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Pathak S, Jeyabalan JB, Liu K, Cook P, Lange B, Kim S, Nadar R, Ward K, Watts Alexander CS, Kumar A, Dua K, Moore T, Govindasamy J, Dhanasekaran M. Assessing effects of Cannabis on various neuropathologies: A systematic review. J Ayurveda Integr Med 2024; 15:100911. [PMID: 38876946 PMCID: PMC11282377 DOI: 10.1016/j.jaim.2024.100911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 01/12/2024] [Accepted: 02/19/2024] [Indexed: 06/16/2024] Open
Abstract
Natural bioactives possess a wide range of chemical structures that can exert a plethora of pharmacological and toxicological actions, resulting in neuroprotection or neurotoxicity. These pharmacodynamic properties can positively or negatively impact human and animal global healthcare. Remarkably, Ayurvedic botanical Cannabis has been used worldwide by different ethnicities and religions for spiritual, commercial, recreational, nutraceutical, cosmeceutical, and medicinal purposes for centuries. Cannabis-based congeners have been approved by the United States of America's (USA) Food & Drug Administration (FDA) and other global law agencies for various therapeutic purposes. Surprisingly, the strict laws associated with possessing cannabis products have been mitigated in multiple states in the USA and across the globe for recreational use. This has consequently led to a radical escalation of exposure to cannabis-related substances of abuse. However, there is a lacuna in the literature on the acute and chronic effects of Cannabis and its congeners on various neuropathologies. Moreover, in the post-COVID era, there has been a drastic increase in the incidence and prevalence of numerous neuropathologies, leading to increased morbidity and mortality. There is an impending necessity for a safe, economically viable, multipotent, natural bioactive to prevent and treat various neuropathologies. The ayurvedic herb, Cannabis is one of the oldest botanicals known to humans and has been widely used. However, the comprehensive effect of Cannabis on various neuropathologies is not well established. Hence, this review presents effects of Cannabis on various neuropathologies.
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Affiliation(s)
- Suhrud Pathak
- Harrison College of Pharmacy, Auburn University, Auburn, AL, 36849, USA
| | - Jeyaram Bharathi Jeyabalan
- Harrison College of Pharmacy, Auburn University, Auburn, AL, 36849, USA; Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Nilgiris, Ooty, Tamil Nadu, 643 001, India
| | - Keyi Liu
- Harrison College of Pharmacy, Auburn University, Auburn, AL, 36849, USA
| | - Preston Cook
- Harrison College of Pharmacy, Auburn University, Auburn, AL, 36849, USA
| | - Bennett Lange
- Harrison College of Pharmacy, Auburn University, Auburn, AL, 36849, USA
| | - Shannon Kim
- Harrison College of Pharmacy, Auburn University, Auburn, AL, 36849, USA
| | - Rishi Nadar
- Harrison College of Pharmacy, Auburn University, Auburn, AL, 36849, USA
| | - Kiersten Ward
- Harrison College of Pharmacy, Auburn University, Auburn, AL, 36849, USA
| | | | - Ashwani Kumar
- Patanjali Herbal Research Department, Patanjali Research Foundation, Haridwar, 249405, India
| | - Kamal Dua
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia; Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Ultimo, NSW, Australia
| | - Timothy Moore
- Harrison College of Pharmacy, Auburn University, Auburn, AL, 36849, USA
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Catamenial chest pain and spontaneous coronary artery dissection: A case report. Case Rep Womens Health 2020; 28:e00256. [PMID: 33033690 PMCID: PMC7533354 DOI: 10.1016/j.crwh.2020.e00256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/19/2020] [Accepted: 09/23/2020] [Indexed: 12/20/2022] Open
Abstract
Spontaneous coronary artery dissection (SCAD) is a rare cause of myocardial infarction, presenting mostly in healthy, young women. The pathogenesis is still poorly understood. A 45-year-old woman presented with an ST-elevation myocardial infarction, caused by SCAD of the mid left anterior descending coronary artery. In the six years prior to this event, she frequently experienced chest pain coinciding with her menstruation. Spontaneous coronary artery dissection in a 45-year-old woman presenting with a ST-elevation myocardial infarction. For six years she had experienced chest pain during menstruation. The case report highlights the importance of investigating catamenial chest pain. Diagnostic tests should be planned and timed according to the menstrual cycle phase in which the chest pain is most severe.
