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Horniakova A, Mikus P, Piestansky J. Development of a CZE-MS/MS method with dynamic pH junction sample pretreatment for analysis of kratom psychoactive alkaloids in urine. Anal Chim Acta 2024; 1323:343076. [PMID: 39182975 DOI: 10.1016/j.aca.2024.343076] [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: 02/27/2024] [Revised: 08/05/2024] [Accepted: 08/06/2024] [Indexed: 08/27/2024]
Abstract
BACKGROUND Kratom is a herbal substance belonging to the group of new psychoactive substances. It contains psychoactive indole alkaloids mitragynine and 7-hydroxymitragynine. At low doses, they act as psychostimulants and at higher doses they mediate an opioid-like effect. The increasing misuse of kratom requires the development of analytical methods that will accurately and reliably identify and quantify its psychoactive alkaloids in biological samples. Therefore, the development of effective, precise, and reliable green analytical methods that are easy to implement in practice is of great importance. On-line combination of capillary zone electrophoresis with tandem mass spectrometry (CZE-MS/MS) seems to be a promising solution. RESULTS We present a novel green approach based on capillary zone electrophoresis - tandem mass spectrometry (CZE-MS/MS) method with on-line dynamic pH junction sample pretreatment to identify and determine mitragynine and 7-hydroxymitragynine in urine samples. The separation was performed in a background electrolyte composed of 100 mM formic acid (pH 2.39). The dynamic pH junction was ensured by injection of a short plug of 12.5 % NH4OH before the sample. Under optimal conditions, the developed method was validated and parameters such as linearity (r2 > 0.99), precision (2.2-8.7 %), accuracy (89.2-102.5 %) or stability of the sample (86.6-114.7 %) met the defined FDA guideline criteria (%RSD and %RE values where within ±15 %). Introduction of a simple in-capillary preconcentration strategy based on dynamic pH junction enabled significant improvement in analytical signal intensity and also the applicability of the method. Applying the presented approach, high sensitivity was achieved as indicated by limit of detection values, which were 0.5 ng mL-1 and 2 ng mL-1 for mitragynine and 7-hydroxymitragynine, respectively. Greenness of the proposed approach was confirmed by the AGREE metrics (score 0.63). The application potential of the developed method was successfully verified using blinded urine model samples. SIGNIFICANCE For the first time a fully validated CZE-MS/MS method for kratom alkaloids determination was introduced. The presented novel method is a cheaper and more ecological alternative to conventionally used chromatographic techniques what was clearly confirmed by its greenness evaluation and comparison with previously published liquid chromatography (LC) approaches. In-capillary sample pretreatment (dynamic pH junction) has been demonstrated to be an effective and fast tool in bioanalysis, minimizing the number of pretreatment steps and the manipulation with the sample. Moreover, LOD values comparable to those obtained by LC methods were recorded. High potential for the implementation of this approach into the toxicology environment in the near future is expected.
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Affiliation(s)
- Andrea Horniakova
- Department of Pharmaceutical Analysis and Nuclear Pharmacy, Faculty of Pharmacy, Comenius University in Bratislava, Odbojarov 10, SK-832 32, Bratislava, Slovak Republic; Toxicological and Antidoping Center, Faculty of Pharmacy, Comenius University in Bratislava, Odbojarov 10, SK-832 32, Bratislava, Slovak Republic
| | - Peter Mikus
- Department of Pharmaceutical Analysis and Nuclear Pharmacy, Faculty of Pharmacy, Comenius University in Bratislava, Odbojarov 10, SK-832 32, Bratislava, Slovak Republic; Toxicological and Antidoping Center, Faculty of Pharmacy, Comenius University in Bratislava, Odbojarov 10, SK-832 32, Bratislava, Slovak Republic
| | - Juraj Piestansky
- Toxicological and Antidoping Center, Faculty of Pharmacy, Comenius University in Bratislava, Odbojarov 10, SK-832 32, Bratislava, Slovak Republic; Department of Galenic Pharmacy, Faculty of Pharmacy, Comenius University in Bratislava, Odbojarov 10, SK-832 32, Bratislava, Slovak Republic.
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2
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Heywood J, Smallets S, Paustenbach D. Beneficial and adverse health effects of kratom (Mitragyna speciosa): A critical review of the literature. Food Chem Toxicol 2024; 192:114913. [PMID: 39134135 DOI: 10.1016/j.fct.2024.114913] [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: 04/15/2024] [Revised: 07/25/2024] [Accepted: 08/06/2024] [Indexed: 08/25/2024]
Abstract
Used in Southeast Asia for generations, kratom gained popularity in the United States and elsewhere over the past several decades. Derived from Mitragyna speciosa, kratom preparations including leaves, teas, powders, capsules, and extracts may yield stimulant, analgesic, and opioid-like effects that occur dose-dependently based on concentrations of kratom's key alkaloids, mitragynine and 7-hydroxymitragynine. Such effects are responsible for kratom's potential as a reduced-harm alternative to opiates and as a withdrawal treatment. But these properties are also associated with tolerance development and addictive potential. Given mitragynine and 7-hydroxymitragynine activity on cytochrome P450 isoforms and opioid receptors, adverse effects among polysubstance users are a concern. Current literature on the toxicology of kratom is reviewed, including product alkaloid concentrations, in vitro and in vivo data, epidemiological evidence, and human case data. The potential harms and benefits of kratom products are discussed within an exposure assessment framework, and recommendations for industry are presented. Current evidence indicates that kratom may have therapeutic potential in some persons and that products present few risks with typical, non-polysubstance use. However, few studies identified alkaloid doses at which adverse effects were expected in humans or animals. Such research is needed to inform future assessments of kratom's risks and benefits.
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Affiliation(s)
- J Heywood
- Paustenbach and Associates, 1550 Wewatta Street, Suite 200, Denver, CO, USA.
| | - S Smallets
- Paustenbach and Associates, 1550 Wewatta Street, Suite 200, Denver, CO, USA
| | - D Paustenbach
- Paustenbach and Associates, 970 West Broadway, Suite E, Jackson, WY, USA
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3
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Rhee J, Shin I, Kim J, Lee J, Cho B, Kim J, Park M, Kim E. LC-MS-MS method for mitragynine and 7-hydroxymitragynine in hair and its application in authentic hair samples of suspected kratom abusers. J Anal Toxicol 2024; 48:429-438. [PMID: 38780234 DOI: 10.1093/jat/bkae041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 05/11/2024] [Accepted: 05/21/2024] [Indexed: 05/25/2024] Open
Abstract
Kratom is a natural psychoactive product known primarily in Southeast Asia, including Thailand, Malaysia, etc. It is also known as krathom, kakuam, ithang, thom (Thailand), biak-biak, ketum (Malaysia) and mambog (Philippines) and is sometimes used as an opium substitute. It is stimulant at doses of 1-5 g, analgesic at doses of 5-15 g and euphoric and sedative at doses of >15 g. Mitragynine is the most abundant indole compound in kratom (Mitragyna speciosa) and is metabolized in humans to 7-hydroxymitragynine, the more active metabolite. Adverse effects include seizures, nausea, vomiting, diarrhea, tachycardia, restlessness, tremors, hallucinations and death. There are few studies on the analytical method for the detection of mitragynine and 7-hydroxymitragynine in hair. Therefore, this study proposes a liquid chromatography-tandem mass spectrometry (LC-MS-MS) method for the analysis of kratom in hair. Hair samples were first weighed to ∼10 mg and washed with methanol. Then the washed hair samples were cut into pieces and incubated in methanol with stirring and heating (16 h/38℃). Extracts were then analyzed by LC-MS-MS. This method was validated by determining the limit of detection (LOD), limit of quantification, linearity, intra- and inter-day accuracy and precision, recovery and matrix effects. The intra- and inter-day precision (CV%) and accuracy (bias%) were within ±20%, which was considered acceptable. Using this newly developed LC-MS-MS method, the simultaneous detection of mitragynine and 7-hydroxymitragynine in six authentic hair samples was achieved to provide the direct evidence of kratom use in the past. Mitragynine concentrations ranged from 16.0 to 2,067 pg/mg (mean 905.3 pg/mg), and 7-hydroxymitragynine concentrations ranged from 0.34 to 15 pg/mg (mean 7.4 pg/mg) in six authentic hair samples from kratom abusers. This may be due to the higher sensitivity of the LOD in this study, with values of 0.05 pg/mg for mitragynine and 0.2 pg/mg for 7-hydroxymitragynine in hair.
