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Murray CH, Gannon BM, Winsauer PJ, Cooper ZD, Delatte MS. The Development of Cannabinoids as Therapeutic Agents in the United States. Pharmacol Rev 2024; 76:915-955. [PMID: 38849155 PMCID: PMC11331953 DOI: 10.1124/pharmrev.123.001121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 05/30/2024] [Accepted: 06/03/2024] [Indexed: 06/09/2024] Open
Abstract
Cannabis is one of the oldest and widely used substances in the world. Cannabinoids within the cannabis plant, known as phytocannabinoids, mediate cannabis' effects through interactions with the body's endogenous cannabinoid system. This endogenous system, the endocannabinoid system, has important roles in physical and mental health. These roles point to the potential to develop cannabinoids as therapeutic agents while underscoring the risks related to interfering with the endogenous system during nonmedical use. This scoping narrative review synthesizes the current evidence for both the therapeutic and adverse effects of the major (i.e., Δ9-tetrahydrocannabinol and cannabidiol) and lesser studied minor phytocannabinoids, from nonclinical to clinical research. We pay particular attention to the areas where evidence is well established, including analgesic effects after acute exposures and neurocognitive risks after acute and chronic use. In addition, drug development considerations for cannabinoids as therapeutic agents within the United States are reviewed. The proposed clinical study design considerations encourage methodological standards for greater scientific rigor and reproducibility to ultimately extend our knowledge of the risks and benefits of cannabinoids for patients and providers. SIGNIFICANCE STATEMENT: This work provides a review of prior research related to phytocannabinoids, including therapeutic potential and known risks in the context of drug development within the United States. We also provide study design considerations for future cannabinoid drug development.
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Affiliation(s)
- Conor H Murray
- UCLA Center for Cannabis and Cannabinoids, Jane and Terry Semel Institute for Neuroscience and Human Behavior, Departments of Psychiatry and Biobehavioral Sciences (C.H.M.) and Departments of Anesthesiology and Perioperative Medicine (Z.D.C.), David Geffen School of Medicine, University of California, Los Angeles, California; Department of Pharmacology and Toxicology, College of Medicine (B.M.G.) and Office of Research Regulatory Affairs, Division of Research and Innovation (B.M.G.), University of Arkansas for Medical Sciences, Little Rock, Arkansas; Departments of Pharmacology and Experimental Therapeutics and Biochemistry and Molecular Biology, School of Medicine (P.J.W.), and Alcohol and Drug Abuse Center of Excellence (P.J.W.) Louisiana State University Health Sciences Center, New Orleans, Louisiana; and Regulatory and Drug Development Consulting, Allucent, Carey, North Carolina (M.S.D.)
| | - Brenda M Gannon
- UCLA Center for Cannabis and Cannabinoids, Jane and Terry Semel Institute for Neuroscience and Human Behavior, Departments of Psychiatry and Biobehavioral Sciences (C.H.M.) and Departments of Anesthesiology and Perioperative Medicine (Z.D.C.), David Geffen School of Medicine, University of California, Los Angeles, California; Department of Pharmacology and Toxicology, College of Medicine (B.M.G.) and Office of Research Regulatory Affairs, Division of Research and Innovation (B.M.G.), University of Arkansas for Medical Sciences, Little Rock, Arkansas; Departments of Pharmacology and Experimental Therapeutics and Biochemistry and Molecular Biology, School of Medicine (P.J.W.), and Alcohol and Drug Abuse Center of Excellence (P.J.W.) Louisiana State University Health Sciences Center, New Orleans, Louisiana; and Regulatory and Drug Development Consulting, Allucent, Carey, North Carolina (M.S.D.)
| | - Peter J Winsauer
- UCLA Center for Cannabis and Cannabinoids, Jane and Terry Semel Institute for Neuroscience and Human Behavior, Departments of Psychiatry and Biobehavioral Sciences (C.H.M.) and Departments of Anesthesiology and Perioperative Medicine (Z.D.C.), David Geffen School of Medicine, University of California, Los Angeles, California; Department of Pharmacology and Toxicology, College of Medicine (B.M.G.) and Office of Research Regulatory Affairs, Division of Research and Innovation (B.M.G.), University of Arkansas for Medical Sciences, Little Rock, Arkansas; Departments of Pharmacology and Experimental Therapeutics and Biochemistry and Molecular Biology, School of Medicine (P.J.W.), and Alcohol and Drug Abuse Center of Excellence (P.J.W.) Louisiana State University Health Sciences Center, New Orleans, Louisiana; and Regulatory and Drug Development Consulting, Allucent, Carey, North Carolina (M.S.D.)
| | - Ziva D Cooper
- UCLA Center for Cannabis and Cannabinoids, Jane and Terry Semel Institute for Neuroscience and Human Behavior, Departments of Psychiatry and Biobehavioral Sciences (C.H.M.) and Departments of Anesthesiology and Perioperative Medicine (Z.D.C.), David Geffen School of Medicine, University of California, Los Angeles, California; Department of Pharmacology and Toxicology, College of Medicine (B.M.G.) and Office of Research Regulatory Affairs, Division of Research and Innovation (B.M.G.), University of Arkansas for Medical Sciences, Little Rock, Arkansas; Departments of Pharmacology and Experimental Therapeutics and Biochemistry and Molecular Biology, School of Medicine (P.J.W.), and Alcohol and Drug Abuse Center of Excellence (P.J.W.) Louisiana State University Health Sciences Center, New Orleans, Louisiana; and Regulatory and Drug Development Consulting, Allucent, Carey, North Carolina (M.S.D.)
| | - Marcus S Delatte
- UCLA Center for Cannabis and Cannabinoids, Jane and Terry Semel Institute for Neuroscience and Human Behavior, Departments of Psychiatry and Biobehavioral Sciences (C.H.M.) and Departments of Anesthesiology and Perioperative Medicine (Z.D.C.), David Geffen School of Medicine, University of California, Los Angeles, California; Department of Pharmacology and Toxicology, College of Medicine (B.M.G.) and Office of Research Regulatory Affairs, Division of Research and Innovation (B.M.G.), University of Arkansas for Medical Sciences, Little Rock, Arkansas; Departments of Pharmacology and Experimental Therapeutics and Biochemistry and Molecular Biology, School of Medicine (P.J.W.), and Alcohol and Drug Abuse Center of Excellence (P.J.W.) Louisiana State University Health Sciences Center, New Orleans, Louisiana; and Regulatory and Drug Development Consulting, Allucent, Carey, North Carolina (M.S.D.)
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Wang X, Zhu H, Liu T, Guo Z, Zhao C, He Z, Zheng W. Comparison of various doses of oral cannabidiol for treating refractory epilepsy indications: a network meta-analysis. Front Neurol 2024; 15:1243597. [PMID: 38994494 PMCID: PMC11238246 DOI: 10.3389/fneur.2024.1243597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 05/20/2024] [Indexed: 07/13/2024] Open
Abstract
Aim To evaluate the comparative efficacy and safety of various doses of oral cannabidiol (CBD) in treating refractory epilepsy indications, thus providing more informative evidence for clinical decision-making. Methods A literature search of PubMed, Embase, the Cochrane library, and Web of Science (WoS) was performed to retrieve relevant randomized controlled trials (RCTs) that compared different doses of oral CBD with placebo or each other in refractory epilepsy indications. The search was limited from the inception of each database to January 3, 2023. Relative risk [RR] with a 95% confidence interval [CI] was used to express results. STATA/SE 14 was employed for network meta-analysis. Results Six RCTs involving 972 patients were included in the final data analysis. Network meta-analysis showed that, CBD10 (10 mg/kg/day) (RR: 1.77, 95%CI: 1.28 to 2.44), CBD20 (20 mg/kg/day) (RR: 1.91, 95%CI: 1.49 to 2.46), CBD25 (25 mg/kg/day) (RR: 1.61, 95%CI: 0.96 to 2.70), and CBD50 (50 mg/kg/day) (RR: 1.78, 95%CI: 1.07 to 2.94) were associated with higher antiseizure efficacy although the pooled result for CBD25 was only close to significant. In addition, in terms of the risk of treatment-emergent adverse events (TEAEs), the difference between different doses is not significant. However, CBD20 ranked first in terms of antiseizure efficacy, followed by CBD50, CBD10, and CBD25. For TEAEs, CBD25 ranked first, followed by CBD10, CBD50, CBD5, and CBD20. Conclusion For refractory indications, CBD20 may be optimal option for antiseizure efficacy; however, CBD25 may be best for TEAEs. Therefore, an appropriate dose of oral CBD should be selected based on the actual situation. Due to the limitations of eligible studies and the limited sample size, more studies are needed in the future to validate our findings.
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Affiliation(s)
- Xin Wang
- The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Haiyan Zhu
- The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Tao Liu
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Zhi Guo
- The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Chenyang Zhao
- The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Zhiyi He
- The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Wenxu Zheng
- Geriatric Department of Dalian Friendship Hospital, Dalian, China
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Lee K, Vanin S, Nashed M, Sarikahya MH, Laviolette SR, Natale DRC, Hardy DB. Cannabidiol Exposure During Gestation Leads to Adverse Cardiac Outcomes Early in Postnatal Life in Male Rat Offspring. Cannabis Cannabinoid Res 2024; 9:781-796. [PMID: 38358335 DOI: 10.1089/can.2023.0213] [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: 02/16/2024] Open
Abstract
Introduction: Studies indicate that ∼7% of pregnant individuals in North America consume cannabis in pregnancy. Pre-clinical studies have established that maternal exposure to Δ9-tetrahydrocannabinol (THC; major psychoactive component in cannabis) leads to fetal growth restriction and impaired cardiac function in offspring. However, the effects of maternal exposure to cannabidiol (CBD; major non-euphoric constituent) on cardiac outcomes in offspring remain unknown. Therefore, our objective is to investigate the functional and underlying molecular impacts in the hearts of offspring exposed to CBD in pregnancy. Methods: Pregnant Wistar rats were exposed to either 3 or 30 mg/kg CBD or vehicle control i.p. daily from gestational day 6 to term. Echocardiography was used to assess cardiac function in male and female offspring at postnatal day (PND) 21. Furthermore, quantitative polymerase chain reaction (qPCR), immunoblotting, and bulk RNA-sequencing (RNA-seq) were performed on PND21 offspring hearts. Results: Despite no differences in the heart-to-body weight ratio, both doses of CBD led to reduced cardiac function exclusively in male offspring at 3 weeks of age. Underlying this, significant alterations in the expression of the endocannabinoid system (ECS; e.g., decreased cannabinoid receptor 2) were observed. In addition, bulk RNA-seq data demonstrated transcriptional pathways significantly enriched in mitochondrial function/metabolism as well as development. Conclusion: Collectively, we demonstrated for the first time that gestational exposure to CBD, a constituent perceived as safe, leads to early sex-specific postnatal cardiac deficits and alterations in the cardiac ECS in offspring.
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Affiliation(s)
- Kendrick Lee
- Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Sebastian Vanin
- Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Mina Nashed
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Mohammed Halit Sarikahya
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Steven R Laviolette
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - David R C Natale
- Departments of Biomedical and Molecular Sciences and Obstetrics and Gynaecology, Queen's University, Kingston, Canada
| | - Daniel B Hardy
- Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Department of Obstetrics and Gynecology, Children's Health Research Institute, Lawson Health Research Institute, Western University, London, Ontario, Canada
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Flavin A, Azizi P, Murataeva N, Yust K, Du W, Ross R, Greig I, Nguyen T, Zhang Y, Mackie K, Straiker A. CB1 Receptor Negative Allosteric Modulators as a Potential Tool to Reverse Cannabinoid Toxicity. Molecules 2024; 29:1881. [PMID: 38675703 PMCID: PMC11053441 DOI: 10.3390/molecules29081881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/11/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
While the opioid crisis has justifiably occupied news headlines, emergency rooms are seeing many thousands of visits for another cause: cannabinoid toxicity. This is partly due to the spread of cheap and extremely potent synthetic cannabinoids that can cause serious neurological and cardiovascular complications-and deaths-every year. While an opioid overdose can be reversed by naloxone, there is no analogous treatment for cannabis toxicity. Without an antidote, doctors rely on sedatives, with their own risks, or 'waiting it out' to treat these patients. We have shown that the canonical synthetic 'designer' cannabinoids are highly potent CB1 receptor agonists and, as a result, competitive antagonists may struggle to rapidly reverse an overdose due to synthetic cannabinoids. Negative allosteric modulators (NAMs) have the potential to attenuate the effects of synthetic cannabinoids without having to directly compete for binding. We tested a group of CB1 NAMs for their ability to reverse the effects of the canonical synthetic designer cannabinoid JWH018 in vitro in a neuronal model of endogenous cannabinoid signaling and also in vivo. We tested ABD1085, RTICBM189, and PSNCBAM1 in autaptic hippocampal neurons that endogenously express a retrograde CB1-dependent circuit that inhibits neurotransmission. We found that all of these compounds blocked/reversed JWH018, though some proved more potent than others. We then tested whether these compounds could block the effects of JWH018 in vivo, using a test of nociception in mice. We found that only two of these compounds-RTICBM189 and PSNCBAM1-blocked JWH018 when applied in advance. The in vitro potency of a compound did not predict its in vivo potency. PSNCBAM1 proved to be the more potent of the compounds and also reversed the effects of JWH018 when applied afterward, a condition that more closely mimics an overdose situation. Lastly, we found that PSNCBAM1 did not elicit withdrawal after chronic JWH018 treatment. In summary, CB1 NAMs can, in principle, reverse the effects of the canonical synthetic designer cannabinoid JWH018 both in vitro and in vivo, without inducing withdrawal. These findings suggest a novel pharmacological approach to at last provide a tool to counter cannabinoid toxicity.
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Affiliation(s)
- Audrey Flavin
- Gill Center for Biomolecular Science, Program in Neuroscience, Department of Psychological and Brain Sciences Indiana University, Bloomington, IN 47405, USA (N.M.); (K.Y.); (W.D.); (K.M.)
| | - Paniz Azizi
- Gill Center for Biomolecular Science, Program in Neuroscience, Department of Psychological and Brain Sciences Indiana University, Bloomington, IN 47405, USA (N.M.); (K.Y.); (W.D.); (K.M.)
| | - Natalia Murataeva
- Gill Center for Biomolecular Science, Program in Neuroscience, Department of Psychological and Brain Sciences Indiana University, Bloomington, IN 47405, USA (N.M.); (K.Y.); (W.D.); (K.M.)
| | - Kyle Yust
- Gill Center for Biomolecular Science, Program in Neuroscience, Department of Psychological and Brain Sciences Indiana University, Bloomington, IN 47405, USA (N.M.); (K.Y.); (W.D.); (K.M.)
| | - Wenwen Du
- Gill Center for Biomolecular Science, Program in Neuroscience, Department of Psychological and Brain Sciences Indiana University, Bloomington, IN 47405, USA (N.M.); (K.Y.); (W.D.); (K.M.)
| | - Ruth Ross
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON M5G 2C8, Canada;
| | - Iain Greig
- Institute of Medical Sciences, University of Aberdeen, Aberdeen AB25 2ZD, UK;
| | - Thuy Nguyen
- Research Triangle Institute, Durham, NC 27709, USA; (T.N.); (Y.Z.)
| | - Yanan Zhang
- Research Triangle Institute, Durham, NC 27709, USA; (T.N.); (Y.Z.)
| | - Ken Mackie
- Gill Center for Biomolecular Science, Program in Neuroscience, Department of Psychological and Brain Sciences Indiana University, Bloomington, IN 47405, USA (N.M.); (K.Y.); (W.D.); (K.M.)
| | - Alex Straiker
- Gill Center for Biomolecular Science, Program in Neuroscience, Department of Psychological and Brain Sciences Indiana University, Bloomington, IN 47405, USA (N.M.); (K.Y.); (W.D.); (K.M.)
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Omotayo OP, Lemmer Y, Mason S. A narrative review of the therapeutic and remedial prospects of cannabidiol with emphasis on neurological and neuropsychiatric disorders. J Cannabis Res 2024; 6:14. [PMID: 38494488 PMCID: PMC10946130 DOI: 10.1186/s42238-024-00222-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 02/29/2024] [Indexed: 03/19/2024] Open
Abstract
BACKGROUND The treatment of diverse diseases using plant-derived products is actively encouraged. In the past few years, cannabidiol (CBD) has emerged as a potent cannabis-derived drug capable of managing various debilitating neurological infections, diseases, and their associated complications. CBD has demonstrated anti-inflammatory and curative effects in neuropathological conditions, and it exhibits therapeutic, apoptotic, anxiolytic, and neuroprotective properties. However, more information on the reactions and ability of CBD to alleviate brain-related disorders and the neuroinflammation that accompanies them is needed. MAIN BODY This narrative review deliberates on the therapeutic and remedial prospects of CBD with an emphasis on neurological and neuropsychiatric disorders. An extensive literature search followed several scoping searches on available online databases such as PubMed, Web of Science, and Scopus with the main keywords: CBD, pro-inflammatory cytokines, and cannabinoids. After a purposive screening of the retrieved papers, 170 (41%) of the articles (published in English) aligned with the objective of this study and retained for inclusion. CONCLUSION CBD is an antagonist against pro-inflammatory cytokines and the cytokine storm associated with neurological infections/disorders. CBD regulates adenosine/oxidative stress and aids the downregulation of TNF-α, restoration of BDNF mRNA expression, and recovery of serotonin levels. Thus, CBD is involved in immune suppression and anti-inflammation. Understanding the metabolites associated with response to CBD is imperative to understand the phenotype. We propose that metabolomics will be the next scientific frontier that will reveal novel information on CBD's therapeutic tendencies in neurological/neuropsychiatric disorders.
