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Kumar D, Khan B, Okcay Y, Sis ÇÖ, Abdallah A, Murray F, Sharma A, Uemura M, Taliyan R, Heinbockel T, Rahman S, Goyal R. Dynamic endocannabinoid-mediated neuromodulation of retinal circadian circuitry. Ageing Res Rev 2024; 99:102401. [PMID: 38964508 DOI: 10.1016/j.arr.2024.102401] [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: 10/04/2023] [Revised: 06/05/2024] [Accepted: 06/28/2024] [Indexed: 07/06/2024]
Abstract
Circadian rhythms are biological rhythms that originate from the "master circadian clock," called the suprachiasmatic nucleus (SCN). SCN orchestrates the circadian rhythms using light as a chief zeitgeber, enabling humans to synchronize their daily physio-behavioral activities with the Earth's light-dark cycle. However, chronic/ irregular photic disturbances from the retina via the retinohypothalamic tract (RHT) can disrupt the amplitude and the expression of clock genes, such as the period circadian clock 2, causing circadian rhythm disruption (CRd) and associated neuropathologies. The present review discusses neuromodulation across the RHT originating from retinal photic inputs and modulation offered by endocannabinoids as a function of mitigation of the CRd and associated neuro-dysfunction. Literature indicates that cannabinoid agonists alleviate the SCN's ability to get entrained to light by modulating the activity of its chief neurotransmitter, i.e., γ-aminobutyric acid, thus preventing light-induced disruption of activity rhythms in laboratory animals. In the retina, endocannabinoid signaling modulates the overall gain of the retinal ganglion cells by regulating the membrane currents (Ca2+, K+, and Cl- channels) and glutamatergic neurotransmission of photoreceptors and bipolar cells. Additionally, endocannabinoids signalling also regulate the high-voltage-activated Ca2+ channels to mitigate the retinal ganglion cells and intrinsically photosensitive retinal ganglion cells-mediated glutamate release in the SCN, thus regulating the RHT-mediated light stimulation of SCN neurons to prevent excitotoxicity. As per the literature, cannabinoid receptors 1 and 2 are becoming newer targets in drug discovery paradigms, and the involvement of endocannabinoids in light-induced CRd through the RHT may possibly mitigate severe neuropathologies.
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Affiliation(s)
- Deepak Kumar
- Department of Neuropharmacology, School of Pharmaceutical Sciences, Shoolini University of Biotechnology and Management Sciences, Solan, HP 173229, India.
| | - Bareera Khan
- Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Solan, HP 173229, India
| | - Yagmur Okcay
- University of Health Sciences Gulhane Faculty of Pharmacy Department of Pharmacology, Turkey.
| | - Çağıl Önal Sis
- University of Health Sciences Gulhane Faculty of Pharmacy Department of Pharmacology, Turkey.
| | - Aya Abdallah
- Institute of Medical Science, University of Aberdeen, Aberdeen, Scotland.
| | - Fiona Murray
- Institute of Medical Science, University of Aberdeen, Aberdeen, Scotland.
| | - Ashish Sharma
- School of Medicine, Washington University, St. Louis, USA
| | - Maiko Uemura
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
| | - Rajeev Taliyan
- Department of Pharmacy, Birla Institute of Technology Science, Pilani, Rajasthan 333301, India.
| | - Thomas Heinbockel
- Howard University College of Medicine, Department of Anatomy, Washington, DC 20059, USA
| | - Shafiqur Rahman
- Department of Pharmaceutical Sciences, College of Pharmacy South Dakota State University, Brookings, SD, USA.
| | - Rohit Goyal
- Department of Neuropharmacology, School of Pharmaceutical Sciences, Shoolini University of Biotechnology and Management Sciences, Solan, HP 173229, India.
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2
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D’Angelo M, Steardo L. Cannabinoids and Sleep: Exploring Biological Mechanisms and Therapeutic Potentials. Int J Mol Sci 2024; 25:3603. [PMID: 38612415 PMCID: PMC11011314 DOI: 10.3390/ijms25073603] [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: 02/08/2024] [Revised: 03/15/2024] [Accepted: 03/21/2024] [Indexed: 04/14/2024] Open
Abstract
The endogenous cannabinoid system (ECS) plays a critical role in the regulation of various physiological functions, including sleep, mood, and neuroinflammation. Phytocannabinoids such as Δ9-tetrahydrocannabinol (THC), cannabidiol (CBD), cannabinomimimetics, and some N-acylethanolamides, particularly palmitoyethanolamide, have emerged as potential therapeutic agents for the management of sleep disorders. THC, the psychoactive component of cannabis, may initially promote sleep, but, in the long term, alters sleep architecture, while CBD shows promise in improving sleep quality without psychoactive effects. Clinical studies suggest that CBD modulates endocannabinoid signaling through several receptor sites, offering a multifaceted approach to sleep regulation. Similarly, palmitoylethanolamide (PEA), in addition to interacting with the endocannabinoid system, acts as an agonist on peroxisome proliferator-activated receptors (PPARs). The favorable safety profile of CBD and PEA and the potential for long-term use make them an attractive alternative to conventional pharmacotherapy. The integration of the latter two compounds into comprehensive treatment strategies, together with cognitive-behavioral therapy for insomnia (CBT-I), represents a holistic approach to address the multifactorial nature of sleep disorders. Further research is needed to establish the optimal dosage, safety, and efficacy in different patient populations, but the therapeutic potential of CBD and PEA offers hope for improved sleep quality and general well-being.
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Affiliation(s)
| | - Luca Steardo
- Psychiatry Unit, Department of Health Sciences, University of Catanzaro Magna Graecia, 88100 Catanzaro, Italy;
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Aukema RJ, Baglot SL, Scheufen J, Lightfoot SH, Hill MN. Circadian Influence on Acute Stress-induced Changes in Cortico-limbic Endocannabinoid Levels in Adult Male Rats. Neuroscience 2024; 537:84-92. [PMID: 38006961 DOI: 10.1016/j.neuroscience.2023.11.026] [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: 08/14/2023] [Revised: 11/17/2023] [Accepted: 11/20/2023] [Indexed: 11/27/2023]
Abstract
The endocannabinoid (eCB) system plays an important role in regulating the stress response, including glucocorticoid release and the generation of avoidance behaviour. Its two major ligands, 2-arachidonoylglycerol (2-AG) and N-arachidonoylethanolamine (anandamide; AEA), are dynamically influenced by psychological stress to gate the generation of the stress response and facilitate recovery upon stress termination. Many biological systems exhibit circadian "daily" rhythms, including glucocorticoids and endocannabinoids, and the behavioural and endocrine impact of stress is modulated by the time of day. Nonetheless, most preclinical experiments investigating the interaction between stress and endocannabinoids occur in the light, "inactive" phase. We therefore tested if circadian phase influences stress-induced changes in eCB levels in the hippocampus (HIP), prefrontal cortex (PFC), and amygdala (AMY). Adult male rats were exposed to 15 min swim stress or immediately euthanized, and brains were collected. Testing occurred either early in the light or early in the dark phase of their cycle to compare circadian effects. We found that overall, stress decreased AEA in the AMY and HIP, with an effect in the PFC dependent on the time of day. Conversely, stress increased 2-AG in the AMY, with an effect in the PFC and HIP dependent on the time of day. This suggests that stress has a similar overall impact on eCB levels regardless of circadian phase, but that subtle differences may occur depending on the brain region, especially the PFC.
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Affiliation(s)
- Robert J Aukema
- Hotchkiss Brain Institute, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada; Mathison Centre for Mental Health, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada
| | - Samantha L Baglot
- Hotchkiss Brain Institute, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada; Mathison Centre for Mental Health, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada
| | - Jessica Scheufen
- Hotchkiss Brain Institute, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada; Mathison Centre for Mental Health, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada
| | - Savannah Hm Lightfoot
- Hotchkiss Brain Institute, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada; Mathison Centre for Mental Health, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada
| | - Matthew N Hill
- Hotchkiss Brain Institute, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada; Mathison Centre for Mental Health, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada; Department of Cell Biology and Anatomy, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada; Department of Psychiatry, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada.
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4
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Cao Q, Zeng H, Liu F, Wang Y, Zhang P, Yin J, Xu F, Weng X. Changes in brain function and heart sound in acute sleep deprivation individuals. Sleep Med 2024; 113:249-259. [PMID: 38064797 DOI: 10.1016/j.sleep.2023.11.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/29/2023] [Accepted: 11/27/2023] [Indexed: 01/07/2024]
Abstract
AIMS Sleep deprivation (SD) has become a health problem in modern society due to its adverse effects on different aspects. However, the relationship between sleep and cardiovascular system function remains unclear. Here we explored the changes occurring in the brain and the heart sounds after SD. METHODS Ninety healthy adult men were recruited and subjected to 36 h of Sleep Deprivation (SD). They participated in a number of tests, including measurements of the heart sound, blood oxygen, and heart rate every 2 h. By using of principal component analysis to reduced the dimensionality of heart sound data. While the ALFF and ReHo indexes were measured via fMRI before and after SD. Correlation and regression analyses were used to reveal the relationship between fMRI and heart sound changes due to SD. RESULTS In this study, there were no abnormal values in the heart rate and blood oxygen during 36 h of SD, whereas the intensity of heart sounds fluctuated significantly increased and decreased. The ALFF was increased in bilateral pericalcarine(Calcarine), left anterior cuneus, (Precuneus_L), right superior temporal gyrus(Temporal_Sup_R), left supplementary motor area (Supp_Motor_Area_L); However, it was reduced in the right medial superior frontal gyrus (Frontal_Sup_Medial_R), right dorsolateral superior frontal gyrus (Frontal_Sup_R) and left medial frontal gyrus (Frontal_Mid_L). The regression analysis uncovered that the intensity of the heart sound in the systole, s1, and s2 phase could be explained by Calcarine_L changes. CONCLUSION Acute sleep deprivation affects cardiac-brain axis and the specific brain regions. Calcarine_L changes during sleep deprivation are involved in regulating heart contractions.
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Affiliation(s)
- Qiongfang Cao
- Department of Public Health, Chengdu Medical College, Sichuan, 610500, China
| | - Hanrui Zeng
- Department of Clinic Medicine, Chengdu Medical College, Sichuan, 610500, China
| | - Fangfang Liu
- Art College, Southwest Minzu University, Sichuan, 610041, China
| | - Yuhan Wang
- Department of Public Health, Chengdu Medical College, Sichuan, 610500, China
| | - Peng Zhang
- Department of Public Health, Chengdu Medical College, Sichuan, 610500, China
| | - Jie Yin
- Department of Neuroscience, Beijing Institute of Basic Medical Sciences, Beijing, 100850, China
| | - Fan Xu
- Department of Public Health, Chengdu Medical College, Sichuan, 610500, China.
| | - Xiechuan Weng
- Department of Neuroscience, Beijing Institute of Basic Medical Sciences, Beijing, 100850, China.
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Meira E Cruz M. Modulatory mechanisms of cannabinoids as a window of hope to patients with sleep-related cardiometabolic risk. Biomed Pharmacother 2023; 168:115721. [PMID: 37852101 DOI: 10.1016/j.biopha.2023.115721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 10/08/2023] [Accepted: 10/11/2023] [Indexed: 10/20/2023] Open
Affiliation(s)
- Miguel Meira E Cruz
- Sleep Unit, Centro Cardiovascular da Universidade de Lisboa, Lisbon School of Medicine, Lisbon, Portugal; Centro Europeu do Sono, Lisbon, Portugal.
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6
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Hitzler M, Matits L, Gumpp AM, Bach AM, Ziegenhain U, Gao W, Kolassa IT, Behnke A. Longitudinal course of endocannabinoids and N-acylethanolamines in hair of mothers and their children in the first year postpartum: investigating the relevance of maternal childhood maltreatment experiences. Psychol Med 2023; 53:7446-7457. [PMID: 37198936 PMCID: PMC10719681 DOI: 10.1017/s0033291723001204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/10/2023] [Accepted: 04/11/2023] [Indexed: 05/19/2023]
Abstract
BACKGROUND Childhood maltreatment (CM) exerts long-lasting psychological and biological alterations in affected individuals and might also affect the endocannabinoid (eCB) system which modulates inflammation and the endocrine stress response. Here, we investigated the eCB system of women with and without CM and their infants using hair samples representing eCB levels accumulated during the last trimester of pregnancy and 10-12 months postpartum. METHODS CM exposure was assessed with the Childhood Trauma Questionnaire. At both timepoints, 3 cm hair strands were collected from mothers and children (N = 170 resp. 150) to measure anandamide (AEA), 2/1-arachidonoylglycerol (2-AG/1-AG), stearoylethanolamide (SEA), oleoylethanolamide (OEA), and palmitoylethanolamide (PEA). RESULTS Maternal hair levels of 2-AG/1-AG increased and SEA levels decreased from late pregnancy to one year postpartum. Maternal CM was associated with lower SEA levels in late pregnancy, but not one year later. In the children's hair, levels of 2-AG/1-AG increased while levels of SEA, OEA, and PEA decreased from late pregnancy to one year later. Maternal CM was not consistently associated with the eCB levels measured in children's hair. CONCLUSIONS We provide first evidence for longitudinal change in the eCB system of mothers and infants from pregnancy to one year later. While maternal CM influenced the maternal eCB system, we found no consistent intergenerational effects on early regulation of the eCB system in children. Longitudinal research on the importance of the eCB system for the course and immunoregulation of pregnancy as well as for the children's development.