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Affiliation(s)
- Jongsook Rhee
- Toxicology & Narcotics Division, National Forensic Service Seoul Institute, 139 Jiyang-ro, Yangcheon-gu, Seoul 08036, Republic of Korea
| | - Ilchung Shin
- Toxicology & Narcotics Division, National Forensic Service Seoul Institute, 139 Jiyang-ro, Yangcheon-gu, Seoul 08036, Republic of Korea
| | - Jihyun Kim
- Toxicology & Narcotics Division, National Forensic Service Seoul Institute, 139 Jiyang-ro, Yangcheon-gu, Seoul 08036, Republic of Korea
| | - Juseun Lee
- Forensic Science Department, National Forensic Service, 10 Ipchun-ro, Wonju-si, Gangwon-do 26460, Republic of Korea
| | - Byungsuk Cho
- Forensic Science Department, National Forensic Service, 10 Ipchun-ro, Wonju-si, Gangwon-do 26460, Republic of Korea
| | - Junghyun Kim
- Toxicology & Narcotics Division, National Forensic Service Seoul Institute, 139 Jiyang-ro, Yangcheon-gu, Seoul 08036, Republic of Korea
| | - Meejung Park
- Toxicology & Narcotics Division, National Forensic Service Seoul Institute, 139 Jiyang-ro, Yangcheon-gu, Seoul 08036, Republic of Korea
| | - Eunmi Kim
- Forensic Science Department, National Forensic Service, 10 Ipchun-ro, Wonju-si, Gangwon-do 26460, Republic of Korea
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4
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Wood ME, Brown GJ, Karschner EL, Seither JZ, Brown JT, Knittel JL, Walterscheid JP. Screening and confirmation of psilocin, mitragynine, phencyclidine, ketamine and ketamine metabolites by liquid chromatography-tandem mass spectrometry. J Anal Toxicol 2024; 48:111-118. [PMID: 38287693 DOI: 10.1093/jat/bkae002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 01/10/2024] [Accepted: 01/22/2024] [Indexed: 01/31/2024] Open
Abstract
A safe and productive workplace requires a sober workforce, free from substances that impair judgment and concentration. Although drug monitoring programs already exist, the scope and loopholes of standard workplace testing panels are well known, allowing other substances to remain a source of risk. Therefore, a high-throughput urine screening method for psilocin, mitragynine, phencyclidine, ketamine, norketamine and dehydronorketamine was developed and validated in conjunction with a urine and blood confirmation method. There are analytical challenges to overcome with psilocin and mitragynine, particularly when it comes to drug stability and unambiguous identification in authentic specimens. Screening and confirmation methods were validated according to the American National Standards Institute/Academy Standards Board (ANSI/ASB) Standard 036, Standard Practices for Method Validation in Forensic Toxicology. An automated liquid handling system equipped with dispersive pipette extraction tips was utilized for preparing screening samples, whereas an offline solid-phase extraction method was used for confirmation sample preparation. Both methods utilized liquid chromatography-tandem mass spectrometry to achieve limits of detection between 1-5 ng/mL for the screening method and 1 ng/mL for the confirmation method. Automation allows for faster throughput and enhanced quality assurance, which improves turnaround time. Compared to previous in-house methods, specimen volumes were substantially decreased for both blood and urine, which is an advantage when volume is limited. This screening technique is well suited for evaluating large numbers of specimens from those employed in safety-sensitive workforce positions. This method can be utilized by workplace drug testing, human performance and postmortem laboratories seeking robust qualitative screening and confirmation methods for analytes that have traditionally been challenging to routinely analyze.
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Affiliation(s)
- Madeleine E Wood
- Division of Forensic Toxicology, Armed Forces Medical Examiner System, 115 Purple Heart Dr., Dover AFB, DE 19902, USA
| | - Glenna J Brown
- Division of Forensic Toxicology, Armed Forces Medical Examiner System, 115 Purple Heart Dr., Dover AFB, DE 19902, USA
| | - Erin L Karschner
- Division of Forensic Toxicology, Armed Forces Medical Examiner System, 115 Purple Heart Dr., Dover AFB, DE 19902, USA
| | - Joshua Z Seither
- Division of Forensic Toxicology, Armed Forces Medical Examiner System, 115 Purple Heart Dr., Dover AFB, DE 19902, USA
| | - Jordan T Brown
- Division of Forensic Toxicology, Armed Forces Medical Examiner System, 115 Purple Heart Dr., Dover AFB, DE 19902, USA
| | - Jessica L Knittel
- Division of Forensic Toxicology, Armed Forces Medical Examiner System, 115 Purple Heart Dr., Dover AFB, DE 19902, USA
| | - Jeffrey P Walterscheid
- Division of Forensic Toxicology, Armed Forces Medical Examiner System, 115 Purple Heart Dr., Dover AFB, DE 19902, USA
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5
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Mustafa R, Sukor R, Mohd Nor SM, Saari N, Mohsin AZ. Development of Methyl Ester Antibody-Based Competitive Indirect ELISA for Quantitative Detection of Mitragynine in Human Urine. ACS OMEGA 2023; 8:47412-47426. [PMID: 38144118 PMCID: PMC10734015 DOI: 10.1021/acsomega.3c02734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 07/26/2023] [Indexed: 12/26/2023]
Abstract
Mitragynine is the main psychoactive compound of Mitragyna speciosa Korth. (kratom). This alkaloid could render psychotropic effects and is often misused as a substitute for commercial drugs. Nowadays, the increasing popularity of kratom has led to the development of a rapid and effective detection method. The detection of mitragynine in a biological sample such as urine requires a highly sensitive and specific method due to the complex nature of mitragynine in urine. Enzyme-linked immunosorbent assay (ELISA) is well known as a rapid screening method for biological samples. In this study, a competitive indirect ELISA was successfully developed using MG-22-OCH3 IgG as a detection antibody for mitragynine in human urine. The mitragynine immunoassay showed a limit of detection and a limit of quantification of 0.412 and 1.25 μg/mL, respectively. The measurement range was between 0.01 and 100.0 μg/mL, with a minimal inhibition (IC50) value of 0.152 μg/mL. The developed ELISA was validated using a gold method such as high-performance liquid chromatography-mass spectrometry (HPLC-MS). The percentage of recovery and the coefficient of variation (CV) for the ELISA and LCMS/MS analyses were 84.0-95.70%, 99.20-112.0%, 7.69-9.78%, and 2.86-6.62%, respectively. This indicates that the developed ELISA is a reliable method that can be used as a rapid approach for quantifying mitragynine content in biological samples.
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Affiliation(s)
- Radhiahtul
Raehan Mustafa
- Academy
of Islamic Civilisation, Faculty of Social Sciences and Humanities, Universiti Teknologi Malaysia, 81310 Skudai, Johor, Malaysia
| | - Rashidah Sukor
- Department
of Food Science, Faculty of Food Science and Technology, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
- Laboratory
of Food Safety and Food Integrity, Institute of Tropical Agriculture
and Food Security, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
| | - Siti Mariam Mohd Nor
- Department
of Chemistry, Faculty of Science, Universiti
Putra Malaysia, 43400 Serdang, Selangor, Malaysia
| | - Nazamid Saari
- Department
of Food Science, Faculty of Food Science and Technology, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
| | - Aliah Zannierah Mohsin
- Department
of Food Science, Faculty of Food Science and Technology, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
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6
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Citti C, Laganà A, Capriotti AL, Montone CM, Cannazza G. Kratom: The analytical challenge of an emerging herbal drug. J Chromatogr A 2023; 1703:464094. [PMID: 37262932 DOI: 10.1016/j.chroma.2023.464094] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/19/2023] [Accepted: 05/20/2023] [Indexed: 06/03/2023]
Abstract
Mitragyna speciosa or kratom is emerging worldwide as a "legal" herbal drug of abuse. An increasing number of papers is appearing in the scientific literature regarding its pharmacological profile and the analysis of its chemical constituents, mainly represented by alkaloids. However, its detection and identification are not straightforward as the plant material is not particularly distinctive. Hyphenated techniques are generally preferred for the identification and quantification of these compounds, especially the main purported psychoactive substances, mitragynine (MG) and 7-hydroxymitragynine (7-OH-MG), in raw and commercial products. Considering the vast popularity of this recreational drug and the growing concern about its safety, the analysis of alkaloids in biological specimens is also of great importance for forensic and toxicological laboratories. The review addresses the analytical aspects of kratom spanning the extraction techniques used to isolate the alkaloids, the qualitative and quantitative analytical methods and the strategies for the distinction of the naturally occurring isomers.
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Affiliation(s)
- Cinzia Citti
- Institute of Nanotechnology - CNR NANOTEC, Campus Ecotekne, Via Monteroni, Lecce 73100, Italy.
| | - Aldo Laganà
- Department of Chemistry, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome 00185, Italy
| | - Anna Laura Capriotti
- Department of Chemistry, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome 00185, Italy
| | - Carmela Maria Montone
- Department of Chemistry, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome 00185, Italy
| | - Giuseppe Cannazza
- Department of Life Sciences, University of Modena and Reggio Emilia, Via Campi 103, Modena 41125, Italy.
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7
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Noguez JH, Koch CD. Bridging the gap: The critical role of laboratory developed tests in clinical toxicology. J Mass Spectrom Adv Clin Lab 2023; 28:70-74. [PMID: 36872953 PMCID: PMC9982682 DOI: 10.1016/j.jmsacl.2023.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023] Open
Abstract
•Toxicology testing provides valuable information for patient management.•Current in vitro diagnostics (IVDs) are unable to meet all clinical needs.•Lab-developed tests (LDTs) in toxicology can be used to close clinical care gaps.•LDTs in clinical toxicology are almost exclusively mass spectrometry-based methods.
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Affiliation(s)
- Jaime H Noguez
- Department of Pathology, Case Western Reserve University, Cleveland, OH, USA.,Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Christopher D Koch
- Department of Pathology, University of South Dakota Sanford School of Medicine, Sioux Falls, SD, USA.,Sanford Laboratories, Sanford Health, Sioux Falls, SD, USA
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8
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Hughs M, Kish-Trier E, O'Brien A, McMillin GA. Analysis of Mitragynine and Speciociliatine in Umbilical Cord by LC-MS-MS for Detecting Prenatal Exposure to Kratom. J Anal Toxicol 2023; 46:957-964. [PMID: 36047661 DOI: 10.1093/jat/bkac064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 08/22/2022] [Accepted: 08/30/2022] [Indexed: 01/26/2023] Open
Abstract
Kratom is an herbal drug that is legal in the USA. While it is marketed as a safer alternative to opioids, it can cause opioid-like withdrawal symptoms when discontinued after regular use. Several case studies have shown that kratom exposure in utero can lead to symptoms in newborns consistent with neonatal abstinence syndrome. Here, we present a validated method for the detection of kratom in umbilical cord by liquid chromatography--tandem mass spectrometry. The umbilical cord is homogenized in solvent and kratom analytes are purified by solid phase extraction (strong cation exchange). Diastereomeric kratom alkaloids mitragynine (MG), speciociliatine (SC), speciogynine and mitraciliatine are separated by reverse phase chromatography on a phenyl-hexyl column. Applying this method to residual umbilical cords submitted to our laboratory for drug testing, 29 positive specimens exhibiting varied kratom analyte distributions were observed. MG and SC were the most abundant kratom analytes and were selected as biomarkers of kratom exposure. A cutoff concentration of 0.08 ng/g was established for both MG and SC.