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Affiliation(s)
- Oluwadara Pelumi Omotayo
- Human Metabolomics, Faculty of Natural and Agricultural Sciences, North-West University, Potchefstroom, South Africa
| | - Yolandy Lemmer
- Council for Scientific and Industrial Research (CSIR), Next Generation Health, Pretoria, South Africa
- Preclinical Drug Development Platform, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Shayne Mason
- Human Metabolomics, Faculty of Natural and Agricultural Sciences, North-West University, Potchefstroom, South Africa.
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Svendsen K, Sharkey KA, Altier C. Non-Intoxicating Cannabinoids in Visceral Pain. Cannabis Cannabinoid Res 2024; 9:3-11. [PMID: 37883662 DOI: 10.1089/can.2023.0113] [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: 10/28/2023] Open
Abstract
Cannabis and cannabis products are becoming increasingly popular options for symptom management of inflammatory bowel diseases, particularly abdominal pain. While anecdotal and patient reports suggest efficacy of these compounds for these conditions, clinical research has shown mixed results. To date, clinical research has focused primarily on delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is a ligand of classical cannabinoid receptors (CBRs). CBD is one of a large group of nonintoxicating cannabinoids (niCBs) that mediate their effects on both CBRs and through non-CBR mechanisms of action. Because they are not psychotropic, there is increasing interest and availability of niCBs. The numerous niCBs show potential to rectify abnormal intestinal motility as well as have anti-inflammatory and analgesic effects. The effects of niCBs are frequently not mediated by CBRs, but rather through actions on other targets, including transient receptor potential channels and voltage-gated ion channels. Additionally, evidence suggests that niCBs can be combined to increase their potency through what is termed the entourage effect. This review examines the pre-clinical data available surrounding these niCBs in treatment of abdominal pain with a focus on non-CBR mechanisms.
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Affiliation(s)
- Kristofer Svendsen
- Department of Physiology and Pharmacology, University of Calgary, Calgary, Canada
- Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Canada
- Inflammation Research Network, University of Calgary, Calgary, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
| | - Keith A Sharkey
- Department of Physiology and Pharmacology, University of Calgary, Calgary, Canada
- Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Canada
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Christophe Altier
- Department of Physiology and Pharmacology, University of Calgary, Calgary, Canada
- Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Canada
- Inflammation Research Network, University of Calgary, Calgary, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada
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Singh S, Sarroza D, English A, McGrory M, Dong A, Zweifel L, Land BB, Li Y, Bruchas MR, Stella N. Pharmacological Characterization of the Endocannabinoid Sensor GRAB eCB2.0. Cannabis Cannabinoid Res 2023. [PMID: 38064488 DOI: 10.1089/can.2023.0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023] Open
Abstract
Introduction: The endocannabinoids (eCBs), 2-arachidonoylglycerol (2-AG) and arachidonoyl ethanolamine (AEA), are produced by separate enzymatic pathways, activate cannabinoid (CB) receptors with distinct pharmacological profiles, and differentially regulate pathophysiological processes. The genetically encoded sensor, GRABeCB2.0, detects real-time changes in eCB levels in cells in culture and preclinical model systems; however, its activation by eCB analogues produced by cells and by phyto-CBs remains uncharacterized, a current limitation when interpreting changes in its response. This information could provide additional utility for the tool in in vivo pharmacology studies of phyto-CB action. Materials and Methods: GRABeCB2.0 was expressed in cultured HEK293 cells. Live cell confocal microscopy and high-throughput fluorescent signal measurements. Results: 2-AG increased GRABeCB2.0 fluorescent signal (EC50=85 nM), and the cannabinoid 1 receptor (CB1R) antagonist, SR141716 (SR1), decreased GRABeCB2.0 signal (IC50=3.3 nM), responses that mirror their known potencies at the CB1R. GRABeCB2.0 fluorescent signal also increased in response to AEA (EC50=815 nM), the eCB analogues 2-linoleoylglycerol and 2-oleoylglycerol (EC50=632 and 868 nM, respectively), Δ9-tetrahydrocannabinol (Δ9-THC), and Δ8-THC (EC50=1.6 and 2.0 μM, respectively), and the artificial CB1R agonist, CP55,940 (CP; EC50=82 nM); however their potencies were less than what has been described at CB1R. Cannabidiol (CBD) did not affect basal GRABeCB2.0 fluorescent signal and yet reduced the 2-AG stimulated GRABeCB2.0 responses (IC50=9.7 nM). Conclusions: 2-AG and SR1 modulate the GRABeCB2.0 fluorescent signal with EC50 values that mirror their potencies at CB1R, whereas AEA, eCB analogues, THC, and CP increase GRABeCB2.0 fluorescent signal with EC50 values significantly lower than their potencies at CB1R. CBD reduces the 2-AG response without affecting basal signal, suggesting that GRABeCB2.0 retains the negative allosteric modulator (NAM) property of CBD at CB1R. This study describes the pharmacological profile of GRABeCB2.0 to improve interpretation of changes in fluorescent signal in response to a series of known eCBs and CB1R ligands.
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Affiliation(s)
- Simar Singh
- Department of Pharmacology, Pain, and Emotion, School of Medicine, University of Washington, Seattle, Washington, USA
- Center for Cannabis Research, Pain, and Emotion, School of Medicine, University of Washington, Seattle, Washington, USA
- Center for the Neurobiology of Addiction, Pain, and Emotion, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Dennis Sarroza
- Department of Pharmacology, Pain, and Emotion, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Anthony English
- Department of Pharmacology, Pain, and Emotion, School of Medicine, University of Washington, Seattle, Washington, USA
- Center for Cannabis Research, Pain, and Emotion, School of Medicine, University of Washington, Seattle, Washington, USA
- Center for the Neurobiology of Addiction, Pain, and Emotion, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Maya McGrory
- Department of Pharmacology, Pain, and Emotion, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Ao Dong
- Peking University School of Life Sciences, PKU-IDG/McGovern Institute for Brain Research, Peking-Tsinghua Center for Life Sciences, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Larry Zweifel
- Department of Pharmacology, Pain, and Emotion, School of Medicine, University of Washington, Seattle, Washington, USA
- Center for Cannabis Research, Pain, and Emotion, School of Medicine, University of Washington, Seattle, Washington, USA
- Center for the Neurobiology of Addiction, Pain, and Emotion, School of Medicine, University of Washington, Seattle, Washington, USA
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Benjamin B Land
- Department of Pharmacology, Pain, and Emotion, School of Medicine, University of Washington, Seattle, Washington, USA
- Center for Cannabis Research, Pain, and Emotion, School of Medicine, University of Washington, Seattle, Washington, USA
- Center for the Neurobiology of Addiction, Pain, and Emotion, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Yulong Li
- Peking University School of Life Sciences, PKU-IDG/McGovern Institute for Brain Research, Peking-Tsinghua Center for Life Sciences, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Michael R Bruchas
- Department of Pharmacology, Pain, and Emotion, School of Medicine, University of Washington, Seattle, Washington, USA
- Center for Cannabis Research, Pain, and Emotion, School of Medicine, University of Washington, Seattle, Washington, USA
- Center for the Neurobiology of Addiction, Pain, and Emotion, School of Medicine, University of Washington, Seattle, Washington, USA
- Department of Anesthesiology, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Nephi Stella
- Department of Pharmacology, Pain, and Emotion, School of Medicine, University of Washington, Seattle, Washington, USA
- Center for Cannabis Research, Pain, and Emotion, School of Medicine, University of Washington, Seattle, Washington, USA
- Center for the Neurobiology of Addiction, Pain, and Emotion, School of Medicine, University of Washington, Seattle, Washington, USA
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, Washington, USA
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Challal S, Skiba A, Langlois M, Esguerra CV, Wolfender JL, Crawford AD, Skalicka-Woźniak K. Natural product-derived therapies for treating drug-resistant epilepsies: From ethnopharmacology to evidence-based medicine. JOURNAL OF ETHNOPHARMACOLOGY 2023; 317:116740. [PMID: 37315641 DOI: 10.1016/j.jep.2023.116740] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 05/17/2023] [Accepted: 06/04/2023] [Indexed: 06/16/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Epilepsy is one of the most prevalent neurological human diseases, affecting 1% of the population in all age groups. Despite the availability of over 25 anti-seizure medications (ASMs), which are approved in most industrialized countries, approximately 30% of epilepsy patients still experience seizures that are resistant to these drugs. Since ASMs target only limited number of neurochemical mechanisms, drug-resistant epilepsy (DRE) is not only an unmet medical need, but also a formidable challenge in drug discovery. AIM In this review, we examine recently approved epilepsy drugs based on natural product (NP) such as cannabidiol (CBD) and rapamycin, as well as NP-based epilepsy drug candidates still in clinical development, such as huperzine A. We also critically evaluate the therapeutic potential of botanical drugs as polytherapy or adjunct therapy specifically for DRE. METHODS Articles related to ethnopharmacological anti-epileptic medicines and NPs in treating all forms of epilepsy were collected from PubMed and Scopus using keywords related to epilepsy, DRE, herbal medicines, and NPs. The database clinicaltrials.gov was used to find ongoing, terminated and planned clinical trials using herbal medicines or NPs in epilepsy treatment. RESULTS A comprehensive review on anti-epileptic herbal drugs and natural products from the ethnomedical literature is provided. We discuss the ethnomedical context of recently approved drugs and drug candidates derived from NPs, including CBD, rapamycin, and huperzine A. Recently published studies on natural products with preclinical efficacy in animal models of DRE are summarized. Moreover, we highlight that natural products capable of pharmacologically activating the vagus nerve (VN), such as CBD, may be therapeutically useful to treat DRE. CONCLUSIONS The review highlights that herbal drugs utilized in traditional medicine offer a valuable source of potential anti-epileptic drug candidates with novel mechanisms of action, and with clinical promise for the treatment of drug-resistant epilepsy (DRE). Moreover, recently developed NP-based anti-seizure medications (ASMs) indicate the translational potential of metabolites of plant, microbial, fungal and animal origin.
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Affiliation(s)
- Soura Challal
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Switzerland; School of Pharmaceutical Sciences, University of Geneva, Switzerland
| | - Adrianna Skiba
- Department of Natural Product Chemistry, Medical University of Lublin, Poland
| | - Mélanie Langlois
- Luxembourg Centre for Systems Biomedicine (LCSB), Belval, Luxembourg
| | - Camila V Esguerra
- Centre for Molecular Medicine Norway (NCMM), University of Oslo, Norway
| | - Jean-Luc Wolfender
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Switzerland; School of Pharmaceutical Sciences, University of Geneva, Switzerland
| | - Alexander D Crawford
- Department of Preclinical Sciences and Pathology, Norwegian University of Life Sciences (NMBU), Ås, Norway; Institute for Orphan Drug Discovery, Bremerhavener Innovations- und Gründerzentum (BRIG), Bremerhaven, Germany
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9
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Winstone J, Shafique H, Clemmer ME, Mackie K, Wager-Miller J. Effects of Tetrahydrocannabinol and Cannabidiol on Brain-Derived Neurotrophic Factor and Tropomyosin Receptor Kinase B Expression in the Adolescent Hippocampus. Cannabis Cannabinoid Res 2023; 8:612-622. [PMID: 35639364 PMCID: PMC10442678 DOI: 10.1089/can.2021.0025] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: Adolescence is an important phase in brain maturation, specifically it is a time during which weak synapses are pruned and neural pathways are strengthened. Adolescence is also a time of experimentation with drugs, including cannabis, which may have detrimental effects on the developing nervous system. The cannabinoid type 1 receptor (CB1) is an important modulator of neurotransmitter release and plays a central role in neural development. Neurotrophic factors such as brain-derived neurotrophic factor (BDNF) and its receptor, tropomyosin receptor kinase B (TrkB), are also critical during development for axon guidance and synapse specification. Objective: The objective of this study was to examine the effects of the phytocannabinoids, Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD), on the expression of BDNF, its receptor TrkB, and other synaptic markers in the adolescent mouse hippocampus. Materials and Methods: Mice of both sexes were injected daily from P28 to P49 with 3 mg/kg THC, CBD, or a combination of THC/CBD. Brains were harvested on P50, and the dorsal and ventral hippocampi were analyzed for levels of BDNF, TrkB, and several synaptic markers using quantitative polymerase chain reaction, western blotting, and image analyses. Results: THC treatment statistically significantly reduced transcript levels of BDNF in adolescent female (BDNF I) and male (BDNF I, II, IV, VI, and IX) hippocampi. These changes were prevented when CBD was co-administered with THC. CBD by itself statistically significantly increased expression of some transcripts (BDNF II, VI, and IX for females, BDNF VI for males). No statistically significant changes were observed in protein expression for BDNF, TrkB, phospho-TrkB, phospho-CREB (cAMP response element-binding protein), and the synaptic markers, vesicular GABA transporter, vesicular glutamate transporter, synaptobrevin, and postsynaptic density protein 95. However, CB1 receptors were statistically significantly reduced in the ventral hippocampus with THC treatment. Conclusions: This study found changes in BDNF mRNA expression within the hippocampus of adolescent mice exposed to THC and CBD. THC represses transcript expression for some BDNF variants, and this effect is rescued when CBD is co-administered. These effects were seen in both males and females, but sex differences were observed in specific BDNF isoforms. While a statistically significant reduction in CB1 receptor protein in the ventral dentate gyrus was seen, no other changes in protein levels were observed.
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Affiliation(s)
- Joanna Winstone
- Department of Psychological and Brain Sciences, The Gill Center for Biomolecular Science, Indiana University, Bloomington, Indiana, USA
| | - Hana Shafique
- Department of Psychological and Brain Sciences, The Gill Center for Biomolecular Science, Indiana University, Bloomington, Indiana, USA
| | - Madeleine E. Clemmer
- Department of Psychological and Brain Sciences, The Gill Center for Biomolecular Science, Indiana University, Bloomington, Indiana, USA
| | - Ken Mackie
- Department of Psychological and Brain Sciences, The Gill Center for Biomolecular Science, Indiana University, Bloomington, Indiana, USA
| | - Jim Wager-Miller
- Department of Psychological and Brain Sciences, The Gill Center for Biomolecular Science, Indiana University, Bloomington, Indiana, USA
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10
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Castelli V, Lavanco G, D’Amico C, Feo S, Tringali G, Kuchar M, Cannizzaro C, Brancato A. CBD enhances the cognitive score of adolescent rats prenatally exposed to THC and fine-tunes relevant effectors of hippocampal plasticity. Front Pharmacol 2023; 14:1237485. [PMID: 37583903 PMCID: PMC10424934 DOI: 10.3389/fphar.2023.1237485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 07/20/2023] [Indexed: 08/17/2023] Open
Abstract
Introduction: An altered neurodevelopmental trajectory associated with prenatal exposure to ∆-9-tetrahydrocannabinol (THC) leads to aberrant cognitive processing through a perturbation in the effectors of hippocampal plasticity in the juvenile offspring. As adolescence presents a unique window of opportunity for "brain reprogramming", we aimed at assessing the role of the non-psychoactive phytocannabinoid cannabidiol (CBD) as a rescue strategy to temper prenatal THC-induced harm. Methods: To this aim, Wistar rats prenatally exposed to THC (2 mg/kg s.c.) or vehicle (gestational days 5-20) were tested for specific indexes of spatial and configural memory in the reinforcement-motivated Can test and in the aversion-driven Barnes maze test during adolescence. Markers of hippocampal excitatory plasticity and endocannabinoid signaling-NMDAR subunits NR1 and 2A-, mGluR5-, and their respective scaffold proteins PSD95- and Homer 1-; CB1R- and the neuromodulatory protein HINT1 mRNA levels were evaluated. CBD (40 mg/kg i.p.) was administered to the adolescent offspring before the cognitive tasks. Results: The present results show that prenatal THC impairs hippocampal memory functions and the underlying synaptic plasticity; CBD is able to mitigate cognitive impairment in both reinforcement- and aversion-related tasks and the neuroadaptation of hippocampal excitatory synapses and CB1R-related signaling. Discussion: While this research shows CBD potential in dampening prenatal THC-induced consequences, we point out the urgency to curb cannabis use during pregnancy in order to avoid detrimental bio-behavioral outcomes in the offspring.
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Affiliation(s)
- Valentina Castelli
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Gianluca Lavanco
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties of Excellence “G. D’Alessandro”, University of Palermo, Palermo, Italy
| | - Cesare D’Amico
- Department of Biological, Chemical and Pharmaceutical Sciences and Technologies and ATEN Center, University of Palermo, Palermo, Italy
| | - Salvatore Feo
- Department of Biological, Chemical and Pharmaceutical Sciences and Technologies and ATEN Center, University of Palermo, Palermo, Italy
| | - Giuseppe Tringali
- Pharmacology Section, Department of Healthcare Surveillance and Bioethics, Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy
| | - Martin Kuchar
- Forensic Laboratory of Biologically Active Compounds, Department of Chemistry of Natural Compounds, University of Chemistry and Technology, Prague, Czechia
- Psychedelics Research Centre, National Institute of Mental Health, Prague, Czechia
| | - Carla Cannizzaro
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Anna Brancato
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties of Excellence “G. D’Alessandro”, University of Palermo, Palermo, Italy
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11
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Bosquez-Berger T, Gudorf JA, Kuntz CP, Desmond JA, Schlebach JP, VanNieuwenhze MS, Straiker A. Structure-Activity Relationship Study of Cannabidiol-Based Analogs as Negative Allosteric Modulators of the μ-Opioid Receptor. J Med Chem 2023; 66:9466-9494. [PMID: 37437224 PMCID: PMC11299522 DOI: 10.1021/acs.jmedchem.3c00061] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
The US faces an unprecedented surge in fatal drug overdoses. Naloxone, the only antidote for opiate overdose, competes at the mu opioid receptor (μOR) orthosteric site. Naloxone struggles against fentanyl-class synthetic opioids that now cause ∼80% of deaths. Negative allosteric modulators (NAMs) targeting secondary sites may noncompetitively downregulate μOR activation. (-)-Cannabidiol ((-)-CBD) is a candidate μOR NAM. To explore its therapeutic potential, we evaluated the structure-activity relationships among CBD analogs to identify NAMs with increased potency. Using a cyclic AMP assay, we characterize reversal of μOR activation by 15 CBD analogs, several of which proved more potent than (-)-CBD. Comparative docking investigations suggest that potent compounds interact with a putative allosteric pocket to stabilize the inactive μOR conformation. Finally, these compounds enhance naloxone displacement of fentanyl from the orthosteric site. Our results suggest that CBD analogs offer considerable potential for the development of next-generation antidotes for opioid overdose.
