite widespread human use. In this study, 12 recently emerged SCRAs (reported between 2018 and 2020) were synthesized, analytically characterized, and pharmacologically evaluated using a live cell-based nanoluciferase complementation reporter assay that monitors in vitro cannabinoid receptor type 1 (CB1) activation via its interaction with β-arrestin 2 (βarr2). All synthesized SCRAs acted as agonists of CB1, although differences in potency (EC50 = 2.33-5475 nM) and efficacy (Emax = 37-378%) were noted, and several structure-activity relationships were identified. SCRAs featuring indazole cores (EC50 = 2.33-159 nM) were generally of equal or greater potency than indole analogues (EC50 = 32.9-330 nM) or 7-azaindole derivatives (EC50 = 64.0-5475 nM). Interestingly, with the exception of APP-BINACA (Emax = 75.7%) and 5F-A-P7AICA (Emax = 37.4%), all SCRAs showed greater efficacy than the historical SCRA JWH-018 to which responses were normalized (Emax = 142-378%). The most potent CB1 agonists in the study were ADB-BINACA (EC50 = 6.36 nM), 4F-MDMB-BINACA (EC50 = 7.39 nM), and MDMB-4en-PINACA (EC50 = 2.33 nM). Notably, all of these SCRAs featured an indazole core as well as a "bulky" tert-butyl moiety in the pendant amino acid side chain. This study confirms that recently detected SCRAs 4F-MDMB-BICA, 5F-MPP-PICA, MMB-4en-PICA, CUMYL-CBMICA, ADB-BINACA, APP-BINACA, 4F-MDMB-BINACA, MDMB-4en-PINACA, A-CHMINACA, 5F-AB-P7AICA, 5F-MDMB-P7AICA, and 5F-AP7AICA were all able to activate the CB1 receptor in vitro, albeit to different extents, and are potentially psychoactive in vivo. These results indicate that further evaluation of these widely used NPS is warranted to better understand the risks associated with human consumption of these drugs.
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Affiliation(s)
- Annelies Cannaert
- Laboratory of Toxicology, Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Ghent B-9000, Belgium
| | - Eric Sparkes
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney 2050, Australia
- School of Chemistry, The University of Sydney, Sydney 2006, Australia
| | - Edward Pike
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney 2050, Australia
- School of Chemistry, The University of Sydney, Sydney 2006, Australia
- Department of Chemistry, University of York, York YO10 5DD, United Kingdom
| | - Jia Lin Luo
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney 2050, Australia
- School of Psychology, The University of Sydney, Sydney 2006, Australia
| | - Ada Fang
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney 2050, Australia
- School of Chemistry, The University of Sydney, Sydney 2006, Australia
| | - Richard C. Kevin
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney 2050, Australia
- School of Psychology, The University of Sydney, Sydney 2006, Australia
| | - Ross Ellison
- Clinical Toxicology and Environmental Biomonitoring Laboratory, School of Medicine, University of California San Francisco, San Francisco, California 94143, United States
| | - Roy Gerona
- Clinical Toxicology and Environmental Biomonitoring Laboratory, School of Medicine, University of California San Francisco, San Francisco, California 94143, United States
| | - Samuel D. Banister
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney 2050, Australia
- School of Chemistry, The University of Sydney, Sydney 2006, Australia
| | - Christophe P. Stove
- Laboratory of Toxicology, Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Ghent B-9000, Belgium