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Affiliation(s)
- Melissa Hitzler
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Lynn Matits
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
- Division of Sports and Rehabilitation Medicine, Department of Medicine, Ulm University Hospital, Ulm, Germany
| | - Anja M. Gumpp
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Alexandra M. Bach
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Ute Ziegenhain
- Department of Child and Adolescent Psychiatry, Ulm University Hospital, Ulm, Germany
| | - Wei Gao
- Department of Biopsychology, Technische Universität Dresden, Dresden, Germany
| | - Iris-Tatjana Kolassa
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Alexander Behnke
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
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7
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Low ZXB, Lee XR, Soga T, Goh BH, Alex D, Kumari Y. Cannabinoids: Emerging sleep modulator. Biomed Pharmacother 2023; 165:115102. [PMID: 37406510 DOI: 10.1016/j.biopha.2023.115102] [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: 04/20/2023] [Revised: 06/28/2023] [Accepted: 06/28/2023] [Indexed: 07/07/2023] Open
Abstract
Sleep is an essential biological phase of our daily life cycle and is necessary for maintaining homeostasis, alertness, metabolism, cognition, and other key functions across the animal kingdom. Dysfunctional sleep leads to deleterious effects on health, mood, and cognition, including memory deficits and an increased risk of diabetes, stroke, and neurological disorders. Sleep is regulated by several brain neuronal circuits, neuromodulators, and neurotransmitters, where cannabinoids have been increasingly found to play a part in its modulation. Cannabinoids, a group of lipid metabolites, are regulatory molecules that bind mainly to cannabinoid receptors (CB1 and CB2). Much evidence supports the role of cannabinoid receptors in the modulation of sleep, where their alteration exhibits sleep-promoting effects, including an increase in non-rapid-eye movement sleep and a reduction in sleep latency. However, the pharmacological alteration of CB1 receptors is associated with adverse psychotropic effects, which are not exhibited in CB2 receptor alteration. Hence, selective alteration of CB2 receptors is also of clinical importance, where it could potentially be used in treating sleep disorders. Thus, it is crucial to understand the neurobiological basis of cannabinoids in sleep physiology. In this review article, the alteration of the endocannabinoid system by various cannabinoids and their respective effects on the sleep-wake cycle are discussed based on recent findings. The mechanisms of the cannabinoid receptors on sleep and wakefulness are also explored for their clinical implications and potential therapeutic use on sleep disorders.
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Affiliation(s)
- Zhen Xuen Brandon Low
- Neurological Disorder and Aging Research Group (NDA), Neuroscience Research Strength (NRS), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, 47500 Selangor, Malaysia
| | - Xin Ru Lee
- Neurological Disorder and Aging Research Group (NDA), Neuroscience Research Strength (NRS), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, 47500 Selangor, Malaysia
| | - Tomoko Soga
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, 47500 Selangor, Malaysia
| | - Bey Hing Goh
- Biofunctional Molecule Exploratory Research Group, School of Pharmacy, Monash University Malaysia, Bandar Sunway, Selangor Darul Ehsan 47500, Malaysia; College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
| | - Deepa Alex
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, 47500 Selangor, Malaysia
| | - Yatinesh Kumari
- Neurological Disorder and Aging Research Group (NDA), Neuroscience Research Strength (NRS), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, 47500 Selangor, Malaysia.
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Kaufmann CN, Malhotra A, Yang KH, Han BH, Nafsu R, Lifset ET, Nguyen K, Sexton M, Moore AA. Cannabis use for Sleep Disturbance Among Older Patients in a Geriatrics Clinic. Int J Aging Hum Dev 2023; 97:3-17. [PMID: 36226368 PMCID: PMC10097827 DOI: 10.1177/00914150221128971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cannabis use is growing among older adults to manage medical concerns including poor sleep. In this study, we characterized how patients seen at a geriatrics clinic use cannabis to address sleep disturbance. Specifically, we conducted an anonymous survey of 568 adults, including 83 who reported cannabis use within the past 3 years, to inquire about such use. We compared cannabis use characteristics between those using it for sleep disturbance versus all other conditions. We considered a p-value <.10 to be statistically significant. Among the cannabis users in our sample, 29% reported using cannabis for sleep disturbance (N = 24). They were more likely than other users to be female (p = .07), consume cannabis more frequently (p = .01), use products containing tetrahydrocannabinol (THC) (vs. cannabidiol [CBD]-only; p < .01), and use cannabis to target more symptoms (p < .01). As cannabis use continues to grow in older populations, it is essential to delineate better how cannabis may be used safely and effectively to improve older adults' sleep health.
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Affiliation(s)
- Christopher N. Kaufmann
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL, USA
| | - Atul Malhotra
- Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, University of California San Diego, La Jolla, CA, USA
| | - Kevin H. Yang
- Department of Medicine, Division of Geriatrics, Gerontology, and Palliative Care, University of California San Diego, La Jolla, CA, USA
| | - Benjamin H. Han
- Department of Medicine, Division of Geriatrics, Gerontology, and Palliative Care, University of California San Diego, La Jolla, CA, USA
| | - Reva Nafsu
- Department of Medicine, Division of Geriatrics, Gerontology, and Palliative Care, University of California San Diego, La Jolla, CA, USA
| | - Ella T. Lifset
- Department of Medicine, Division of Geriatrics, Gerontology, and Palliative Care, University of California San Diego, La Jolla, CA, USA
| | - Khai Nguyen
- Department of Medicine, Division of Geriatrics, Gerontology, and Palliative Care, University of California San Diego, La Jolla, CA, USA
| | - Michelle Sexton
- Department of Anesthesiology, University of California San Diego, La Jolla, CA, USA
| | - Alison A. Moore
- Department of Medicine, Division of Geriatrics, Gerontology, and Palliative Care, University of California San Diego, La Jolla, CA, USA
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Morrone CD, Raghuraman R, Hussaini SA, Yu WH. Proteostasis failure exacerbates neuronal circuit dysfunction and sleep impairments in Alzheimer's disease. Mol Neurodegener 2023; 18:27. [PMID: 37085942 PMCID: PMC10119020 DOI: 10.1186/s13024-023-00617-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 03/29/2023] [Indexed: 04/23/2023] Open
Abstract
Failed proteostasis is a well-documented feature of Alzheimer's disease, particularly, reduced protein degradation and clearance. However, the contribution of failed proteostasis to neuronal circuit dysfunction is an emerging concept in neurodegenerative research and will prove critical in understanding cognitive decline. Our objective is to convey Alzheimer's disease progression with the growing evidence for a bidirectional relationship of sleep disruption and proteostasis failure. Proteostasis dysfunction and tauopathy in Alzheimer's disease disrupts neurons that regulate the sleep-wake cycle, which presents behavior as impaired slow wave and rapid eye movement sleep patterns. Subsequent sleep loss further impairs protein clearance. Sleep loss is a defined feature seen early in many neurodegenerative disorders and contributes to memory impairments in Alzheimer's disease. Canonical pathological hallmarks, β-amyloid, and tau, directly disrupt sleep, and neurodegeneration of locus coeruleus, hippocampal and hypothalamic neurons from tau proteinopathy causes disruption of the neuronal circuitry of sleep. Acting in a positive-feedback-loop, sleep loss and circadian rhythm disruption then increase spread of β-amyloid and tau, through impairments of proteasome, autophagy, unfolded protein response and glymphatic clearance. This phenomenon extends beyond β-amyloid and tau, with interactions of sleep impairment with the homeostasis of TDP-43, α-synuclein, FUS, and huntingtin proteins, implicating sleep loss as an important consideration in an array of neurodegenerative diseases and in cases of mixed neuropathology. Critically, the dynamics of this interaction in the neurodegenerative environment are not fully elucidated and are deserving of further discussion and research. Finally, we propose sleep-enhancing therapeutics as potential interventions for promoting healthy proteostasis, including β-amyloid and tau clearance, mechanistically linking these processes. With further clinical and preclinical research, we propose this dynamic interaction as a diagnostic and therapeutic framework, informing precise single- and combinatorial-treatments for Alzheimer's disease and other brain disorders.
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Affiliation(s)
- Christopher Daniel Morrone
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, 250 College St., Toronto, ON, M5T 1R8, Canada.
| | - Radha Raghuraman
- Taub Institute, Columbia University Irving Medical Center, 630W 168th Street, New York, NY, 10032, USA
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, 630W 168th Street, New York, NY, 10032, USA
| | - S Abid Hussaini
- Taub Institute, Columbia University Irving Medical Center, 630W 168th Street, New York, NY, 10032, USA.
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, 630W 168th Street, New York, NY, 10032, USA.
| | - Wai Haung Yu
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, 250 College St., Toronto, ON, M5T 1R8, Canada.
- Geriatric Mental Health Research Services, Centre for Addiction and Mental Health, 250 College St., Toronto, ON, M5T 1R8, Canada.
- Department of Pharmacology and Toxicology, University of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada.
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10
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Cooke ME, Potter KW, Jashinski J, Pascale M, Schuster RM, Tervo-Clemmens B, Hoeppner BB, Pachas GN, Evins AE, Gilman JM. Development of cannabis use disorder in medical cannabis users: A 9-month follow-up of a randomized clinical trial testing effects of medical cannabis card ownership. Front Psychiatry 2023; 14:1083334. [PMID: 36960460 PMCID: PMC10027723 DOI: 10.3389/fpsyt.2023.1083334] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 02/13/2023] [Indexed: 03/09/2023] Open
Abstract
Background Evidence for long-term effectiveness of commercial cannabis products used to treat medical symptoms is inconsistent, despite increasingly widespread use. Objective To prospectively evaluate the effects of using cannabis on self-reported symptoms of pain, insomnia, anxiety, depression, and cannabis use disorder (CUD) after 12 months of use. Methods This observational cohort study describes outcomes over 9 months following a 12-week randomized, waitlist-controlled trial (RCT: NCT03224468) in which adults (N = 163) who wished to use cannabis to alleviate insomnia, pain, depression, or anxiety symptoms were randomly assigned to obtain a medical marijuana card immediately (immediate card acquisition group) or to delay obtaining a card for 12 weeks delay (delayed card acquisition group). During the 9-month post-randomization period, all participants could use cannabis as they wished and choose their cannabis products, doses, and frequency of use. Insomnia, pain, depression, anxiety, and CUD symptoms were assessed over the 9-month post-randomization period. Results After 12 months of using cannabis for medical symptoms, 11.7% of all participants (n = 19), and 17.1% of those using cannabis daily or near-daily (n = 6) developed CUD. Frequency of cannabis use was positively correlated with pain severity and number of CUD symptoms, but not significantly associated with severity of self-reported insomnia, depression, or anxiety symptoms. Depression scores improved throughout the 9 months in all participants, regardless of cannabis use frequency. Conclusions Frequency of cannabis use was not associated with improved pain, anxiety, or depression symptoms but was associated with new-onset cannabis use disorder in a significant minority of participants. Daily or near-daily cannabis use appears to have little benefit for these symptoms after 12 months of use.
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Affiliation(s)
- Megan E. Cooke
- Department of Psychiatry, Center for Addiction Medicine (CAM), Massachusetts General Hospital (MGH), Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital (MGH), Harvard Medical School, Charlestown, MA, United States
| | - Kevin W. Potter
- Department of Psychiatry, Center for Addiction Medicine (CAM), Massachusetts General Hospital (MGH), Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Julia Jashinski
- Department of Psychiatry, Center for Addiction Medicine (CAM), Massachusetts General Hospital (MGH), Boston, MA, United States
| | - Michael Pascale
- Department of Psychiatry, Center for Addiction Medicine (CAM), Massachusetts General Hospital (MGH), Boston, MA, United States
| | - Randi M. Schuster
- Department of Psychiatry, Center for Addiction Medicine (CAM), Massachusetts General Hospital (MGH), Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Brenden Tervo-Clemmens
- Department of Psychiatry, Center for Addiction Medicine (CAM), Massachusetts General Hospital (MGH), Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital (MGH), Harvard Medical School, Charlestown, MA, United States
| | - Bettina B. Hoeppner
- Department of Psychiatry, Center for Addiction Medicine (CAM), Massachusetts General Hospital (MGH), Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Gladys N. Pachas
- Department of Psychiatry, Center for Addiction Medicine (CAM), Massachusetts General Hospital (MGH), Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - A. Eden Evins
- Department of Psychiatry, Center for Addiction Medicine (CAM), Massachusetts General Hospital (MGH), Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Jodi M. Gilman
- Department of Psychiatry, Center for Addiction Medicine (CAM), Massachusetts General Hospital (MGH), Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital (MGH), Harvard Medical School, Charlestown, MA, United States
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11
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Hosseinzadeh Anvar L, Ahmadalipour A. Fatty acid amide hydrolase C385A polymorphism affects susceptibility to various diseases. Biofactors 2023; 49:62-78. [PMID: 36300805 DOI: 10.1002/biof.1911] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 09/24/2022] [Indexed: 11/08/2022]
Abstract
The endocannabinoid (eCB) system is an important neuromodulatory system with its extensive network of receptors throughout the human body that has complex actions in the nervous system, immune system, and all of the body's other organs. Fatty acid amide hydrolase (FAAH) is an important membrane-bound homodimeric degrading enzyme that controls the biological activity of N-arachidonoylethanolamide (AEA) in the eCB system and other relevant bioactive lipids. It has been shown that several single nucleotide polymorphisms (SNPs) of FAAH are associated with various phenotypes and diseases including cardiovascular, endocrine, drug abuse, and neuropsychiatric disorders. A common functional and most studied polymorphism of this gene is C385A (rs324420), which results in the replacement of a conserved proline to threonine in the FAAH enzyme structure, leads to a reduction of the activity and expression of FAAH, compromises the inactivation of AEA and causes higher synaptic concentrations of AEA that can be associated with several various phenotypes. The focus of this review is on evidence-based studies on the associations of the FAAH C385A polymorphism and the various diseases or traits. Although there was variability in the results of these reports, the overall consensus is that the FAAH C385A genotype can affect susceptibility to some multifactorial disorders and can be considered a potential therapeutic target.