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Affiliation(s)
- Taryn Bosquez-Berger
- Gill Center for Biomolecular Science, Department of Psychological and Brain Sciences, Program in Neuroscience, Indiana University, Bloomington, Indiana 47405, United States
| | - Jessica A Gudorf
- Department of Chemistry, Indiana University, Bloomington, Indiana 47405, United States
| | - Charles P Kuntz
- Department of Chemistry, Indiana University, Bloomington, Indiana 47405, United States
| | - Jacob A Desmond
- Department of Chemistry, Indiana University, Bloomington, Indiana 47405, United States
| | - Jonathan P Schlebach
- Department of Chemistry, Indiana University, Bloomington, Indiana 47405, United States
| | | | - Alex Straiker
- Gill Center for Biomolecular Science, Department of Psychological and Brain Sciences, Program in Neuroscience, Indiana University, Bloomington, Indiana 47405, United States
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12
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Straiker A, Dvorakova M, Bosquez-Berger T, Blahos J, Mackie K. A collection of cannabinoid-related negative findings from autaptic hippocampal neurons. Sci Rep 2023; 13:9610. [PMID: 37311900 PMCID: PMC10264370 DOI: 10.1038/s41598-023-36710-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 06/08/2023] [Indexed: 06/15/2023] Open
Abstract
Autaptic hippocampal neurons are an architecturally simple model of neurotransmission that express several forms of cannabinoid signaling. Over the past twenty years this model has proven valuable for studies ranging from enzymatic control of endocannabinoid production and breakdown, to CB1 receptor structure/function, to CB2 signaling, understanding 'spice' (synthetic cannabinoid) pharmacology, and more. However, while studying cannabinoid signaling in these neurons, we have occasionally encountered what one might call 'interesting negatives', valid and informative findings in the context of our experimental design that, given the nature of scientific publishing, may not otherwise find their way into the scientific literature. In autaptic hippocampal neurons we have found that: (1) The fatty acid binding protein (FABP) blocker SBFI-26 does not alter CB1-mediated neuroplasticity. (2) 1-AG signals poorly relative to 2-AG in autaptic neurons. (3) Indomethacin is not a CB1 PAM in autaptic neurons. (4) The CB1-associated protein SGIP1a is not necessary for CB1 desensitization. We are presenting these negative or perplexing findings in the hope that they will prove beneficial to other laboratories and elicit fruitful discussions regarding their relevance and significance.
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Affiliation(s)
- Alex Straiker
- Department of Psychological and Brain Sciences, Gill Center for Biomolecular Science, Program in Neuroscience, Indiana University, Bloomington, IN, 47405, USA.
| | - Michaela Dvorakova
- Department of Psychological and Brain Sciences, Gill Center for Biomolecular Science, Program in Neuroscience, Indiana University, Bloomington, IN, 47405, USA
| | - Taryn Bosquez-Berger
- Department of Psychological and Brain Sciences, Gill Center for Biomolecular Science, Program in Neuroscience, Indiana University, Bloomington, IN, 47405, USA
| | - Jaroslav Blahos
- Department of Molecular Pharmacology, Institute of Molecular Genetics of the Czech Academy of Sciences, Videnska 1083, 142 20, Prague 4, Czech Republic
| | - Ken Mackie
- Department of Psychological and Brain Sciences, Gill Center for Biomolecular Science, Program in Neuroscience, Indiana University, Bloomington, IN, 47405, USA
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13
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Lathrop JR, Rosen SN, Heitkemper MM, Buchanan DT. Cyclic Vomiting Syndrome and Cannabis Hyperemesis Syndrome: The State of the Science. Gastroenterol Nurs 2023; 46:208-224. [PMID: 37074964 DOI: 10.1097/sga.0000000000000730] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 10/10/2022] [Indexed: 04/20/2023] Open
Abstract
This article provides a narrative review of the state of the science for both cyclic vomiting syndrome and cannabis hyperemesis syndrome along with a discussion of the relationship between these 2 conditions. The scope of this review includes the historical context of these conditions as well as the prevalence, diagnostic criteria, pathogenesis, and treatment strategies for both conditions. A synopsis of the endocannabinoid system provides a basis for the hypothesis that a lack of cannabidiol in modern high-potency Δ 9 -tetrahydrocannabinol cannabis may be contributory to cannabis hyperemesis syndrome and possibly other cannabis use disorders. In concluding assessment, though the publications addressing both adult cyclic vomiting syndrome and cannabis hyperemesis syndrome are steadily increasing overall, the state of the science supporting the treatments, prognosis, etiology, and confounding factors (including cannabis use) is of moderate quality. Much of the literature portrays these conditions separately and as such sometimes fails to account for the confounding of adult cyclic vomiting syndrome with cannabis hyperemesis syndrome. The diagnostic and therapeutic approaches are, at present, based generally on case series publications and expert opinion, with a very limited number of randomized controlled trials and a complete absence of Level 1 evidence within the cyclic vomiting literature overall as well as for cannabis hyperemesis syndrome specifically.
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Affiliation(s)
- James R Lathrop
- James R. Lathrop, DNP, FNP, ARNP, is a PhD student under the Department of Biobehavioral Nursing & Health Informatics, School of Nursing, University of Washington, Seattle
- Sheldon N. Rosen, MD, is Clinical Associate Professor, Division of Gastroenterology, School of Medicine, University of Washington, Seattle
- Margaret M. Heitkemper, PhD, RN, FAAN, is Professor and Elizabeth Sterling Soule Endowed Chair in Nursing, Department of Biobehavioral Nursing & Health Informatics, School of Nursing, University of Washington, Seattle
- Diana Taibi Buchanan, PhD, RN, is Associate Professor and Mary S. Tschudin Endowed Professor of Nursing Education, Department of Biobehavioral Nursing & Health Informatics, School of Nursing, University of Washington, Seattle
| | - Sheldon N Rosen
- James R. Lathrop, DNP, FNP, ARNP, is a PhD student under the Department of Biobehavioral Nursing & Health Informatics, School of Nursing, University of Washington, Seattle
- Sheldon N. Rosen, MD, is Clinical Associate Professor, Division of Gastroenterology, School of Medicine, University of Washington, Seattle
- Margaret M. Heitkemper, PhD, RN, FAAN, is Professor and Elizabeth Sterling Soule Endowed Chair in Nursing, Department of Biobehavioral Nursing & Health Informatics, School of Nursing, University of Washington, Seattle
- Diana Taibi Buchanan, PhD, RN, is Associate Professor and Mary S. Tschudin Endowed Professor of Nursing Education, Department of Biobehavioral Nursing & Health Informatics, School of Nursing, University of Washington, Seattle
| | - Margaret M Heitkemper
- James R. Lathrop, DNP, FNP, ARNP, is a PhD student under the Department of Biobehavioral Nursing & Health Informatics, School of Nursing, University of Washington, Seattle
- Sheldon N. Rosen, MD, is Clinical Associate Professor, Division of Gastroenterology, School of Medicine, University of Washington, Seattle
- Margaret M. Heitkemper, PhD, RN, FAAN, is Professor and Elizabeth Sterling Soule Endowed Chair in Nursing, Department of Biobehavioral Nursing & Health Informatics, School of Nursing, University of Washington, Seattle
- Diana Taibi Buchanan, PhD, RN, is Associate Professor and Mary S. Tschudin Endowed Professor of Nursing Education, Department of Biobehavioral Nursing & Health Informatics, School of Nursing, University of Washington, Seattle
| | - Diana Taibi Buchanan
- James R. Lathrop, DNP, FNP, ARNP, is a PhD student under the Department of Biobehavioral Nursing & Health Informatics, School of Nursing, University of Washington, Seattle
- Sheldon N. Rosen, MD, is Clinical Associate Professor, Division of Gastroenterology, School of Medicine, University of Washington, Seattle
- Margaret M. Heitkemper, PhD, RN, FAAN, is Professor and Elizabeth Sterling Soule Endowed Chair in Nursing, Department of Biobehavioral Nursing & Health Informatics, School of Nursing, University of Washington, Seattle
- Diana Taibi Buchanan, PhD, RN, is Associate Professor and Mary S. Tschudin Endowed Professor of Nursing Education, Department of Biobehavioral Nursing & Health Informatics, School of Nursing, University of Washington, Seattle
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14
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Rosenberg EC, Chamberland S, Bazelot M, Nebet ER, Wang X, McKenzie S, Jain S, Greenhill S, Wilson M, Marley N, Salah A, Bailey S, Patra PH, Rose R, Chenouard N, Sun SED, Jones D, Buzsáki G, Devinsky O, Woodhall G, Scharfman HE, Whalley BJ, Tsien RW. Cannabidiol modulates excitatory-inhibitory ratio to counter hippocampal hyperactivity. Neuron 2023; 111:1282-1300.e8. [PMID: 36787750 DOI: 10.1016/j.neuron.2023.01.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/27/2022] [Accepted: 01/20/2023] [Indexed: 02/15/2023]
Abstract
Cannabidiol (CBD), a non-euphoric component of cannabis, reduces seizures in multiple forms of pediatric epilepsies, but the mechanism(s) of anti-seizure action remain unclear. In one leading model, CBD acts at glutamatergic axon terminals, blocking the pro-excitatory actions of an endogenous membrane phospholipid, lysophosphatidylinositol (LPI), at the G-protein-coupled receptor GPR55. However, the impact of LPI-GPR55 signaling at inhibitory synapses and in epileptogenesis remains underexplored. We found that LPI transiently increased hippocampal CA3-CA1 excitatory presynaptic release probability and evoked synaptic strength in WT mice, while attenuating inhibitory postsynaptic strength by decreasing GABAARγ2 and gephyrin puncta. LPI effects at excitatory and inhibitory synapses were eliminated by CBD pre-treatment and absent after GPR55 deletion. Acute pentylenetrazole-induced seizures elevated GPR55 and LPI levels, and chronic lithium-pilocarpine-induced epileptogenesis potentiated LPI's pro-excitatory effects. We propose that CBD exerts potential anti-seizure effects by blocking LPI's synaptic effects and dampening hyperexcitability.
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Affiliation(s)
- Evan C Rosenberg
- Department of Neuroscience & Physiology and Neuroscience Institute, NYU Langone Medical Center, 435 E 30th St, New York, NY 10016, USA
| | - Simon Chamberland
- Department of Neuroscience & Physiology and Neuroscience Institute, NYU Langone Medical Center, 435 E 30th St, New York, NY 10016, USA
| | - Michael Bazelot
- School of Chemistry, Food and Nutritional Sciences, and Pharmacy, University of Reading, Hopkins Life Science Building, Whiteknights, Reading, Berks RG6 6AP, UK; GW Research Ltd, Histon, Cambridge, UK
| | - Erica R Nebet
- Department of Neuroscience & Physiology and Neuroscience Institute, NYU Langone Medical Center, 435 E 30th St, New York, NY 10016, USA
| | - Xiaohan Wang
- Department of Neuroscience & Physiology and Neuroscience Institute, NYU Langone Medical Center, 435 E 30th St, New York, NY 10016, USA
| | - Sam McKenzie
- Department of Neuroscience & Physiology and Neuroscience Institute, NYU Langone Medical Center, 435 E 30th St, New York, NY 10016, USA
| | - Swati Jain
- Departments of Child and Adolescent Psychiatry, Neuroscience & Physiology, and Psychiatry, NYU Langone Medical Center, 435 E 30th St, New York, NY 10016, USA; Center for Dementia Research, Nathan Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Bldg. 35, Orangeburg, NY 10962, USA
| | - Stuart Greenhill
- Aston Neuroscience Institute, School of Life and Health Sciences, Aston University, Birmingham, UK
| | - Max Wilson
- Aston Neuroscience Institute, School of Life and Health Sciences, Aston University, Birmingham, UK
| | - Nicole Marley
- Aston Neuroscience Institute, School of Life and Health Sciences, Aston University, Birmingham, UK
| | - Alejandro Salah
- Department of Neuroscience & Physiology and Neuroscience Institute, NYU Langone Medical Center, 435 E 30th St, New York, NY 10016, USA
| | - Shanice Bailey
- School of Chemistry, Food and Nutritional Sciences, and Pharmacy, University of Reading, Hopkins Life Science Building, Whiteknights, Reading, Berks RG6 6AP, UK
| | - Pabitra Hriday Patra
- School of Chemistry, Food and Nutritional Sciences, and Pharmacy, University of Reading, Hopkins Life Science Building, Whiteknights, Reading, Berks RG6 6AP, UK
| | - Rebecca Rose
- Department of Advanced Research Technologies, NYU Langone Medical Center, 435 E 30th St, New York, NY 10016, USA
| | - Nicolas Chenouard
- Department of Neuroscience & Physiology and Neuroscience Institute, NYU Langone Medical Center, 435 E 30th St, New York, NY 10016, USA
| | - Simón E D Sun
- Department of Neuroscience & Physiology and Neuroscience Institute, NYU Langone Medical Center, 435 E 30th St, New York, NY 10016, USA
| | - Drew Jones
- Department of Biochemistry and Molecular Pharmacology, NYU Langone Medical Center, 435 E 30th St, New York, NY 10016, USA
| | - György Buzsáki
- Department of Neuroscience & Physiology and Neuroscience Institute, NYU Langone Medical Center, 435 E 30th St, New York, NY 10016, USA
| | - Orrin Devinsky
- Department of Neurology, NYU Langone Medical Center, 435 E 30th St, New York, NY 10016, USA
| | - Gavin Woodhall
- Aston Neuroscience Institute, School of Life and Health Sciences, Aston University, Birmingham, UK
| | - Helen E Scharfman
- Departments of Child and Adolescent Psychiatry, Neuroscience & Physiology, and Psychiatry, NYU Langone Medical Center, 435 E 30th St, New York, NY 10016, USA; Center for Dementia Research, Nathan Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Bldg. 35, Orangeburg, NY 10962, USA
| | - Benjamin J Whalley
- School of Chemistry, Food and Nutritional Sciences, and Pharmacy, University of Reading, Hopkins Life Science Building, Whiteknights, Reading, Berks RG6 6AP, UK; GW Research Ltd, Histon, Cambridge, UK
| | - Richard W Tsien
- Department of Neuroscience & Physiology and Neuroscience Institute, NYU Langone Medical Center, 435 E 30th St, New York, NY 10016, USA; Department of Neurology, NYU Langone Medical Center, 435 E 30th St, New York, NY 10016, USA.
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15
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Singh S, Sarroza D, English A, McGrory M, Dong A, Zweifel L, Land BB, Li Y, Bruchas MR, Stella N. Pharmacological characterization of the endocannabinoid sensor GRAB eCB2.0. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.03.03.531053. [PMID: 36945533 PMCID: PMC10028790 DOI: 10.1101/2023.03.03.531053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
Introduction The endocannabinoids (eCBs), 2-arachidonoylglycerol (2-AG) and arachidonoyl ethanolamine (AEA), are produced by separate enzymatic pathways, activate cannabinoid receptors with distinct pharmacology, and differentially regulate pathophysiological processes. The genetically encoded sensor, GRABeCB2.0, detects real-time changes in eCB levels in cells in culture and preclinical model systems; however, its activation by eCB analogues produced by cells and by phyto-cannabinoids remains uncharacterized, a current limitation when interpreting changes in its response. This information could provide additional utility for the tool in in vivo pharmacology studies of phyto-cannabinoid action. Methods GRABeCB2.0 was expressed in cultured HEK293 cells. Live cell confocal microscopy and high-throughput fluorescent signal measurements. Results 2-AG increased GRABeCB2.0 fluorescent signal (EC50 = 85 nM), and the cannabinoid 1 receptor (CB1R) antagonist, SR141617, decreased GRABeCB2.0 signal (SR1, IC50 = 3.3 nM), responses that mirror their known potencies at cannabinoid 1 receptors (CB1R). GRABeCB2.0 fluorescent signal also increased in response to AEA (EC50 = 815 nM), the eCB analogues 2-linoleoylglycerol and 2-oleoylglycerol (2-LG and 2-OG, EC50s = 1.5 and 1.0 μM, respectively), Δ9-tetrahydrocannabinol (Δ9-THC) and Δ8-THC (EC50s = 1.6 and 2.0 μM, respectively), and the artificial CB1R agonist, CP55,940 (CP, EC50 = 82 nM); however their potencies were less than what has been described at CB1R. Cannabidiol (CBD) did not affect basal GRABeCB2.0 fluorescent signal and yet reduced the 2-AG stimulated GRABeCB2.0 responses (IC50 = 8.8 nM). Conclusions 2-AG and SR1 modulate the GRABeCB2.0 fluorescent signal with EC50s that mirror their potencies at CB1R whereas AEA, eCB analogues, THC and CP increase GRABeCB2.0 fluorescent signal with EC50s significantly lower than their potencies at CB1R. CBD reduces the 2-AG response without affecting basal signal, suggesting that GRABeCB2.0 retains the negative allosteric modulator (NAM) property of CBD at CB1R. This study describes the pharmacological profile of GRABeCB2.0 to improve interpretation of changes in fluorescent signal in response to a series of known eCBs and CB1R ligands.