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Heblinski M, Santiago M, Fletcher C, Stuart J, Connor M, McGregor IS, Arnold JC. Terpenoids Commonly Found in Cannabis sativa Do Not Modulate the Actions of Phytocannabinoids or Endocannabinoids on TRPA1 and TRPV1 Channels. Cannabis Cannabinoid Res 2020; 5:305-317. [PMID: 33376801 PMCID: PMC7759271 DOI: 10.1089/can.2019.0099] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Introduction:Cannabis sativa produces hundreds of bioactive compounds, including cannabinoids and terpenoids. It has been proposed that cannabinoids act in synergy with terpenoids to produce the entourage effect, a concept used to explain the therapeutic benefits of medicinal cannabis. One molecular explanation for the entourage effect is that the terpenoids augment the actions of cannabinoids at their molecular drug targets in cells. We recently reported that terpenoids commonly found in cannabis do not influence the functional effects of Δ9-tetrahydrocannabinol (Δ9-THC) on cannabinoid 1 and cannabinoid 2 receptors. The present study aimed to extend on this research by examining whether terpenoids influence the effects of phytocannabinoids and endocannabinoids on human transient receptor potential ankyrin 1 (hTRPA1) and human transient receptor potential vanilloid 1 (hTRPV1) channels heterologously expressed in mammalian cells. Materials and Methods: The activity of terpenoids, phytocannabinoids, and endocannabinoids was assessed in inducible HEK Flp-In T-Rex cells transfected with hTRPA1 and hTRPV1 channels, respectively. Real-time changes in intracellular calcium ([Ca]i) were measured using the Calcium 5 dye and a FlexStation 3 plate reader. Results: α-pinene, β-pinene, β-caryophyllene, linalool, limonene, β-myrcene or α-humulene did not affect [Ca]i in hTRPA1 and hTRPV1 overexpressing cells. Cinnamaldehyde (CA), Δ9-THC, and 2-arachidonoylglycerol (2-AG) activated TRPA1 receptors with high efficacy and similar potency (EC50s of ∼10 μM). Capsaicin and anandamide (AEA) activated TRPV1 receptors with an EC50 of 61 nM and 4.3 μM, respectively, but TRPV1 showed no response to Δ9-THC, cannabidiol, and other minor cannabinoids. Terpenoids did not significantly affect the responses of TRPA1 and TRPV1 receptors to submaximal and maximal concentrations of CA and Δ9-THC or the endocannabinoids AEA and 2-AG. Discussion: We could not find any evidence that the terpenoids tested here activate TRPA1 and TRPV1 channels or modulate their activation by Δ9-THC and other agonists, including endocannabinoids.
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Affiliation(s)
- Marika Heblinski
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, Australia.,Faculty of Medicine and Health and School of Medical Sciences, The University of Sydney, Sydney, Australia
| | - Marina Santiago
- Faculty of Medicine and Health Sciences, Macquarie University, Macquarie Park, Sydney, Australia
| | - Charlotte Fletcher
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, Australia.,Faculty of Science and School of Psychology, The University of Sydney, Sydney, Australia
| | - Jordyn Stuart
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, Australia.,Faculty of Medicine and Health Sciences, Macquarie University, Macquarie Park, Sydney, Australia.,Faculty of Science and School of Psychology, The University of Sydney, Sydney, Australia
| | - Mark Connor
- Faculty of Medicine and Health Sciences, Macquarie University, Macquarie Park, Sydney, Australia
| | - Iain S McGregor
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, Australia.,Faculty of Science and School of Psychology, The University of Sydney, Sydney, Australia
| | - Jonathon C Arnold
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, Australia.,Faculty of Medicine and Health and School of Medical Sciences, The University of Sydney, Sydney, Australia