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Affiliation(s)
- Melissa Hughs
- ARUP Institute for Clinical and Experimental Pathology, 500 Chipeta Way, Salt Lake City, UT 84108, USA
| | - Erik Kish-Trier
- ARUP Institute for Clinical and Experimental Pathology, 500 Chipeta Way, Salt Lake City, UT 84108, USA
| | - Aidin O'Brien
- ARUP Institute for Clinical and Experimental Pathology, 500 Chipeta Way, Salt Lake City, UT 84108, USA
| | - Gwendolyn A McMillin
- ARUP Institute for Clinical and Experimental Pathology, 500 Chipeta Way, Salt Lake City, UT 84108, USA.,Department of Pathology, University of Utah School of Medicine, 15 North Medical Drive, East Street #1100, Salt Lake City, UT 84112, USA
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9
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Methyl ester and aromatic ether modification of mitragynine for generation of mitragynine-specific polyclonal antibodies. J Immunol Methods 2022; 507:113291. [DOI: 10.1016/j.jim.2022.113291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 05/19/2022] [Accepted: 05/25/2022] [Indexed: 11/21/2022]
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10
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Torres-Ortiz A, Al Zein S, Alqudsi M. A Case of Hyperkalemia Induced by Kratom (Mitragyna speciosa). Cureus 2022; 14:e24036. [PMID: 35573520 PMCID: PMC9093675 DOI: 10.7759/cureus.24036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2022] [Indexed: 11/26/2022] Open
Abstract
Kratom (Mitragyna speciosa), a tree found abundantly in Southeast Asia, has been used for centuries because of its opioid-like properties. In the last 20 years, it has gained popularity in the United States of America due to its easy availability and effects on pain control. However, different types of toxicity from kratom use have been reported in the literature. Here, we present a case of kratom-induced hyperkalemia in a 61-year-old patient with no significant past medical history. His laboratory work-up excluded other etiologies, and his potassium level eventually normalized after the discontinuation of kratom. Although reasonable data exist on kratom effects on the nervous and cardiovascular systems, the magnitude of its effect on potassium homeostasis and whether it is kidney mediated or not is not well recognized.
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Affiliation(s)
- Aldo Torres-Ortiz
- Department of Internal Medicine, Ochsner Medical Center, New Orleans, USA
| | - Said Al Zein
- Department of Medicine, University of Pittsburgh, Pittsburgh, USA
| | - Muhannad Alqudsi
- Department of Nephrology, The University of Queensland Ochsner Clinical School, New Orleans, USA
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11
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Hiranita T, Obeng S, Sharma A, Wilkerson JL, McCurdy CR, McMahon LR. In vitro and in vivo pharmacology of kratom. ADVANCES IN PHARMACOLOGY (SAN DIEGO, CALIF.) 2021; 93:35-76. [PMID: 35341571 DOI: 10.1016/bs.apha.2021.10.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Kratom products have been historically and anecdotally used in south Asian countries for centuries to manage pain and opioid withdrawal. The use of kratom products has dramatically increased in the United States. More than 45 kratom alkaloids have been isolated, yet the overall pharmacology of the individual alkaloids is still not well characterized. The purpose of this chapter is to summarize in vitro and in vivo opioid activities of the primary kratom alkaloid mitragynine and its more potent metabolite 7-hydroxymitragynine. Following are experimental procedures described to characterize opioid receptor activity; receptor binding and functional assays, antinociceptive assays, operant conditioning assays, and respiratory plethysmography. The capacity of kratom alkaloids to confer tolerance and physical dependence as well as their pharmacokinetic properties are also summarized. The data reviewed here suggest that kratom products and mitragynine possess low efficacy agonist activity at the mu-opioid receptor in vivo. In addition, kratom products and mitragynine have been demonstrated to antagonize the effects of high efficacy mu-opioid agonists. The data further suggest that 7-hydroxymitragynine formed in vivo by metabolism of mitragynine may be minimally involved in the overall behavioral profile of mitragynine and kratom, whereas 7-hydroxymitragynine itself, at sufficiently high doses administered exogenously, shares many of the same abuse- and dependence-related behavioral effects associated with traditional opioid agonists. The apparent low efficacy of kratom products and mitragynine at mu-opioid receptors supports the development of these ligands as effective and potentially safe medications for opioid use disorder.
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Affiliation(s)
- Takato Hiranita
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, United States
| | - Samuel Obeng
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, United States; Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL, United States
| | - Abhisheak Sharma
- Department of Pharmaceutics, College of Pharmacy, University of Florida, Gainesville, FL, United States; Translational Drug Development Core, Clinical and Translational Sciences Institute, College of Pharmacy, University of Florida, Gainesville, FL, United States
| | - Jenny L Wilkerson
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, United States
| | - Christopher R McCurdy
- Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL, United States; Department of Pharmaceutics, College of Pharmacy, University of Florida, Gainesville, FL, United States; Translational Drug Development Core, Clinical and Translational Sciences Institute, College of Pharmacy, University of Florida, Gainesville, FL, United States
| | - Lance R McMahon
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, United States.
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12
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Chakraborty S, Uprety R, Slocum ST, Irie T, Le Rouzic V, Li X, Wilson LL, Scouller B, Alder AF, Kruegel AC, Ansonoff M, Varadi A, Eans SO, Hunkele A, Allaoa A, Kalra S, Xu J, Pan YX, Pintar J, Kivell BM, Pasternak GW, Cameron MD, McLaughlin JP, Sames D, Majumdar S. Oxidative Metabolism as a Modulator of Kratom's Biological Actions. J Med Chem 2021; 64:16553-16572. [PMID: 34783240 DOI: 10.1021/acs.jmedchem.1c01111] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The leaves of Mitragyna speciosa (kratom), a plant native to Southeast Asia, are increasingly used as a pain reliever and for attenuation of opioid withdrawal symptoms. Using the tools of natural products chemistry, chemical synthesis, and pharmacology, we provide a detailed in vitro and in vivo pharmacological characterization of the alkaloids in kratom. We report that metabolism of kratom's major alkaloid, mitragynine, in mice leads to formation of (a) a potent mu opioid receptor agonist antinociceptive agent, 7-hydroxymitragynine, through a CYP3A-mediated pathway, which exhibits reinforcing properties, inhibition of gastrointestinal (GI) transit and reduced hyperlocomotion, (b) a multifunctional mu agonist/delta-kappa antagonist, mitragynine pseudoindoxyl, through a CYP3A-mediated skeletal rearrangement, displaying reduced hyperlocomotion, inhibition of GI transit and reinforcing properties, and (c) a potentially toxic metabolite, 3-dehydromitragynine, through a non-CYP oxidation pathway. Our results indicate that the oxidative metabolism of the mitragynine template beyond 7-hydroxymitragynine may have implications in its overall pharmacology in vivo.