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Affiliation(s)
- Simar Singh
- Department of Pharmacology, University of Washington, Seattle, USA
- Center for Cannabis Research, University of Washington, Seattle, USA
- Center for the Neurobiology of Addiction, Pain, and Emotion, University of Washington, Seattle, USA
| | - Dennis Sarroza
- Department of Pharmacology, University of Washington, Seattle, USA
| | - Anthony English
- Department of Pharmacology, University of Washington, Seattle, USA
- Center for Cannabis Research, University of Washington, Seattle, USA
- Center for the Neurobiology of Addiction, Pain, and Emotion, University of Washington, Seattle, USA
| | - Maya McGrory
- Department of Pharmacology, University of Washington, Seattle, USA
| | - Ao Dong
- Peking University School of Life Sciences, PKU-IDG/McGovern Institute for Brain Research, Peking-Tsinghua Center for Life Sciences, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Larry Zweifel
- Department of Pharmacology, University of Washington, Seattle, USA
- Center for Cannabis Research, University of Washington, Seattle, USA
- Center for the Neurobiology of Addiction, Pain, and Emotion, University of Washington, Seattle, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, USA
| | - Benjamin B. Land
- Department of Pharmacology, University of Washington, Seattle, USA
- Center for Cannabis Research, University of Washington, Seattle, USA
- Center for the Neurobiology of Addiction, Pain, and Emotion, University of Washington, Seattle, USA
| | - Yulong Li
- Peking University School of Life Sciences, PKU-IDG/McGovern Institute for Brain Research, Peking-Tsinghua Center for Life Sciences, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Michael R. Bruchas
- Department of Pharmacology, University of Washington, Seattle, USA
- Center for Cannabis Research, University of Washington, Seattle, USA
- Center for the Neurobiology of Addiction, Pain, and Emotion, University of Washington, Seattle, USA
- Department of Anesthesiology, School of Medicine, University of Washington, Seattle, USA
| | - Nephi Stella
- Department of Pharmacology, University of Washington, Seattle, USA
- Center for Cannabis Research, University of Washington, Seattle, USA
- Center for the Neurobiology of Addiction, Pain, and Emotion, University of Washington, Seattle, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, USA
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16
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Martin F, Dubertret C, Le Strat Y, Mallet J. Le potentiel thérapeutique du cannabidiol chez les sujets présentant un trouble du spectre psychotique : une revue systématique de la littérature sur les essais contrôlés randomisés. ANNALES MÉDICO-PSYCHOLOGIQUES, REVUE PSYCHIATRIQUE 2023. [DOI: 10.1016/j.amp.2023.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
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17
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Stella N. THC and CBD: Similarities and differences between siblings. Neuron 2023; 111:302-327. [PMID: 36638804 PMCID: PMC9898277 DOI: 10.1016/j.neuron.2022.12.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/14/2022] [Accepted: 12/13/2022] [Indexed: 01/13/2023]
Abstract
Δ9-tetrahydrocannabinol (THC) and its sibling, cannabidiol (CBD), are produced by the same Cannabis plant and have similar chemical structures but differ dramatically in their mechanisms of action and effects on brain functions. Both THC and CBD exhibit promising therapeutic properties; however, impairments and increased incidence of mental health diseases are associated with acute and chronic THC use, respectively, and significant side effects are associated with chronic use of high-dose CBD. This review covers recent molecular and preclinical discoveries concerning the distinct mechanisms of action and bioactivities of THC and CBD and their impact on human behavior and diseases. These discoveries provide a foundation for the development of cannabinoid-based therapeutics for multiple devastating diseases and to assure their safe use in the growing legal market of Cannabis-based products.
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Affiliation(s)
- Nephi Stella
- Department of Pharmacology, Department Psychiatry and Behavioral Sciences, Center for Cannabis Research, Center for the Neurobiology of Addiction, Pain, and Emotion, University of Washington School of Medicine, Seattle, WA 98195, USA
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18
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Reddy DS. Therapeutic and clinical foundations of cannabidiol therapy for difficult-to-treat seizures in children and adults with refractory epilepsies. Exp Neurol 2023; 359:114237. [PMID: 36206806 DOI: 10.1016/j.expneurol.2022.114237] [Citation(s) in RCA: 27] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 09/27/2022] [Accepted: 09/29/2022] [Indexed: 11/09/2022]
Abstract
Novel and effective antiseizure medications are needed to treat refractory and rare forms of epilepsy. Cannabinoids, which are obtained from the cannabis plant, have a long history of medical use, including for neurologic conditions. In 2018, the US Food and Drug Administration approved the first phytocannabinoid, cannabidiol (CBD, Epidiolex), which is now indicated for severe seizures associated with three rare forms of developmental and epileptic encephalopathy: Dravet syndrome, Lennox-Gastaut syndrome, and tuberous sclerosis complex. Compelling evidence supports the efficacy of CBD in experimental models and patients with epilepsy. In randomized clinical trials, highly-purified CBD has demonstrated efficacy with an acceptable safety profile in children and adults with difficult-to-treat seizures. Although the underlying antiseizure mechanisms of CBD in humans have not yet been elucidated, the identification of novel antiseizure targets of CBD preclinically indicates multimodal mechanisms that include non-cannabinoid pathways. In addition to antiseizure effects, CBD possesses strong anti-inflammatory and neuroprotective activities, which might contribute to protective effects in epilepsy and other conditions. This article provides a succinct overview of therapeutic approaches and clinical foundations of CBD, emphasizing the clinical utility of CBD for the treatment of seizures associated with refractory and rare epilepsies. CBD has shown to be a safe and effective antiseizure medicine, demonstrating a broad spectrum of efficacy across multiple seizure types, including those associated with severe epilepsies with childhood onset. Despite such promise, there are many perils with CBD that hampers its widespread use, including limited understanding of pharmacodynamics, limited exposure-response relationship, limited information for seizure freedom with continued use, complex pharmacokinetics with drug interactions, risk of adverse effects, and lack of expert therapeutic guidelines. These scientific issues need to be resolved by further investigations, which would decide the unique role of CBD in the management of refractory epilepsy.
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Affiliation(s)
- Doodipala Samba Reddy
- Department of Neuroscience and Experimental Therapeutics, School of Medicine, Texas A&M University Health Science Center, Bryan, TX, USA; Texas A&M Health Institute of Pharmacology and Neurotherapeutics, School of Medicine, Texas A&M University, Bryan, TX, USA; Engineering Medicine, Intercollegiate School of Engineering Medicine, Texas A&M University, Houston, TX, USA; Department of Biomedical Engineering, College of Engineering, Texas A&M University, College Station, TX, USA; Department of Veterinary Integrative Biosciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX, USA.
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19
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Martinez Ramirez CE, Ruiz-Pérez G, Stollenwerk TM, Behlke C, Doherty A, Hillard CJ. Endocannabinoid signaling in the central nervous system. Glia 2023; 71:5-35. [PMID: 36308424 PMCID: PMC10167744 DOI: 10.1002/glia.24280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 09/02/2022] [Accepted: 09/29/2022] [Indexed: 11/07/2022]
Abstract
It is hard to overestimate the influence of the endocannabinoid signaling (ECS) system on central nervous system (CNS) function. In the 40 years since cannabinoids were found to trigger specific cell signaling cascades, studies of the ECS system continue to cause amazement, surprise, and confusion! CB1 cannabinoid receptors are expressed widely in the CNS and regulate cell-cell communication via effects on the release of both neurotransmitters and gliotransmitters. CB2 cannabinoid receptors are difficult to detect in the CNS but seem to "punch above their weight" as compounds targeting these receptors have significant effects on inflammatory state and behavior. Positive and negative allosteric modulators for both receptors have been identified and examined in preclinical studies. Concentrations of the endocannabinoid ligands, N-arachidonoylethanolamine and 2-arachidonoylglycerol (2-AG), are regulated by a combination of enzymatic synthesis and degradation and inhibitors of these processes are available and making their way into clinical trials. Importantly, ECS regulates many essential brain functions, including regulation of reward, anxiety, inflammation, motor control, and cellular development. While the field is on the cusp of preclinical discoveries providing impactful clinical and therapeutic insights into many CNS disorders, there is still much to be learned about this remarkable and versatile modulatory system.
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Affiliation(s)
- César E Martinez Ramirez
- Neuroscience Research Center and Department of Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Gonzalo Ruiz-Pérez
- Neuroscience Research Center and Department of Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Todd M Stollenwerk
- Neuroscience Research Center and Department of Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Christina Behlke
- Neuroscience Research Center and Department of Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Ashley Doherty
- Neuroscience Research Center and Department of Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Cecilia J Hillard
- Neuroscience Research Center and Department of Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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Madeo G, Kapoor A, Giorgetti R, Busardò FP, Carlier J. Update on Cannabidiol Clinical Toxicity and Adverse Effects: A Systematic Review. Curr Neuropharmacol 2023; 21:2323-2342. [PMID: 36946485 PMCID: PMC10556379 DOI: 10.2174/1570159x21666230322143401] [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: 12/04/2022] [Revised: 01/15/2023] [Accepted: 01/16/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Compelling evidence from preclinical and clinical studies supports the therapeutic role of cannabidiol (CBD) in several medical disorders. We reviewed the scientific evidence on CBD-related toxicity and adverse events (AEs) in 2019, at the beginning of the spike in clinical studies involving CBD. However, CBD safety remained uncertain. OBJECTIVE With the benefit of hindsight, we aimed to provide an update on CBD-related toxicity and AEs in humans. METHODS A systematic literature search was conducted following PRISMA guidelines. PubMed, Cochrane, and Embase were accessed in October 2022 to identify clinical studies mentioning CBDrelated toxicity/AEs from February 2019 to September 2022. Study design, population characteristics, CBD doses, treatment duration, co-medications, and AEs were compiled. RESULTS A total of 51 reports were included. Most studies investigated CBD efficacy and safety in neurological conditions, such as treatment-resistant epilepsies, although a growing number of studies are focusing on specific psychopathological conditions, such as substance use disorders, chronic psychosis, and anxiety. Most studies report mild or moderate severity of AEs. The most common AEs are diarrhea, somnolence, sedation, and upper respiratory disturbances. Few serious AEs have been reported, especially when CBD is co-administered with other classes of drugs, such as clobazam and valproate. CONCLUSION Clinical data suggest that CBD is well tolerated and associated with few serious AEs at therapeutic doses both in children and adults. However, interactions with other medications should be monitored carefully. Additional data are needed to investigate CBD's long-term efficacy and safety, and CBD use in medical conditions other than epilepsy syndromes.
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Affiliation(s)
- Graziella Madeo
- Clinical Center of Neurology and Psychiatry, Brain&Care Group, Rimini, Italy
| | - Ashita Kapoor
- Unit of Forensic Toxicology, Section of Legal Medicine, Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy
| | - Raffaele Giorgetti
- Unit of Forensic Toxicology, Section of Legal Medicine, Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy
| | - Francesco Paolo Busardò
- Unit of Forensic Toxicology, Section of Legal Medicine, Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy
| | - Jeremy Carlier
- Unit of Forensic Toxicology, Section of Legal Medicine, Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy
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21
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Bosquez-Berger T, Wilson S, Iliopoulos-Tsoutsouvas C, Jiang S, Wager-Miller J, Nikas SP, Mackie KP, Makriyannis A, Straiker A. Differential Enantiomer-Specific Signaling of Cannabidiol at CB 1 Receptors. Mol Pharmacol 2022; 102:259-268. [PMID: 36153039 PMCID: PMC11033957 DOI: 10.1124/molpharm.121.000305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 09/05/2022] [Indexed: 11/22/2022] Open
Abstract
The two main constituents of cannabis are Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD). While Δ9-THC pharmacology has been studied extensively, CBD-long considered inactive-is now the subject of vigorous research related to epilepsy, pain, and inflammation and is popularly embraced as a virtual cure-all. However, our understanding of CBD pharmacology remains limited, although CBD inhibits cannabinoid CB1 receptor signaling, likely as a negative allosteric modulator. Cannabis synthesizes (-)-CBD, but CBD can also exist as an enantiomer, (+)-CBD. We enantioselectively synthesized both CBD enantiomers using established conditions and describe here a new, practical, and reliable, NMR-based method for confirming the enantiomeric purity of two CBD enantiomers. We also investigated the pharmacology of (+)-CBD in autaptic hippocampal neurons, a well-characterized neuronal model of endogenous cannabinoid signaling, and in CHO-K1 cells. We report the inhibition constant for displacing CP55,940 at CB1 by (+)-CBD, is 5-fold lower than (-)-CBD. We find that (+)-CBD is ∼10 times more potent at inhibiting depolarization-induced suppression of excitation (DSE), a form of endogenous cannabinoid-mediated retrograde synaptic plasticity. (+)-CBD also inhibits CB1 suppression of cAMP accumulation but with less potency, indicating that the signaling profiles of the enantiomers differ in a pathway-specific manner. In addition, we report that (+)-CBD stereoselectively and potently activates the sphingosine-1 phosphate (S1P) receptors, S1P1 and S1P3 These results provide an attractive method for synthesizing and distinguishing enantiomers of CBD and related phytocannabinoids and provide further evidence that these enantiomers have their own unique and interesting signaling properties. SIGNIFICANCE STATEMENT: Cannabidiol (CBD) is the subject of considerable scientific and popular interest, but we know little of the enantiomers of CBD. We find that the enantiomer (+)-CBD is substantially more potent inhibitor of cannabinoid CB1 receptors and that it activates sphingosine-1-phosphate receptors in an enantiomer-specific manner; we have additionally developed an improved method for the synthesis of enantiomers of CBD and related compounds.
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Affiliation(s)
- Taryn Bosquez-Berger
- Gill Center for Biomolecular Science, Department of Psychological and Brain Sciences, Program in Neuroscience, Indiana University, Bloomington, Indiana (T.B., S.W., J.W.M., K.M., A.S.); and Center for Drug Discovery and Department of Pharmaceutical Sciences (C.I.T., S.P.N., A.M.) and Center for Drug Discovery and Department of Chemistry and Chemical Biology (S.J., A.M.), Northeastern University, Boston, Massachusetts
| | - Sierra Wilson
- Gill Center for Biomolecular Science, Department of Psychological and Brain Sciences, Program in Neuroscience, Indiana University, Bloomington, Indiana (T.B., S.W., J.W.M., K.M., A.S.); and Center for Drug Discovery and Department of Pharmaceutical Sciences (C.I.T., S.P.N., A.M.) and Center for Drug Discovery and Department of Chemistry and Chemical Biology (S.J., A.M.), Northeastern University, Boston, Massachusetts
| | - Christos Iliopoulos-Tsoutsouvas
- Gill Center for Biomolecular Science, Department of Psychological and Brain Sciences, Program in Neuroscience, Indiana University, Bloomington, Indiana (T.B., S.W., J.W.M., K.M., A.S.); and Center for Drug Discovery and Department of Pharmaceutical Sciences (C.I.T., S.P.N., A.M.) and Center for Drug Discovery and Department of Chemistry and Chemical Biology (S.J., A.M.), Northeastern University, Boston, Massachusetts
| | - Shan Jiang
- Gill Center for Biomolecular Science, Department of Psychological and Brain Sciences, Program in Neuroscience, Indiana University, Bloomington, Indiana (T.B., S.W., J.W.M., K.M., A.S.); and Center for Drug Discovery and Department of Pharmaceutical Sciences (C.I.T., S.P.N., A.M.) and Center for Drug Discovery and Department of Chemistry and Chemical Biology (S.J., A.M.), Northeastern University, Boston, Massachusetts
| | - Jim Wager-Miller
- Gill Center for Biomolecular Science, Department of Psychological and Brain Sciences, Program in Neuroscience, Indiana University, Bloomington, Indiana (T.B., S.W., J.W.M., K.M., A.S.); and Center for Drug Discovery and Department of Pharmaceutical Sciences (C.I.T., S.P.N., A.M.) and Center for Drug Discovery and Department of Chemistry and Chemical Biology (S.J., A.M.), Northeastern University, Boston, Massachusetts
| | - Spyros P Nikas
- Gill Center for Biomolecular Science, Department of Psychological and Brain Sciences, Program in Neuroscience, Indiana University, Bloomington, Indiana (T.B., S.W., J.W.M., K.M., A.S.); and Center for Drug Discovery and Department of Pharmaceutical Sciences (C.I.T., S.P.N., A.M.) and Center for Drug Discovery and Department of Chemistry and Chemical Biology (S.J., A.M.), Northeastern University, Boston, Massachusetts
| | - Ken P Mackie
- Gill Center for Biomolecular Science, Department of Psychological and Brain Sciences, Program in Neuroscience, Indiana University, Bloomington, Indiana (T.B., S.W., J.W.M., K.M., A.S.); and Center for Drug Discovery and Department of Pharmaceutical Sciences (C.I.T., S.P.N., A.M.) and Center for Drug Discovery and Department of Chemistry and Chemical Biology (S.J., A.M.), Northeastern University, Boston, Massachusetts
| | - Alexandros Makriyannis
- Gill Center for Biomolecular Science, Department of Psychological and Brain Sciences, Program in Neuroscience, Indiana University, Bloomington, Indiana (T.B., S.W., J.W.M., K.M., A.S.); and Center for Drug Discovery and Department of Pharmaceutical Sciences (C.I.T., S.P.N., A.M.) and Center for Drug Discovery and Department of Chemistry and Chemical Biology (S.J., A.M.), Northeastern University, Boston, Massachusetts
| | - Alex Straiker
- Gill Center for Biomolecular Science, Department of Psychological and Brain Sciences, Program in Neuroscience, Indiana University, Bloomington, Indiana (T.B., S.W., J.W.M., K.M., A.S.); and Center for Drug Discovery and Department of Pharmaceutical Sciences (C.I.T., S.P.N., A.M.) and Center for Drug Discovery and Department of Chemistry and Chemical Biology (S.J., A.M.), Northeastern University, Boston, Massachusetts
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Andreis K, Billingsley J, Naimi Shirazi K, Wager-Miller J, Johnson C, Bradshaw H, Straiker A. Cannabinoid CB1 receptors regulate salivation. Sci Rep 2022; 12:14182. [PMID: 35986066 PMCID: PMC9391487 DOI: 10.1038/s41598-022-17987-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 08/03/2022] [Indexed: 01/30/2023] Open
Abstract
Saliva serves multiple important functions within the body that we typically take for granted, such as helping prepare food for swallowing and defense against oral pathogens. Dry mouth is a primary symptom of Sjӧgren’s syndrome and is a side effect of many drug treatments. Cannabis users frequently report dry mouth, but the basis for this is still unknown. If the effects occur via the endogenous cannabinoid signaling system, then this may represent a novel mechanism for the regulation of salivation. We examined expression of cannabinoid CB1 receptors in submandibular salivary gland using immunohistochemistry and tested regulation of salivation by THC and cannabinoid-related ligands. We now report that CB1 receptors are expressed in the axons of cholinergic neurons innervating the submandibular gland. No staining is seen in submandibular gland epithelial cells (acinar and ductal), or myoepithelial cells (MECs). Treatment with THC (4 mg/kg, IP) or the cannabinoid receptor agonist CP55940 (0.5 mg/kg) reduced salivation in both male and female mice 1 h after treatment. CBD had no effect on its own but reversed the effect of THC in a concentration-dependent manner. Neither the CB1 receptor antagonist SR141716 (4 mg/kg) nor the CB2-selective agonist JWH133 (4 mg/kg) had an effect on salivation. We also found that fatty acid amide hydrolase (FAAH), the enzyme that metabolizes the endocannabinoid anandamide and related lipids, regulates salivation. Salivation was reduced in FAAH knockout mice as well as mice treated with the FAAH blocker URB597 (4 mg/kg). URB597 had no effect in CB1 knockout mice. FAAH protein is detected intracellularly in acinar but not ductal epithelial cells. In lipidomics experiments, we found that FAAH knockout mice chiefly had elevated levels of acylethanolamines, including anandamide, and reduced levels of acyglycines. Our results are consistent with a model wherein endocannabinoids activate CB1 receptors on cholinergic axons innervating the submandibular gland. THC likely acts by plugging into this system, activating CB1 receptors to reduce salivation, thus offering a mechanism underlying the dry mouth reported by cannabis users.