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Verghese D, Alrifai T, Nimmagadda M, Upadhyay M. It could be in the kidneys: fibromuscular dysplasia and the association with headaches and mood disorders. BMJ Case Rep 2019; 12:12/12/e231322. [PMID: 31888890 DOI: 10.1136/bcr-2019-231322] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Dhiran Verghese
- Internal Medicine, AMITA Health Saint Joseph Hospital, Chicago, Illinois, USA
| | - Taha Alrifai
- Internal Medicine, AMITA Health Saint Joseph Hospital, Chicago, Illinois, USA
| | - Manojna Nimmagadda
- Internal Medicine, AMITA Health Saint Joseph Hospital, Chicago, Illinois, USA
| | - Manisha Upadhyay
- Internal Medicine, AMITA Health Saint Joseph Hospital, Chicago, Illinois, USA
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Soun JE, Song JW, Romero JM, Schaefer PW. Central Nervous System Vasculopathies. Radiol Clin North Am 2019; 57:1117-1131. [DOI: 10.1016/j.rcl.2019.07.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Bagh I, Olin JW, Froehlich JB, Kline-Rogers E, Gray B, Kim ESH, Sharma A, Weinberg I, Wells BJ, Gu X, Gornik HL. Association of Multifocal Fibromuscular Dysplasia in Elderly Patients With a More Benign Clinical Phenotype: Data From the US Registry for Fibromuscular Dysplasia. JAMA Cardiol 2019; 3:756-760. [PMID: 29926082 DOI: 10.1001/jamacardio.2018.1638] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Fibromuscular dysplasia (FMD) is a nonatherosclerotic arterial disease that predominately affects women and is most commonly diagnosed in middle age. The natural history of FMD among patients diagnosed at an older age is not well understood. Objective To examine the differences in clinical presentation, arterial bed involvement, vascular events, and need for vascular procedures between younger and older patients with FMD. Design, Setting, and Participants Analysis of baseline data for patients enrolled in the US Registry for FMD as of December 15, 2016, at referral centers participating in the US Registry for FMD. Patients 18 years and older at the time of enrollment and those with only confirmed multifocal (string of beads type) FMD were included. Patients were categorized according to age at the time of diagnosis (≥65 years vs <65 years). Main Outcomes and Measures Prevalence of specific symptoms, vascular events, and prior vascular procedures at the time of enrollment in the registry. Results A total of 1016 patients were included in the analysis, of whom, 170 (16.7%) were 65 years or older at the time of diagnosis. Older patients with FMD were more likely to be asymptomatic at the time of diagnosis (4.2% vs 1.4%; P = .02). Headache and pulsatile tinnitus, both common manifestations of FMD, were less common in older patients (40.5% vs 69.1%; P < .001 and 30% vs 44.6%; P < .001, respectively). Extracranial carotid arteries were more commonly involved in patients 65 years or older at time of diagnosis (87% vs 79.4%; P = .03). There was no difference in prevalence of renal artery involvement, number of arterial beds involved, or diagnosis of any aneurysm. Patients 65 years or older were less likely to have had a major vascular event (37.1% vs 46.1%; P = .03) and fewer had undergone a therapeutic vascular procedure (18.5% vs 33.1%; P < .001). Conclusions and Relevance In the US Registry for FMD, patients 65 years or older at the time of diagnosis of multifocal FMD were more likely to be asymptomatic, had lower prevalence of major vascular events, and had undergone fewer therapeutic vascular procedures than younger patients. Patients with multifocal FMD diagnosed at an older age may have a more benign phenotype and fewer symptoms.
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Affiliation(s)
- Imad Bagh
- Vascular Medicine Section, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio
| | - Jeffrey W Olin
- Zena and Michael A. Wiener Cardiovascular Institute, Mt Sinai Medical Center, New York, New York
| | - James B Froehlich
- Michigan Cardiovascular Outcomes Research and Reporting Program, University of Michigan, Ann Arbor
| | - Eva Kline-Rogers
- Michigan Cardiovascular Outcomes Research and Reporting Program, University of Michigan, Ann Arbor
| | - Bruce Gray
- Department of Surgery, Greenville Health System, Greenville, South Carolina
| | - Esther S H Kim
- Cardiovascular Division, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Aditya Sharma
- Division of Cardiovascular Medicine, University of Virginia, Charlottesville
| | - Ido Weinberg
- Vascular Center, Massachusetts General Hospital, Boston
| | - Bryan J Wells
- Divison of Cardiology, Emory University, Atlanta, Georgia
| | - Xiaokui Gu
- Michigan Cardiovascular Outcomes Research and Reporting Program, University of Michigan, Ann Arbor
| | - Heather L Gornik
- Vascular Medicine Section, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio
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Progesterone receptor expression in fibromuscular dysplasia: A report of two unusual cases. TURK GOGUS KALP DAMAR CERRAHISI DERGISI-TURKISH JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2019; 27:234-240. [PMID: 32082860 DOI: 10.5606/tgkdc.dergisi.2019.15051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 01/20/2019] [Indexed: 11/21/2022]
Abstract
Fibromuscular dysplasia is rarely biopsied. Progesterone receptor expression in myofibroblastic cells is useful for the histopathological evaluation in difficult-to-diagnose cases. Herein, we report two unusual cases of fibromuscular dysplasia in which progesterone receptor expression was shown in vessel sections.