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Affiliation(s)
- Leila Hosseinzadeh Anvar
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Ahmadalipour
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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12
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Ried K, Tamanna T, Matthews S, Sali A. Medicinal cannabis improves sleep in adults with insomnia: a randomised double‐blind placebo‐controlled crossover study. J Sleep Res 2022; 32:e13793. [PMID: 36539991 DOI: 10.1111/jsr.13793] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 11/08/2022] [Accepted: 11/10/2022] [Indexed: 12/24/2022]
Abstract
Insomnia or difficulty falling and or staying asleep is experienced by up to 30% of the general population. This randomised crossover double-blind placebo-controlled 6-week trial aimed to assess the tolerability and effectiveness of the Entoura-10:15 medicinal cannabis oil on sleep in adults with insomnia. A total of 29 participants with self-reported clinical insomnia completed the crossover trial. Participants were randomly allocated to receive placebo or active oil containing 10 mg/ml tetrahydrocannabinol (THC) and 15 mg/ml cannabidiol (CBD) over 2-weeks titrated 0.2-1.5 ml/day, followed by a 1-week wash-out period before crossover. Tolerability was assessed by daily diary. Effectiveness was measured by saliva midnight melatonin levels, validated questionnaires, i.e., the Insomnia Severity Index, and the Fitbit activity/sleep wrist tracker. Entoura-10:15 medicinal cannabis oil was generally well tolerated, and was effective in improving sleep, whereby 60% of participants no longer classified as clinical insomniacs at the end of the 2-week intervention period. Midnight melatonin levels significantly improved in the active group by 30% compared to a 20% decline in the placebo group (p = 0.035). Medicinal cannabis oil improved both time and quality of sleep, in particular light sleep increased by 21 min/night compared to placebo (p = 0.041). The quality of sleep improved overall by up to 80% in the active group (pPhase2 = 0.003), including higher daily functioning (p = 0.032). Observed effects were more pronounced in Phase 2 due to the period effect and loss of blinding. Entoura-10:15 medicinal cannabis oil was well tolerated and effective in improving sleep in adults with insomnia.
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Affiliation(s)
- Karin Ried
- National Institute of Integrative Medicine (NIIM) Melbourne Victoria Australia
- Torrens University Adelaide South Australia Australia
- Discipline of General Practice The University of Adelaide Adelaide South Australia Australia
| | - Tasnuva Tamanna
- National Institute of Integrative Medicine (NIIM) Melbourne Victoria Australia
| | - Sonja Matthews
- National Institute of Integrative Medicine (NIIM) Melbourne Victoria Australia
| | - Avni Sali
- National Institute of Integrative Medicine (NIIM) Melbourne Victoria Australia
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13
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Ouellet J, Spinney S, Assaf R, Boers E, Livet A, Potvin S, Conrod P. Sleep as a Mediator Between Cannabis Use and Psychosis Vulnerability: A Longitudinal Cohort Study. SCHIZOPHRENIA BULLETIN OPEN 2022; 4:sgac072. [PMID: 36756192 PMCID: PMC9894023 DOI: 10.1093/schizbullopen/sgac072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Objectives Increasing evidence implicates cannabis consumption as a key risk factor in the development of psychosis, but the mechanisms underpinning this relationship remain understudied. This study proposes to determine whether sleep disruption acts as a mediator of the cannabis-to-psychosis relationship. Study Design This longitudinal study assessed measures of cannabis use frequency, sleep quality (SQ), and psychotic-like experiences (PLEs) were collected using self-reported questionnaires. Data were collected from September 2012 to September 2018. Data were collected from a general population sample of adolescents who entered the seventh grade in 31 schools in the Greater Montreal area. The study uses data collected on an annual basis from 3801 high school students from grades 7 to 11. The aforementioned measures were measured using the Detection of Alcohol and Drug Problems in Adolescents questionnaire, a SQ Likert scale, and measures the Psychotic-Like Experiences Questionnaire for Children. Study Results Results show a reciprocal 1-year cross-lagged effect of cannabis use and sleep (β = -0.076, 95% CI = -0.037 to -0.018, P = .000), of sleep on cannabis use (β = -.016, 95% CI = -0.025 to -0.006, P = .007), of sleep on PLEs (β = -0.077, 95%CI = -0.014 to -0.051, P = .000), and of PLEs on sleep (β = -0.027, 95% CI = -0.037 to -0.018, P = .000). We additionally found a 2 years indirect lagged-effect of cannabis use on PLEs (β = 0.068, 95% CI = 0.024 to 0.113, P = .011) mediated by 1-year sleep (β = 0.006, 95% CI = 0.003 to 0.009, P = .001). Conclusions Our results suggest sleep disruptions simultaneously aggravate, and are aggravated by, cannabis addiction and PLEs. The longitudinal sleep-mediated effect of cannabis use on PLEs encourages further research into the role of sleep as a potential therapeutic target in the prevention of cannabis-related psychosis.
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Affiliation(s)
- Julien Ouellet
- To whom correspondence should be addressed; tel: 514-833-5026, e-mail:
| | - Sean Spinney
- CHU Sainte-Justine Research Center, Montreal, QC, Canada,Department of Computer Science and Operations Research, Université de Montréal, Montreal, QC, Canada
| | - Roxane Assaf
- CHU Sainte-Justine Research Center, Montreal, QC, Canada,Department of Psychiatry, Université de Montréal, Montreal, QC, Canada
| | - Elroy Boers
- CHU Sainte-Justine Research Center, Montreal, QC, Canada
| | - Audrey Livet
- Department of Psychiatry, Université de Montréal, Montreal, QC, Canada
| | - Stéphane Potvin
- Department of Psychiatry, Université de Montréal, Montreal, QC, Canada,Institut Universitaire en Santé Mentale de Montréal Research Center, Montreal, QC, Canada
| | - Patricia Conrod
- CHU Sainte-Justine Research Center, Montreal, QC, Canada,Department of Psychiatry, Université de Montréal, Montreal, QC, Canada,Department of Pediatrics, Université de Montréal, Montreal, QC, Canada
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14
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Keen L, Turner AD, George L, Lawrence K. Cannabis use disorder severity and sleep quality among undergraduates attending a Historically Black University. Addict Behav 2022; 134:107414. [PMID: 35810645 DOI: 10.1016/j.addbeh.2022.107414] [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: 01/14/2022] [Revised: 06/09/2022] [Accepted: 06/15/2022] [Indexed: 11/20/2022]
Abstract
Nearly one third of Americans experience poor sleep, which is associated with numerous deleterious health outcomes. Poor sleep may be exacerbated when an individual attends college, as they experience drastic shifts in lifestyle and sleep patterns. Previous research suggests cannabis has therapeutic potential for sleep disorders but may also impair sleep quality long-term. However, no study has examined the differences in sleep quality within individuals who meet criteria for Cannabis Use Disorder (CUD). The purpose of the current study was to determine differences in sleep quality among undergraduate students who met criteria for mild CUD (n = 18), moderate CUD (n = 22), severe CUD (n = 16) and students who did not meet criteria for CUD (n = 244). Participants included 300 predominantly Black/African American undergraduate students (79% female), aged between 18 and 25 years. Each participant completed an online survey that included measures assessing sleep quality and CUD criteria. Employing analysis of covariance, the moderate CUD subgroup (M = 9.00, SD = 3.32) reported poorer sleep quality than individuals who did not meet criteria for CUD (M = 6.93, SD = 3.03). Interestingly, the severe CUD subgroup (M = 6.75, SD = 2.52) reported similar sleep quality to individuals who did not meet criteria for CUD (M = 6.93, SD = 3.03). Individuals meeting criteria for mild and moderate CUD reported the poorest sleep quality among the groups, suggesting a differentiation within CUD severity. Future research should assess withdrawal and cannabis use frequency among individuals who meet criteria for CUD to further elucidate disturbances in sleep quality among those with CUD.
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Affiliation(s)
- Larry Keen
- Psychology Department, Virginia State University, USA
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15
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Salivary Endocannabinoid Profiles in Chronic Orofacial Pain and Headache Disorders: An Observational Study Using a Novel Tool for Diagnosis and Management. Int J Mol Sci 2022; 23:ijms232113017. [PMID: 36361803 PMCID: PMC9659113 DOI: 10.3390/ijms232113017] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/24/2022] [Accepted: 10/25/2022] [Indexed: 11/28/2022] Open
Abstract
The endocannabinoid system is involved in physiological and pathological processes, including pain generation, modulation, and sensation. Its role in certain types of chronic orofacial pain (OFP) has not been thoroughly examined. By exploring the profiles of specific salivary endocannabinoids (eCBs) in individuals with different types of OFP, we evaluated their use as biomarkers and the influence of clinical parameters and pain characteristics on eCB levels. The salivary levels of anandamide (AEA), 2-arachidonoyl glycerol (2-AG), and their endogenous breakdown product arachidonic acid (AA), as well as the eCB-like molecules N-palmitoylethanolamide (PEA) and N-oleoylethanolamide (OEA), were assessed in 83 OFP patients and 43 pain-free controls using liquid chromatography/tandem mass spectrometry. Patients were grouped by diagnosis: post-traumatic neuropathy (PTN), trigeminal neuralgia (TN), temporomandibular disorder (TMD), migraine, tension-type headache (TTH), and burning mouth syndrome (BMS). Correlation analyses between a specific diagnosis, pain characteristics, and eCB levels were conducted. Significantly lower levels of 2-AG were found in the TN and TTH groups, while significantly lower PEA levels were found in the migraine group. BMS was the only group with elevated eCBs (AEA) versus the control. Significant correlations were found between levels of specific eCBs and gender, health-related quality of life (HRQoL), BMI, pain duration, and sleep awakenings. In conclusion, salivary samples exhibited signature eCBs profiles for major OFP disorders, especially migraine, TTH, TN, and BMS. This finding may pave the way for using salivary eCBs biomarkers for more accurate diagnoses and management of chronic OFP patients.
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16
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Russo EB, Cuttler C, Cooper ZD, Stueber A, Whiteley VL, Sexton M. Survey of Patients Employing Cannabigerol-Predominant Cannabis Preparations: Perceived Medical Effects, Adverse Events, and Withdrawal Symptoms. Cannabis Cannabinoid Res 2022; 7:706-716. [PMID: 34569849 PMCID: PMC9587780 DOI: 10.1089/can.2021.0058] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Introduction: Cannabigerol (CBG), and its precursor before decarboxylation, cannabigerolic acid is sometimes labeled the "mother of all cannabinoids." The purpose of the present study was to investigate reasons for use and self-reported therapeutic effects in CBG-predominant cannabis users. Usage patterns and adverse effects, including withdrawal symptoms were also explored. Methods: Cannabidiol-predominant cannabis users were recruited online to complete an online survey assessing CBG use patterns, conditions treated with CBG-predominant cannabis (containing >50% CBG), perceived efficacy, associated adverse events, and withdrawal symptoms. One hundred twenty-seven eligible participants (U.S. residents ages 21+ who reported using CBG-predominant cannabis in the past 6 months) completed the survey. Results: Most of the samples (n=65; 51.2%) reported use of CBG-predominant products solely for medical purposes (n=46; 36.2% reported use for medical and recreational purposes; n=8; 6.3% reported recreational use only, and n=8 were missing). The most common conditions the complete sample reported using CBG to treat were anxiety (51.2%), chronic pain (40.9%), depression (33.1%), and insomnia/disturbed sleep (30.7%). Efficacy was highly rated, with the majority reporting their conditions were "very much improved" or "much improved" by CBG. Furthermore, 73.9% claimed superiority of CBG-predominant cannabis over conventional medicines for chronic pain, 80% for depression, 73% for insomnia, and 78.3% for anxiety. Forty-four percent of CBG-predominant cannabis users reported no adverse events, with 16.5% noting dry mouth, 15% sleepiness, 11.8% increased appetite, and 8.7% dry eyes. Around 84.3% reported no withdrawal symptoms, with sleep difficulties representing the most frequently endorsed withdrawal symptom (endorsed by two respondents). Conclusions: This is the first patient survey of CBG-predominant cannabis use to date, and the first to document self-reported efficacy of CBG-predominant products, particularly for anxiety, chronic pain, depression, and insomnia. Most respondents reported greater efficacy of CBG-predominant cannabis over conventional pharmacotherapy, with a benign adverse event profile and negligible withdrawal symptoms. This study establishes that humans are employing CBG and suggests that CBG-predominant cannabis-based medicines should be studied in randomized controlled trials.
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Affiliation(s)
| | | | - Ziva D. Cooper
- University of California, Los Angeles, Los Angeles, California, USA
| | | | | | - Michelle Sexton
- University of California, San Diego, San Diego, California, USA
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17
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Ranum RM, Whipple MO, Croghan I, Bauer B, Toussaint LL, Vincent A. Use of Cannabidiol in the Management of Insomnia: A Systematic Review. Cannabis Cannabinoid Res 2022; 8:213-229. [PMID: 36149724 DOI: 10.1089/can.2022.0122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Cannabidiol (CBD), one of the major cannabinoids derived from the cannabis plant, is available over the counter. CBD is often used by patients for the management of insomnia, yet research supporting CBDs effectiveness as a treatment for insomnia is inadequate. Objective: The objective of this review was to critically evaluate the literature regarding the therapeutic benefits of CBD in the management of insomnia. Methods: A comprehensive search of the following databases from inception to December 29, 2021, was conducted: Ovid MEDLINE® and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily, Ovid Embase, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus. The search included randomized controlled trials, nonrandomized experimental studies, cross-sectional studies, cohort studies, case series, and case reports. Risk of bias was assessed with the Agency for Healthcare Research and Quality design-specific recommended criteria. Results: Thirty-four studies were eligible for inclusion. All studies reported improvement in the insomnia symptoms of at least a portion of their participants. Of the 34 studies, 19 studies used CBD predominant therapy and 21 studies used nearly equal ratios of CBD to Δ9-tetrahydrocannabinol (THC). Of the studies that performed hypothesis testing, 4 of 7 studies with a CBD predominant arm and 12 of 16 studies with a nearly equal ratio of CBD to THC arm reported significant improvement in insomnia outcomes. However, only 2 of the 34 studies focused on patients with insomnia, of which 1 study was a case report. Additionally, several studies used nonvalidated subjective measures, and most studies failed to include objective measures for symptom assessment. Conclusions: The results of our systematic review suggest that CBD alone or with equal quantities of THC may be beneficial in alleviating the symptoms of insomnia. Nevertheless, future research assessing CBDs effectiveness in population of patients specifically with insomnia utilizing validated subjective and objective measures is necessary before definitive inferences can be made.