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23
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Acute effects of Δ 9-tetrahydrocannabinol and cannabidiol on auditory mismatch negativity. Psychopharmacology (Berl) 2022; 239:1409-1424. [PMID: 34719731 DOI: 10.1007/s00213-021-05997-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 10/04/2021] [Indexed: 10/20/2022]
Abstract
RATIONALE Mismatch negativity (MMN) is a candidate endophenotype for schizophrenia subserved by N-methyl-D-aspartate receptor (NMDAR) function and there is increasing evidence that prolonged cannabis use adversely affects MMN generation. Few human studies have investigated the acute effects of cannabinoids on brain-based biomarkers of NMDAR function and synaptic plasticity. OBJECTIVES The current study investigated the acute effects of Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD) alone and in combination on the mismatch negativity (MMN). METHODS In a randomised, double-blind, crossover placebo-controlled study, 18 frequent and 18 less-frequent cannabis users underwent 5 randomised drug sessions administered via vaporiser: (1) placebo; (2) THC 8 mg; (3) CBD 400 mg; (4) THC 8 mg + CBD 4 mg [THC + CBDlow]; (5) THC 12 mg + CBD 400 mg [THC + CBDhigh]. Participants completed a multifeature MMN auditory oddball paradigm with duration, frequency and intensity deviants (6% each). RESULTS Relative to placebo, both THC and CBD were observed to increase duration and intensity MMN amplitude in less-frequent users, and THC also increased frequency MMN in this group. The addition of low-dose CBD added to THC attenuated the effect of THC on duration and intensity MMN amplitude in less-frequent users. The same pattern of effects was observed following high-dose CBD added to THC on duration and frequency MMN in frequent users. CONCLUSIONS The pattern of effects following CBD combined with THC on MMN may be subserved by different underlying neurobiological interactions within the endocannabinoid system that vary as a function of prior cannabis exposure. These results highlight the complex interplay between the acute effects of exogenous cannabinoids and NMDAR function. Further research is needed to determine how this process normalises after the acute effects dissipate and following repeated acute exposure.
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24
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Zhang HXB, Heckman L, Niday Z, Jo S, Fujita A, Shim J, Pandey R, Al Jandal H, Jayakar S, Barrett LB, Smith J, Woolf CJ, Bean BP. Cannabidiol activates neuronal Kv7 channels. eLife 2022; 11:73246. [PMID: 35179483 PMCID: PMC8856652 DOI: 10.7554/elife.73246] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 02/09/2022] [Indexed: 01/10/2023] Open
Abstract
Cannabidiol (CBD), a chemical found in the Cannabis sativa plant, is a clinically effective antiepileptic drug whose mechanism of action is unknown. Using a fluorescence-based thallium flux assay, we performed a large-scale screen and found enhancement of flux through heterologously expressed human Kv7.2/7.3 channels by CBD. Patch-clamp recordings showed that CBD acts at submicromolar concentrations to shift the voltage dependence of Kv7.2/7.3 channels in the hyperpolarizing direction, producing a dramatic enhancement of current at voltages near –50 mV. CBD enhanced native M-current in mouse superior cervical ganglion starting at concentrations of 30 nM and also enhanced M-current in rat hippocampal neurons. The potent enhancement of Kv2/7.3 channels by CBD may contribute to its effectiveness as an antiepileptic drug by reducing neuronal hyperexcitability.
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Affiliation(s)
| | - Laurel Heckman
- F.M. Kirby Neurobiology Research Center, Boston Children's Hospital, Boston, United States
| | - Zachary Niday
- Department of Neurobiology, Harvard Medical School, Boston, United States
| | - Sooyeon Jo
- Department of Neurobiology, Harvard Medical School, Boston, United States
| | - Akie Fujita
- Department of Neurobiology, Harvard Medical School, Boston, United States
| | - Jaehoon Shim
- F.M. Kirby Neurobiology Research Center, Boston Children's Hospital, Boston, United States
| | - Roshan Pandey
- F.M. Kirby Neurobiology Research Center, Boston Children's Hospital, Boston, United States
| | - Hoor Al Jandal
- F.M. Kirby Neurobiology Research Center, Boston Children's Hospital, Boston, United States
| | - Selwyn Jayakar
- F.M. Kirby Neurobiology Research Center, Boston Children's Hospital, Boston, United States
| | - Lee B Barrett
- F.M. Kirby Neurobiology Research Center, Boston Children's Hospital, Boston, United States
| | - Jennifer Smith
- ICCB-Longwood Screening Facility and Department of Immunology, Harvard Medical School, Boston, United States
| | - Clifford J Woolf
- Department of Neurobiology, Harvard Medical School, Boston, United States.,F.M. Kirby Neurobiology Research Center, Boston Children's Hospital, Boston, United States
| | - Bruce P Bean
- Department of Neurobiology, Harvard Medical School, Boston, United States
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25
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Sugaya Y, Kano M. Endocannabinoid-Mediated Control of Neural Circuit Excitability and Epileptic Seizures. Front Neural Circuits 2022; 15:781113. [PMID: 35046779 PMCID: PMC8762319 DOI: 10.3389/fncir.2021.781113] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 11/29/2021] [Indexed: 01/11/2023] Open
Abstract
Research on endocannabinoid signaling has greatly advanced our understanding of how the excitability of neural circuits is controlled in health and disease. In general, endocannabinoid signaling at excitatory synapses suppresses excitability by inhibiting glutamate release, while that at inhibitory synapses promotes excitability by inhibiting GABA release, although there are some exceptions in genetically epileptic animal models. In the epileptic brain, the physiological distributions of endocannabinoid signaling molecules are disrupted during epileptogenesis, contributing to the occurrence of spontaneous seizures. However, it is still unknown how endocannabinoid signaling changes during seizures and how the redistribution of endocannabinoid signaling molecules proceeds during epileptogenesis. Recent development of cannabinoid sensors has enabled us to investigate endocannabinoid signaling in much greater spatial and temporal details than before. Application of cannabinoid sensors to epilepsy research has elucidated activity-dependent changes in endocannabinoid signaling during seizures. Furthermore, recent endocannabinoid research has paved the way for the clinical use of cannabidiol for the treatment of refractory epilepsy, such as Dravet syndrome, Lennox-Gastaut syndrome and tuberous sclerosis complex. Cannabidiol significantly reduces seizures and is considered to have comparable tolerability to conventional antiepileptic drugs. In this article, we introduce recent advances in research on the roles of endocannabinoid signaling in epileptic seizures and discuss future directions.
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Affiliation(s)
- Yuki Sugaya
- Department of Neurophysiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- International Research Center for Neurointelligence (WPI-IRCN), The University of Tokyo Institutes for Advanced Study (UTIAS), The University of Tokyo, Tokyo, Japan
| | - Masanobu Kano
- Department of Neurophysiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- International Research Center for Neurointelligence (WPI-IRCN), The University of Tokyo Institutes for Advanced Study (UTIAS), The University of Tokyo, Tokyo, Japan
- *Correspondence: Masanobu Kano,
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26
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Nidadavolu P, Bilkei-Gorzo A, Krämer M, Schürmann B, Palmisano M, Beins EC, Madea B, Zimmer A. Efficacy of Δ 9 -Tetrahydrocannabinol (THC) Alone or in Combination With a 1:1 Ratio of Cannabidiol (CBD) in Reversing the Spatial Learning Deficits in Old Mice. Front Aging Neurosci 2021; 13:718850. [PMID: 34526890 PMCID: PMC8435893 DOI: 10.3389/fnagi.2021.718850] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/06/2021] [Indexed: 12/28/2022] Open
Abstract
Decline in cognitive performance, an aspect of the normal aging process, is influenced by the endocannabinoid system (ECS). Cannabinoid receptor 1 (CB1) signaling diminishes with advancing age in specific brain regions that regulate learning and memory and abolishing CB1 receptor signaling accelerates cognitive aging in mice. We recently demonstrated that prolonged exposure to low dose (3 mg/kg/day) Δ9-tetrahydrocannabinol (THC) improved the cognitive performances in old mice on par with young untreated mice. Here we investigated the potential influence of cannabidiol (CBD) on this THC effect, because preclinical and clinical studies indicate that the combination of THC and CBD often exhibits an enhanced therapeutic effect compared to THC alone. We first tested the effectiveness of a lower dose (1 mg/kg/day) THC, and then the efficacy of the combination of THC and CBD in 1:1 ratio, same as in the clinically approved medicine Sativex®. Our findings reveal that a 1 mg/kg/day THC dose still effectively improved spatial learning in aged mice. However, a 1:1 combination of THC and CBD failed to do so. The presence of CBD induced temporal changes in THC metabolism ensuing in a transient elevation of blood THC levels. However, as CBD metabolizes, the inhibitory effect on THC metabolism was alleviated, causing a rapid clearance of THC. Thus, the beneficial effects of THC seemed to wane off more swiftly in the presence of CBD, due to these metabolic effects. The findings indicate that THC-treatment alone is more efficient to improve spatial learning in aged mice than the 1:1 combination of THC and CBD.
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Affiliation(s)
- Prakash Nidadavolu
- Institute of Molecular Psychiatry, Medical Faculty, University of Bonn, Bonn, Germany
| | - Andras Bilkei-Gorzo
- Institute of Molecular Psychiatry, Medical Faculty, University of Bonn, Bonn, Germany
| | - Michael Krämer
- Institute of Forensic Medicine, Medical Faculty, University of Bonn, Bonn, Germany
| | - Britta Schürmann
- Institute of Molecular Psychiatry, Medical Faculty, University of Bonn, Bonn, Germany
| | - Michela Palmisano
- Institute of Molecular Psychiatry, Medical Faculty, University of Bonn, Bonn, Germany
| | - Eva C Beins
- Institute of Molecular Psychiatry, Medical Faculty, University of Bonn, Bonn, Germany.,Institute of Human Genetics, Medical Faculty, University of Bonn, Bonn, Germany
| | - Burkhard Madea
- Institute of Forensic Medicine, Medical Faculty, University of Bonn, Bonn, Germany
| | - Andreas Zimmer
- Institute of Molecular Psychiatry, Medical Faculty, University of Bonn, Bonn, Germany
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Cannabidiol Selectively Binds to the Voltage-Gated Sodium Channel Na v1.4 in Its Slow-Inactivated State and Inhibits Sodium Current. Biomedicines 2021; 9:biomedicines9091141. [PMID: 34572327 PMCID: PMC8465134 DOI: 10.3390/biomedicines9091141] [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: 08/16/2021] [Revised: 08/31/2021] [Accepted: 09/01/2021] [Indexed: 12/28/2022] Open
Abstract
Cannabidiol (CBD), one of the cannabinoids from the cannabis plant, can relieve the myotonia resulting from sodium channelopathy, which manifests as repetitive discharges of muscle membrane. We investigated the binding kinetics of CBD to Nav1.4 channels on the muscle membrane. The binding affinity of CBD to the channel was evaluated using whole-cell recording. The CDOCKER program was employed to model CBD docking onto the Nav1.4 channel to determine its binding sites. Our results revealed no differential inhibition of sodium current by CBD when the channels were in activation or fast inactivation status. However, differential inhibition was observed with a dose-dependent manner after a prolonged period of depolarization, leaving the channel in a slow-inactivated state. Moreover, CBD binds selectively to the slow-inactivated state with a significantly faster binding kinetics (>64,000 M−1 s−1) and a higher affinity (Kd of fast inactivation vs. slow-inactivation: >117.42 μM vs. 51.48 μM), compared to the fast inactivation state. Five proposed CBD binding sites in a bundle crossing region of the Nav1.4 channels pore was identified as Val793, Leu794, Phe797, and Cys759 in domain I/S6, and Ile1279 in domain II/S6. Our findings imply that CBD favorably binds to the Nav1.4 channel in its slow-inactivated state.
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Straiker A, Wilson S, Corey W, Dvorakova M, Bosquez T, Tracey J, Wilkowski C, Ho K, Wager-Miller J, Mackie K. An Evaluation of Understudied Phytocannabinoids and Their Effects in Two Neuronal Models. Molecules 2021; 26:5352. [PMID: 34500785 PMCID: PMC8434068 DOI: 10.3390/molecules26175352] [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: 07/31/2021] [Revised: 08/27/2021] [Accepted: 08/28/2021] [Indexed: 11/16/2022] Open
Abstract
Cannabis contains more than 100 phytocannabinoids. Most of these remain poorly characterized, particularly in neurons. We tested a panel of five phytocannabinoids-cannabichromene (CBC), cannabidiolic acid (CBDA), cannabidivarin (CBDV), cannabidivarinic acid (CBDVA), and Δ9-tetrahydrocannabivarin (THCV) in two neuronal models, autaptic hippocampal neurons and dorsal root ganglion (DRG) neurons. Autaptic neurons expressed a form of CB1-dependent retrograde plasticity while DRGs expressed a variety of transient receptor potential (TRP) channels. CBC, CBDA, and CBDVA had little or no effect on neuronal cannabinoid signaling. CBDV and THCV differentially inhibited cannabinoid signaling. THCV inhibited CB1 receptors presynaptically while CBDV acted post-synaptically, perhaps by inhibiting 2-AG production. None of the compounds elicited a consistent DRG response. In summary, we find that two of five 'minor' phytocannabinoids tested antagonized CB1-based signaling in a neuronal model, but with very different mechanisms. Our findings highlight the diversity of potential actions of phytocannabinoids and the importance of fully evaluating these compounds in neuronal models.
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Affiliation(s)
- Alex Straiker
- Gill Center for Molecular Bioscience, Program in Neuroscience, Department of Psychological & Brain Sciences, Indiana University, Bloomington, IN 47405, USA; (S.W.); (W.C.); (M.D.); (T.B.); (J.T.); (C.W.); (K.H.); (J.W.-M.); (K.M.)
| | - Sierra Wilson
- Gill Center for Molecular Bioscience, Program in Neuroscience, Department of Psychological & Brain Sciences, Indiana University, Bloomington, IN 47405, USA; (S.W.); (W.C.); (M.D.); (T.B.); (J.T.); (C.W.); (K.H.); (J.W.-M.); (K.M.)
| | - Wesley Corey
- Gill Center for Molecular Bioscience, Program in Neuroscience, Department of Psychological & Brain Sciences, Indiana University, Bloomington, IN 47405, USA; (S.W.); (W.C.); (M.D.); (T.B.); (J.T.); (C.W.); (K.H.); (J.W.-M.); (K.M.)
| | - Michaela Dvorakova
- Gill Center for Molecular Bioscience, Program in Neuroscience, Department of Psychological & Brain Sciences, Indiana University, Bloomington, IN 47405, USA; (S.W.); (W.C.); (M.D.); (T.B.); (J.T.); (C.W.); (K.H.); (J.W.-M.); (K.M.)