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Ametovski A, Macdonald C, Manning JJ, Haneef SAS, Santiago M, Martin L, Sparkes E, Reckers A, Gerona RR, Connor M, Glass M, Banister SD. Exploring Stereochemical and Conformational Requirements at Cannabinoid Receptors for Synthetic Cannabinoids Related to SDB-006, 5F-SDB-006, CUMYL-PICA, and 5F-CUMYL-PICA. ACS Chem Neurosci 2020; 11:3672-3682. [PMID: 33054155 DOI: 10.1021/acschemneuro.0c00591] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Synthetic cannabinoid receptor agonists (SCRAs) represent the most rapidly expanding class of new psychoactive substances (NPSs). Despite the prevalence and potency of recent chiral indole-3-carboxamide SCRAs, few pharmacological data are available regarding the enantiomeric bias of these NPSs toward human CB1 and CB2 receptors. A series of homochiral indole-3-carboxamides derived from (S)- and (R)-α-methylbenzylamine and featuring variation of the 1-alkyl substituent were prepared, pharmacologically evaluated, and compared to related achiral congeners derived from cumyl- and benzylamine. Competitive binding assays demonstrated that all analogues derived from either enantiomer of α-methylbenzylamine (14-17) showed affinities for CB1 (Ki = 47.9-813 nM) and CB2 (Ki = 47.9-347 nM) that were intermediate to that of the corresponding benzylic (10-13, CB1 Ki = 550 nM to >10 μM; CB2 Ki = 61.7 nM to >10 μM) and cumyl derivatives (6-9, CB1 Ki = 12.6-21.4 nM; CB2 Ki = 2.95-24.5 nM). In a fluorometric membrane potential assay, all α-methylbenzyl analogues (excluding 17) were potent, efficacious agonists of CB1 (EC50 = 32-464 nM; Emax = 89-104%) and low efficacy agonists of CB2 (EC50 = 54-500 nM; Emax = 52-77%), with comparable or greater potency than the benzyl analogues and much lower potency than the cumyl derivatives, consistent with binding trends. The relatively greater affinity and potency of (S)-14-17 compared to (R)-14-17 analogues at CB1 highlighted an enantiomeric bias for this series of SCRAs. Molecular dynamics simulations provided a conformational basis for the observed differences in agonist potency at CB1 pending benzylic substitution.
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Affiliation(s)
- Adam Ametovski
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Camperdown, NSW 2050, Australia
- School of Chemistry, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Christa Macdonald
- School of Medical Sciences, The University of Auckland, Auckland 1142, New Zealand
| | - Jamie J. Manning
- Department of Pharmacology and Toxicology, University of Otago, Dunedin 9016, New Zealand
| | - S. A. Syed Haneef
- Faculty of Medicine and Health Sciences, Macquarie University, Macquarie Park, NSW 2109, Australia
| | - Marina Santiago
- Faculty of Medicine and Health Sciences, Macquarie University, Macquarie Park, NSW 2109, Australia
| | - Lewis Martin
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Camperdown, NSW 2050, Australia
| | - Eric Sparkes
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Camperdown, NSW 2050, Australia
- School of Chemistry, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Andrew Reckers
- Clinical Toxicology and Environmental Biomonitoring Laboratory, University of California, San Francisco, California 94143, United States
| | - Roy R. Gerona
- Clinical Toxicology and Environmental Biomonitoring Laboratory, University of California, San Francisco, California 94143, United States
| | - Mark Connor
- Faculty of Medicine and Health Sciences, Macquarie University, Macquarie Park, NSW 2109, Australia
| | - Michelle Glass
- Department of Pharmacology and Toxicology, University of Otago, Dunedin 9016, New Zealand
| | - Samuel D. Banister
- The Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Camperdown, NSW 2050, Australia