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Affiliation(s)
- Rylea M Ranum
- Department of Psychology, Luther College, Decorah, Iowa, USA
| | - Mary O Whipple
- Department of Adult and Gerontological Health Cooperative, School of Nursing, University of Minnesota, Minneapolis, Minnesota, USA
| | - Ivana Croghan
- Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Brent Bauer
- Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Ann Vincent
- Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
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18
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Martin SC, Gay SM, Armstrong ML, Pazhayam NM, Reisdorph N, Diering GH. Tonic endocannabinoid signaling supports sleep through development in both sexes. Sleep 2022; 45:6565640. [PMID: 35395682 PMCID: PMC9366650 DOI: 10.1093/sleep/zsac083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 03/07/2022] [Indexed: 12/24/2022] Open
Abstract
Abstract
Sleep is an essential behavior that supports brain function and cognition throughout life, in part by acting on neuronal synapses. The synaptic signaling pathways that mediate the restorative benefits of sleep are not fully understood, particularly in the context of development. Endocannabinoids (eCBs) including 2-arachidonyl glycerol (2-AG) and anandamide (AEA), are bioactive lipids that activate cannabinoid receptor, CB1, to regulate synaptic transmission and mediate cognitive functions and many behaviors, including sleep. We used targeted mass spectrometry to measure changes in forebrain synaptic eCBs during the sleep/wake cycle in juvenile and adolescent mice of both sexes. We find that eCBs lack a daily rhythm in juvenile mice, while in adolescents AEA and related oleoyl ethanolamide are increased during the sleep phase in a circadian manner. Next, we manipulated the eCB system using selective pharmacology and measured the effects on sleep behavior in developing and adult mice of both sexes using a noninvasive piezoelectric home-cage recording apparatus. Enhancement of eCB signaling through inhibition of 2-AG or AEA degradation, increased dark-phase sleep amount and bout length in developing and adult males, but not in females. Inhibition of CB1 by injection of the antagonist AM251 reduced sleep time and caused sleep fragmentation in developing and adult males and females. Our data suggest that males are more sensitive to the sleep-promoting effects of enhanced eCBs but that tonic eCB signaling supports sleep behavior through multiple stages of development in both sexes. This work informs the further development of cannabinoid-based therapeutics for sleep disruption.
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Affiliation(s)
- Shenée C Martin
- Department of Cell Biology and Physiology and the UNC Neuroscience Center, University of North Carolina at Chapel Hill , Chapel Hill, NC , USA
| | - Sean M Gay
- Department of Cell Biology and Physiology and the UNC Neuroscience Center, University of North Carolina at Chapel Hill , Chapel Hill, NC , USA
| | - Michael L Armstrong
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus , Aurora, CO , USA
| | - Nila M Pazhayam
- Department of Cell Biology and Physiology and the UNC Neuroscience Center, University of North Carolina at Chapel Hill , Chapel Hill, NC , USA
| | - Nichole Reisdorph
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus , Aurora, CO , USA
| | - Graham H Diering
- Department of Cell Biology and Physiology and the UNC Neuroscience Center, University of North Carolina at Chapel Hill , Chapel Hill, NC , USA
- Carolina Institute for Developmental Disabilities , Carrboro, NC , USA
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19
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Lavender I, McGregor IS, Suraev A, Grunstein RR, Hoyos CM. Cannabinoids, Insomnia, and Other Sleep Disorders. Chest 2022; 162:452-465. [PMID: 35537535 DOI: 10.1016/j.chest.2022.04.151] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 04/18/2022] [Accepted: 04/19/2022] [Indexed: 01/20/2023] Open
Abstract
Sleep disturbances are often cited as a primary reason for medicinal cannabis use, and there is increasing clinical interest in the therapeutic potential of cannabinoids in treating sleep disorders. Burgeoning evidence suggests a role of the endocannabinoid system in regulating the circadian sleep-wake cycle, highlighting a potential avenue for developing novel therapeutics. Despite widespread use of cannabis products as sleep aids globally, robustly designed studies verifying efficacy in sleep-disordered populations are limited. Although some study outcomes have suggested cannabinoid utility in insomnia disorder and sleep apnea, most studies to date are limited by small sample sizes, lack of rigorously controlled study designs, and high risk of bias. This critical review summarizes the current evidence for the use of cannabinoids as a treatment for sleep disorders and provides an overview of endocannabinoid modulation of sleep-wake cycles, as well as the sleep-modulating effects of plant-derived cannabinoids such as delta-9-tetrahydrocannbinol, cannabidiol, and cannabinol. The review also discusses practical considerations for clinicians regarding cannabinoid formulations, routes of administration, respiratory concerns, dosing, potential side effects, drug interactions, and effects relevant to driving, tolerance, and withdrawal. Although current interest in, and uptake of, medicinal cannabis use for sleep disorders may have surpassed the evidence base, there is a strong rationale for continued investigation into the therapeutic potential of cannabinoids.
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Affiliation(s)
- Isobel Lavender
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia; Faculty of Science, School of Psychology, University of Sydney, Sydney, NSW, Australia; Lambert Initiative for Cannabinoid Therapeutics, University of Sydney, Sydney, NSW, Australia; Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Iain S McGregor
- Faculty of Science, School of Psychology, University of Sydney, Sydney, NSW, Australia; Lambert Initiative for Cannabinoid Therapeutics, University of Sydney, Sydney, NSW, Australia; Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Anastasia Suraev
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia; Faculty of Science, School of Psychology, University of Sydney, Sydney, NSW, Australia; Lambert Initiative for Cannabinoid Therapeutics, University of Sydney, Sydney, NSW, Australia; Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Ronald R Grunstein
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Camilla M Hoyos
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia; Faculty of Science, School of Psychology, University of Sydney, Sydney, NSW, Australia; Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia.
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20
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Holdman R, Vigil D, Robinson K, Shah P, Contreras AE. Safety and Efficacy of Medical Cannabis in Autism Spectrum Disorder Compared with Commonly Used Medications. Cannabis Cannabinoid Res 2022; 7:451-463. [PMID: 34432543 PMCID: PMC9418362 DOI: 10.1089/can.2020.0154] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: The objective of this study was to evaluate the safety and efficacy of medications commonly used in autism spectrum disorder (ASD) and compare this to what current research has shown regarding medical cannabis use in this population. Methods: Searches were performed to collect information surrounding currently used medications and their safety and efficacy profiles, biologic plausibility of cannabis use for symptoms of ASD, and studies detailing cannabis' safety and efficacy profile for use in the ASD population. Results were used to compare medications to cannabis as a proposed treatment. Results: The heterogeneity of ASD produces great difficulties in finding appropriate treatment, leading to many medication changes or treatment trials throughout a patient's life. Commonly prescribed medications display varying levels of efficacy, safety, and tolerability between patients and symptoms targeted. Some of the most common side effects cited are also considered the most troubling symptoms associated with ASD; aggression, anxiety, irritability, and a negative effect on cognition, leading many patients to discontinue use as the side effects outweigh benefits. Recent case reports and retrospective studies have displayed the potential efficacy, safety, and tolerability of cannabidiol (CBD)-rich medical cannabis use for treating both core symptoms of ASD and many comorbid symptoms such as irritability and sleep problems. Studies have also identified circulating endocannabinoids as a possible biomarker for ASD, providing another possible method of diagnosis. Conclusions: Currently, there are no approved medications for the core symptoms of ASD and only two medications Food and Drug Administration approved for associated irritability. Prescribed medications for symptoms associated with ASD display varying levels of efficacy, safety, and tolerability among the heterogeneous ASD population. At the time of this study there are no published placebo-controlled trials of medical cannabis for ASD and the observational studies have limitations. CBD-rich medical cannabis seems to be an effective, tolerable, and relatively safe option for many symptoms associated with ASD, however, the long-term safety is unknown at this time.
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Affiliation(s)
- Richard Holdman
- Colorado Department of Public Health and Environment, Marijuana Health Monitoring and Research, Denver, Colorado, USA
| | - Daniel Vigil
- Colorado Department of Public Health and Environment, Marijuana Health Monitoring and Research, Denver, Colorado, USA
| | - Kelsey Robinson
- Colorado Department of Public Health and Environment, Marijuana Health Monitoring and Research, Denver, Colorado, USA
| | - Puja Shah
- Colorado Department of Public Health and Environment, Marijuana Health Monitoring and Research, Denver, Colorado, USA
| | - Alexandra Elyse Contreras
- Colorado Department of Public Health and Environment, Marijuana Health Monitoring and Research, Denver, Colorado, USA
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21
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Henson JD, Vitetta L, Hall S. Tetrahydrocannabinol and cannabidiol medicines for chronic pain and mental health conditions. Inflammopharmacology 2022; 30:1167-1178. [PMID: 35796920 PMCID: PMC9294022 DOI: 10.1007/s10787-022-01020-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 06/13/2022] [Indexed: 01/07/2023]
Abstract
Combination tetrahydrocannabinol (THC)/cannabidiol (CBD) medicines or CBD-only medicines are prospective treatments for chronic pain, stress, anxiety, depression, and insomnia. THC and CBD increase signaling from cannabinoid receptors, which reduces synaptic transmission in parts of the central and peripheral nervous systems and reduces the secretion of inflammatory factors from immune and glial cells. The overall effect of adding CBD to THC medicines is to enhance the analgesic effect but counteract some of the adverse effects. There is substantial evidence for the effectiveness of THC/CBD combination medicines for chronic pain, especially neuropathic and nociplastic pain or pain with an inflammatory component. For CBD-only medication, there is substantial evidence for stress, moderate evidence for anxiety and insomnia, and minimal evidence for depression and pain. THC/CBD combination medicines have a good tolerability and safety profile relative to opioid analgesics and have negligible dependence and abuse potential; however, should be avoided in patients predisposed to depression, psychosis and suicide as these conditions appear to be exacerbated. Non-serious adverse events are usually dose-proportional, subject to tachyphylaxis and are rarely dose limiting when patients are commenced on a low dose with gradual up-titration. THC and CBD inhibit several Phase I and II metabolism enzymes, which increases the exposure to a wide range of drugs and appropriate care needs to be taken. Low-dose CBD that appears effective for chronic pain and mental health has good tolerability and safety, with few adverse effects and is appropriate as an initial treatment.
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Affiliation(s)
- Jeremy D Henson
- Prince of Wales Clinical School, University of NSW, Sydney, NSW, 2052, Australia. .,Medlab Clinical Ltd, Sydney, NSW, 2015, Australia.
| | - Luis Vitetta
- Prince of Wales Clinical School, University of NSW, Sydney, NSW, 2052, Australia.,Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Sean Hall
- Medlab Clinical Ltd, Sydney, NSW, 2015, Australia
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Circadian regulation of memory under stress: Endocannabinoids matter. Neurosci Biobehav Rev 2022; 138:104712. [PMID: 35643119 DOI: 10.1016/j.neubiorev.2022.104712] [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: 02/07/2022] [Revised: 04/27/2022] [Accepted: 05/23/2022] [Indexed: 11/24/2022]
Abstract
Organisms ranging from plants to higher mammals have developed 24-hour oscillation rhythms to optimize physiology to environmental changes and regulate a plethora of neuroendocrine and behavioral processes, including neurotransmitter and hormone regulation, stress response and learning and memory function. Compelling evidence indicates that a wide array of memory processes is strongly influenced by stress- and emotional arousal-activated neurobiological systems, including the endocannabinoid system which has been extensively shown to play an integral role in mediating stress effects on memory. Here, we review findings showing how circadian rhythms and time-of-day influence stress systems and memory performance. We report evidence of circadian regulation of memory under stress, focusing on the role of the endocannabinoid system and highlighting its circadian rhythmicity. Our discussion illustrates how the endocannabinoid system mediates stress effects on memory in a circadian-dependent fashion. We suggest that endocannabinoids might regulate molecular mechanisms that control memory function under circadian and stress influence, with potential important clinical implications for both neurodevelopmental disorders and psychiatric conditions involving memory impairments.
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Rapid treatments for depression: Endocannabinoid system as a therapeutic target. Neurosci Biobehav Rev 2022; 137:104635. [PMID: 35351488 DOI: 10.1016/j.neubiorev.2022.104635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 03/19/2022] [Accepted: 03/20/2022] [Indexed: 12/16/2022]
Abstract
Current first-line treatments for major depressive disorder (MDD), i.e., antidepressant drugs and psychotherapy, show delayed onset of therapeutic effect as late as 2-3 weeks or more. In the clinic, the speed of beginning of the actions of antidepressant drugs or other interventions is vital for many reasons. Late-onset means that depression, its related disability, and the potential danger of suicide remain a threat for some patients. There are some rapid-acting antidepressant interventions, such as sleep deprivation, ketamine, acute exercise, which induce a significant response, ranging from a few hours to maximally one week, and most of them share a common characteristic that is the activation of the endocannabinoid (eCB) system. Activation of this system, i.e., augmentation of eCB signaling, appears to have anti-depressant-like actions. This article puts the idea forward that the activation of eCB signaling represents a critical mechanism of rapid-acting therapeutic interventions in MDD, and this system might contribute to the development of novel rapid-acting treatments for MDD.