- Department of Molecular Pharmacology, Institute of Molecular Genetics of the Czech Academy of Sciences, Videnska 1083, 14220 Prague, Czech Republic
| | - Taryn Bosquez
- Gill Center for Molecular Bioscience, Program in Neuroscience, Department of Psychological & Brain Sciences, Indiana University, Bloomington, IN 47405, USA; (S.W.); (W.C.); (M.D.); (T.B.); (J.T.); (C.W.); (K.H.); (J.W.-M.); (K.M.)
| | - Joye Tracey
- Gill Center for Molecular Bioscience, Program in Neuroscience, Department of Psychological & Brain Sciences, Indiana University, Bloomington, IN 47405, USA; (S.W.); (W.C.); (M.D.); (T.B.); (J.T.); (C.W.); (K.H.); (J.W.-M.); (K.M.)
| | - Caroline Wilkowski
- Gill Center for Molecular Bioscience, Program in Neuroscience, Department of Psychological & Brain Sciences, Indiana University, Bloomington, IN 47405, USA; (S.W.); (W.C.); (M.D.); (T.B.); (J.T.); (C.W.); (K.H.); (J.W.-M.); (K.M.)
| | - Kathleen Ho
- Gill Center for Molecular Bioscience, Program in Neuroscience, Department of Psychological & Brain Sciences, Indiana University, Bloomington, IN 47405, USA; (S.W.); (W.C.); (M.D.); (T.B.); (J.T.); (C.W.); (K.H.); (J.W.-M.); (K.M.)
| | - Jim Wager-Miller
- Gill Center for Molecular Bioscience, Program in Neuroscience, Department of Psychological & Brain Sciences, Indiana University, Bloomington, IN 47405, USA; (S.W.); (W.C.); (M.D.); (T.B.); (J.T.); (C.W.); (K.H.); (J.W.-M.); (K.M.)
| | - Ken Mackie
- Gill Center for Molecular Bioscience, Program in Neuroscience, Department of Psychological & Brain Sciences, Indiana University, Bloomington, IN 47405, USA; (S.W.); (W.C.); (M.D.); (T.B.); (J.T.); (C.W.); (K.H.); (J.W.-M.); (K.M.)
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At the intersection of sleep deficiency and opioid use: mechanisms and therapeutic opportunities. Transl Res 2021; 234:58-73. [PMID: 33711513 PMCID: PMC8217216 DOI: 10.1016/j.trsl.2021.03.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 02/17/2021] [Accepted: 03/06/2021] [Indexed: 12/18/2022]
Abstract
Due to the ongoing opioid epidemic, innovative scientific perspectives and approaches are urgently needed to reduce the unprecedented personal and societal burdens of nonmedical and recreational opioid use. One promising opportunity is to focus on the relationship between sleep deficiency and opioid use. In this review, we examine empirical evidence: (1) at the interface of sleep deficiency and opioid use, including hypothesized bidirectional associations between sleep efficiency and opioid abstinence; (2) as to whether normalization of sleep deficiency might directly or indirectly improve opioid abstinence (and vice versa); and (3) regarding mechanisms that could link improvements in sleep to opioid abstinence. Based on available data, we identify candidate sleep-restorative therapeutic approaches that should be examined in rigorous clinical trials.
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Vitale RM, Iannotti FA, Schiano Moriello A, Tunisi L, Piscitelli F, Savopoulos R, Cristino L, De Petrocellis L, Amodeo P, Gray R, Di Marzo V. Identification and Characterization of Cannabidiol as an OX1R Antagonist by Computational and In Vitro Functional Validation. Biomolecules 2021; 11:1134. [PMID: 34439801 PMCID: PMC8394412 DOI: 10.3390/biom11081134] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 07/22/2021] [Accepted: 07/28/2021] [Indexed: 12/22/2022] Open
Abstract
The potential, multifaceted therapeutic profile of cannabidiol (CBD), a major constituent derived from the Cannabis sativa plant, covers a wide range of neurological and psychiatric disorders, ranging from anxiety to pediatric epilepsy and drug addiction. However, the molecular targets responsible for these effects have been only partially identified. In this view, the involvement of the orexin system, the key regulator in arousal and the sleep/wake cycle, and in motivation and reward processes, including drug addiction, prompted us to explore, using computational and experimental approaches, the possibility that CBD could act as a ligand of orexin receptors, orexin 1 receptor of type 1 (OX1R) and type 2 (OX2R). Ligand-binding assays showed that CBD is a selective ligand of OX1R in the low micromolar range (Ki 1.58 ± 0.2 μM) while in vitro functional assays, carried out by intracellular calcium imaging and mobilization assays, showed that CBD acts as an antagonist at this receptor. Finally, the putative binding mode of CBD has been inferred by molecular docking and molecular dynamics simulations and its selectivity toward the OX1R subtype rationalized at the molecular level. This study provides the first evidence that CBD acts as an OX1R antagonist, supporting its potential use in addictive disorders and/or body weight regulation.
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Affiliation(s)
- Rosa Maria Vitale
- Institute of Biomolecular Chemistry, National Research Council (ICB-CNR), Via Campi Flegrei 34, 80078 Pozzuoli, Italy; (F.A.I.); (F.P.); (L.C.); (L.D.); (P.A.)
| | - Fabio Arturo Iannotti
- Institute of Biomolecular Chemistry, National Research Council (ICB-CNR), Via Campi Flegrei 34, 80078 Pozzuoli, Italy; (F.A.I.); (F.P.); (L.C.); (L.D.); (P.A.)
- Endocannabinoid Research Group (ERG), Institute of Biomolecular Chemistry, National Research Council (ICB-CNR), Via Campi Flegrei 34, 80078 Pozzuoli, Italy; (A.S.M.); (L.T.)
| | - Aniello Schiano Moriello
- Endocannabinoid Research Group (ERG), Institute of Biomolecular Chemistry, National Research Council (ICB-CNR), Via Campi Flegrei 34, 80078 Pozzuoli, Italy; (A.S.M.); (L.T.)
- Epitech Group SpA, Saccolongo, 35100 Padova, Italy
| | - Lea Tunisi
- Endocannabinoid Research Group (ERG), Institute of Biomolecular Chemistry, National Research Council (ICB-CNR), Via Campi Flegrei 34, 80078 Pozzuoli, Italy; (A.S.M.); (L.T.)
- Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, 80131 Naples, Italy
| | - Fabiana Piscitelli
- Institute of Biomolecular Chemistry, National Research Council (ICB-CNR), Via Campi Flegrei 34, 80078 Pozzuoli, Italy; (F.A.I.); (F.P.); (L.C.); (L.D.); (P.A.)
- Endocannabinoid Research Group (ERG), Institute of Biomolecular Chemistry, National Research Council (ICB-CNR), Via Campi Flegrei 34, 80078 Pozzuoli, Italy; (A.S.M.); (L.T.)
| | - Ranjev Savopoulos
- GW Research Ltd., Sovereign House, Vision Park, Histon, Cambridge CB24 9BZ, UK; (R.S.); (R.G.)
| | - Luigia Cristino
- Institute of Biomolecular Chemistry, National Research Council (ICB-CNR), Via Campi Flegrei 34, 80078 Pozzuoli, Italy; (F.A.I.); (F.P.); (L.C.); (L.D.); (P.A.)
- Endocannabinoid Research Group (ERG), Institute of Biomolecular Chemistry, National Research Council (ICB-CNR), Via Campi Flegrei 34, 80078 Pozzuoli, Italy; (A.S.M.); (L.T.)
| | - Luciano De Petrocellis
- Institute of Biomolecular Chemistry, National Research Council (ICB-CNR), Via Campi Flegrei 34, 80078 Pozzuoli, Italy; (F.A.I.); (F.P.); (L.C.); (L.D.); (P.A.)
- Endocannabinoid Research Group (ERG), Institute of Biomolecular Chemistry, National Research Council (ICB-CNR), Via Campi Flegrei 34, 80078 Pozzuoli, Italy; (A.S.M.); (L.T.)
| | - Pietro Amodeo
- Institute of Biomolecular Chemistry, National Research Council (ICB-CNR), Via Campi Flegrei 34, 80078 Pozzuoli, Italy; (F.A.I.); (F.P.); (L.C.); (L.D.); (P.A.)
| | - Roy Gray
- GW Research Ltd., Sovereign House, Vision Park, Histon, Cambridge CB24 9BZ, UK; (R.S.); (R.G.)
| | - Vincenzo Di Marzo
- Institute of Biomolecular Chemistry, National Research Council (ICB-CNR), Via Campi Flegrei 34, 80078 Pozzuoli, Italy; (F.A.I.); (F.P.); (L.C.); (L.D.); (P.A.)
- Endocannabinoid Research Group (ERG), Institute of Biomolecular Chemistry, National Research Council (ICB-CNR), Via Campi Flegrei 34, 80078 Pozzuoli, Italy; (A.S.M.); (L.T.)
- Canada Excellence Research Chair on the Microbiome-Endocannabinoidome Axis in Metabolic Health (CERC-MEND), Université Laval, Quebec City, QC G1V 4G5, Canada
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31
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Winters BL, Vaughan CW. Mechanisms of endocannabinoid control of synaptic plasticity. Neuropharmacology 2021; 197:108736. [PMID: 34343612 DOI: 10.1016/j.neuropharm.2021.108736] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 07/27/2021] [Accepted: 07/28/2021] [Indexed: 01/13/2023]
Abstract
The endogenous cannabinoid transmitter system regulates synaptic transmission throughout the nervous system. Unlike conventional transmitters, specific stimuli induce synthesis of endocannabinoids (eCBs) in the postsynaptic neuron, and these travel backwards to modulate presynaptic inputs. In doing so, eCBs can induce short-term changes in synaptic strength and longer-term plasticity. While this eCB regulation is near ubiquitous, it displays major regional and synapse specific variations with different synapse specific forms of short-versus long-term plasticity throughout the brain. These differences are due to the plethora of pre- and postsynaptic mechanisms which have been implicated in eCB signalling, the intricacies of which are only just being realised. In this review, we shall describe the current understanding and highlight new advances in this area, with a focus on the retrograde action of eCBs at CB1 receptors (CB1Rs).
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Affiliation(s)
- Bryony Laura Winters
- Pain Management Research Institute, Kolling Institute of Medical Research, Northern Clinical School, University of Sydney at Royal North Shore Hospital, NSW, Australia.
| | - Christopher Walter Vaughan
- Pain Management Research Institute, Kolling Institute of Medical Research, Northern Clinical School, University of Sydney at Royal North Shore Hospital, NSW, Australia
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32
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Schlag AK, Hindocha C, Zafar R, Nutt DJ, Curran HV. Cannabis based medicines and cannabis dependence: A critical review of issues and evidence. J Psychopharmacol 2021; 35:773-785. [PMID: 33593117 PMCID: PMC8278552 DOI: 10.1177/0269881120986393] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Cannabis has been legalised for medical use in an ever-increasing number of countries. A growing body of scientific evidence supports the use of medical cannabis for a range of therapeutic indications. In parallel with these developments, concerns have been expressed by many prescribers that increased use will lead to patients developing cannabis use disorder. Cannabis use disorder has been widely studied in recreational users, and these findings have often been projected onto patients using medical cannabis. However, studies exploring medical cannabis dependence are scarce and the appropriate methodology to measure this construct is uncertain. This article provides a narrative review of the current research to discern if, how and to what extent, concerns about problems of dependence in recreational cannabis users apply to prescribed medical users. We focus on the main issues related to medical cannabis and dependence, including the importance of dose, potency, cannabinoid content, pharmacokinetics and route of administration, frequency of use, as well as set and setting. Medical and recreational cannabis use differs in significant ways, highlighting the challenges of extrapolating findings from the recreational cannabis literature. There are many questions about the potential for medical cannabis use to lead to dependence. It is therefore imperative to address these questions in order to be able to minimise harms of medical cannabis use. We draw out seven recommendations for increasing the safety of medical cannabis prescribing. We hope that the present review contributes to answering some of the key questions surrounding medical cannabis dependence.
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Affiliation(s)
- Anne K Schlag
- Drug Science, St Peter’s House, London, UK
- Neuropsychopharmacology Unit, Centre for Psychiatry, Imperial College London, London, UK
| | - Chandni Hindocha
- Clinical Psychopharmacology Unit, University College London, London, UK
- University College Hospital National Institute of Health Research (NIHR) Biomedical Research Centre, London, UK
| | - Rayyan Zafar
- Drug Science, St Peter’s House, London, UK
- Neuropsychopharmacology Unit, Centre for Psychiatry, Imperial College London, London, UK
| | - David J Nutt
- Drug Science, St Peter’s House, London, UK
- Neuropsychopharmacology Unit, Centre for Psychiatry, Imperial College London, London, UK
| | - H Valerie Curran
- Clinical Psychopharmacology Unit, University College London, London, UK
- University College Hospital National Institute of Health Research (NIHR) Biomedical Research Centre, London, UK
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Calpe-López C, Gasparyan A, Navarrete F, Manzanares J, Miñarro J, Aguilar MA. Cannabidiol prevents priming- and stress-induced reinstatement of the conditioned place preference induced by cocaine in mice. J Psychopharmacol 2021; 35:864-874. [PMID: 33427014 DOI: 10.1177/0269881120965952] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Cocaine dependence is an important problem without any effective pharmacological treatment. Some preclinical studies have suggested that cannabidiol (CBD), a component of the Cannabis sativa plant, could be useful for the treatment of cocaine use disorders. AIMS This work aims to evaluate the ability of CBD to reduce priming- and stress-induced reinstatement of the conditioned place preference (CPP) induced by cocaine. METHODS Young adult CD-1 male mice were allocated to 10 groups (n = 12/group), conditioned with cocaine (10 mg/kg) and exposed to extinction of CPP (two sessions per week). When extinction was achieved, each group received the corresponding treatment before the reinstatement test. In experiment 1, six groups were used: vehicle+saline (Veh+Sal), 5 mg/kg cocaine alone (Veh+Coc) or with CBD 30 or 60 mg/kg (CBD30+Coc, CBD60+Coc) and CBD alone (CBD30+Sal, CBD60+Sal). In experiment 2, four groups were used: exploration (Veh+Expl), social defeat (Veh+SD) and social defeat with CBD (CBD30+SD and CBD60+SD). Furthermore, the relative gene expression of the dopamine transporter (DAT) in the ventral tegmental area was measured. RESULTS All mice acquired cocaine CPP and extinguished it after three or four weeks. Only the groups treated with cocaine priming (Veh+Coc) or exposed to social defeat (Veh+SD) showed reinstatement of CPP. Interestingly, CBD itself did not induce reinstatement and blocked the reinstating effects of cocaine priming and social defeat. Furthermore, cocaine priming increased DAT gene expression in the ventral tegmental area and CBD completely reversed this effect. CONCLUSION These results suggest that CBD could reduce reinstatement to cocaine seeking after a period of abstinence.