- School of Chemistry, The University of Sydney, Camperdown, NSW 2006, Australia
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41
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A Critical Review of the Role of the Cannabinoid Compounds Δ 9-Tetrahydrocannabinol (Δ 9-THC) and Cannabidiol (CBD) and their Combination in Multiple Sclerosis Treatment. Molecules 2020; 25:molecules25214930. [PMID: 33113776 PMCID: PMC7663366 DOI: 10.3390/molecules25214930] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/02/2020] [Accepted: 10/07/2020] [Indexed: 02/07/2023] Open
Abstract
Many people with MS (pwMS) use unregulated cannabis or cannabis products to treat the symptoms associated with the disease. In line with this, Sativex, a synthetic combination of cannabidiol (CBD) and Δ9-tetrahydrocannabinol (Δ9-THC) has been approved to treat symptoms of spasticity. In animals, CBD is effective in reducing the amounts of T-cell infiltrates in the spinal cord, suggesting CBD has anti-inflammatory properties. By doing this, CBD has shown to delay symptom onset in animal models of multiple sclerosis and slow disease progression. Importantly, combinations of CBD and Δ9-THC appear more effective in treating animal models of multiple sclerosis. While CBD reduces the amounts of cell infiltrates in the spinal cord, Δ9-THC reduces scores of spasticity. In human studies, the results are less encouraging and conflict with the findings in animals. Drugs which deliver a combination of Δ9-THC and CBD in a 1:1 ratio appear to be only moderately effective in reducing spasticity scores, but appear to be almost as effective as current front-line treatments and cause less severe side effects than other treatments, such as baclofen (a GABA-B receptor agonist) and tizanidine (an α2 adrenergic receptor agonist). The findings of the studies reviewed suggest that cannabinoids may help treat neuropathic pain in pwMS as an add-on therapy to already established pain treatments. It is important to note that treatment with cannabinoid compounds may cause significant cognitive dysfunction. Long term double-blind placebo studies are greatly needed to further our understanding of the role of cannabinoids in multiple sclerosis treatment.
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Schoeder CT, Mahardhika AB, Drabczyńska A, Kieć-Kononowicz K, Müller CE. Discovery of Tricyclic Xanthines as Agonists of the Cannabinoid-Activated Orphan G-Protein-Coupled Receptor GPR18. ACS Med Chem Lett 2020; 11:2024-2031. [PMID: 33062188 DOI: 10.1021/acsmedchemlett.0c00208] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 06/11/2020] [Indexed: 12/14/2022] Open
Abstract
GPR18 is a rhodopsin-like orphan G-protein-coupled receptor (GPCR) that is activated by the natural cannabinoid (CB) Δ9-tetrahydrocannabinol (THC). It is highly expressed in immune cells and represents a promising new drug target. However, THC is much more potent in activating CB receptors than GPR18, and several other proposed lipidic agonists for GPR18 have not been independently confirmed. Herein we describe the first non-lipid-like agonists for GPR18 based on a tricyclic xanthine-derived scaffold, along with initial structure-activity relationships. PSB-KD107 (5) and PSB-KD477 (16) displayed significantly higher potency and efficacy than THC, determined in a GPR18-dependent β-arrestin recruitment assay, and were found to be selective versus the CB-sensitive receptors CB1, CB2, and GPR55. Structure-activity relationships were steep, and indole substitution was crucial for biological activity. These first selective agonists, which are structurally distinct from the lipidic agonist(s), will allow target validation studies and may eventually contribute to the deorphanization of GPR18.