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Affiliation(s)
- Soumen Chakraborty
- Center for Clinical Pharmacology, University of Health Sciences & Pharmacy and Washington University School of Medicine, St. Louis, Missouri 63110, United States
| | - Rajendra Uprety
- Department of Neurology and Molecular Pharmacology, Memorial Sloan Kettering Cancer Center, New York 10065, United States
| | - Samuel T Slocum
- Department of Pharmacology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States
| | - Takeshi Irie
- Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York 10065, United States
| | - Valerie Le Rouzic
- Department of Neurology and Molecular Pharmacology, Memorial Sloan Kettering Cancer Center, New York 10065, United States
| | - Xiaohai Li
- Department of Molecular Therapeutics, Scripps Research Institute, Jupiter, Florida 33458, United States
| | - Lisa L Wilson
- Department of Pharmacodynamics, University of Florida, Gainesville, Florida 32610, United States
| | - Brittany Scouller
- Centre for Biodiscovery, School of Biological Science, Victoria University of Wellington, Wellington 6012, New Zealand
| | - Amy F Alder
- Centre for Biodiscovery, School of Biological Science, Victoria University of Wellington, Wellington 6012, New Zealand
| | - Andrew C Kruegel
- Department of Chemistry, Columbia University, New York 10027, United States
| | - Michael Ansonoff
- Department of Neuroscience and Cell Biology, Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey 08854-8021, United States
| | - Andras Varadi
- Department of Neurology and Molecular Pharmacology, Memorial Sloan Kettering Cancer Center, New York 10065, United States
| | - Shainnel O Eans
- Department of Pharmacodynamics, University of Florida, Gainesville, Florida 32610, United States
| | - Amanda Hunkele
- Department of Neurology and Molecular Pharmacology, Memorial Sloan Kettering Cancer Center, New York 10065, United States
| | - Abdullah Allaoa
- Department of Neurology and Molecular Pharmacology, Memorial Sloan Kettering Cancer Center, New York 10065, United States
| | - Sanjay Kalra
- Department of Neurology and Molecular Pharmacology, Memorial Sloan Kettering Cancer Center, New York 10065, United States
| | - Jin Xu
- Department of Neurology and Molecular Pharmacology, Memorial Sloan Kettering Cancer Center, New York 10065, United States
| | - Ying Xian Pan
- Department of Neurology and Molecular Pharmacology, Memorial Sloan Kettering Cancer Center, New York 10065, United States
| | - John Pintar
- Department of Neuroscience and Cell Biology, Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey 08854-8021, United States
| | - Bronwyn M Kivell
- Centre for Biodiscovery, School of Biological Science, Victoria University of Wellington, Wellington 6012, New Zealand
| | - Gavril W Pasternak
- Department of Neurology and Molecular Pharmacology, Memorial Sloan Kettering Cancer Center, New York 10065, United States
| | - Michael D Cameron
- Department of Molecular Therapeutics, Scripps Research Institute, Jupiter, Florida 33458, United States
| | - Jay P McLaughlin
- Department of Pharmacodynamics, University of Florida, Gainesville, Florida 32610, United States
| | - Dalibor Sames
- Department of Chemistry, Columbia University, New York 10027, United States
| | - Susruta Majumdar
- Center for Clinical Pharmacology, University of Health Sciences & Pharmacy and Washington University School of Medicine, St. Louis, Missouri 63110, United States
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13
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Hartley C, Bulloch M, Penzak SR. Clinical Pharmacology of the Dietary Supplement, Kratom (Mitragyna speciosa). J Clin Pharmacol 2021; 62:577-593. [PMID: 34775626 DOI: 10.1002/jcph.2001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 11/05/2021] [Indexed: 11/10/2022]
Abstract
Kratom (Mitragyna speciosa) consists of over 40 alkaloids with two of them, mitragynine (MG) and 7-OH-mitragynine (7-OH-MG) being the main psychoactive compounds. MG and 7-OH-MG each target opioid receptors and have been referred to as atypical opioids. They exert their pharmacologic effects on the μ, δ, and κ opioid receptors. In addition, they affect adrenergic, serotonergic, and dopaminergic pathways. Kratom has been touted as an inexpensive, legal alternative to standard opioid replacement therapy such as methadone and buprenorphine. Other uses for kratom include chronic pain, attaining a "legal high," and numerous CNS disorders including anxiety depression and post-traumatic stress disorder (PTSD). Kratom induces analgesia and mild euphoria with a lower risk of respiratory depression or adverse central nervous system effects compared to traditional opioid medications. Nonetheless, kratom has been associated with both physical and psychological dependence with some individuals experiencing classic opioid withdrawal symptoms upon abrupt cessation. Kratom use has been linked to serious adverse effects including liver toxicity, seizures, and death. These risks are often compounded by poly-substance abuse. Further, kratom may potentiate the toxicity of coadministered medications through modulation of cytochrome P450, P-glycoprotein, and uridine diphosphate glucuronosyltransferase enzymes (UGDT). In 2016 the U.S. Drug Enforcement Administration (DEA) took steps to classify kratom as a federal schedule 1 medication; however, due to public resistance, this plan was set aside. Until studies are conducted that define kratom's role in treating opioid withdrawal and/or other CNS conditions, kratom will likely remain available as a dietary supplement for the foreseeable future. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Chad Hartley
- Department of Pharmacy Practice, Harrison School of Pharmacy, Auburn University, Auburn, Alabama, 36849, United States
| | - Marilyn Bulloch
- Department of Pharmacy Practice, Harrison School of Pharmacy, Auburn University, Auburn, Alabama, 36849, United States
| | - Scott R Penzak
- Department of Pharmacy Practice, Harrison School of Pharmacy, Auburn University, Auburn, Alabama, 36849, United States
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14
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Groff D, Stuckey H, Philpott C, Van Dyke E, Silvis M, Leong SL, Bone C. Kratom use disorder: a primer for primary care physicians. J Addict Dis 2021; 40:131-141. [PMID: 34281482 DOI: 10.1080/10550887.2021.1950263] [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: 10/20/2022]
Abstract
Kratom is a substance similar to opioids that is often used for its euphoric effects, however it can be obtained legally in most of the United States. The substance is often not assessed on routine urine drug screen, however it is estimated that millions of people engage in kratom use each year and level of use is rising. Given the increasing prevalence of kratom use, and its potentially lethal consequences, it is imperative that primary care physicians be familiar with this substance and have a framework to approach identification and treatment of individuals with kratom use disorder. This manuscript offers a review of the epidemiology and pharmacology of kratom, along with guidance for care of individuals with kratom use disorder in the primary care setting.
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Affiliation(s)
- Destin Groff
- Penn State Health Milton S Hershey Medical Center, Hershey, PA, USA
| | - Heather Stuckey
- Penn State Health Milton S Hershey Medical Center, Hershey, PA, USA
| | - Carolyn Philpott
- UC Health: University of Cincinnati Medical Center, Cincinnati, OH, USA
| | - Erika Van Dyke
- Penn State Health Milton S Hershey Medical Center, Hershey, PA, USA
| | - Matthew Silvis
- Penn State Health Milton S Hershey Medical Center, Hershey, PA, USA
| | - Shou Ling Leong
- Penn State Health Milton S Hershey Medical Center, Hershey, PA, USA
| | - Curtis Bone
- Penn State Health Milton S Hershey Medical Center, Hershey, PA, USA
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15
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Anand A, Hosanagar A. The Addictive Potential and Challenges With Use of the "Herbal Supplement" Kratom: A Case Report and Literature Review. PAIN MEDICINE 2021; 23:4-9. [PMID: 33822210 DOI: 10.1093/pm/pnab126] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Akhil Anand
- Alcohol and Drug Recovery Center, Center for Behavioral Health, Department of Psychiatry and Psychology, Cleveland Clinic, Cleveland, OH, USA
| | - Avinash Hosanagar
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.,VA Ann Arbor Healthcare System, Mental Health Service, Ann Arbor, MI, USA
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16
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Tungphatthong C, Urumarudappa SKJ, Awachai S, Sooksawate T, Sukrong S. Differentiation of Mitragyna speciosa, a narcotic plant, from allied Mitragyna species using DNA barcoding-high-resolution melting (Bar-HRM) analysis. Sci Rep 2021; 11:6738. [PMID: 33762644 PMCID: PMC7990970 DOI: 10.1038/s41598-021-86228-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 03/12/2021] [Indexed: 11/11/2022] Open
Abstract
Mitragyna speciosa (Korth.) Havil. [MS], or “kratom” in Thai, is the only narcotic species among the four species of Mitragyna in Thailand, which also include Mitragyna diversifolia (Wall. ex G. Don) Havil. [MD], Mitragyna hirsuta Havil. [MH], and Mitragyna rotundifolia (Roxb.) O. Kuntze [MR]. M. speciosa is a tropical tree belonging to the Rubiaceae family and has been prohibited by law in Thailand. However, it has been extensively covered in national and international news, as its abuse has become more popular. M. speciosa is a narcotic plant and has been used as an opium substitute and traditionally used for the treatment of chronic pain and various illnesses. Due to morphological disparities in the genus, the identification of plants in various forms, including fresh leaves, dried leaf powder, and finished products, is difficult. In this study, DNA barcoding combined with high-resolution melting (Bar-HRM) analysis was performed to differentiate M. speciosa from allied Mitragyna and to assess the capability of Bar-HRM assays to identify M. speciosa in suspected kratom or M. speciosa-containing samples. Bar-HRM analysis of PCR amplicons was based on the ITS2, rbcL, trnH-psbA, and matK DNA barcode regions. The melting profiles of ITS2 amplicons were clearly distinct, which enabled the authentication and differentiation of Mitragyna species from allied species. This study reveals that DNA barcoding coupled with HRM is an efficient tool with which to identify M. speciosa and M. speciosa-containing samples and ensure the safety and quality of traditional Thai herbal medicines.
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Affiliation(s)
- Chayapol Tungphatthong
- Research Unit of DNA Barcoding of Thai Medicinal Plants, Department of Pharmacognosy and Pharmaceutical Botany, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Santhosh Kumar J Urumarudappa
- Research Unit of DNA Barcoding of Thai Medicinal Plants, Department of Pharmacognosy and Pharmaceutical Botany, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Supita Awachai
- Research Unit of DNA Barcoding of Thai Medicinal Plants, Department of Pharmacognosy and Pharmaceutical Botany, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Thongchai Sooksawate
- Department of Pharmacology and Physiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Suchada Sukrong
- Research Unit of DNA Barcoding of Thai Medicinal Plants, Department of Pharmacognosy and Pharmaceutical Botany, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, 10330, Thailand.
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17
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Psychoactive Substances of Natural Origin: Toxicological Aspects, Therapeutic Properties and Analysis in Biological Samples. Molecules 2021; 26:molecules26051397. [PMID: 33807728 PMCID: PMC7961374 DOI: 10.3390/molecules26051397] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 02/28/2021] [Accepted: 03/02/2021] [Indexed: 12/14/2022] Open
Abstract
The consumption of new psychoactive substances (NPSs) has been increasing, and this problem affects several countries worldwide. There is a class of NPSs of natural origin, consisting of plants and fungi, which have a wide range of alkaloids, responsible for causing relaxing, stimulating or hallucinogenic effects. The consumption of some of these substances is prompted by religious beliefs and cultural reasons, making the legislation very variable or even ambiguous. However, the abusive consumption of these substances can present an enormous risk to the health of the individuals, since their metabolism and effects are not yet fully known. Additionally, NPSs are widely spread over the internet, and their appearance is very fast, which requires the development of sophisticated analytical methodologies, capable of detecting these compounds. Thus, the objective of this work is to review the toxicological aspects, traditional use/therapeutic potential and the analytical methods developed in biological matrices in twelve plant specimens (Areca catechu, Argyreia nervosa, Ayahuasca, Catha edulis, Datura stramonium, Lophophora williamsii, Mandragora officinarum, Mitragyna speciosa, Piper methysticum Forst, Psilocybe, Salvia divinorum and Tabernanthe iboga).