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Affiliation(s)
- Claudia Calpe-López
- Unit of Research 'Neurobehavioural mechanisms and endophenotypes of addictive behaviour', Departamento de Psicobiología, Facultad de Psicología, Universitat de València, Valencia, Spain
| | - Ani Gasparyan
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Alicante, Spain.,Red Temática de Investigación Cooperativa en Salud (RETICS), Red de Trastornos Adictivos, Instituto de Salud Carlos III, MICINN and FEDER, Madrid, Spain
| | - Francisco Navarrete
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Alicante, Spain.,Red Temática de Investigación Cooperativa en Salud (RETICS), Red de Trastornos Adictivos, Instituto de Salud Carlos III, MICINN and FEDER, Madrid, Spain
| | - Jorge Manzanares
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Alicante, Spain.,Red Temática de Investigación Cooperativa en Salud (RETICS), Red de Trastornos Adictivos, Instituto de Salud Carlos III, MICINN and FEDER, Madrid, Spain
| | - Jose Miñarro
- Red Temática de Investigación Cooperativa en Salud (RETICS), Red de Trastornos Adictivos, Instituto de Salud Carlos III, MICINN and FEDER, Madrid, Spain.,Unidad de Investigación Psicobiología de las Drogodependencias, Departamento de Psicobiología, Facultad de Psicología, Universitat de València, Valencia, Spain
| | - Maria A Aguilar
- Unit of Research 'Neurobehavioural mechanisms and endophenotypes of addictive behaviour', Departamento de Psicobiología, Facultad de Psicología, Universitat de València, Valencia, Spain.,Red Temática de Investigación Cooperativa en Salud (RETICS), Red de Trastornos Adictivos, Instituto de Salud Carlos III, MICINN and FEDER, Madrid, Spain
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Todorova J, Lazarov LI, Petrova M, Tzintzarov A, Ugrinova I. The antitumor activity of cannabidiol on lung cancer cell lines A549 and H1299: the role of apoptosis. BIOTECHNOL BIOTEC EQ 2021. [DOI: 10.1080/13102818.2021.1915870] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Jordana Todorova
- Department of Structure and Function of Chromatin, Institute of Molecular Biology “Roumen Tsanev”, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - Lazar I. Lazarov
- Department of Structure and Function of Chromatin, Institute of Molecular Biology “Roumen Tsanev”, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - Maria Petrova
- Department of Structure and Function of Chromatin, Institute of Molecular Biology “Roumen Tsanev”, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - Alexander Tzintzarov
- Department of Structure and Function of Chromatin, Institute of Molecular Biology “Roumen Tsanev”, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - Iva Ugrinova
- Department of Structure and Function of Chromatin, Institute of Molecular Biology “Roumen Tsanev”, Bulgarian Academy of Sciences, Sofia, Bulgaria
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Cannabidiol Inhibition of Murine Primary Nociceptors: Tight Binding to Slow Inactivated States of Na v1.8 Channels. J Neurosci 2021; 41:6371-6387. [PMID: 34131037 DOI: 10.1523/jneurosci.3216-20.2021] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 05/11/2021] [Accepted: 06/04/2021] [Indexed: 02/06/2023] Open
Abstract
The nonpsychoactive phytocannabinoid cannabidiol (CBD) has been shown to have analgesic effects in animal studies but little is known about its mechanism of action. We examined the effects of CBD on intrinsic excitability of primary pain-sensing neurons. Studying acutely dissociated capsaicin-sensitive mouse DRG neurons at 37°C, we found that CBD effectively inhibited repetitive action potential firing, from 15-20 action potentials evoked by 1 s current injections in control to 1-3 action potentials with 2 μm CBD. Reduction of repetitive firing was accompanied by a reduction of action potential height, widening of action potentials, reduction of the afterhyperpolarization, and increased propensity to enter depolarization block. Voltage-clamp experiments showed that CBD inhibited both TTX-sensitive and TTX-resistant (TTX-R) sodium currents in a use-dependent manner. CBD showed strong state-dependent inhibition of TTX-R channels, with fast binding to inactivated channels during depolarizations and slow unbinding on repolarization. CBD alteration of channel availability at various voltages suggested that CBD binds especially tightly [K d (dissociation constant), ∼150 nm] to the slow inactivated state of TTX-R channels, which can be substantially occupied at voltages as negative as -40 mV. Remarkably, CBD was more potent in inhibiting TTX-R channels and inhibiting action potential firing than the local anesthetic bupivacaine. We conclude that CBD might produce some of its analgesic effects by direct effects on neuronal excitability, with tight binding to the slow inactivated state of Nav1.8 channels contributing to effective inhibition of repetitive firing by modest depolarizations.SIGNIFICANCE STATEMENT Cannabidiol (CBD) has been shown to inhibit pain in various rodent models, but the mechanism of this effect is unknown. We describe the ability of CBD to inhibit repetitive action potential firing in primary nociceptive neurons from mouse dorsal root ganglia and analyze the effects on voltage-dependent sodium channels. We find that CBD interacts with TTX-resistant sodium channels in a state-dependent manner suggesting particularly tight binding to slow inactivated states of Nav1.8 channels, which dominate the overall inactivation of Nav1.8 channels for small maintained depolarizations from the resting potential. The results suggest that CBD can exert analgesic effects in part by directly inhibiting repetitive firing of primary nociceptors and suggest a strategy of identifying compounds that bind selectively to slow inactivated states of Nav1.8 channels for developing effective analgesics.
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Sadaka AH, Ozuna AG, Ortiz RJ, Kulkarni P, Johnson CT, Bradshaw HB, Cushing BS, Li AL, Hohmann AG, Ferris CF. Cannabidiol has a unique effect on global brain activity: a pharmacological, functional MRI study in awake mice. J Transl Med 2021; 19:220. [PMID: 34030718 PMCID: PMC8142641 DOI: 10.1186/s12967-021-02891-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 05/17/2021] [Indexed: 01/13/2023] Open
Abstract
Background The phytocannabinoid cannabidiol (CBD) exhibits anxiolytic activity and has been promoted as a potential treatment for post-traumatic stress disorders. How does CBD interact with the brain to alter behavior? We hypothesized that CBD would produce a dose-dependent reduction in brain activity and functional coupling in neural circuitry associated with fear and defense. Methods During the scanning session awake mice were given vehicle or CBD (3, 10, or 30 mg/kg I.P.) and imaged for 10 min post treatment. Mice were also treated with the 10 mg/kg dose of CBD and imaged 1 h later for resting state BOLD functional connectivity (rsFC). Imaging data were registered to a 3D MRI mouse atlas providing site-specific information on 138 different brain areas. Blood samples were collected for CBD measurements. Results CBD produced a dose-dependent polarization of activation along the rostral-caudal axis of the brain. The olfactory bulb and prefrontal cortex showed an increase in positive BOLD whereas the brainstem and cerebellum showed a decrease in BOLD signal. This negative BOLD affected many areas connected to the ascending reticular activating system (ARAS). The ARAS was decoupled to much of the brain but was hyperconnected to the olfactory system and prefrontal cortex. Conclusion The CBD-induced decrease in ARAS activity is consistent with an emerging literature suggesting that CBD reduces autonomic arousal under conditions of emotional and physical stress. Supplementary Information The online version contains supplementary material available at 10.1186/s12967-021-02891-6.
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Affiliation(s)
- Aymen H Sadaka
- Center for Translational NeuroImaging, Northeastern University, Boston, MA, USA
| | - Ana G Ozuna
- Center for Translational NeuroImaging, Northeastern University, Boston, MA, USA
| | - Richard J Ortiz
- Department of Biological Sciences, University of Texas At El Paso, El Paso, TX, 79968, USA
| | - Praveen Kulkarni
- Center for Translational NeuroImaging, Northeastern University, Boston, MA, USA
| | - Clare T Johnson
- Psychological and Brain Sciences, Program in Neuroscience, Indiana University, Bloomington, IN, USA
| | - Heather B Bradshaw
- Psychological and Brain Sciences, Program in Neuroscience, Indiana University, Bloomington, IN, USA
| | - Bruce S Cushing
- Department of Biological Sciences, University of Texas At El Paso, El Paso, TX, 79968, USA
| | - Ai-Ling Li
- Psychological and Brain Sciences, Program in Neuroscience, Indiana University, Bloomington, IN, USA
| | - Andrea G Hohmann
- Psychological and Brain Sciences, Program in Neuroscience, Indiana University, Bloomington, IN, USA.,Gill Center for Biomolecular Science, Indiana University, Bloomington, IN, USA
| | - Craig F Ferris
- Center for Translational NeuroImaging, Northeastern University, Boston, MA, USA. .,Psychology and Pharmaceutical Sciences, Northeastern University, Boston, MA, USA. .,Department of Psychology, Northeastern University, 125 NI Hall, 360 Huntington Ave, Boston, MA, 02115-5000, USA.
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Mielnik CA, Lam VM, Ross RA. CB 1 allosteric modulators and their therapeutic potential in CNS disorders. Prog Neuropsychopharmacol Biol Psychiatry 2021; 106:110163. [PMID: 33152384 DOI: 10.1016/j.pnpbp.2020.110163] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/30/2020] [Accepted: 10/29/2020] [Indexed: 01/05/2023]
Abstract
CB1 is the most abundant GPCR found in the mammalian brain. It has garnered considerable attention as a potential therapeutic drug target. CB1 is involved in a wide range of physiological and psychiatric processes and has the potential to be targeted in a wide range of disease states. However, most of the selective and non-selective synthetic CB1 agonists and antagonists/inverse agonists developed to date are primarily used as research tools. No novel synthetic cannabinoids are currently in the clinic for use in psychiatric illness; synthetic analogues of the phytocannabinoid THC are on the market to treat nausea and vomiting caused by cancer chemotherapy, along with off-label use for pain. Novel strategies are being explored to target CB1, but with emphasis on the elimination or mitigation of the potential psychiatric adverse effects that are observed by central agonism/antagonism of CB1. New pharmacological options are being pursued that may avoid these adverse effects while preserving the potential therapeutic benefits of CB1 modulation. Allosteric modulation of CB1 is one such approach. In this review, we will summarize and critically analyze both the in vitro characterization and in vivo validation of CB1 allosteric modulators developed to date, with a focus on CNS therapeutic effects.
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Affiliation(s)
- Catharine A Mielnik
- Department of Pharmacology & Toxicology, University of Toronto, ON M5S 1A8, Canada
| | - Vincent M Lam
- Department of Pharmacology & Toxicology, University of Toronto, ON M5S 1A8, Canada
| | - Ruth A Ross
- Department of Pharmacology & Toxicology, University of Toronto, ON M5S 1A8, Canada.
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Mori MA, Meyer E, da Silva FF, Milani H, Guimarães FS, Oliveira RMW. Differential contribution of CB1, CB2, 5-HT1A, and PPAR-γ receptors to cannabidiol effects on ischemia-induced emotional and cognitive impairments. Eur J Neurosci 2021; 53:1738-1751. [PMID: 33522084 DOI: 10.1111/ejn.15134] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 12/03/2020] [Accepted: 01/17/2021] [Indexed: 01/08/2023]
Abstract
An ever-increasing body of preclinical studies has shown the multifaceted neuroprotective profile of cannabidiol (CBD) against impairments caused by cerebral ischemia. In this study, we have explored the neuropharmacological mechanisms of CBD action and its impact on functional recovery using a model of transient global cerebral ischemia in mice. C57BL/6J mice were subjected to bilateral common carotid artery occlusion (BCCAO) for 20 min and received vehicle or CBD (10 mg/Kg) 0.5 hr before and 3, 24, and 48 hr after reperfusion. To investigate the neuropharmacological mechanisms of CBD, the animals were injected with CB1 (AM251, 1 mg/kg), CB2 (AM630, 1 mg/kg), 5-HT1A (WAY-100635, 10 mg/kg), or PPAR-γ (GW9662, 3 mg/kg) receptor antagonists 0.5 hr prior to each injection of CBD. The animals were evaluated using a multi-task testing battery that included the open field, elevated zero maze, Y-maze (YM), and forced swim test. CBD prevented anxiety-like behavior, memory impairments, and despair-like behaviors induced by BCCAO in mice. The anxiolytic-like effects of CBD in BCCAO mice were attenuated by CB1 , CB2 , 5-HT1A , and PPAR-γ receptor antagonists. In the YM, both CBD and the CB1 receptor antagonist AM251 increased the exploration of the novel arm in ischemic animals, indicating beneficial effects of these treatments in the spatial memory performance. Together, these findings indicate the involvement of CB1 , CB2 , 5-HT1A, and PPAR-γ receptors in the functional recovery induced by CBD in BCCAO mice.
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Affiliation(s)
- Marco Aurélio Mori
- Department of Pharmacology and Therapeutics, State University of Maringá, Maringá, Brazil
| | - Erika Meyer
- Department of Pharmacology and Therapeutics, State University of Maringá, Maringá, Brazil
| | - Francielly F da Silva
- Department of Pharmacology and Therapeutics, State University of Maringá, Maringá, Brazil
| | - Humberto Milani
- Department of Pharmacology and Therapeutics, State University of Maringá, Maringá, Brazil
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Szkudlarek HJ, Rodríguez-Ruiz M, Hudson R, De Felice M, Jung T, Rushlow WJ, Laviolette SR. THC and CBD produce divergent effects on perception and panic behaviours via distinct cortical molecular pathways. Prog Neuropsychopharmacol Biol Psychiatry 2021; 104:110029. [PMID: 32623021 DOI: 10.1016/j.pnpbp.2020.110029] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 06/12/2020] [Accepted: 06/21/2020] [Indexed: 12/17/2022]
Abstract
Clinical and pre-clinical evidence demonstrates divergent psychotropic effects of THC vs. CBD. While THC can induce perceptual distortions and anxiogenic effects, CBD displays antipsychotic and anxiolytic properties. A key brain region responsible for regulation of cognition and affect, the medial prefrontal cortex (PFC), is strongly modulated by cannabinoids, suggesting that these dissociable THC/CBD-dependent effects may involve functional and molecular interplay within the PFC. The primary aim of this study was to investigate potential interactions and molecular substrates involved in PFC-mediated effects of THC and CBD on differential cognitive and affective behavioural processing. Male Sprague Dawley rats received intra-PFC microinfusions of THC, CBD or their combination, and tested in the latent inhibition paradigm, spontaneous oddity discrimination test, elevated T-maze and open field. To identify local, drug-induced molecular modulation in the PFC, PFC samples were collected and processed with Western Blotting. Intra-PFC THC induced strong panic-like responses that were counteracted with CBD. In contrast, CBD did not affect panic-like behaviours but blocked formation of associative fear memories and impaired latent inhibition and oddity discrimination performance. Interestingly, these CBD effects were dependent upon 5-HT1A receptor transmission but not influenced by THC co-administration. Moreover, THC induced robust phosphorylation of ERK1/2 that was prevented by CBD, while CBD decreased phosphorylation of p70S6K, independently of THC. These results suggest that intra-PFC infusion of THC promotes panic-like behaviour associated with increased ERK1/2 phosphorylation. In contrast, CBD impairs perceptive functions and latent inhibition via activation of 5-HT1A receptors and reduced phosphorylation of p70S6K.
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Affiliation(s)
- Hanna J Szkudlarek
- Addiction Research Group, University of Western Ontario, London, Ontario N6A 5C1, Canada; Department of Anatomy and Cell Biology, University of Western Ontario, London, Ontario N6A 5C1, Canada.
| | - Mar Rodríguez-Ruiz
- Addiction Research Group, University of Western Ontario, London, Ontario N6A 5C1, Canada; Department of Anatomy and Cell Biology, University of Western Ontario, London, Ontario N6A 5C1, Canada
| | - Roger Hudson
- Addiction Research Group, University of Western Ontario, London, Ontario N6A 5C1, Canada; Department of Anatomy and Cell Biology, University of Western Ontario, London, Ontario N6A 5C1, Canada
| | - Marta De Felice
- Addiction Research Group, University of Western Ontario, London, Ontario N6A 5C1, Canada; Department of Anatomy and Cell Biology, University of Western Ontario, London, Ontario N6A 5C1, Canada
| | - Tony Jung
- Addiction Research Group, University of Western Ontario, London, Ontario N6A 5C1, Canada; Department of Anatomy and Cell Biology, University of Western Ontario, London, Ontario N6A 5C1, Canada
| | - Walter J Rushlow
- Addiction Research Group, University of Western Ontario, London, Ontario N6A 5C1, Canada; Department of Anatomy and Cell Biology, University of Western Ontario, London, Ontario N6A 5C1, Canada; Department of Psychiatry. Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario N6A 5C1, Canada
| | - Steven R Laviolette
- Addiction Research Group, University of Western Ontario, London, Ontario N6A 5C1, Canada; Department of Anatomy and Cell Biology, University of Western Ontario, London, Ontario N6A 5C1, Canada; Department of Psychiatry. Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario N6A 5C1, Canada.
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Kwan Cheung KA, Mitchell MD, Heussler HS. Cannabidiol and Neurodevelopmental Disorders in Children. Front Psychiatry 2021; 12:643442. [PMID: 34093265 PMCID: PMC8175856 DOI: 10.3389/fpsyt.2021.643442] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 04/19/2021] [Indexed: 12/17/2022] Open
Abstract
Neurodevelopmental and neuropsychiatric disorders (such as autism spectrum disorder) have broad health implications for children, with no definitive cure for the vast majority of them. However, recently medicinal cannabis has been successfully trialled as a treatment to manage many of the patients' symptoms and improve quality of life. The cannabinoid cannabidiol, in particular, has been reported to be safe and well-tolerated with a plethora of anticonvulsant, anxiolytic and anti-inflammatory properties. Lately, the current consensus is that the endocannabinoid system is a crucial factor in neural development and health; research has found evidence that there are a multitude of signalling pathways involving neurotransmitters and the endocannabinoid system by which cannabinoids could potentially exert their therapeutic effects. A better understanding of the cannabinoids' mechanisms of action should lead to improved treatments for neurodevelopmental disorders.
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Affiliation(s)
- Keith A Kwan Cheung
- Centre for Children's Health Research, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Murray D Mitchell
- Centre for Children's Health Research, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Helen S Heussler
- Centre for Clinical Trials in Rare Neurodevelopmental Disorders, Child Development Program, Children's Health Queensland, Brisbane, QLD, Australia.,Centre for Children's Health Research, University of Queensland, Brisbane, QLD, Australia
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41
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Zhelyazkova M, Hristova-Avakumova N, Todorov L, Momekov G. In vitro anticancer activity and oxidative molecular damage by cannabidiol administered alone and in combination with epirubicin. BIOTECHNOL BIOTEC EQ 2021. [DOI: 10.1080/13102818.2021.1996270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Margarita Zhelyazkova
- Department of Pharmacology, Pharmacotherapy and Toxicology, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Nadya Hristova-Avakumova
- Department of Medical Physics and Biophysics, Faculty of Medicine, Medical University of Sofia, Sofia, Bulgaria
| | - Lozan Todorov
- Department of Chemistry, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Georgi Momekov
- Department of Pharmacology, Pharmacotherapy and Toxicology, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
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Cannabidiol Therapy for Refractory Epilepsy and Seizure Disorders. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1264:93-110. [PMID: 33332006 DOI: 10.1007/978-3-030-57369-0_7] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Cannabis-derived cannabinoids have neuroactive properties. Recently, there has been emerging interest in the use of cannabidiol (CBD)-enriched products for treatment of drug-resistant epilepsy. In 2018, the FDA approved the use of CBD-rich Epidiolex for two severe forms of epilepsy in children (Lennox-Gastaut and Dravet syndromes). Experimental research supports the use of CBD in many CNS disorders, though the mechanisms underlying its anticonvulsant and neuroprotective effects remain unclear. CBD has been shown to reduce inflammation, protect against neuronal loss, normalize neurogenesis, and act as an antioxidant. These actions appear to be due to the multimodal mechanism of action of CBD in the brain. This chapter briefly describes the current information on cannabis pharmacology with an emphasis on the clinical utility of CBD in the treatment of refractory epilepsies and other related seizure conditions. Clinical trials are ongoing for other forms of epilepsy and refractory seizures associated with infantile spasms, tuberous sclerosis, and Rett syndrome. Overall, adjunct CBD has been found to be generally safe and effective for treatment-resistant seizures in children with severe early-onset epilepsy. Whether an add-on CBD is efficacious for the long-term treatment of various epilepsy and seizure types in adults being tested in various clinical trials.