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Affiliation(s)
- Clara T. Schoeder
- Pharmaceutical Institute, Department of Pharmaceutical & Medicinal Chemistry, University of Bonn, Bonn 53121, Germany
- Research Training Group 1873, University of Bonn, 53127 Bonn, Germany
| | - Andhika B. Mahardhika
- Pharmaceutical Institute, Department of Pharmaceutical & Medicinal Chemistry, University of Bonn, Bonn 53121, Germany
- Research Training Group 1873, University of Bonn, 53127 Bonn, Germany
| | - Anna Drabczyńska
- Department of Technology and Biotechnology of Drugs, Faculty of Pharmacy, Jagiellonian University Medical College, 9 Medyczna Street, 30-688 Kraków, Poland
| | - Katarzyna Kieć-Kononowicz
- Department of Technology and Biotechnology of Drugs, Faculty of Pharmacy, Jagiellonian University Medical College, 9 Medyczna Street, 30-688 Kraków, Poland
| | - Christa E. Müller
- Pharmaceutical Institute, Department of Pharmaceutical & Medicinal Chemistry, University of Bonn, Bonn 53121, Germany
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Abstract
The Australian Federal Government legalised access to medicinal cannabis in 2016 More than 100 different cannabis products are now available to prescribe. Most are oral preparations (oils) or capsules containing delta-9-tetrahydrocannabinol or cannabidiol. Dried-flower products are also available As most products are unregistered drugs, prescribing requires approval under the Therapeutic Goods Administration Special Access Scheme-B or Authorised Prescriber Scheme Special Access Scheme Category B applications can be made online, with approval usually being given within 24–48 hours. However, supply chain problems may delay dispensing by the pharmacy By the end of 2019, over 28,000 prescribing approvals had been issued to patients, involving more than 1400 doctors, mostly GPs. More than 70,000 approvals are projected by the end of 2020 Most prescriptions are for chronic non-cancer pain, anxiety, cancer-related symptoms, epilepsy and other neurological disorders. However, the evidence supporting some indications is limited Many doctors are cautious about prescribing cannabis. While serious adverse events are rare, there are legitimate concerns around driving, cognitive impairment and drug dependence with products containing delta-9-tetrahydrocannabinol. Cannabidiol-only products pose fewer risks
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Affiliation(s)
- Jonathon C Arnold
- University of Sydney
- National Institute of Integrative Medicine, Melbourne
| | - Tamara Nation
- University of Sydney
- National Institute of Integrative Medicine, Melbourne
| | - Iain S McGregor
- University of Sydney
- National Institute of Integrative Medicine, Melbourne
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44
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McCartney D, Benson MJ, Desbrow B, Irwin C, Suraev A, McGregor IS. Cannabidiol and Sports Performance: a Narrative Review of Relevant Evidence and Recommendations for Future Research. SPORTS MEDICINE - OPEN 2020; 6:27. [PMID: 32632671 PMCID: PMC7338332 DOI: 10.1186/s40798-020-00251-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 05/17/2020] [Indexed: 12/17/2022]
Abstract
Cannabidiol (CBD) is a non-intoxicating cannabinoid derived from Cannabis sativa. CBD initially drew scientific interest due to its anticonvulsant properties but increasing evidence of other therapeutic effects has attracted the attention of additional clinical and non-clinical populations, including athletes. Unlike the intoxicating cannabinoid, Δ9-tetrahydrocannabinol (Δ9-THC), CBD is no longer prohibited by the World Anti-Doping Agency and appears to be safe and well-tolerated in humans. It has also become readily available in many countries with the introduction of over-the-counter "nutraceutical" products. The aim of this narrative review was to explore various physiological and psychological effects of CBD that may be relevant to the sport and/or exercise context and to identify key areas for future research. As direct studies of CBD and sports performance are is currently lacking, evidence for this narrative review was sourced from preclinical studies and a limited number of clinical trials in non-athlete populations. Preclinical studies have observed robust anti-inflammatory, neuroprotective and analgesic effects of CBD in animal models. Preliminary preclinical evidence also suggests that CBD may protect against gastrointestinal damage associated with inflammation and promote healing of traumatic skeletal injuries. However, further research is required to confirm these observations. Early stage clinical studies suggest that CBD may be anxiolytic in "stress-inducing" situations and in individuals with anxiety disorders. While some case reports indicate that CBD improves sleep, robust evidence is currently lacking. Cognitive function and thermoregulation appear to be unaffected by CBD while effects on food intake, metabolic function, cardiovascular function, and infection require further study. CBD may exert a number of physiological, biochemical, and psychological effects with the potential to benefit athletes. However, well controlled, studies in athlete populations are required before definitive conclusions can be reached regarding the utility of CBD in supporting athletic performance.
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Affiliation(s)
- Danielle McCartney
- The University of Sydney, Faculty of Science, School of Psychology, Sydney, New South Wales, 2050, Australia.
- The University of Sydney, Lambert Initiative for Cannabinoid Therapeutics, Sydney, New South Wales, Australia.