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Kerut CK, Sheahan C, Sheahan M. Carotid artery fibromuscular dysplasia: Ultrasound and
CT
imaging. Echocardiography 2019; 36:971-974. [DOI: 10.1111/echo.14322] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 03/04/2019] [Accepted: 03/06/2019] [Indexed: 11/30/2022] Open
Affiliation(s)
- Christian K. Kerut
- Franklin College of Arts and SciencesUniversity of Georgia Athens Georgia
| | - Claudie Sheahan
- Division of Vascular SurgeryDepartment of SurgeryLSU Health Sciences CenterSchool of Medicine New Orleans Louisiana
| | - Malachi Sheahan
- Division of Vascular SurgeryDepartment of SurgeryLSU Health Sciences CenterSchool of Medicine New Orleans Louisiana
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Fibromuscular Dysplasia: Recognition and Management. J Nurse Pract 2019. [DOI: 10.1016/j.nurpra.2018.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Van der Niepen P, van Tussenbroek F, Devos H, Debing E, Di Monaco S, Goffette P, Astarci P, Persu A. Visceral Fibromuscular Dysplasia: From asymptomatic disorder to emergency. Eur J Clin Invest 2018; 48:e13023. [PMID: 30156710 DOI: 10.1111/eci.13023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 08/16/2018] [Accepted: 08/24/2018] [Indexed: 12/24/2022]
Abstract
Fibromuscular dysplasia (FMD) is an idiopathic, segmental, non-atherosclerotic and non-inflammatory disease of the musculature of arterial walls, leading to stenosis of small and medium-sized arteries, mostly involving renal and cervical arteries. As a result of better and more systematic screening, it appears that involvement of the splanchnic vascular bed is more frequent than originally assumed. We review epidemiology, pathogenesis, clinical picture as well as diagnosis and treatment of visceral artery (VA) FMD. The clinical picture is very diverse, and diagnosis is based on CT-, MR- or conventional catheter-based angiography. Involvement of VAs generally occurs among patients with multi-vessel FMD. Therefore, screening for VA FMD is advised especially in renal artery (RA) FMD and in case of aneurysms and/or dissections. Treatment depends on the clinical picture. However, the level of evidence is low, and much of the common practice is extrapolated from visceral atherosclerotic disease.
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Affiliation(s)
- Patricia Van der Niepen
- Department of Nephrology & Hypertension, Universitair Ziekenhuis Brussel. Vrije Universiteit Brussel, Brussels, Belgium
| | - Frank van Tussenbroek
- Department of Radiology, Universitair Ziekenhuis Brussel. Vrije Universiteit Brussel, Brussels, Belgium
| | - Hannes Devos
- Department of Radiology, Universitair Ziekenhuis Brussel. Vrije Universiteit Brussel, Brussels, Belgium
| | - Erik Debing
- Department of Vascular Surgery, Universitair Ziekenhuis Brussel. Vrije Universiteit Brussel, Brussels, Belgium
| | - Silvia Di Monaco
- Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.,Internal Medicine and Hypertension Division, Department of Medical Sciences, AOU Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Pierre Goffette
- Department of Radiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Parla Astarci
- Division of Vascular Surgery, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.,Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - Alexandre Persu
- Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.,Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
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Vitiello GA, Blumberg SN, Sadek M. Endovascular Treatment of Spontaneous Renal Artery Dissection After Failure of Medical Management. Vasc Endovascular Surg 2017; 51:509-512. [DOI: 10.1177/1538574417723155] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Gerardo A. Vitiello
- Division of Vascular and Endovascular Surgery, New York University Langone Medical Center, NY, USA
| | - Sheila N. Blumberg
- Division of Vascular and Endovascular Surgery, New York University Lutheran Medical Center, Brooklyn, NY, USA
| | - Mikel Sadek
- Division of Vascular and Endovascular Surgery, New York University Langone Medical Center, NY, USA
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Vasuri F, Freyrie A, Pasquinelli G. Unusual lamellar calcifications in two rare cases of splenic aneurysms associated with fibromuscular dysplasia. Ultrastruct Pathol 2017; 40:116-20. [PMID: 27031177 DOI: 10.3109/01913123.2016.1156797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Fibromuscular dysplasia (FMD) of the splenic artery is a rare underdiagnosed condition. Here, we report two cases of FMD affecting the splenic artery: one alone and one concomitantly with the renal artery. Histology revealed fibromuscular thickening of the media layer alternating with a circumferential calcification of the whole artery thickness. Ultrastructurally, FMD showed matrix vesicles and dense bodies in the extracellular matrix. A diagnosis of FMD with calcification was made. This is the first report to document circumferential lamellar calcifications alternating with the more typical fibrotic medial areas in the rare FMD localized to splenic artery.