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18
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Overview of the major classes of new psychoactive substances, psychoactive effects, analytical determination and conformational analysis of selected illegal drugs. OPEN CHEM 2021. [DOI: 10.1515/chem-2021-0196] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Abstract
The misuse of psychoactive substances is attracting a great deal of attention from the general public. An increase use of psychoactive substances is observed among young people who do not have enough awareness of the harmful effects of these substances. Easy access to illicit drugs at low cost and lack of effective means of routine screening for new psychoactive substances (NPS) have contributed to the rapid increase in their use. New research and evidence suggest that drug use can cause a variety of adverse psychological and physiological effects on human health (anxiety, panic, paranoia, psychosis, and seizures). We describe different classes of these NPS drugs with emphasis on the methods used to identify them and the identification of their metabolites in biological specimens. This is the first review that thoroughly gives the literature on both natural and synthetic illegal drugs with old known data and very hot new topics and investigations, which enables the researcher to use it as a starting point in the literature exploration and planning of the own research. For the first time, the conformational analysis was done for selected illegal drugs, giving rise to the search of the biologically active conformations both theoretically and using lab experiments.
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Lee MJ, Ramanathan S, Mansor SM, Tan SC. Development of an ELISA for detection of mitragynine and its metabolites in human urine. Anal Biochem 2020; 599:113733. [PMID: 32302607 DOI: 10.1016/j.ab.2020.113733] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 04/07/2020] [Accepted: 04/08/2020] [Indexed: 10/24/2022]
Abstract
An enzyme-linked immunosorbent assay for detection of mitragynine, other closely related Kratom alkaloids and metabolites was developed using polyclonal antibodies. Mitragynine was conjugated to a carrier protein, cationized-bovine serum albumin using Mannich reaction. The synthesized antigen was injected into rabbits to elicit specific polyclonal antibodies against mitragynine. An enzyme conjugate was synthesized for evaluating its performance with the antibodies produced. The assay had an IC50 of 7.3 ng/mL with a limit of detection of 15 ng/mL for mitragynine. Antibody produced have high affinity for mitragynine (100%), other closely related Kratom alkaloids such as paynantheine (54%), speciociliatine (63%), 7α-hydroxy-7H-mitragynine (83%) and cross-reacted with metabolites 9-O-demethyl mitragynine (79%), 16-carboxy mitragynine (103%), 9-O-demethyl mitragynine sulfate (263%), 9-O-demethyl mitragynine glucuronide (60%), 16-carboxy mitragynine glucuronide (60%), 9-O-demethyl-16-carboxy mitragynine sulfate (270%) and 17-O-demethyl-16,17-dihydro mitragynine glucuronide (34%). It showed cross-reactivity less than 0.01% to reserpine, codeine, morphine, caffeine, methadone, amphetamine, and cocaine. Ten-fold dilution urine was used in the assay to reduce the matrix effects. The recovery ranged from 83% to 112% with variation coefficients in intraday and interday less than 8% and 6%, respectively. The ELISA turned out to be a convenient tool to diagnose mitragynine, other closely related Kratom alkaloids and metabolites in human urine samples.
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Affiliation(s)
- Mei Jin Lee
- Institute for Research in Molecular Medicine (INFORMM), Main Campus, Universiti Sains Malaysia, 11800, Penang, Malaysia.
| | - Surash Ramanathan
- Centre for Drug Research (CDR), Main Campus, Universiti Sains Malaysia, 11800, Penang, Malaysia
| | - Sharif Mahsufi Mansor
- Centre for Drug Research (CDR), Main Campus, Universiti Sains Malaysia, 11800, Penang, Malaysia
| | - Soo Choon Tan
- Institute for Research in Molecular Medicine (INFORMM), Main Campus, Universiti Sains Malaysia, 11800, Penang, Malaysia
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20
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Basiliere S, Kerrigan S. Identification of metabolites and potential biomarkers of kratom in urine. J Chromatogr B Analyt Technol Biomed Life Sci 2020; 1140:121971. [DOI: 10.1016/j.jchromb.2020.121971] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 01/06/2020] [Accepted: 01/07/2020] [Indexed: 12/13/2022]
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21
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Basiliere S, Kerrigan S. CYP450-Mediated Metabolism of Mitragynine and Investigation of Metabolites in Human Urine. J Anal Toxicol 2020; 44:301-313. [DOI: 10.1093/jat/bkz108] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 10/05/2019] [Accepted: 10/08/2019] [Indexed: 12/13/2022] Open
Abstract
Abstract
Mitragyna speciosa (Kratom) has emerged as a recreational drug and a substance of medicinal intrigue. Although the drug was initially used recreationally for its sedating and euphoric effects, more recently its use has been associated with the non-medically supervised treatment of opioid abstinence syndrome. Mitragynine is the principal pharmacologically active alkaloid in kratom. Although metabolites of mitragynine have been identified, the cytochrome P450 (CYP450) enzymes responsible for its biotransformation are still under investigation. The goal of this study was to contribute further knowledge regarding CYP450 activity as it relates to mitragynine. Recombinant cytochrome P450 enzymes (rCYPs) were used to investigate the isoforms involved in its metabolism. Biotransformational products were identified using liquid chromatography-quadrupole/time of flight-mass spectrometry. Four rCYP enzymes (2C18, 2C19, 2D6 and 3A4) were found to contribute to the metabolism of mitragynine. 7-Hydroxymitragynine (which has an affinity for the mu-opioid receptor >10-folds that of morphine) was produced exclusively by 3A4. 9-O-demethylmitragynine, the most abundant metabolite in vitro (and the most prevalent metabolite in urine among kratom users) was produced by 2C19, 3A4 and 2D6. 16-Carboxymitragynine was produced by rCYPs 2D6, 2C19 and 2C18. 2C19 was solely responsible for the formation of 9-O-demethyl-16-carboxymitragynine. In vitro rCYP studies were compared with phase I metabolites in urine from cases involving mitragynine.
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Affiliation(s)
- Stephanie Basiliere
- Department of Forensic Science, Sam Houston State University, Box 2525, 1003 Bowers Blvd, Huntsville, TX 77341, USA
| | - Sarah Kerrigan
- Department of Forensic Science, Sam Houston State University, Box 2525, 1003 Bowers Blvd, Huntsville, TX 77341, USA
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22
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Lo Faro AF, Di Trana A, La Maida N, Tagliabracci A, Giorgetti R, Busardò FP. Biomedical analysis of New Psychoactive Substances (NPS) of natural origin. J Pharm Biomed Anal 2019; 179:112945. [PMID: 31704129 DOI: 10.1016/j.jpba.2019.112945] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 10/16/2019] [Accepted: 10/18/2019] [Indexed: 12/16/2022]
Abstract
New psychoactive substances (NPS) can be divided into two main groups: synthetic molecules and active principles of natural origin. With respect to this latter group, a wide range of alkaloids contained in plants, mainly from Asia and South America, can be included in the class of NPS of natural origin. The majority NPS of natural origin presents stimulant and/or hallucinogenic effects (e.g. Catha edulis and Ayahuasca, respectively) while few of them show sedative and relaxing properties (e.g. kratom). Few information is available in relation to the analytical identification of psychoactive principles contained in the plant material. Moreover, to our knowledge, scarce data are present in literature, about the characterization and quantification of the parent drug in biological matrices from intoxication and fatality cases. In addition, the metabolism of natural active principles has not been yet fully investigated for most of the psychoactive substances from plant material. Consequently, their identification is not frequently performed and produced metabolites are often unknown. To fill this gap, we reviewed the currently available analytical methodologies for the identification and quantification of NPS of natural origin in plant material and, whenever possible, in conventional and non-conventional biological matrices of intoxicated and dead subjects. The psychoactive principles contained in the following plants were investigated: Areca catechu, Argyreia nervosa, Ayahuasca, Catha edulis, Ipomoea violacea, Mandragora officinarum, Mitragyna speciosa, Pausinystalia yohimbe, Piper methisticum, Psilocybe, Rivea corymbosa, Salvia divinorum, Sceletium tortuosum, Lactuca virosa. From the results obtained, it can be evidenced that although several analytical methods for the simultaneous quantification of different molecules from the same plants have been developed and validated, a comprehensive method to detect active compounds from different natural specimens both in biological and non-biological matrices is still lacking.
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Affiliation(s)
- Alfredo Fabrizio Lo Faro
- Department of Excellence of Biomedical Sciences and Public Health, University "Politecnica delle Marche" of Ancona, Via Tronto 71, Ancona, Italy
| | - Annagiulia Di Trana
- Department of Excellence of Biomedical Sciences and Public Health, University "Politecnica delle Marche" of Ancona, Via Tronto 71, Ancona, Italy
| | - Nunzia La Maida
- Department of Excellence of Biomedical Sciences and Public Health, University "Politecnica delle Marche" of Ancona, Via Tronto 71, Ancona, Italy
| | - Adriano Tagliabracci
- Department of Excellence of Biomedical Sciences and Public Health, University "Politecnica delle Marche" of Ancona, Via Tronto 71, Ancona, Italy
| | - Raffaele Giorgetti
- Department of Excellence of Biomedical Sciences and Public Health, University "Politecnica delle Marche" of Ancona, Via Tronto 71, Ancona, Italy
| | - Francesco Paolo Busardò
- Department of Excellence of Biomedical Sciences and Public Health, University "Politecnica delle Marche" of Ancona, Via Tronto 71, Ancona, Italy.