- The University of Sydney, Brain and Mind Centre, Sydney, New South Wales, Australia.
| | - Melissa J Benson
- The University of Sydney, Faculty of Science, School of Psychology, Sydney, New South Wales, 2050, Australia
- The University of Sydney, Lambert Initiative for Cannabinoid Therapeutics, Sydney, New South Wales, Australia
- The University of Sydney, Brain and Mind Centre, Sydney, New South Wales, Australia
| | - Ben Desbrow
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Christopher Irwin
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
- Menzies Health Institute Queensland, Gold Coast, Queensland, Australia
| | - Anastasia Suraev
- The University of Sydney, Faculty of Science, School of Psychology, Sydney, New South Wales, 2050, Australia
- The University of Sydney, Lambert Initiative for Cannabinoid Therapeutics, Sydney, New South Wales, Australia
- The University of Sydney, Brain and Mind Centre, Sydney, New South Wales, Australia
| | - Iain S McGregor
- The University of Sydney, Faculty of Science, School of Psychology, Sydney, New South Wales, 2050, Australia
- The University of Sydney, Lambert Initiative for Cannabinoid Therapeutics, Sydney, New South Wales, Australia
- The University of Sydney, Brain and Mind Centre, Sydney, New South Wales, Australia
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45
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Richards JR. Mechanisms for the Risk of Acute Coronary Syndrome and Arrhythmia Associated With Phytogenic and Synthetic Cannabinoid Use. J Cardiovasc Pharmacol Ther 2020; 25:508-522. [PMID: 32588641 DOI: 10.1177/1074248420935743] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Phytogenic cannabinoids from Cannabis sativa and synthetic cannabinoids are commonly used substances for their recreational and medicinal properties. There are increasing reports of cardiotoxicity in close temporal association with cannabinoid use in patients with structurally normal hearts and absence of coronary arterial disease. Associated adverse events include myocardial ischemia, conduction abnormalities, arrhythmias, and sudden death. This review details the effects of phytogenic and synthetic cannabinoids on diverse receptors based on evidence from in vitro, human, and animal studies to establish a molecular basis for these deleterious clinical effects. The synergism between endocannabinoid dysregulation, cannabinoid receptor, and noncannabinoid receptor binding, and impact on cellular ion flux and coronary microvascular circulation is delineated. Pharmacogenetic factors placing certain patients at higher risk for cardiotoxicity are also correlated with the diverse effects of cannabinoids.
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Affiliation(s)
- John R Richards
- Department of Emergency Medicine, 70083University of California Davis Medical Center, Sacramento, California, CA, USA
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Richards JR, Blohm E, Toles KA, Jarman AF, Ely DF, Elder JW. The association of cannabis use and cardiac dysrhythmias: a systematic review. Clin Toxicol (Phila) 2020; 58:861-869. [DOI: 10.1080/15563650.2020.1743847] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- John R. Richards
- Department of Emergency Medicine, University of California Davis Health System, Sacramento, CA, USA
| | - Eike Blohm
- Department of Emergency Medicine, University of Vermont Medical Center, Burlington, VT, USA
| | - Kara A. Toles
- Department of Emergency Medicine, University of California Davis Health System, Sacramento, CA, USA
| | - Angela F. Jarman
- Department of Emergency Medicine, University of California Davis Health System, Sacramento, CA, USA
| | - Dylan F. Ely
- Department of Emergency Medicine, University of California Davis Health System, Sacramento, CA, USA
| | - Joshua W. Elder
- Department of Emergency Medicine, University of California Davis Health System, Sacramento, CA, USA
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Hitchcock LN, Tracy BL, Bryan AD, Hutchison KE, Bidwell LC. Acute Effects of Cannabis Concentrate on Motor Control and Speed: Smartphone-Based Mobile Assessment. Front Psychiatry 2020; 11:623672. [PMID: 33551884 PMCID: PMC7862106 DOI: 10.3389/fpsyt.2020.623672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 12/21/2020] [Indexed: 12/28/2022] Open
Abstract