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Paronis C, Iliopoulos-Tsoutsouvas C, Papanastasiou I, Makriyannis A, Bergman J, Nikas SP. Evidence for spontaneous cannabinoid withdrawal in mice. Behav Pharmacol 2022; 33:184-194. [PMID: 35288509 PMCID: PMC8924453 DOI: 10.1097/fbp.0000000000000665] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Although the behavioral effects of acute and chronic exposure to cannabinoids have been extensively studied in mice, spontaneous withdrawal following exposure to cannabinoids has not been well characterized in this species. To address this issue, different groups of mice were treated for 5 days with saline, 20-36 mg/kg/day of the CB partial agonist Δ9-tetrahydrocannabinol (Δ9-THC), or 0.06-0.1 mg/kg/day of the CB high-efficacy agonist AM2389. Initial studies assessed changes in observable behavior (paw tremors) that were scored from the recordings taken at 4 or 24 h after the last injection. Subsequently, radiotelemetry was used to continuously measure body temperature and locomotor activity before (baseline), during, and after the 5-day dosing regimens. Results show that increases in paw tremors occurred following 5-day exposure to AM2389 or Δ9-THC. In telemetry studies, acute AM2389 or THC decreased both temperature and activity. Rapid tolerance occurred to the hypothermic effects of the cannabinoids, whereas locomotor activity continued to be suppressed following each drug injection. In contrast, increases in locomotor activity were evident 12-72 h after discontinuing daily injections of either 0.06 or 0.1 mg/kg/day AM2389. Increases in locomotor activity were also noted in mice treated daily with 30 or 36, but not 20 mg/kg/day Δ9-THC; these effects were smaller and appeared later than effects seen in AM2389-treated mice. These results indicate that the discontinuation of daily treatment with a CB high-efficacy agonist will yield evidence of spontaneous withdrawal that may reflect prior dependence, and that the degree of cannabinoid dependence may vary in relation to the dose or efficacy of the agonist injected daily.
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Affiliation(s)
- Carol Paronis
- Laboratory of Preclinical Pharmacology, McLean Hospital
- Department of Pharmaceutical Sciences
- Center for Drug Discovery, Northeastern University, Belmont, Massachusetts, USA
| | | | | | - Alex Makriyannis
- Department of Pharmaceutical Sciences
- Center for Drug Discovery, Northeastern University, Belmont, Massachusetts, USA
| | - Jack Bergman
- Laboratory of Preclinical Pharmacology, McLean Hospital
| | - Spyros P Nikas
- Center for Drug Discovery, Northeastern University, Belmont, Massachusetts, USA
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Clinical Management of Sleep and Sleep Disorders With Cannabis and Cannabinoids. Clin Neuropharmacol 2022; 45:27-31. [DOI: 10.1097/wnf.0000000000000494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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26
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Hay JK, Hocker SE, Monteith G, Woods JP. Circulating Endocannabinoids in Canine Multicentric Lymphoma Patients. Front Vet Sci 2022; 9:828095. [PMID: 35242839 PMCID: PMC8887993 DOI: 10.3389/fvets.2022.828095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 01/19/2022] [Indexed: 12/22/2022] Open
Abstract
The endocannabinoid system is increasingly being implicated in the pathogenesis and progression of various human cancers. Specifically, increased levels of 2-arachidonoylglycerol (2-AG) and oleoythanolamide (OEA) have been demonstrated in human diffuse large B-cell lymphoma (DLBCL) and chronic lymphocytic leukemia (CLL) patients, respectively. The objectives of this paper were to compare 2-AG, OEA, N-arachidonoylethanolamine (AEA), and palmitoylethanolamide (PEA) levels between dogs with multicentric lymphoma and healthy control dogs. In addition, evaluate 2-AG, OEA, AEA, and PEA levels as biomarkers for progression free interval (PFI) and overall survival time (OST) in the dogs with lymphoma. The study consisted of 26 dogs with multicentric B cell lymphoma, 14 dogs with multicentric T cell lymphoma, and 12 healthy control dogs. Serum 2-AG, OEA, AEA, and PEA levels were measured using liquid chromatography combined with tandem mass spectrometry (LC—MS/MS) in dogs with lymphoma and in healthy dogs. OEA, AEA, and PEA levels were significantly elevated in dogs with lymphoma compared to healthy controls (p < 0.05). Total AG was significantly higher in healthy control dogs (p = 0.049). There was no significant difference between dogs with B cell and T cell lymphoma for any of the measured endocannabinoids. Elevated PEA was significantly associated with decreased PFI (p = 0.04) in dogs with lymphoma with a hazards ratio of 1.816 [95% Confidence Interval (CI): 1.020–3.232]. Overall, dogs with lymphoma have elevated levels of OEA, AEA, and PEA. PEA levels have the potential to be a prognostic biomarker.
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Affiliation(s)
- Jennifer K. Hay
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS, United States
| | - Samuel E. Hocker
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS, United States
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
- *Correspondence: Samuel E. Hocker
| | - Gabrielle Monteith
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - J. Paul Woods
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
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Kratz D, Sens A, Schäfer SMG, Hahnefeld L, Geisslinger G, Thomas D, Gurke R. Pre-analytical challenges for the quantification of endocannabinoids in human serum. J Chromatogr B Analyt Technol Biomed Life Sci 2022; 1190:123102. [PMID: 35026652 DOI: 10.1016/j.jchromb.2022.123102] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 12/21/2021] [Accepted: 01/03/2022] [Indexed: 10/19/2022]
Abstract
Endocannabinoids (ECs) are potent lipid mediators with high physiological relevance. They are involved in a wide variety of diseases like depression or multiple sclerosis and are closely connected to metabolic parameters in humans. Therefore, their suitability as a biomarker in different (patho-)physiological conditions is discussed intensively and predominantly investigated by analyzing systemic concentrations in easily accessible matrices like blood. Carefully designed pre-analytical sample handling is of major importance for high-quality data, but harmonization is not achieved yet. Whole blood is either processed to serum or plasma before the onset of analytical workflows and while knowledge about pre-analytical challenges in plasma handling is thorough they were not systematically investigated for serum. Therefore, the ECs AEA and 2-AG, and closely related EC-like substances 1-AG, DHEA, and PEA were examined by LC-MS/MS in serum samples of nine healthy volunteers employing different pre-analytical sample handling protocols, including prolonged coagulation, and storage after centrifugation at room temperature (RT) or on ice. Furthermore, all analytes were also assessed in plasma samples obtained from the same individuals at the same time points to investigate the comparability between those two blood-based matrices regarding obtained concentrations and their 2-AG/1-AG ratio. This study shows that ECs and EC-like substances in serum samples were significantly higher than in plasma and are especially prone to ex vivo changes during initial and prolonged storage for coagulation at RT. Storage on ice after centrifugation is less critical. However, storage at RT further increases 1-AG and 2-AG concentrations, while also lowering the already reduced 2-AG/1-AG ratio due to isomerization. Thus, avoidance of prolonged processing at RT can increase data quality if serum as the matrix of choice is unavoidable. However, serum preparation in itself is expected to initiate changes of physiological concentrations as standard precautionary measures like fast and cooled processing can only be utilized by using plasma, which should be the preferred matrix for analyses of ECs and EC-like substances.
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Affiliation(s)
- D Kratz
- Institute of Clinical Pharmacology, pharmazentrum frankfurt/ZAFES, University Hospital of Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - A Sens
- Institute of Clinical Pharmacology, pharmazentrum frankfurt/ZAFES, University Hospital of Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - S M G Schäfer
- Fraunhofer Institute for Translational Medicine and Pharmacology (ITMP), and Fraunhofer Cluster of Excellence for Immune Mediated Diseases (CIMD), Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
| | - L Hahnefeld
- Institute of Clinical Pharmacology, pharmazentrum frankfurt/ZAFES, University Hospital of Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology (ITMP), and Fraunhofer Cluster of Excellence for Immune Mediated Diseases (CIMD), Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
| | - G Geisslinger
- Institute of Clinical Pharmacology, pharmazentrum frankfurt/ZAFES, University Hospital of Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology (ITMP), and Fraunhofer Cluster of Excellence for Immune Mediated Diseases (CIMD), Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
| | - D Thomas
- Institute of Clinical Pharmacology, pharmazentrum frankfurt/ZAFES, University Hospital of Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology (ITMP), and Fraunhofer Cluster of Excellence for Immune Mediated Diseases (CIMD), Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
| | - R Gurke
- Institute of Clinical Pharmacology, pharmazentrum frankfurt/ZAFES, University Hospital of Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology (ITMP), and Fraunhofer Cluster of Excellence for Immune Mediated Diseases (CIMD), Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany.
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Maremmani I, Spera V, Maiello M, Maremmani AGI, Perugi G. Adult Attention-Deficit Hyperactivity Disorder/Substance Use Disorder Dual Disorder Patients: A Dual Disorder Unit Point of View. Curr Top Behav Neurosci 2022; 57:179-198. [PMID: 35507285 DOI: 10.1007/7854_2022_335] [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] [Indexed: 06/14/2023]
Abstract
Substance Use Disorders (SUDs) are often associated with Attention-Deficit Hyperactivity Disorder (ADHD) in adult populations due to multiple neurobiological, genetic, and psychosocial risk factors. This chapter provides a picture of the clinical aspects of adults with both ADHD and SUDs at treatment entry into a Dual Disorder Unit introducing the concept of different types of craving that may lead to substance use and abuse. At treatment entry, the presence of different comorbid SUD clusters, characterized by either stimulants/alcohol or by the use of cannabinoids, has not been shown to influence ADHD-specific symptomatology or severity, despite being crucial for the identification of a specific type of craving. We identified four clinical presentations of adult ADHD: Emotional Dysregulation, Substance Use, Core-ADHD Symptoms, and Positive Emotionality variants, that offer a practical guide in diagnosing and managing adult ADHD patients. Although the evidence of an effective medical treatment for Cocaine Use Disorder is insufficient, in our experience, toxicomanic behavior during stimulant treatment is sharply reduced in ADHD patients with cocaine addiction. Moreover, caffeinated compounds in military soldiers with ADHD may help reduce ADHD symptoms, making caffeine a potential pharmacological tool worth further investigation. Finally, substance use comorbidity does not influence treatment retention rate.
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Affiliation(s)
- Icro Maremmani
- Association for the Application of Neuroscientific Knowledge to Social Aims (AU-CNS), Pietrasanta, Lucca, Italy.
- V.P. Dole Research Group, G. De Lisio Institute of Behavioral Sciences, Pisa, Italy.
- Saint Camillus International University of Health and Medical Sciences - UniCamillus, Rome, Italy.
| | - Vincenza Spera
- Psychiatric Clinic, Sociopsychiatric Organization, Mendrisio, Switzerland
| | - Marco Maiello
- Drug Addiction Unit, Northern-West Tuscany Region Local Health Unit, Apuan Zone, Massa, Italy
| | - Angelo G I Maremmani
- Association for the Application of Neuroscientific Knowledge to Social Aims (AU-CNS), Pietrasanta, Lucca, Italy
- V.P. Dole Research Group, G. De Lisio Institute of Behavioral Sciences, Pisa, Italy
- Department of Psychiatry, North-Western Tuscany Local Health Unit, Tuscany NHS, Versilia Zone, Viareggio, Italy
| | - Giulio Perugi
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
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Kumar D, Sharma A, Taliyan R, Urmera MT, Herrera Calderon O, Heinbockel T, Rahman S, Goyal R. Orchestration of the circadian clock and its association with Alzheimer's disease: Role of endocannabinoid signaling. Ageing Res Rev 2022; 73:101533. [PMID: 34844016 PMCID: PMC8729113 DOI: 10.1016/j.arr.2021.101533] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 10/24/2021] [Accepted: 11/22/2021] [Indexed: 01/03/2023]
Abstract
Circadian rhythms are 24-hour natural rhythms regulated by the suprachiasmatic nucleus, also known as the "master clock". The retino-hypothalamic tract entrains suprachiasmatic nucleus with photic information to synchronise endogenous circadian rhythms with the Earth's light-dark cycle. However, despite the robustness of circadian rhythms, an unhealthy lifestyle and chronic photic disturbances cause circadian rhythm disruption in the suprachiasmatic nucleus's TTFL loops via affecting glutamate and γ-aminobutyric acid-mediated neurotransmission in the suprachiasmatic nucleus. Recently, considerable evidence has been shown correlating CRd with the incidence of Alzheimer's disease. The present review aims to identify the existence and signalling of endocannabinoids in CRd induced Alzheimer's disease through retino-hypothalamic tract- suprachiasmatic nucleus-cortex. Immunohistochemistry has confirmed the expression of cannabinoid receptor 1 in the suprachiasmatic nucleus to modulate the circadian phases of the master clock. Literature also suggests that cannabinoids may alter activity of suprachiasmatic nucleus by influencing the activity of their major neurotransmitter γ-aminobutyric acid or by interacting indirectly with the suprachiasmatic nucleus's two other major inputs i.e., the geniculo-hypothalamic tract-mediated release of neuropeptide Y and serotonergic inputs from the dorsal raphe nuclei. Besides, the expression of cannabinoid receptor 2 ameliorates cognitive deficits via reduction of tauopathy and microglial activation. In conclusion, endocannabinoids may be identified as a putative target for correcting CRd and decelerating Alzheimer's disease.