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Schmuhl KK, Gardner SM, Cottrill CB, Bonny AE. Home induction and outpatient treatment of kratom use disorder with buprenorphine-naloxone: A case report in a young adult. Subst Abus 2019; 41:311-314. [PMID: 31644379 DOI: 10.1080/08897077.2019.1671945] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: The use of the natural product, kratom, has increased significantly in recent years. The active compounds in kratom have been shown to produce both opioid and stimulant-like effects. While kratom is marketed as a safe, non-addictive method to treat pain and opioid withdrawal, there have been reports demonstrating that kratom is physiologically addictive and linked to overdose deaths. A limited number of case-reports are available describing treatment of kratom use disorder in middle-aged adults, generally in the context of chronic pain and in inpatient settings. Our case is unique in that we describe outpatient treatment of kratom use disorder in a young adult with comorbid attention deficit hyperactivity disorder (ADHD) and in the absence of chronic pain. Case: A 20-year-old college student with ADHD presented to an office-based opioid agonist treatment clinic (OBOT) for treatment of kratom use disorder. He was unable to attend inpatient or residential substance use treatment due to work and school obligations. Additionally, he had stopped taking his prescribed stimulant due to cardiac side effects. The OBOT team successfully initiated buprenorphine-naloxone (BUP/NAL) sublingual films via home induction to treat his kratom use disorder. The patient is being monitored monthly with plans to slowly taper his BUP/NAL dose as tolerated. Discussion: We present a case of a young adult male with kratom use disorder, complicated by a diagnosis of ADHD, successfully treated with BUP/NAL via home induction. The patient is currently kratom-free, reports improved mood and sleep patterns since initiating BUP/NAL, and is able to once again tolerate his ADHD stimulant medication. Healthcare providers should be aware of the use of kratom and consider utilizing BUP/NAL to treat dependence to this botanical drug.
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Affiliation(s)
- Kelsey K Schmuhl
- The College of Pharmacy, The Ohio State University, Columbus, Ohio, USA.,Division of Adolescent Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Spencer M Gardner
- The College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Casey B Cottrill
- Division of Adolescent Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA.,The College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Andrea E Bonny
- The College of Medicine, The Ohio State University, Columbus, Ohio, USA
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24
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Ya K, Tangamornsuksan W, Scholfield CN, Methaneethorn J, Lohitnavy M. Pharmacokinetics of mitragynine, a major analgesic alkaloid in kratom (Mitragyna speciosa): A systematic review. Asian J Psychiatr 2019; 43:73-82. [PMID: 31100603 DOI: 10.1016/j.ajp.2019.05.016] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 05/05/2019] [Accepted: 05/08/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND OBJECTIVE Kratom (Mitragyna speciosa) is a tropical tree found in southern Thailand and northern states of the Malay Peninsula. Kratom is commercially available and used as an alternative to treat opioid withdrawal. Mitragynine is the major indole alkaloid found in kratom leaves. This review aimed to summarize available pharmacokinetic information about mitragynine. METHODS PubMed, Scopus, and Web of Science were systematically searched from their inceptions to June 2018. All types of pharmacokinetic studies of mitragynine were included for further systematic review. RESULTS Seventeen articles were reviewed. Mitragynine is a lipophilic weak base passively transported across the intestinal wall and blood brain barrier. 85-95% is bound to plasma protein and extensively metabolized by phase I and particularly phase II enzymes. Actions on CYP enzymes are unlikely to impact drug metabolism at concentrations likely to exist in kratom-consuming humans. In rats and humans, mitragynine is rapidly absorbed after orally administration (Tmax˜1.5 h, Cmax˜0.3-1.8 μM). Vd was 37-90 L/kg; t1/2 was 3-9 hr; mostly excreted as metabolites in urine. Bioavailability was estimated as 21%. It also rapidly penetrated and redistributed in brain. A quality assessment tool tailored for pharmacokinetic studies was also created which rated some studies of lower value. CONCLUSION Rudimentary pharmacokinetics of mitragynine was described in this systematic review. However, the discovered studies provided scant information on the role of metabolism and redistribution into tissues nor the rate of excretion.
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Affiliation(s)
- Kimheang Ya
- Center of Excellence for Environmental Health & Toxicology, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand; Pharmacokinetic Research Unit, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand; Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand
| | - Wimonchat Tangamornsuksan
- Faculty of Medicine and Public Health, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
| | - C Norman Scholfield
- Center of Excellence for Environmental Health & Toxicology, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand; Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand
| | - Janthima Methaneethorn
- Center of Excellence for Environmental Health & Toxicology, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand; Pharmacokinetic Research Unit, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand
| | - Manupat Lohitnavy
- Center of Excellence for Environmental Health & Toxicology, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand; Pharmacokinetic Research Unit, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand; Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.
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Meireles V, Rosado T, Barroso M, Soares S, Gonçalves J, Luís Â, Caramelo D, Simão AY, Fernández N, Duarte AP, Gallardo E. Mitragyna speciosa: Clinical, Toxicological Aspects and Analysis in Biological and Non-Biological Samples. MEDICINES 2019; 6:medicines6010035. [PMID: 30836609 PMCID: PMC6473843 DOI: 10.3390/medicines6010035] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 02/24/2019] [Accepted: 02/27/2019] [Indexed: 02/07/2023]
Abstract
The abuse of psychotropic substances is a well-known phenomenon, and many of them are usually associated with ancestral traditions and home remedies. This is the case of Mitragyna speciosa (kratom), a tropical tree used to improve work performance and to withstand great heat. According to several published studies, the main reasons for kratom consumption involve improving sexual performance and endurance, but also social and recreational uses for the feeling of happiness and euphoria; it is also used for medical purposes as a pain reliever, and in the treatment of diarrhea, fever, diabetes, and hypertension. However, this plant has gained more popularity amongst young people over the last years. Since it is available on the internet for purchase, its use is now widely as a drug of abuse, namely as a new psychoactive substance, being a cheaper alternative to opioids that does not require medical prescription in most countries. According to internet surveys by the European Monitoring Centre for Drugs and Drug Addiction in 2008 and 2011, kratom was one of the most widely supplied new psychoactive substances. The composition of kratom is complex; in fact, more than 40 different alkaloids have been identified in Mitragyna speciosa so far, the major constituent being mitragynine, which is exclusive to this plant. Besides mitragynine, alkaloids such as corynantheidine and 7-hydroxamitragynine also present pharmacological effects, a feature that may be attributed to the remaining constituents as well. The main goal of this review is not only to understand the origin, chemistry, consumption, and analytical methodologies for analysis and mechanism of action, but also the use of secondary metabolites of kratom as therapeutic drugs and the assessment of potential risks associated with its consumption, in order to aid health professionals, toxicologists, and police authorities in cases where this plant is present.
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Affiliation(s)
- Vânia Meireles
- Centro de Investigação em Ciências da Saúde, Faculdade de Ciências da Saúde da Universidade da Beira Interior (CICS-UBI), 6200-506 Covilhã, Portugal.
| | - Tiago Rosado
- Centro de Investigação em Ciências da Saúde, Faculdade de Ciências da Saúde da Universidade da Beira Interior (CICS-UBI), 6200-506 Covilhã, Portugal.
| | - Mário Barroso
- Serviço de Química e Toxicologia Forenses, Instituto de Medicina Legal e Ciências Forenses-Delegação do Sul, 1169-201 Lisboa, Portugal.
| | - Sofia Soares
- Centro de Investigação em Ciências da Saúde, Faculdade de Ciências da Saúde da Universidade da Beira Interior (CICS-UBI), 6200-506 Covilhã, Portugal.
| | - Joana Gonçalves
- Centro de Investigação em Ciências da Saúde, Faculdade de Ciências da Saúde da Universidade da Beira Interior (CICS-UBI), 6200-506 Covilhã, Portugal.
| | - Ângelo Luís
- Centro de Investigação em Ciências da Saúde, Faculdade de Ciências da Saúde da Universidade da Beira Interior (CICS-UBI), 6200-506 Covilhã, Portugal.
| | - Débora Caramelo
- Centro de Investigação em Ciências da Saúde, Faculdade de Ciências da Saúde da Universidade da Beira Interior (CICS-UBI), 6200-506 Covilhã, Portugal.
| | - Ana Y Simão
- Centro de Investigação em Ciências da Saúde, Faculdade de Ciências da Saúde da Universidade da Beira Interior (CICS-UBI), 6200-506 Covilhã, Portugal.
| | - Nicolás Fernández
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Cátedra de Toxicología y Química Legal, Laboratorio de Asesoramiento Toxicológico Analítico (CENATOXA). Junín 956 7mo piso. Ciudad Autónoma de Buenos Aires (CABA), Buenos Aires C1113AAD, Argentina.
| | - Ana Paula Duarte
- Centro de Investigação em Ciências da Saúde, Faculdade de Ciências da Saúde da Universidade da Beira Interior (CICS-UBI), 6200-506 Covilhã, Portugal.
| | - Eugenia Gallardo
- Centro de Investigação em Ciências da Saúde, Faculdade de Ciências da Saúde da Universidade da Beira Interior (CICS-UBI), 6200-506 Covilhã, Portugal.