Background: The use of cannabis concentrate is dramatically rising and sparking major safety concerns. Cannabis concentrate contains tetrahydrocannabinol (THC) potencies up to 90%, yet there has been little research on motor impairment after concentrate use (commonly referred to as "dabbing"). This study measured postural control and motor speed after the use of high potency concentrates in males and females. Methods: Experienced concentrate users (N = 65, Female: 46%, 17 ± 11 days/month of concentrate use) were assessed for motor performance in a mobile laboratory before, immediately after, and 1 h after ad-libitum cannabis concentrate use. Plasma levels of THC were obtained via venipuncture at each timepoint. We used a remotely deployable motor performance battery to assess arm and leg movement speed, index finger tapping rate, and balance. The sensors on a smart device (iPod Touch) attached to the participant provided quantitative measures of movement. Results: Arm speed slowed immediately after concentrate use and remained impaired after 1 h (p < 0.001), leg speed slowed 1 h after use (p = 0.033), and balance decreased immediately after concentrate use (eyes open: p = 0.017, eyes closed: p = 0.013) but not at 1 h post-use. These effects were not different between sexes and there was no effect of concentrate use on finger tapping speed. Acute changes in THC plasma levels after use of concentrates were minimally correlated with acute changes in balance performance. Conclusions: Use of cannabis concentrates in frequent users impairs movement speed and balance similarly in men and women. The motor impairment is largely uncorrelated with the change in THC plasma levels. These results warrant further refinement of cannabis impairment testing and encourage caution related to use of cannabis concentrates in work and driving settings.
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Affiliation(s)
- Leah N Hitchcock
- Institute of Cognitive Science, University of Colorado-Boulder, Boulder, CO, United States
| | - Brian L Tracy
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, United States
| | - Angela D Bryan
- Institute of Cognitive Science, University of Colorado-Boulder, Boulder, CO, United States.,Department of Psychology and Neuroscience, University of Colorado-Boulder, Boulder, CO, United States
| | - Kent E Hutchison
- Institute of Cognitive Science, University of Colorado-Boulder, Boulder, CO, United States.,Department of Psychology and Neuroscience, University of Colorado-Boulder, Boulder, CO, United States
| | - L Cinnamon Bidwell
- Institute of Cognitive Science, University of Colorado-Boulder, Boulder, CO, United States.,Department of Psychology and Neuroscience, University of Colorado-Boulder, Boulder, CO, United States
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48
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Worob A, Wenthur C. DARK Classics in Chemical Neuroscience: Synthetic Cannabinoids (Spice/K2). ACS Chem Neurosci 2019; 11:3881-3892. [PMID: 31799831 DOI: 10.1021/acschemneuro.9b00586] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
This Review covers the background, pharmacology, adverse effects, synthesis, pharmacokinetics, metabolism, and history of synthetic cannabinoid compounds. Synthetic cannabinoids are a class of novel psychoactive substances that act as agonists at cannabinoid receptors. This class of compounds is structurally diverse and rapidly changing, with multiple generations of molecules having been developed in the past decade. The structural diversity of synthetic cannabinoids is supported by the breadth of chemical space available for exploitation by clandestine chemists and incentivized by attempts to remain ahead of legal pressures. As a class, synthetic cannabinoid products have a more serious adverse effect profile than that of traditional phytocannabinoids, including notable risks of lethality, as well as a history of dangerous adulteration. Most synthetic cannabinoids are rapidly metabolized to active species with prolonged residence times and peripheral tissue distribution, and analytical confirmation of use of these compounds remains challenging. Overall, the emergence of synthetic cannabinoids serves as a noteworthy example of the pressing public health challenges associated with the increasing development of easily synthesized, structurally flexible, highly potent, psychoactive drugs.