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Affiliation(s)
- Deepak Kumar
- Department of Neuropharmacology, School of Pharmaceutical Sciences, Shoolini University of Biotechnology and Management Sciences, Solan, H.P., 173229, India
| | - Ashish Sharma
- School of Medicine, Washington University, St. Louis, USA
| | - Rajeev Taliyan
- Department of Pharmacy, Birla Institute of Technology Science, Pilani, Rajasthan, 333301, India
| | - Maiko T. Urmera
- Institute on Aging and Centre for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Oscar Herrera Calderon
- Department of Pharmacology, Bromatology and Toxicology, Faculty of Pharmacy and Biochemistry, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Thomas Heinbockel
- Howard University College of Medicine, Washington, District of Columbia, USA
| | - Shafiqur Rahman
- Department of Pharmaceutical Sciences, College of Pharmacy South Dakota State University, Brookings, South Dakota, USA
| | - Rohit Goyal
- Department of Neuropharmacology, School of Pharmaceutical Sciences, Shoolini University of Biotechnology and Management Sciences, Solan, H.P., 173229, India.,Corresponding author: Dr Rohit Goyal, Professor, Department of Neuropharmacology, School of Pharmaceutical Sciences, Shoolini University of Biotechnology and Management Sciences, Solan, H.P., 173229, India, ; Mob. +91 98160 62679
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30
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Kumar D, Sharma A, Taliyan R, Urmera MT, Herrera-Calderon O, Heinbockel T, Rahman S, Goyal R. Orchestration of the circadian clock and its association with Alzheimer's disease: Role of endocannabinoid signaling. Ageing Res Rev 2022. [DOI: https://doi.org/10.1016/j.arr.2021.101533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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31
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Kratz D, Thomas D, Gurke R. Endocannabinoids as potential biomarkers: It's all about pre-analytics. J Mass Spectrom Adv Clin Lab 2021; 22:56-63. [PMID: 34939056 DOI: 10.1016/j.jmsacl.2021.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 11/01/2021] [Accepted: 11/05/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction Arachidonoyl ethanolamide (AEA) and 2-arachidonoyl glycerol (2-AG) are central lipid mediators of the endocannabinoid system. They are highly relevant due to their involvement in a wide variety of inflammatory, metabolic or malign diseases. Further elucidation of their modes of action and use as biomarkers in an easily accessible matrix, like blood, is restricted by their susceptibility to deviations during blood sampling and physiological co-dependences, which results in high variability of reported concentrations in low ng/mL ranges. Objectives The objective of this review is the identification of critical parameters during the pre-analytical phase and proposal of minimum requirements for reliable determination of endocannabinoids (ECs) in blood samples. Methods Reported physiological processes influencing the EC concentrations were put into context with published pre-analytical research and stability data from bioanalytical method validation. Results The cause for variability in EC concentrations is versatile. In part, they are caused by inter-individual factors like sex, metabolic status and/or diurnal changes. Nevertheless, enzymatic activity in freshly drawn blood samples is the main reason for changing concentrations of AEA and 2-AG, besides additional non-enzymatic isomerization of the latter. Conclusion Blood samples for EC analyses require immediate processing at low temperatures (>0 °C) to maintain sample integrity. Standardization of the respective blood tube or anti-coagulant, sampling time point, applied centrifugal force and complete processing time can further decrease variability caused by sample handling. Nevertheless, extensive characterization of study participants is needed to reduce distortion of clinical data caused by co-variables and facilitate research on the endocannabinoid system.
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Key Words
- (U)HPLC, (ultra) high performance liquid chromatography
- 1-AG, 1-arachidonoyl glycerol
- 2-AG, 2-arachidonoyl glycerol
- 2-Arachidonoyl glycerol
- AEA, arachidonoyl ethanolamide
- Anandamide
- BMI, body mass index
- Blood sampling
- CBR, cannabinoid receptor
- EC-like, endocannabinoid-like
- ECS, endocannabinoid system
- ECs, endocannabinoids
- EDTA, ethylenediaminetetraacetic acid
- Endocannabinoid
- FAAH, fatty acid amide hydrolase
- FT, freezing temperature
- FTC, freeze–thaw cycles
- HDL, high density lipo protein
- KSCN, potassium thiocyanate
- LLE, liquid–liquid extraction
- MAGL, monoacylglycerol lipase
- MS/MS, tandem mass spectrometry
- O-AEA, virodhamine
- OEA, oleoyl ethanolamide
- PAF, platelet-activating factor
- PEA, palmitoyl ethanolamide
- PMSF, phenylmethylsulfonyl fluoride
- Pre-analytics
- RT, room temperature
- SPE, solid-phase extraction
- WB, whole blood
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Affiliation(s)
- Daniel Kratz
- Institute of Clinical Pharmacology, pharmazentrum frankfurt/ZAFES, University Hospital of Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Dominique Thomas
- Institute of Clinical Pharmacology, pharmazentrum frankfurt/ZAFES, University Hospital of Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology (ITMP), and Fraunhofer Cluster of Excellence for Immune Mediated Diseases (CIMD), Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
| | - Robert Gurke
- Institute of Clinical Pharmacology, pharmazentrum frankfurt/ZAFES, University Hospital of Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology (ITMP), and Fraunhofer Cluster of Excellence for Immune Mediated Diseases (CIMD), Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
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Pietropaolo S, Marsicano G. The role of the endocannabinoid system as a therapeutic target for autism spectrum disorder: Lessons from behavioral studies on mouse models. Neurosci Biobehav Rev 2021; 132:664-678. [PMID: 34813825 DOI: 10.1016/j.neubiorev.2021.11.031] [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: 03/26/2021] [Revised: 11/02/2021] [Accepted: 11/19/2021] [Indexed: 12/17/2022]
Abstract
Recent years have seen an impressive amount of research devoted to understanding the etiopathology of Autism Spectrum Disorder (ASD) and developing therapies for this syndrome. Because of the lack of biomarkers of ASD, this work has been largely based on the behavioral characterization of rodent models, based on a multitude of genetic and environmental manipulations. Here we highlight how the endocannabinoid system (ECS) has recently emerged within this context of mouse behavioral studies as an etiopathological factor in ASD and a valid potential therapeutic target. We summarize the most recent results showing alterations of the ECS in rodent models of ASD, and demonstrating ASD-like behaviors in mice with altered ECS, induced either by genetic or pharmacological manipulations. We also give a critical overview of the most relevant advances in designing treatments and novel mouse models for ASD targeting the ECS, highlighting the relevance of thorough and innovative behavioral approaches to investigate the mechanisms acting underneath the complex features of ASD.
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Affiliation(s)
| | - Giovanni Marsicano
- INSERM, U1215 NeuroCentre Magendie, 146 rue Léo Saignat, 33077, Bordeaux Cedex, France
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Gao W, Schmidt K, Enge S, Kirschbaum C. Intra-individual stability of hair endocannabinoid and N-acylethanolamine concentrations. Psychoneuroendocrinology 2021; 133:105395. [PMID: 34482257 DOI: 10.1016/j.psyneuen.2021.105395] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 08/02/2021] [Accepted: 08/20/2021] [Indexed: 10/20/2022]
Abstract
Hair analysis of endocannabinoids and N-acylethanolamines presents a promising methodological advancement for the retrospective assessment of long-term cumulative endocannabinoids and N-acylethanolamines secretion over extended periods of time. A main assumption of this method application that hair endocannabinoid and N-acylethanolamine concentrations show intra-individual stability has not been confirmed yet. Thus, in the current study hair endocannabinoid and N-acylethanolamine levels were measured over a period of two and a half years with six months between each hair sample collection in 100 female participants. We found strong test-retest associations of hair endocannabinoid and N-acylethanolamine levels with intraclass correlation coefficients between 0.79 and 0.92. Furthermore, no correlations between perceived stress and hair endocannabinoids or N-acylethanolamines was observed. The current findings support the notion that endocannabinoids and N-acylethanolamines in hair are rather trait biomarkers that are stable over a considerable period of time rather than rapidly changing state markers.
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Affiliation(s)
- Wei Gao
- Faculty of Psychology, Chair of Biological Psychology, Technische Universität Dresden, Dresden, Germany.
| | - Kornelius Schmidt
- Faculty of Psychology, Chair of Biological Psychology, Technische Universität Dresden, Dresden, Germany
| | - Sören Enge
- Faculty of Natural Sciences, Department of Psychology, Medical School Berlin, Berlin, Germany
| | - Clemens Kirschbaum
- Faculty of Psychology, Chair of Biological Psychology, Technische Universität Dresden, Dresden, Germany
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34
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Li J, Carvajal R, Bruner L, Kaminski NE. The current understanding of the benefits, safety, and regulation of cannabidiol in consumer products. Food Chem Toxicol 2021; 157:112600. [PMID: 34626752 DOI: 10.1016/j.fct.2021.112600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 09/30/2021] [Accepted: 10/04/2021] [Indexed: 01/04/2023]
Abstract
The popularity of cannabidiol (CBD) in consumer products is soaring as consumers are using CBD for general health and well-being as well as to seek relief from ailments especially pain, inflammation, anxiety, depression, and sleep disorders. However, there are limited data currently in the public domain that provide support for these benefits. By contrast, a significant amount of safety evaluation data for CBD have been obtained recently from pre-clinical and clinical studies of the CBD therapeutic Epidiolex®. Yet some key data gaps concerning the safe use of CBD still remain. Furthermore, current regulations on CBD use in consumer products remain uncertain and often conflict between the state and federal level. In light of the rapidly expanding popularity of CBD-related products in the marketplace, here we review the current understanding of the benefits, safety, and regulations surrounding CBD in consumer products. This review does not advocate for or against the use of CBD in consumer products. Rather this review seeks to assess the state-of-the-science on the health effects and safety of CBD, to identify critical knowledge gaps for future studies, and to raise the awareness of the current regulations that govern CBD use in consumer products.
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Affiliation(s)
- Jinpeng Li
- Center for Research on Ingredient Safety, Michigan State University, East Lansing, MI, 48824, USA; Institute for Integrative Toxicology, Michigan State University, East Lansing, MI, 48824, USA
| | | | - Leon Bruner
- Institute for Integrative Toxicology, Michigan State University, East Lansing, MI, 48824, USA
| | - Norbert E Kaminski
- Center for Research on Ingredient Safety, Michigan State University, East Lansing, MI, 48824, USA; Institute for Integrative Toxicology, Michigan State University, East Lansing, MI, 48824, USA; Department of Pharmacology and Toxicology, Michigan State University, East Lansing, MI, 48824, USA.
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35
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Christie S, Zagorodnyuk V. Time-of-day dependent changes in guinea pig bladder afferent mechano-sensitivity. Sci Rep 2021; 11:19283. [PMID: 34588547 PMCID: PMC8481311 DOI: 10.1038/s41598-021-98831-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/08/2021] [Indexed: 01/03/2023] Open
Abstract
The voiding of urine has a clear circadian rhythm with increased voiding during active phases and decreased voiding during inactive phases. Bladder spinal afferents play a key role in the regulation of bladder storage and voiding, but it is unknown whether they exhibit themselves a potential circadian rhythm. Therefore, this study aimed to determine the mechano- and chemo- sensitivity of three major bladder afferent classes at two opposite day-night time points. Adult female guinea pigs underwent conscious voiding monitoring and bladder ex vivo single unit extracellular afferent recordings at 0300 h and 1500 h to determine day-night modulation of bladder afferent activity. All guinea pigs voided a higher amount of urine at 1500 h compared to 0300 h. This was due to an increased number of voids at 1500 h. The mechano-sensitivity of low- and high-threshold stretch-sensitive muscular-mucosal bladder afferents to mucosal stroking and stretch was significantly higher at 1500 h compared to 0300 h. Low-threshold stretch-insensitive mucosal afferent sensitivity to stroking was significantly higher at 1500 h compared to 0300 h. Further, the chemosensitivity of mucosal afferents to N-Oleoyl Dopamine (endogenous TRPV1 agonist) was also significantly increased at 1500 h compared to 0300 h. This data indicates that bladder afferents exhibit a significant time-of-day dependent variation in mechano-sensitivity which may influence urine voiding patterns. Further studies across a 24 h period are warranted to reveal potential circadian rhythm modulation of bladder afferent activity.
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Affiliation(s)
- Stewart Christie
- Discipline of Human Physiology, Flinders Health & Medical Research Institute, College of Medicine and Public Health, Flinders University, GPO Box 2100, Adelaide, SA, Australia
| | - Vladimir Zagorodnyuk
- Discipline of Human Physiology, Flinders Health & Medical Research Institute, College of Medicine and Public Health, Flinders University, GPO Box 2100, Adelaide, SA, Australia.
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Rao A, Ebelt P, Mallard A, Briskey D. Palmitoylethanolamide for sleep disturbance. A double-blind, randomised, placebo-controlled interventional study. SLEEP SCIENCE AND PRACTICE 2021; 5:12. [PMID: 34522787 PMCID: PMC8428962 DOI: 10.1186/s41606-021-00065-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 07/12/2021] [Indexed: 11/12/2022] Open
Abstract
Background Sleep is essential for wellbeing, yet sleep disturbance is a common problem linked to a wide range of health conditions. Palmitoylethanolamide (PEA) is an endogenous fatty acid amide proposed to promote better sleep via potential interaction with the endocannabinoid system. Methods This double-blind, randomised study on 103 adults compared the efficacy and tolerability of 8 weeks of daily supplemented PEA formulation (350 mg Levagen + ®) to a placebo. Sleep quality and quantity were measured using wrist actigraphy, a sleep diary and questionnaires. Results At week 8, PEA supplementation reduced sleep onset latency, time to feel completely awake and improved cognition on waking. After 8 weeks, both groups improved their sleep quality and quantity scores similarly. There was no difference between groups at baseline or week 8 for sleep quantity or quality as measured from actigraphy or sleep diaries. Conclusion These findings support PEA as a potential sleeping aid capable of reducing sleep onset time and improving cognition on waking. Trial registration Australian
New Zealand Clinical Trials Registry ACTRN12618001339246. Registered 9th
August 2018.