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Osman AG, Haider S, Chittiboyina AG, Khan IA. Utility of alkaloids as chemical and biomarkers for quality, efficacy, and safety assessment of botanical ingredients. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2019; 54:347-356. [PMID: 30837071 DOI: 10.1016/j.phymed.2018.03.064] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 02/04/2018] [Accepted: 03/26/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Selecting the appropriate chemical and bio-markers for monitoring the quality, efficacy, and safety is critical for efficient and reliable assessment of traditional medicines derived from botanical sources. Chemical markers have been implicated primarily in establishing the analytical methodologies aiming at verification of the botanical sources of the raw materials, the extracts, and the finished products such as botanical dietary supplements and nutraceuticals. In addition, they have been employed in differentiation between crude or raw (unprocessed) and processed plant extracts, and identification as well as determination of potential toxicants and adulterants in herbal medicines. Additionally, these chemical markers are utilized for selection of efficient methods for extraction of plants. Further, biomarkers have been exploited in determination of the pharmacokinetic properties of bioactive herbal constituents. Alkaloids, unlike other plant constituents, are uniquely characterized by having basic properties, and possessing substantial and diverse pharmacological effects. These features make alkaloids attractive components for functioning as chemical and biomarkers in determining the quality of botanical ingredients where this class of phytochemicals prevail or is responsible for lending biological effects. PURPOSE The aim of the review is to exhibit the function of alkaloids as biomarkers and chemical markers in the evaluation of quality, efficacy, and safety of medicinal herbs and their commercial products. METHODS Literature acquisition was accomplished using the most commonly accessed scholarly search engines including SciFinder, PubMed, and Google Scholar. Secondly, the full-texts which are relevant to the topic were included in this review. This was followed by a thorough and detailed analysis of the collected information. RESULTS The literature search with main emphasis on the roles of alkaloids in the evaluation of quality, efficacy and safety of herbal medicines was evaluated to provide all succinct information in one place. Compilation of such critical information is expected to help the reader to appreciate alkaloids as important markers in the quality control of herbal drugs and products. CONCLUSION The current review article covers the fundamental roles played by alkaloids as chemical and biomarkers in assessing the essential parameters of the quality of botanical ingredients, as briefly described earlier. The utilization of alkaloids as biomarkers to determine the efficacy-linked pharmacokinetic parameters is limited to reviewing studies on human subjects.
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Affiliation(s)
- Ahmed G Osman
- National Center for Natural Products Research, University of Mississippi, University, MS 38677, USA
| | - Saqlain Haider
- National Center for Natural Products Research, University of Mississippi, University, MS 38677, USA
| | - Amar G Chittiboyina
- National Center for Natural Products Research, University of Mississippi, University, MS 38677, USA.
| | - Ikhlas A Khan
- National Center for Natural Products Research, University of Mississippi, University, MS 38677, USA; Division of Pharmacognosy, Department of BioMolecular Sciences, School of Pharmacy, University of Mississippi, University, MS 38677, USA.
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Abstract
Neonatal abstinence syndrome (NAS) secondary to maternal drug use is a well-recognized clinical entity. We present a novel case of moderately severe NAS in a term infant whose mother was self-medicating with kratom tea. The baby required oral morphine for NAS. After 12 days in neonatal intensive care unit, she was discharged on oral morphine which was discontinued after 2 months. Kratom, a psychoactive herb with opioid activity, has traditionally been used as a stimulant to boost energy, cure cough, depression, pain, sickness and a substitute for opium. Although well known in South East Asia and Africa, this drug is less familiar to physicians in North America. It is undetectable by standard urine drug screening and is being sold as a legal herbal remedy. This is the first report of a newborn developing significant NAS after maternal use of kratom tea. We believe physicians should be aware of this 'new' risk to newborns.
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Affiliation(s)
- Prashanth Murthy
- Department of Pediatrics, Rockyview General Hospital Calgary, Cumming School of Medicine, University of Calgary, Calgary, Alberta
| | - Deborah Clark
- Department of Pediatrics, Rockyview General Hospital Calgary, Cumming School of Medicine, University of Calgary, Calgary, Alberta
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Wright TH. Suspected Driving Under the Influence Case Involving Mitragynine. J Anal Toxicol 2018; 42:e65-e68. [DOI: 10.1093/jat/bky028] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Indexed: 10/17/2022] Open
Affiliation(s)
- Trista H Wright
- Virginia Department of Forensic Science, 6600 Northside High School Rd, Roanoke, VA, USA
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Basiliere S, Bryand K, Kerrigan S. Identification of five Mitragyna alkaloids in urine using liquid chromatography-quadrupole/time of flight mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 2018; 1080:11-19. [PMID: 29459087 DOI: 10.1016/j.jchromb.2018.02.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 02/08/2018] [Accepted: 02/09/2018] [Indexed: 12/31/2022]
Abstract
Mitragyna speciosa (Kratom) is a psychoactive plant that has recently emerged as a recreational drug. Mitragyna alkaloids are not within the scope of traditional forensic toxicology screening methods, which may contribute to under-reporting. Solid phase extraction (SPE) and liquid chromatography-quadrupole/time of flight mass spectrometry (LC-Q/TOF-MS) were used to identify five alkaloids in urine. Target analytes included the two known psychoactive compounds, mitragynine and 7-hydroxymitragynine, in addition to speciociliatine, speciogynine, and paynantheine. Two deuterated internal standards (mitragynine-D3 and 7-hydroxymitragynine-D3) were employed. Using traditional reversed phase chromatography all compounds and isomers were separated in 10 min. The procedure was validated in accordance with the Scientific Working Group for Forensic Toxicology (SWGTOX) Standard Practices for Method Validation. Extraction efficiencies were 63-96% and limits of quantitation were 0.5-1 ng/mL. Precision, bias and matrix effects were all within acceptable thresholds, with the exception of 7-hydroxymitragynine, which is notably unstable and unsuitable for quantitative analysis. In this paper we present a simultaneous quantitative analytical method for mitragynine, speciociliatine, speciogynine and paynantheine, and a qualitative assay for 7-hydroxymitragynine in urine using high resolution mass spectrometry (HRMS).
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Affiliation(s)
- Stephanie Basiliere
- Department of Forensic Science, Sam Houston State University, Huntsville, TX 77341, United States
| | - Kelsie Bryand
- Department of Forensic Science, Sam Houston State University, Huntsville, TX 77341, United States
| | - Sarah Kerrigan
- Department of Forensic Science, Sam Houston State University, Huntsville, TX 77341, United States.
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Limsuwanchote S, Putalun W, Tanaka H, Morimoto S, Keawpradub N, Wungsintaweekul J. Development of an immunochromatographic strip incorporating anti-mitragynine monoclonal antibody conjugated to colloidal gold for kratom alkaloids detection. Drug Test Anal 2017; 10:1168-1175. [PMID: 29287305 DOI: 10.1002/dta.2354] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 12/09/2017] [Accepted: 12/20/2017] [Indexed: 02/01/2023]
Abstract
A lateral flow-based immunochromatographic strip was developed for the rapid detection of mitragynine (MG), a dominant alkaloid found in the leaves of kratom. Monoclonal antibody (mAb) against MG (anti-MG mAb) was conjugated to colloidal gold and used as a recognition probe. MG-ovalbumin conjugate (MG-OVA) and goat anti-mouse IgG were immobilized on the strip to produce a test zone and control zone, respectively. Based on the principle of a competitive assay, MG in a test sample competed with MG-OVA resident in the test zone to bind with colloidal gold-anti-MG mAb, resulting in an inverse relation of color intensity at the test zone and MG amount. The limit of detection (LOD) of the immunochromatographic strip is determined at 1 mg/mL of MG by visual assessment and 0.60 mg/mL by Image J analysis. The developed immunochromatographic strip can determine MG in kratom cocktails and kratom leaf samples. It could serve as a rapid and simple diagnostic kit for the detection of MG in kratom samples.
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Affiliation(s)
- Supattra Limsuwanchote
- Department of Pharmacognosy and Pharmaceutical Botany, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Songkhla, Thailand
- Department of Pharmacology, Faculty of Science, Prince of Songkla University, Songkhla, Thailand
| | - Waraporn Putalun
- Faculty of Pharmaceutical Sciences, Khon Kaen University, Thailand
| | - Hiroyuki Tanaka
- Department of Pharmacognosy, Graduate School of Pharmaceutical Sciences, Kyushu University, Fukuoka, Japan
| | - Satoshi Morimoto
- Department of Pharmacognosy, Graduate School of Pharmaceutical Sciences, Kyushu University, Fukuoka, Japan
| | - Niwat Keawpradub
- Department of Pharmacognosy and Pharmaceutical Botany, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Songkhla, Thailand
| | - Juraithip Wungsintaweekul
- Department of Pharmacognosy and Pharmaceutical Botany, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Songkhla, Thailand
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Lee MJ, Ramanathan S, Mansor SM, Yeong KY, Tan SC. Method validation in quantitative analysis of phase I and phase II metabolites of mitragynine in human urine using liquid chromatography-tandem mass spectrometry. Anal Biochem 2017; 543:146-161. [PMID: 29248503 DOI: 10.1016/j.ab.2017.12.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Revised: 11/30/2017] [Accepted: 12/13/2017] [Indexed: 11/17/2022]
Abstract
A method using solid phase extraction and liquid chromatography-tandem mass spectrometry to quantitatively detect mitragynine, 16-carboxy mitragynine, and 9-O-demethyl mitragynine in human urine samples was developed and validated. The relevant metabolites were identified using multiple reaction monitoring in positive ionization mode using nalorphine as an internal standard. The method was validated for accuracy, precision, recovery, linearity, and lower limit of quantitation. The intra- and inter-day accuracy and precision were found in the range of 83.6-117.5% with coefficient of variation less than 13%. The percentage of recovery for mitragynine, 16-carboxy mitragynine, and 9-O-demethyl mitragynine was within the range of 80.1-118.9%. The lower limit of quantification was 1 ng/mL for mitragynine, 2 ng/mL for 16-carboxy mitragynine, and 50 ng/mL for 9-O-demethyl mitragynine. The developed method was reproducible, high precision and accuracy with good linearity and recovery for mitragynine, 16-carboxy mitragynine, and 9-O-demethyl mitragynine in human urine.