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Affiliation(s)
- Adam Worob
- Divisions of Pharmaceutical Sciences and Pharmacy Practice, School of Pharmacy, University of Wisconsin—Madison, Madison, Wisconsin 53705, United States
| | - Cody Wenthur
- Divisions of Pharmaceutical Sciences and Pharmacy Practice, School of Pharmacy, University of Wisconsin—Madison, Madison, Wisconsin 53705, United States
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49
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Wouters E, Walraed J, Banister SD, Stove CP. Insights into biased signaling at cannabinoid receptors: synthetic cannabinoid receptor agonists. Biochem Pharmacol 2019; 169:113623. [DOI: 10.1016/j.bcp.2019.08.025] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 08/26/2019] [Indexed: 01/09/2023]
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50
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Santiago M, Sachdev S, Arnold JC, McGregor IS, Connor M. Absence of Entourage: Terpenoids Commonly Found in Cannabis sativa Do Not Modulate the Functional Activity of Δ 9-THC at Human CB 1 and CB 2 Receptors. Cannabis Cannabinoid Res 2019; 4:165-176. [PMID: 31559333 PMCID: PMC6757242 DOI: 10.1089/can.2019.0016] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Introduction: Compounds present in Cannabis sativa such as phytocannabinoids and terpenoids may act in concert to elicit therapeutic effects. Cannabinoids such as Δ9-tetrahydrocannabinol (Δ9-THC) directly activate cannabinoid receptor 1 (CB1) and cannabinoid receptor 2 (CB2); however, it is not known if terpenoids present in Cannabis also affect cannabinoid receptor signaling. Therefore, we examined six common terpenoids alone, and in combination with cannabinoid receptor agonists, on CB1 and CB2 signaling in vitro. Materials and Methods: Potassium channel activity in AtT20 FlpIn cells transfected with human CB1 or CB2 receptors was measured in real time using FLIPR® membrane potential dye in a FlexStation 3 plate reader. Terpenoids were tested individually and in combination for periods up to 30 min. Endogenous somatostatin receptors served as a control for direct effects of drugs on potassium channels. Results: α-Pinene, β-pinene, β-caryophyllene, linalool, limonene, and β-myrcene (up to 30-100 μM) did not change membrane potential in AtT20 cells expressing CB1 or CB2, or affect the response to a maximally effective concentration of the synthetic cannabinoid CP55,940. The presence of individual or a combination of terpenoids did not affect the hyperpolarization produced by Δ9-THC (10 μM): (CB1: control, 59%±7%; with terpenoids (10 μM each) 55%±4%; CB2: Δ9-THC 16%±5%, with terpenoids (10 μM each) 17%±4%). To investigate possible effect on desensitization of CB1 responses, all six terpenoids were added together with Δ9-THC and signaling measured continuously over 30 min. Terpenoids did not affect desensitization, after 30 min the control hyperpolarization recovered by 63%±6% in the presence of the terpenoids recovery was 61%±5%. Discussion: None of the six of the most common terpenoids in Cannabis directly activated CB1 or CB2, or modulated the signaling of the phytocannabinoid agonist Δ9-THC. These results suggest that if a phytocannabinoid-terpenoid entourage effect exists, it is not at the CB1 or CB2 receptor level. It remains possible that terpenoids activate CB1 and CB2 signaling pathways that do not involve potassium channels; however, it seems more likely that they may act at different molecular target(s) in the neuronal circuits important for the behavioral effect of Cannabis.
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Affiliation(s)
- Marina Santiago
- Department of Biomedical Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Shivani Sachdev
- Department of Biomedical Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Jonathon C. Arnold
- The Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, Sydney, New South Wales, Australia
- Discipline of Pharmacology, The University of Sydney, Sydney, New South Wales, Australia
| | - Iain S. McGregor
- The Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, Sydney, New South Wales, Australia
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Mark Connor
- Department of Biomedical Sciences, Macquarie University, Sydney, New South Wales, Australia
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