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Zagzoog A, Mohamed KA, Kim HJJ, Kim ED, Frank CS, Black T, Jadhav PD, Holbrook LA, Laprairie RB. In vitro and in vivo pharmacological activity of minor cannabinoids isolated from Cannabis sativa. Sci Rep 2020; 10:20405. [PMID: 33230154 PMCID: PMC7684313 DOI: 10.1038/s41598-020-77175-y] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 11/05/2020] [Indexed: 12/15/2022] Open
Abstract
The Cannabis sativa plant contains more than 120 cannabinoids. With the exceptions of ∆9-tetrahydrocannabinol (∆9-THC) and cannabidiol (CBD), comparatively little is known about the pharmacology of the less-abundant plant-derived (phyto) cannabinoids. The best-studied transducers of cannabinoid-dependent effects are type 1 and type 2 cannabinoid receptors (CB1R, CB2R). Partial agonism of CB1R by ∆9-THC is known to bring about the 'high' associated with Cannabis use, as well as the pain-, appetite-, and anxiety-modulating effects that are potentially therapeutic. CB2R activation by certain cannabinoids has been associated with anti-inflammatory activities. We assessed the activity of 8 phytocannabinoids at human CB1R, and CB2R in Chinese hamster ovary (CHO) cells stably expressing these receptors and in C57BL/6 mice in an attempt to better understand their pharmacodynamics. Specifically, ∆9-THC, ∆9-tetrahydrocannabinolic acid (∆9-THCa), ∆9-tetrahydrocannabivarin (THCV), CBD, cannabidiolic acid (CBDa), cannabidivarin (CBDV), cannabigerol (CBG), and cannabichromene (CBC) were evaluated. Compounds were assessed for their affinity to receptors, ability to inhibit cAMP accumulation, βarrestin2 recruitment, receptor selectivity, and ligand bias in cell culture; and cataleptic, hypothermic, anti-nociceptive, hypolocomotive, and anxiolytic effects in mice. Our data reveal partial agonist activity for many phytocannabinoids tested at CB1R and/or CB2R, as well as in vivo responses often associated with activation of CB1R. These data build on the growing body of literature showing cannabinoid receptor-dependent pharmacology for these less-abundant phytocannabinoids and are critical in understanding the complex and interactive pharmacology of Cannabis-derived molecules.
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Affiliation(s)
- Ayat Zagzoog
- College of Pharmacy and Nutrition, University of Saskatchewan, 3B36, Health Sciences Building, 107 Wiggins Road, Saskatoon, SK, S7N 2Z4, Canada
| | - Kawthar A Mohamed
- College of Pharmacy and Nutrition, University of Saskatchewan, 3B36, Health Sciences Building, 107 Wiggins Road, Saskatoon, SK, S7N 2Z4, Canada
| | - Hye Ji J Kim
- College of Pharmacy and Nutrition, University of Saskatchewan, 3B36, Health Sciences Building, 107 Wiggins Road, Saskatoon, SK, S7N 2Z4, Canada
| | - Eunhyun D Kim
- College of Pharmacy and Nutrition, University of Saskatchewan, 3B36, Health Sciences Building, 107 Wiggins Road, Saskatoon, SK, S7N 2Z4, Canada
| | - Connor S Frank
- College of Pharmacy and Nutrition, University of Saskatchewan, 3B36, Health Sciences Building, 107 Wiggins Road, Saskatoon, SK, S7N 2Z4, Canada
| | - Tallan Black
- College of Pharmacy and Nutrition, University of Saskatchewan, 3B36, Health Sciences Building, 107 Wiggins Road, Saskatoon, SK, S7N 2Z4, Canada
| | | | | | - Robert B Laprairie
- College of Pharmacy and Nutrition, University of Saskatchewan, 3B36, Health Sciences Building, 107 Wiggins Road, Saskatoon, SK, S7N 2Z4, Canada. .,Department of Pharmacology, College of Medicine, Dalhousie University, Halifax, NS, Canada.
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Zhelyazkova M, Kirilov B, Momekov G. The pharmacological basis for application of cannabidiol in cancer chemotherapy. PHARMACIA 2020. [DOI: 10.3897/pharmacia.67.e51304] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Chemotherapy is one of the therapeutic approaches for cancer treatment and has demonstrated great success with the introduction of selectively acting molecules against specific biomarkers of some types of tumors. Despite this success there is a large unmet need for novel therapies that provide effective control on the progression of advanced or drug-resistant cancer diseases. In this review, we briefly summarized our knowledge of cannabinoids and the endocannabinoid system, as possible agents for cancer therapy. We analyzed the anticancer properties and mechanism of action of cannabidiol (CBD), the main non-psychoactive cannabinoid received from hemp of Cannabis plant. Despite of data for pleiotropic effects of CBD, we here present the results for the efficacy of CBD in the modulation of different stages of cancer development. The analysis of the anticancer properties of CBD is made in relation to the proposed or newly discovered molecular targets of action. Thereafter, we consider the specific effects of CBD on primary tumors, their invasiveness and metastases, whether the influence on identified tumor markers in different types of tumors reflect the therapeutic potential of CBD. The studies reviewed herein indicate that CBD elicit activity through the cannabinoid receptor dependent and independent pathways. The processes such as ceramide production, ER-stress, autophagy and apoptosis, angiogenesis and matrix remodeling also appear to regulate the anticancer activity of CBD. So, the pharmacological basis for therapeutic application of CBD is constructed on the scientific data for its antitumor activity, extensively provided studies in vitro and in vivo in animal tumor models, and available data on the safety profile of clinically approved CBD products. We also try to reduce the deficits of our understanding in relation of pharmacological synergistic interactions of CBD with cytostatic drugs, where data remains limited. It is recognized that more studies for defining the specific molecular and signaling mechanisms of anticancer action of cannabinoids, particularly CBD, requires further evaluation. We believe that the therapeutic advantages of CBD are associated not only with its non-psychoactive behavior, but also are related to its influence on the important biochemical pathways and signal molecules, defining the genome instability and specific changes of the malignant tumor cells.
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45
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Williams CM, Stephens GJ. Development of cannabidiol as a treatment for severe childhood epilepsies. Br J Pharmacol 2020; 177:5509-5517. [PMID: 32986848 DOI: 10.1111/bph.15274] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 09/16/2020] [Accepted: 09/21/2020] [Indexed: 12/17/2022] Open
Abstract
In recent years, there has been a growing appreciation by regulatory authorities that cannabis-based medicines can play a useful role in disease therapy. Although often conflagrated by proponents of recreational use, the legislative rescheduling of cannabis-derived compounds, such as cannabidiol (CBD), has been associated with the steady increase in the pursuit of use of medicinal cannabis. One key driver in this interest has been the scientific demonstration of efficacy and safety of CBD in randomised, placebo-controlled clinical trials in children and young adults with difficult-to-treat epilepsies, which has encouraged increasing numbers of human trials of CBD for other indications and in other populations. The introduction of CBD as the medicine Epidiolex in the United States (in 2018) and as Epidyolex in the European Union (in 2019) as the first cannabis-derived therapeutic for the treatment of seizures was underpinned by preclinical research performed at the University of Reading. This work was awarded the British Pharmacological Society Sir James Black Award for Contributions to Drug Discovery 2019 and is discussed in the following review article.
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Affiliation(s)
- Claire M Williams
- School of Psychology and Clinical Language Science, University of Reading, Reading, Berkshire, UK
| | - Gary J Stephens
- School of Pharmacy, University of Reading, Reading, Berkshire, UK
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46
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Lu HC, Mackie K. Review of the Endocannabinoid System. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 6:607-615. [PMID: 32980261 DOI: 10.1016/j.bpsc.2020.07.016] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/27/2020] [Accepted: 07/27/2020] [Indexed: 01/02/2023]
Abstract
The endocannabinoid system (ECS) is a widespread neuromodulatory network involved in the developing central nervous system as well as playing a major role in tuning many cognitive and physiological processes. The ECS is composed of endogenous cannabinoids, cannabinoid receptors, and the enzymes responsible for the synthesis and degradation of endocannabinoids. In addition to its endogenous roles, cannabinoid receptors are the primary target of Δ9-tetrahydrocannabinol, the intoxicating component of cannabis. In this review, we summarize our current understanding of the ECS. We start with a description of ECS components and their role in synaptic plasticity and neurodevelopment, and then discuss how phytocannabinoids and other exogenous compounds may perturb the ECS, emphasizing examples relevant to psychosis.
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Affiliation(s)
- Hui-Chen Lu
- Gill Center for Biomolecular Science and the Department of Psychological and Brain Sciences, Indiana University Bloomington, Bloomington, Indiana
| | - Ken Mackie
- Gill Center for Biomolecular Science and the Department of Psychological and Brain Sciences, Indiana University Bloomington, Bloomington, Indiana.
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47
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Chye Y, Kirkham R, Lorenzetti V, McTavish E, Solowij N, Yücel M. Cannabis, Cannabinoids, and Brain Morphology: A Review of the Evidence. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 6:627-635. [PMID: 32948510 DOI: 10.1016/j.bpsc.2020.07.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/19/2020] [Accepted: 07/10/2020] [Indexed: 11/26/2022]
Abstract
Cannabis and cannabinoid-based products are increasingly being accepted and commodified globally. Yet there is currently limited understanding of the effect of the varied cannabinoid compounds on the brain. Exogenous cannabinoids interact with the endogenous cannabinoid system that underpins vital functions in the brain and body, and they are thought to perturb key brain and cognitive function. However, much neuroimaging research has been confined to observational studies of cannabis users, without examining the specific role of the various cannabinoids (Δ9-tetrahydrocannabinol, cannabidiol, etc.). This review summarizes the brain structural imaging evidence to date associated with cannabis use, its major cannabinoids (e.g., Δ9-tetrahydrocannabinol, cannabidiol), and synthetic cannabinoid products that have emerged as recreational drugs. In doing so, we seek to highlight some of the key issues to consider in understanding cannabinoid-related brain effects, emphasizing the dual neurotoxic and neuroprotective role of cannabinoids, and the need to consider the distinct role of the varied cannabinoids in establishing their effect on the brain.
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Affiliation(s)
- Yann Chye
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Monash Biomedical Imaging Facility, Monash University, Melbourne, Victoria, Australia
| | - Rebecca Kirkham
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Monash Biomedical Imaging Facility, Monash University, Melbourne, Victoria, Australia
| | - Valentina Lorenzetti
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Monash Biomedical Imaging Facility, Monash University, Melbourne, Victoria, Australia; School of Psychology, Faculty of Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia
| | - Eugene McTavish
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Monash Biomedical Imaging Facility, Monash University, Melbourne, Victoria, Australia
| | - Nadia Solowij
- School of Psychology, University of Wollongong, Wollongong, New South Wales, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia; Australian Centre for Cannabinoid Clinical and Research Excellence, New Lambton Heights, New South Wales, Australia
| | - Murat Yücel
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Monash Biomedical Imaging Facility, Monash University, Melbourne, Victoria, Australia.
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48
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Bekkers JM. Autaptic Cultures: Methods and Applications. Front Synaptic Neurosci 2020; 12:18. [PMID: 32425765 PMCID: PMC7203343 DOI: 10.3389/fnsyn.2020.00018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 04/01/2020] [Indexed: 11/13/2022] Open
Abstract
Neurons typically form daisy chains of synaptic connections with other neurons, but they can also form synapses with themselves. Although such self-synapses, or autapses, are comparatively rare in vivo, they are surprisingly common in dissociated neuronal cultures. At first glance, autapses in culture seem like a mere curiosity. However, by providing a simple model system in which a single recording electrode gives simultaneous access to the pre- and postsynaptic compartments, autaptic cultures have proven to be invaluable in facilitating important and elegant experiments in the area of synaptic neuroscience. Here, I provide detailed protocols for preparing and recording from autaptic cultures (also called micro-island or microdot cultures). Variations on the basic procedure are presented, as well as practical tips for optimizing the outcomes. I also illustrate the utility of autaptic cultures by reviewing the types of experiments that have used them over the past three decades. These examples serve to highlight the power and elegance of this simple model system, and will hopefully inspire new experiments for the interrogation of synaptic function.
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Affiliation(s)
- John M Bekkers
- Eccles Institute of Neuroscience, The John Curtin School of Medical Research, The Australian National University, Canberra, ACT, Australia
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49
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Olesen JA, Posselt CM, Poulsen CH, Nordentoft M, Hjorthøj C. Cannabis use disorders may protect against certain disorders of the digestive organs in people with schizophrenia but not in healthy controls. Psychol Med 2020; 50:499-506. [PMID: 30880659 DOI: 10.1017/s0033291719000370] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Previous studies have shown a potential for cannabis in disorders of the digestive organs. We aimed to investigate whether cannabis use disorders (CUD) would decrease the risk of incident disorders of the digestive organs, in people with schizophrenia and population controls. METHODS We combined nationwide Danish registers to identify 21 066 cases with schizophrenia and 176 935 sex-and-age-matched controls. Two models were analyzed for the associations between CUD and digestive disorders in time-varying Cox regressions: one adjusted for sex, year of birth, and calendar year; and one further adjusted for alcohol and other substance use disorders and parental education. RESULTS CUD was associated with a decreased risk of developing disorders of gut-brain interaction (e.g. irritable bowel syndrome, dyspepsia, etc.) among cases with schizophrenia (HR = 0.84, 95% CI 0.74-0.94, p = 0.003). CUD was associated with decreased risk of inflammatory bowel disease (HR = 0.70, 95% CI 0.49-0.99, p = 0.045) in the basically adjusted model, dropping just below statistical significance in the fully adjusted model (HR = 0.71, 95% CI 0.48-1.03, p = 0.07). CUD displayed a tendency toward a decreased risk of serious disorders of the digestive organs among cases with schizophrenia (HR = 0.89, 95% CI 0.77-1.02, p = 0.09) in the fully adjusted model. No associations were observed among controls. CONCLUSIONS In people with schizophrenia, but not in controls, CUD is associated with decreased risk of disorders of gut-brain interaction and inflammatory bowel disease, and possibly other serious disorders of the digestive organs. Our findings could lead to new targets for treatment and prevention of disorders of the digestive organs.
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Affiliation(s)
- Julie Aamand Olesen
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPsych, Aarhus and Copenhagen, Denmark
- University of Copenhagen, The Research Unit for General Practice, Copenhagen, Denmark
| | - Christine Merrild Posselt
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPsych, Aarhus and Copenhagen, Denmark
| | - Chalotte Heinsvig Poulsen
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPsych, Aarhus and Copenhagen, Denmark
| | - Merete Nordentoft
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPsych, Aarhus and Copenhagen, Denmark
| | - Carsten Hjorthøj
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPsych, Aarhus and Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Section of Epidemiology, Copenhagen, Denmark
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Hindocha C, Cousijn J, Rall M, Bloomfield MAP. The Effectiveness of Cannabinoids in the Treatment of Posttraumatic Stress Disorder (PTSD): A Systematic Review. J Dual Diagn 2020; 16:120-139. [PMID: 31479625 DOI: 10.1080/15504263.2019.1652380] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objectives: Posttraumatic stress disorder (PTSD) is a potentially debilitating mental health problem. There has been a recent surge of interest regarding the use of cannabinoids in the treatment of PTSD. We therefore sought to systematically review and assess the quality of the clinical evidence of the effectiveness of cannabinoids for the treatment of PTSD. Method: We included all studies published until December 2018 where a patient has had PTSD diagnosed and had been prescribed or were using a cannabinoid for the purpose of reducing PTSD symptoms. Our primary outcome measure was the reduction in PTSD symptoms using a validated instrument. In the absence of randomized controlled trials, we included the next best available levels of evidence including observational and retrospective studies and case reports. We assessed risk of bias and quality using validated tools appropriate for the study design. Results: We included 10 studies in this review, of which only one study was a pilot randomized, double-blind, placebo-controlled, crossover clinical trial. Every identified study had medium to high risk of bias and was of low quality. We found that cannabinoids may decrease PTSD symptomology, in particular sleep disturbances and nightmares. Conclusions: Most studies to date are small and of low quality, with significant limitations to the study designs precluding any clinical recommendations about its use in routine clinical practice. Evidence that cannabinoids may help reduce global PTSD symptoms, sleep disturbances, and nightmares indicates that future well-controlled, randomized, double-blind clinical trials are highly warranted.PROSPERO registration number: 121646.
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Affiliation(s)
- C Hindocha
- Clinical Psychopharmacology Unit, University College London, London, United Kingdom.,Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, London, United Kingdom.,NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, United Kingdom
| | - J Cousijn
- Neuroscience of Addiction (NofA) Lab, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - M Rall
- Clinical Psychopharmacology Unit, University College London, London, United Kingdom.,Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, London, United Kingdom
| | - M A P Bloomfield
- Clinical Psychopharmacology Unit, University College London, London, United Kingdom.,Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, London, United Kingdom.,NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, United Kingdom.,The Traumatic Stress Clinic, St Pancras Hospital, Camden and Islington NHS Foundation Trust, London, UK
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