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Affiliation(s)
- Amanda Rao
- RDC Clinical, Brisbane, 4006 Australia.,University of Sydney, School of Medicine, Sydney, Australia
| | | | - Alistair Mallard
- Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - David Briskey
- RDC Clinical, Brisbane, 4006 Australia.,School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia
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L’usage du cannabidiol dans le sport : une bonne idée ? Sci Sports 2021. [DOI: 10.1016/j.scispo.2021.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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38
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Murillo-Rodríguez E, Arankowsky-Sandoval G, Budde H, Imperatori C, Machado S, Yamamoto T, Yadollahpour A, Torterolo P. In vivo brain levels of acetylcholine and 5-hydroxytryptamine after oleoylethanolamide or palmitoylethanolamide administrations are mediated by PPARα engagement. Eur J Neurosci 2021; 54:5932-5950. [PMID: 34396611 DOI: 10.1111/ejn.15409] [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: 05/18/2021] [Revised: 07/06/2021] [Accepted: 07/25/2021] [Indexed: 11/29/2022]
Abstract
The peroxisome proliferator-activated receptor alpha (PPARα) is a nuclear receptor that has been linked to the modulation of several physiological functions, including the sleep-wake cycle. The PPARα recognizes as endogenous ligands the lipids oleoylethanolamide (OEA) and palmitoylethanolamide (PEA), which in turn, if systemically injected, they exert wake-promoting effects. Moreover, the activation of PPARα by the administration of OEA or PEA increases the extracellular contents of neurotransmitters linked to the control of wakefulness; however, the role of PPARα activated by OEA or PEA on additional biochemicals related to waking regulation, such as acetylcholine (ACh) and 5-hydroxytryptamine (5-HT), has not been fully studied. Here, we have investigated the effects of treatments of OEA or PEA on the contents of ACh and 5-HT by using in vivo microdialysis techniques coupled to HPLC means. For this purpose, OEA or PEA were systemically injected (5, 10 or 30 mg/kg; i.p.), and the levels of ACh and 5-HT were collected from the basal forebrain, a wake-related brain area. These pharmacological treatments significantly increased the contents of ACh and 5-HT as determined by HPLC procedures. Interestingly, PPARα antagonist MK-886 (30 mg/kg; i.p.) injected before the treatments of OEA or PEA blocked these outcomes. Our data suggest that the activation of PPARα by OEA or PEA produces significant changes on ACh and 5-HT levels measured from the basal forebrain and support the conclusion that PPARα is a suitable molecular element involved in the regulation of wake-related neurotransmitters.
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Affiliation(s)
- Eric Murillo-Rodríguez
- Laboratorio de Neurociencias Moleculares e Integrativas, Escuela de Medicina, División Ciencias de la Salud, Universidad Anáhuac Mayab, Mérida, Yucatán, Mexico.,Intercontinental Neuroscience Research Group
| | - Gloria Arankowsky-Sandoval
- Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Universidad Autónoma de Yucatán, Mérida, Yucatán, Mexico
| | - Henning Budde
- Intercontinental Neuroscience Research Group.,Institute for Systems Medicine, Faculty of Human Sciences, MSH Medical School Hamburg, Hamburg, Germany
| | - Claudio Imperatori
- Intercontinental Neuroscience Research Group.,Cognitive and Clinical Psychology Laboratory, Department of Human Science, European University of Rome, Rome, Italy
| | - Sérgio Machado
- Intercontinental Neuroscience Research Group.,Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil.,Laboratory of Physical Activity Neuroscience, Neurodiversity Institute, Queimados, Brazil
| | - Tetsuya Yamamoto
- Intercontinental Neuroscience Research Group.,Graduate School of Technology, Industrial and Social Sciences, Tokushima University, Tokushima, Japan
| | - Ali Yadollahpour
- Intercontinental Neuroscience Research Group.,Department of Psychology, University of Sheffield, Sheffield, UK
| | - Pablo Torterolo
- Intercontinental Neuroscience Research Group.,Laboratorio de Neurobiología del Sueño, Departamento de Fisiología, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
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Zloczower O, Brill S, Zeitak Y, Peles E. Risk and benefit of cannabis prescription for chronic non-cancer pain. J Addict Dis 2021; 40:157-167. [PMID: 34338621 DOI: 10.1080/10550887.2021.1956673] [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
OBJECTIVES We investigated whether cannabis usage was associated with reduced opioid usage, and the rates of opioid and cannabis use disorders among chronic pain patients who had been prescribed medical cannabis. METHODS A random sample of chronic pain patients who had license for cannabis use were interviewed by telephone about their lifetime opioid and cannabis usage. Cannabis and opioid use disorders were assessed with Portenoy's criteria. RESULTS Of the 100 participants aged 18-70 years (compliance 67% (aged >40) and 33% (aged ≤ 40y)), 76 ever used opioids. Of them, 93% decreased or stopped opioids following cannabis initiation. Ten patients (10%), 17.4% of the ≤40 y age group, met the criteria for cannabis use disorder. Compared to those who did not meet the criteria, their lifetime depression was higher (80% vs. 43.2%, respectively, P=.042), and they were less educated (12.2 ± 0.6y vs. 13.5 ± 2.1y, p = 0.05). CONCLUSIONS Cannabis usage was associated with reduced opioid usage. The prevalence of cannabis use disorder was high among the younger participants who also had a lower study compliance rate, suggesting the higher actual prevalence of cannabis use disorder. While medical cannabis may help reduce opioid use in chronic non-cancer pain patients, younger age, depression, and other risk factors should be carefully evaluated before cannabis is prescribed.
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Affiliation(s)
- Ory Zloczower
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Buchmann Faculty of Law, Tel Aviv University, Tel Aviv, Israel
| | - Silviu Brill
- Pain Center, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Yael Zeitak
- Pain Center, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Einat Peles
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Dr. Miriam and Sheldon G. Adelson Clinic for Drug Abuse, Treatment and Research, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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40
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Kalaba M, MacNair L, Peters EN, Eglit GML, Rapin L, El Hage C, Prosk E, Ware MA. Authorization Patterns, Safety, and Effectiveness of Medical Cannabis in Quebec. Cannabis Cannabinoid Res 2021; 6:564-572. [PMID: 33998902 PMCID: PMC8713264 DOI: 10.1089/can.2020.0140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Introduction: Despite increasing demand for data, little is known about the authorization patterns, safety, and effectiveness of medical cannabis products. Materials and Methods: We conducted a 2 year observational study of adult patients who were legally authorized a medical cannabis product from a single licensed producer; we captured and analyzed authorized cannabis use patterns by cannabinoid profile (tetrahydrocannabinol [THC]-dominant; cannabidiol [CBD]-dominant; and balanced (THC:CBD) and clinical outcomes using standardized outcome measures every 3 months for 12 months at a network of medical cannabis clinics in Quebec, Canada. Results: We recruited 585 patients (average age 56.5 years), of whom 61% identified as female and 85% reported pain as their primary complaint. Over 12 months, there was a significant increase in the number of products authorized (Z=2.59, p=0.01). The proportion of authorizations for a THC-dominant or CBD-dominant product increased relative to the proportion of authorizations for a balanced (THC:CBD) product (all p<0.01). Symptom improvement over time was observed for pain, tiredness, drowsiness, anxiety, and well-being. Patients authorized THC-dominant products exhibited less symptom improvement for anxiety and well-being relative to those authorized CBD-dominant or balanced (THC:CBD) products. Medical cannabis was well tolerated across all product profiles. Conclusion: These real-world data reveal changes in medical cannabis authorization patterns and suggest that symptom improvement may vary by cannabinoid profile over 12 months of follow-up.
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Affiliation(s)
- Maja Kalaba
- Canopy Growth Corporation, Smiths Falls, Canada
| | | | | | | | | | | | | | - Mark A Ware
- Canopy Growth Corporation, Smiths Falls, Canada
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Piggott VM, Lloyd SC, Matchynski JI, Perrine SA, Conti AC. Traumatic Stress, Chronic Ethanol Exposure, or the Combination, Alter Cannabinoid System Components in Reward and Limbic Regions of the Mouse Brain. Molecules 2021; 26:2086. [PMID: 33917316 PMCID: PMC8038692 DOI: 10.3390/molecules26072086] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/01/2021] [Accepted: 04/03/2021] [Indexed: 12/17/2022] Open
Abstract
The cannabinoid system is independently affected by stress and chronic ethanol exposure. However, the extent to which co-occurrence of traumatic stress and chronic ethanol exposure modulates the cannabinoid system remains unclear. We examined levels of cannabinoid system components, anandamide, 2-arachidonoylglycerol, fatty acid amide hydrolase, and monoacylglycerol lipase after mouse single-prolonged stress (mSPS) or non-mSPS (Control) exposure, with chronic intermittent ethanol (CIE) vapor or without CIE vapor (Air) across several brain regions using ultra-high-performance liquid chromatography tandem mass spectrometry or immunoblotting. Compared to mSPS-Air mice, anandamide and 2-arachidonoylglycerol levels in the anterior striatum were increased in mSPS-CIE mice. In the dorsal hippocampus, anandamide content was increased in Control-CIE mice compared to Control-Air, mSPS-Air, or mSPS-CIE mice. Finally, amygdalar anandamide content was increased in Control-CIE mice compared to Control-Air, or mSPS-CIE mice, but the anandamide content was decreased in mSPS-CIE compared to mSPS-Air mice. Based on these data we conclude that the effects of combined traumatic stress and chronic ethanol exposure on the cannabinoid system in reward pathway regions are driven by CIE exposure and that traumatic stress affects the cannabinoid components in limbic regions, warranting future investigation of neurotherapeutic treatment to attenuate these effects.
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Affiliation(s)
- Veronica M. Piggott
- Research & Development Service, John D. Dingell VA Medical Center, Detroit, MI 48201, USA; (V.M.P.); (S.C.L.); (J.I.M.); (S.A.P.)
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Scott C. Lloyd
- Research & Development Service, John D. Dingell VA Medical Center, Detroit, MI 48201, USA; (V.M.P.); (S.C.L.); (J.I.M.); (S.A.P.)
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - James I. Matchynski
- Research & Development Service, John D. Dingell VA Medical Center, Detroit, MI 48201, USA; (V.M.P.); (S.C.L.); (J.I.M.); (S.A.P.)
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48201, USA
- Translational Neuroscience Program, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Shane A. Perrine
- Research & Development Service, John D. Dingell VA Medical Center, Detroit, MI 48201, USA; (V.M.P.); (S.C.L.); (J.I.M.); (S.A.P.)
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48201, USA
- Translational Neuroscience Program, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Alana C. Conti
- Research & Development Service, John D. Dingell VA Medical Center, Detroit, MI 48201, USA; (V.M.P.); (S.C.L.); (J.I.M.); (S.A.P.)
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48201, USA
- Translational Neuroscience Program, Wayne State University School of Medicine, Detroit, MI 48201, USA
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Roehrs T, Sibai M, Roth T. Sleep and alertness disturbance and substance use disorders: A bi-directional relation. Pharmacol Biochem Behav 2021; 203:173153. [PMID: 33582097 PMCID: PMC7996967 DOI: 10.1016/j.pbb.2021.173153] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/18/2021] [Accepted: 02/09/2021] [Indexed: 02/04/2023]
Abstract
The majority of the literature describing the relation of sleep/alertness disturbance and substance use disorders (SUD) has focused on the disruptive effects of substances with abuse liability on sleep and alertness. Rarely have studies or literature reviews assessed or discussed how sleep/alertness disturbance affects substance use. This paper focuses on the sleep/alertness disturbance side of the relation. We argue that the relation is bi-directional and review evidence showing that sleep/alertness disturbance affects all phases of the addiction cycle, including the initiation, maintenance and relapse of SUD. We review a variety of substances across all phases of the addiction cycle and conclude sleep/alertness disturbance is a critical factor in both understanding and treating SUD.
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Affiliation(s)
- Timothy Roehrs
- Sleep Medicine, Henry Ford Health System, Detroit, MI, United States of America; Dept of Psychiatry & Behavioral Neuroscience, Wayne State University, SOM, Detroit, MI, United States of America; Dept of Psychology, University of Detroit Mercy, Detroit, MI, United States of America
| | - Mohammad Sibai
- Sleep Medicine, Henry Ford Health System, Detroit, MI, United States of America; Dept of Psychology, University of Detroit Mercy, Detroit, MI, United States of America
| | - Thomas Roth
- Sleep Medicine, Henry Ford Health System, Detroit, MI, United States of America; Dept of Psychiatry & Behavioral Neuroscience, Wayne State University, SOM, Detroit, MI, United States of America.
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Winiger EA, Ellingson JM, Morrison CL, Corley RP, Pasman JA, Wall TL, Hopfer CJ, Hewitt JK. Sleep deficits and cannabis use behaviors: an analysis of shared genetics using linkage disequilibrium score regression and polygenic risk prediction. Sleep 2021; 44:zsaa188. [PMID: 32935850 PMCID: PMC7953210 DOI: 10.1093/sleep/zsaa188] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 08/27/2020] [Indexed: 12/17/2022] Open
Abstract
STUDY OBJECTIVES Estimate the genetic relationship of cannabis use with sleep deficits and an eveningness chronotype. METHODS We used linkage disequilibrium score regression (LDSC) to analyze genetic correlations between sleep deficits and cannabis use behaviors. Secondly, we generated sleep deficit polygenic risk score (PRS) and estimated their ability to predict cannabis use behaviors using linear and logistic regression. Summary statistics came from existing genome-wide association studies of European ancestry that were focused on sleep duration, insomnia, chronotype, lifetime cannabis use, and cannabis use disorder (CUD). A target sample for PRS prediction consisted of high-risk participants and participants from twin/family community-based studies (European ancestry; n = 760, male = 64%; mean age = 26.78 years). Target data consisted of self-reported sleep (sleep duration, feeling tired, and taking naps) and cannabis use behaviors (lifetime ever use, number of lifetime uses, past 180-day use, age of first use, and lifetime CUD symptoms). RESULTS Significant genetic correlation between lifetime cannabis use and an eveningness chronotype (rG = 0.24, p < 0.001), as well as between CUD and both short sleep duration (<7 h; rG = 0.23, p = 0.017) and insomnia (rG = 0.20, p = 0.020). Insomnia PRS predicted earlier age of first cannabis use (OR = 0.92, p = 0.036) and increased lifetime CUD symptom count (OR = 1.09, p = 0.012). CONCLUSION Cannabis use is genetically associated with both sleep deficits and an eveningness chronotype, suggesting that there are genes that predispose individuals to both cannabis use and sleep deficits.