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Affiliation(s)
- Mei Jin Lee
- Institute for Research in Molecular Medicine (INFORMM), Main Campus, Universiti Sains Malaysia, 11800, Penang, Malaysia.
| | - Surash Ramanathan
- Centre for Drug Research (CDR), Main Campus, Universiti Sains Malaysia, 11800, Penang, Malaysia
| | - Sharif Mahsufi Mansor
- Centre for Drug Research (CDR), Main Campus, Universiti Sains Malaysia, 11800, Penang, Malaysia
| | - Keng Yoon Yeong
- Institute for Research in Molecular Medicine (INFORMM), Main Campus, Universiti Sains Malaysia, 11800, Penang, Malaysia; School of Science, Monash University Malaysia Campus, Jalan Lagoon Selatan, Bandar Sunway, 47500, Selangor, Malaysia
| | - Soo Choon Tan
- Institute for Research in Molecular Medicine (INFORMM), Main Campus, Universiti Sains Malaysia, 11800, Penang, Malaysia.
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Suhaimi FW, Yusoff NHM, Hassan R, Mansor SM, Navaratnam V, Müller CP, Hassan Z. Neurobiology of Kratom and its main alkaloid mitragynine. Brain Res Bull 2016; 126:29-40. [PMID: 27018165 DOI: 10.1016/j.brainresbull.2016.03.015] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 03/22/2016] [Accepted: 03/23/2016] [Indexed: 12/17/2022]
Abstract
Kratom or its main alkaloid, mitragynine is derived from the plant Mitragyna speciosa Korth which is indigenous to Southeast Asian countries. This substance has become widely available in other countries like Europe and United States due to its opium- and coca-like effects. In this article, we have reviewed available reports on mitragynine and other M. speciosa extracts. M. speciosa has been proven to have a rewarding effect and is effective in alleviating the morphine and ethanol withdrawal effects. However, studies in human revealed that prolonged consumption of this plant led to dependence and tolerance while cessation caused a series of aversive withdrawal symptoms. Findings also showed that M. speciosa extracts possess antinociceptive, anti-inflammatory, anti-depressant, and muscle relaxant properties. Available evidence further supports the adverse effects of M. speciosa preparations, mitragynine on cognition. Pharmacological activities are mainly mediated via opioid receptors as well as neuronal Ca2+ channels, expression of cAMP and CREB protein and via descending monoaminergic system. Physicochemical properties of mitragynine have been documented which may further explain the variation in pharmacological responses. In summary, current researchs on its main indole alkaloid, mitragynine suggest both therapeutic and addictive potential but further research on its molecular effects is needed.
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Affiliation(s)
- Farah W Suhaimi
- Centre for Drug Research, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia
| | - Nurul H M Yusoff
- Centre for Drug Research, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia
| | - Rahimah Hassan
- Centre for Drug Research, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia
| | - Sharif M Mansor
- Centre for Drug Research, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia
| | | | - Christian P Müller
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-University Erlangen-Nuremberg, Schwabachanlage 6, 91054 Erlangen, Germany
| | - Zurina Hassan
- Centre for Drug Research, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia.
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Guddat S, Görgens C, Steinhart V, Schänzer W, Thevis M. Mitragynine (Kratom) - monitoring in sports drug testing. Drug Test Anal 2016; 8:1114-1118. [DOI: 10.1002/dta.1970] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 02/10/2016] [Accepted: 02/10/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Sven Guddat
- German Sport University Cologne; Institute of Biochemistry and Center of Preventive Doping Research; Cologne Germany
| | - Christian Görgens
- German Sport University Cologne; Institute of Biochemistry and Center of Preventive Doping Research; Cologne Germany
| | - Vanessa Steinhart
- German Sport University Cologne; Institute of Biochemistry and Center of Preventive Doping Research; Cologne Germany
| | - Wilhelm Schänzer
- German Sport University Cologne; Institute of Biochemistry and Center of Preventive Doping Research; Cologne Germany
| | - Mario Thevis
- German Sport University Cologne; Institute of Biochemistry and Center of Preventive Doping Research; Cologne Germany
- European Monitoring Center for Emerging Doping Agents (EuMoCEDA); Cologne/Bonn Germany
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Oliveira AS, Fraga S, Carvalho F, Araújo AM, Pereira CC, Teixeira JP, de Lourdes Bastos M, de Pinho PG. Chemical characterization and in vitro cyto- and genotoxicity of ‘legal high’ products containing Kratom (Mitragyna speciosa). Forensic Toxicol 2016. [DOI: 10.1007/s11419-015-0305-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Screening and Identification of Mitragynine and 7-Hydroxymitragynine in Human Urine by LC-MS/MS. CHROMATOGRAPHY 2015. [DOI: 10.3390/chromatography2020253] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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36
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Rapid detection by direct analysis in real time-mass spectrometry (DART-MS) of psychoactive plant drugs of abuse: The case of Mitragyna speciosa aka “Kratom”. Forensic Sci Int 2014; 242:210-218. [DOI: 10.1016/j.forsciint.2014.07.005] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Revised: 06/28/2014] [Accepted: 07/01/2014] [Indexed: 11/20/2022]
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Abstract
Kratom use is a growing problem in the United States. Kratom exposures reported to Texas poison centers between January 1998 and September 2013 were identified. No kratom exposures were reported from 1998 to 2008 and 14 exposures were reported from 2009 to September 2013. Eleven patients were male, and 11 patients were in their 20s. The kratom was ingested in 12 patients, inhaled in 1, and both ingested and inhaled in 1. Twelve patients were managed at a healthcare facility and the remaining 2 were managed at home.
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Vuppala PK, Jamalapuram S, Furr EB, McCurdy CR, Avery BA. Development and validation of a UPLC-MS/MS method for the determination of 7-hydroxymitragynine, a μ-opioid agonist, in rat plasma and its application to a pharmacokinetic study. Biomed Chromatogr 2013; 27:1726-32. [PMID: 23893615 DOI: 10.1002/bmc.2986] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2013] [Revised: 05/29/2013] [Accepted: 05/29/2013] [Indexed: 11/11/2022]
Abstract
A simple, sensitive and specific ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method was developed and validated to determine the concentrations of 7-hydroxymitragynine in rat plasma. Following a single-step liquid-liquid extraction of plasma samples using chloroform, 7-hydroxymitragynine and the internal standard (tryptoline) were separated on an Acquity UPLC(TM) BEH C18 (1.7 µm, 2.1 × 50 mm) column using an isocratic elution at a flow rate of 0.2 mL/min. The mobile phase consisted of 0.1% acetic acid in water and 0.1% acetic acid in acetonitrile (10:90, v/v). The run time was 2.5 min. The analysis was carried out under the multiple reaction-monitoring mode using positive electrospray ionization. Protonated ions [M + H](+) and their respective product ions were monitored at the following transitions: 415 → 190 for 7-hydroxymitragynine and 173 → 144 for the internal standard. The calibration curve was linear over the range of 10-4000 ng/mL (r(2) = 0.999) with a lower limit of quantification of 10 ng/mL. The extraction recoveries ranged from 62.0 to 67.3% at concentrations of 20, 600 and 3200 ng/mL). Intra- and inter-day assay precisions (relative standard deviation) were <15% and the accuracy was within 96.5-104.0%. This validated method was successfully applied to quantify 7-hydroxymitragynine in rat plasma following intravenous administration.
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Affiliation(s)
- Pradeep K Vuppala
- Department of Pharmaceutics, School of Pharmacy, The University of Mississippi, University, MS, 38677, USA
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39
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Hassan Z, Muzaimi M, Navaratnam V, Yusoff NHM, Suhaimi FW, Vadivelu R, Vicknasingam BK, Amato D, von Hörsten S, Ismail NIW, Jayabalan N, Hazim AI, Mansor SM, Müller CP. From Kratom to mitragynine and its derivatives: physiological and behavioural effects related to use, abuse, and addiction. Neurosci Biobehav Rev 2012. [PMID: 23206666 DOI: 10.1016/j.neubiorev.2012.11.012] [Citation(s) in RCA: 216] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Kratom (or Ketum) is a psychoactive plant preparation used in Southeast Asia. It is derived from the plant Mitragyna speciosa Korth. Kratom as well as its main alkaloid, mitragynine, currently spreads around the world. Thus, addiction potential and adverse health consequences are becoming an important issue for health authorities. Here we reviewed the available evidence and identified future research needs. It was found that mitragynine and M. speciosa preparations are systematically consumed with rather well defined instrumentalization goals, e.g. to enhance tolerance for hard work or as a substitute in the self-treatment of opiate addiction. There is also evidence from experimental animal models supporting analgesic, muscle relaxant, anti-inflammatory as well as strong anorectic effects. In humans, regular consumption may escalate, lead to tolerance and may yield aversive withdrawal effects. Mitragynine and its derivatives actions in the central nervous system involve μ-opioid receptors, neuronal Ca²⁺ channels and descending monoaminergic projections. Altogether, available data currently suggest both, a therapeutic as well as an abuse potential.
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Affiliation(s)
- Zurina Hassan
- Centre for Drug Research, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia
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