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Affiliation(s)
- Evan A Winiger
- Institute for Behavioral Genetics, University of Colorado Boulder, CO
- Department of Psychology and Neuroscience, University of Colorado Boulder, CO
| | - Jarrod M Ellingson
- Institute for Behavioral Genetics, University of Colorado Boulder, CO
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO
| | - Claire L Morrison
- Institute for Behavioral Genetics, University of Colorado Boulder, CO
- Department of Psychology and Neuroscience, University of Colorado Boulder, CO
| | - Robin P Corley
- Institute for Behavioral Genetics, University of Colorado Boulder, CO
| | - Joëlle A Pasman
- Behavioural Science Institute, Radboud University Nijmegen, Amsterdam, The Netherlands
| | - Tamara L Wall
- Department of Psychiatry, University of California, San Diego, CA
| | - Christian J Hopfer
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO
| | - John K Hewitt
- Institute for Behavioral Genetics, University of Colorado Boulder, CO
- Department of Psychology and Neuroscience, University of Colorado Boulder, CO
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Loss CM, Teodoro L, Rodrigues GD, Moreira LR, Peres FF, Zuardi AW, Crippa JA, Hallak JEC, Abílio VC. Is Cannabidiol During Neurodevelopment a Promising Therapy for Schizophrenia and Autism Spectrum Disorders? Front Pharmacol 2021; 11:635763. [PMID: 33613289 PMCID: PMC7890086 DOI: 10.3389/fphar.2020.635763] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 12/24/2020] [Indexed: 01/22/2023] Open
Abstract
Schizophrenia and autism spectrum disorders (ASD) are psychiatric neurodevelopmental disorders that cause high levels of functional disabilities. Also, the currently available therapies for these disorders are limited. Therefore, the search for treatments that could be beneficial for the altered course of the neurodevelopment associated with these disorders is paramount. Preclinical and clinical evidence points to cannabidiol (CBD) as a promising strategy. In this review, we discuss clinical and preclinical studies on schizophrenia and ASD investigating the behavioral, molecular, and functional effects of chronic treatment with CBD (and with cannabidivarin for ASD) during neurodevelopment. In summary, the results point to CBD's beneficial potential for the progression of these disorders supporting further investigations to strengthen its use.
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Affiliation(s)
- Cássio Morais Loss
- Molecular and Behavioral Neuroscience Laboratory, Departamento de Farmacologia, Universidade Federal de São Paulo, São Paulo, Brazil.,National Institute for Translational Medicine (INCT-TM), National Council for Scientific and Technological Development (CNPq/CAPES/FAPESP), Ribeirão Preto, Brazil
| | - Lucas Teodoro
- Molecular and Behavioral Neuroscience Laboratory, Departamento de Farmacologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Gabriela Doná Rodrigues
- Molecular and Behavioral Neuroscience Laboratory, Departamento de Farmacologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Lucas Roberto Moreira
- Molecular and Behavioral Neuroscience Laboratory, Departamento de Farmacologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Fernanda Fiel Peres
- Molecular and Behavioral Neuroscience Laboratory, Departamento de Farmacologia, Universidade Federal de São Paulo, São Paulo, Brazil.,National Institute for Translational Medicine (INCT-TM), National Council for Scientific and Technological Development (CNPq/CAPES/FAPESP), Ribeirão Preto, Brazil
| | - Antonio Waldo Zuardi
- National Institute for Translational Medicine (INCT-TM), National Council for Scientific and Technological Development (CNPq/CAPES/FAPESP), Ribeirão Preto, Brazil.,Department of Neuroscience and Behavior, Ribeirão Preto Medical School, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - José Alexandre Crippa
- National Institute for Translational Medicine (INCT-TM), National Council for Scientific and Technological Development (CNPq/CAPES/FAPESP), Ribeirão Preto, Brazil.,Department of Neuroscience and Behavior, Ribeirão Preto Medical School, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Jaime Eduardo Cecilio Hallak
- National Institute for Translational Medicine (INCT-TM), National Council for Scientific and Technological Development (CNPq/CAPES/FAPESP), Ribeirão Preto, Brazil.,Department of Neuroscience and Behavior, Ribeirão Preto Medical School, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Vanessa Costhek Abílio
- Molecular and Behavioral Neuroscience Laboratory, Departamento de Farmacologia, Universidade Federal de São Paulo, São Paulo, Brazil.,National Institute for Translational Medicine (INCT-TM), National Council for Scientific and Technological Development (CNPq/CAPES/FAPESP), Ribeirão Preto, Brazil
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Saldaña-Shumaker SL, Grenning AJ, Cunningham CW. Modern approaches to the development of synthetic cannabinoid receptor probes. Pharmacol Biochem Behav 2021; 203:173119. [PMID: 33508249 DOI: 10.1016/j.pbb.2021.173119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 10/13/2020] [Accepted: 01/18/2021] [Indexed: 10/22/2022]
Abstract
The endocannabinoid system, which spans the central and peripheral nervous systems and regulates many biologic processes, is an important target for probe discovery and medications development. Whereas the earliest endocannabinoid receptor probes were derivatives of the non-selective phytocannabinoids isolated from Cannabis species, modern drug discovery techniques have expanded the definitions of what constitutes a CB1R or CB2R cannabinoid receptor ligand. This review highlights recent advances in synthetic cannabinoid receptor chemistry and pharmacology. We provide examples of new CB1R- and CB2R-selective probes, and discuss rational approaches to the design of peripherally-restricted agents. We also describe structural classes of positive- and negative allosteric modulators (PAMs and NAMs) of CB1R and CB2R. Finally, we introduce new opportunities for cannabinoid receptor probe development that have emerged in recent years, including biased agonists that may lead to medications lacking adverse effects.
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Affiliation(s)
- Savanah L Saldaña-Shumaker
- Department of Pharmaceutical Sciences, Concordia University Wisconsin, 12800 N. Lake Shore Drive, Mequon, WI 53097, USA
| | - Alexander J Grenning
- Department of Chemistry, University of Florida, PO Box 117200, Gainesville, FL 32611, USA
| | - Christopher W Cunningham
- Department of Pharmaceutical Sciences, Concordia University Wisconsin, 12800 N. Lake Shore Drive, Mequon, WI 53097, USA.
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Phytocannabinoids-A Green Approach toward Non-Alcoholic Fatty Liver Disease Treatment. J Clin Med 2021; 10:jcm10030393. [PMID: 33498537 PMCID: PMC7864168 DOI: 10.3390/jcm10030393] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 01/17/2021] [Accepted: 01/19/2021] [Indexed: 02/06/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most frequent chronic liver disease in adults in developed countries, with a global prevalence as high as one billion. The pathogenesis of NAFLD is a multifactorial and multi-step process. Nowadays, a growing body of research suggests the considerable role of the endocannabinoid system (ECS) as a complex cell-signaling system in NAFLD development. Although increased endocannabinoid tone in the liver highly contributes to NAFLD development, the complex effects and impacts of plant-derived cannabinoids in the aspect of NAFLD pathophysiology are yet not fully understood, and effective medications are still in demand. In our review, we present the latest reports describing the role of ECS in NAFLD, focusing primarily on two types of cannabinoid receptors. Moreover, we sum up the recent literature on the clinical use of natural cannabinoids in NAFLD treatment. This review is useful for understanding the importance of ECS in NAFLD development, and it also provides the basis for more extensive clinical phytocannabinoids testing in patients suffering from NAFLD.
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Ek J, Jacobs W, Kaylor B, McCall WV. Addiction and Sleep Disorders. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1297:163-171. [PMID: 33537944 DOI: 10.1007/978-3-030-61663-2_12] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Shared neurophysiology of addiction and sleep disorders results in a bidirectional interplay. Diagnosing and treating primary sleep disorders, particularly in adolescents, can prevent the development of addiction in susceptible individuals. Addressing sleep issues in early recovery, and throughout maintenance, can prevent relapse. Cannabis use for insomnia shows mixed results; assisting with onset sleep latency in early use, this subsides with chronic use and holds addiction risk. Insomnia is a primary complaint of cannabis withdrawal syndrome and a primary cause of relapse in cannabis use disorder. An ideal sleep aid would prevent relapse and have low abuse potential. Pharmaceutical and behavioral options include suvorexant, mirtazapine, trazodone, and aerobic exercise, but clinical trials are lacking to demonstrate efficacy.
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Affiliation(s)
- Jonathan Ek
- Division of Addiction Medicine, Augusta University-Medical College of Georgia, Augusta, GA, USA.
| | - William Jacobs
- Division of Addiction Medicine, Augusta University-Medical College of Georgia, Augusta, GA, USA
| | - Brett Kaylor
- Division of Addiction Medicine, Augusta University-Medical College of Georgia, Augusta, GA, USA
| | - W Vaughn McCall
- Division of Addiction Medicine, Augusta University-Medical College of Georgia, Augusta, GA, USA
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Abstract
The sleep-wake cycle is a complex process that includes wake (W), non-rapid-eye-movement (NREM) and rapid-eye-movement (REM) sleep. Each phase is regulated by specialized brain structures that, by means of different neurotransmitters, maintain the constant expression of the sleep-wake cycle. Molecules like orexin, serotonin, noradrenaline, histamine, for waking; GABA, adenosine, prostaglandins, for NREM sleep and acetylcholine and glutamate for REM sleep, among other molecules are responsible for the expression and maintenance of each phase. When the endocannabinoid system was being described for the first time, almost three decades ago, oleamide's sleep promoting properties were highlighted. Nowadays, enough evidence has been cumulated to support the endocannabinoid system role in the sleep-wake cycle regulation. The endocannabinoids oleamide anandamide, and 2-arachidonylglycerol promote NREM and/or REM sleep via the CB1R, thereby making this system a target to treat sleep disorders, such as insomnia.
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Su T, Yan Y, Li Q, Ye J, Pei L. Endocannabinoid System Unlocks the Puzzle of Autism Treatment via Microglia. Front Psychiatry 2021; 12:734837. [PMID: 34744824 PMCID: PMC8568770 DOI: 10.3389/fpsyt.2021.734837] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 09/27/2021] [Indexed: 01/15/2023] Open
Abstract
Autism spectrum disorder (ASD) is a serious neurodevelopmental disorder and characterized by early childhood-onset impairments in social interaction and communication, restricted and repetitive patterns of behavior or interests. So far there is no effective treatment for ASD, and the pathogenesis of ASD remains unclear. Genetic and epigenetic factors have been considered to be the main cause of ASD. It is known that endocannabinoid and its receptors are widely distributed in the central nervous system, and provide a positive and irreversible change toward a more physiological neurodevelopment. Recently, the endocannabinoid system (ECS) has been found to participate in the regulation of social reward behavior, which has attracted considerable attention from neuroscientists and neurologists. Both animal models and clinical studies have shown that the ECS is a potential target for the treatment of autism, but the mechanism is still unknown. In the brain, microglia express a complete ECS signaling system. Studies also have shown that modulating ECS signaling can regulate the functions of microglia. By comprehensively reviewing previous studies and combining with our recent work, this review addresses the effects of targeting ECS on microglia, and how this can contribute to maintain the positivity of the central nervous system, and thus improve the symptoms of autism. This will provide insights for revealing the mechanism and developing new treatment strategies for autism.
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Affiliation(s)
- Tangfeng Su
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu Yan
- Department of Neurology, People's Hospital of Dongxihu District, Wuhan, China
| | - Qiang Li
- Exchange, Development and Service Center for Science and Technology Talents, The Ministry of Science and Technology, Beijing, China
| | - Jiacai Ye
- Department of Radiation Oncology, Affiliated Cancer Hospital and Institute of Guangzhou Medical University, Guangzhou, China
| | - Lei Pei
- Collaborative Innovation Center for Brain Science, The Institute for Brain Research, Huazhong University of Science and Technology, Wuhan, China.,Department of Neurobiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of Anesthesiology, Washington University in Saint Louis School of Medicine, Saint Louis, MO, United States
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Kaul M, Zee PC, Sahni AS. Effects of Cannabinoids on Sleep and their Therapeutic Potential for Sleep Disorders. Neurotherapeutics 2021; 18:217-227. [PMID: 33580483 PMCID: PMC8116407 DOI: 10.1007/s13311-021-01013-w] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2021] [Indexed: 12/19/2022] Open
Abstract
The recent trend for legalization of medicinal cannabis and cannabinoid-containing products, together with their soporific effects, has led to a surge of interest of their potential therapeutic role in the management of some common sleep disorders, such as insomnia, sleep disordered breathing, and restless legs syndrome, and less common disorders such as narcolepsy and parasomnias. Although much of the pre-clinical and clinical data were derived from studies with relatively small sample sizes and limited by biases in assessment, and in clinical trials lack of allocation concealment, as a whole, the results indicate a potential therapeutic role for cannabinoids in the management of some sleep disorders. Clinical trials are underway for insomnia and obstructive sleep apnea management, but there remains a substantial need for rigorous large multi-center studies to assess the dose, efficacy, and safety of the various types of cannabinoids on sleep disorders. This review aims to summarize the modulatory effects of cannabinoids on sleep physiology and provide a critical evaluation of the research on their potential therapeutic benefit in various sleep disorders.
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Affiliation(s)
- Malvika Kaul
- Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Illinois at Chicago, 909 S Wolcott Ave, Room 3135 (MC 719), Chicago, IL, 60612, USA
| | - Phyllis C Zee
- Department of Neurology, Center for Circadian and Sleep Medicine, Northwestern University Feinberg School of Medicine, 305 E. Chicago Ave., Chicago, IL, 60611, USA
| | - Ashima S Sahni
- Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Illinois at Chicago, 909 S Wolcott Ave, Room 3135 (MC 719), Chicago, IL, 60612, USA.
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