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Affiliation(s)
- Francesco Vasuri
- a Unit of Surgical Pathology, Department of Specialty, Diagnostic and Experimental Medicine (DIMES ), S. Orsola-Malpighi Hospital, Bologna University , Bologna , Italy
| | - Antonio Freyrie
- b Unit of Vascular Surgery, Department of Specialty, Diagnostic and Experimental Medicine (DIMES) , S. Orsola-Malpighi Hospital, Bologna University , Bologna , Italy
| | - Gianandrea Pasquinelli
- a Unit of Surgical Pathology, Department of Specialty, Diagnostic and Experimental Medicine (DIMES ), S. Orsola-Malpighi Hospital, Bologna University , Bologna , Italy
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Abstract
Atherosclerotic peripheral artery disease is the most common cause of intermittent claudication. Nonatherosclerotic peripheral artery disease is a heterogeneous collection of diseases affecting the extracoronary arteries which is not due to atherosclerosis. These diseases include, but are not limited to, popliteal artery entrapment syndrome, cystic adventitial disease, external iliac endofibrosis, and thromboangiitis obliterans. Due to its relatively low prevalence, nonatherosclerotic peripheral artery disease may be misdiagnosed leading to the mismanagement of potentially treatable conditions. The proper and timely diagnosis of these conditions is paramount to the prevention of adverse outcomes as treatments widely vary. The diagnostic approach to patients presenting with intermittent claudication must take into account both atherosclerotic as well as nonatherosclerotic causes of peripheral artery disease making the differential vital to clinical practice.
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Affiliation(s)
- Ari J Mintz
- Internal Medicine, Lahey Hospital and Medical Center, 41 Mall Road, Burlington, MA, 01805, USA,
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The Diagnosis and Treatment of Fibromuscular Dysplasia: An Update for Cardiologists. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2016; 18:37. [DOI: 10.1007/s11936-016-0460-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Shimabukuro M. A New Plausible Link between Lysophosphatidylcholine, TGF-β, and Fibromuscular Dysplasia. J Atheroscler Thromb 2016; 23:665-7. [PMID: 27009435 DOI: 10.5551/jat.ed040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Michio Shimabukuro
- Department of Cardio-Diabetes Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School
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Tanaka H, Zaima N, Sasaki T, Yamamoto N, Inuzuka K, Sano M, Konno H, Urano T, Setou M, Unno N. Characteristic Distribution Pattern of Lysophosphatidylcholine in Fibromuscular Dysplasia-Associated Visceral Artery Aneurysms Compared with Atherosclerotic Visceral Artery Aneurysms. J Atheroscler Thromb 2015; 23:673-80. [PMID: 26666464 DOI: 10.5551/jat.32318] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM Asymptomatic visceral artery aneurysms (VAAs) have increasingly been found, with most being either atherosclerotic VAAs or fibromuscular dysplasia (FMD)-associated VAAs. However, little is known about the pathogenesis of both diseases. We aimed to identify the differences in the distribution pattern of lipid molecules between atherosclerotic VAAs and FMD-associated VAAs. METHODS We conducted a histological study of VAAs using imaging mass spectrometry (IMS) to assess the accumulation of lipid molecules in both the aneurysmal sac and the adjacent arteries without aneurysmal changes in 17 VAA samples, which were resected during the surgery. RESULTS IMS revealed characteristic distributions of cholesterol ester in intima and media in the atherosclerotic VAAs, which was hardly detected in FMD-associated VAAs. However, lysophosphatidylcholine (lysoPC), a proinflammatory and proapoptotic lipid mediator, was accumulated in the medial ridge of the adventitia of FMD-associated in the aneurysmal sac, and it was also diffusely accumulated in the adjacent arteries. In contrast, lysoPC was accumulated in the area of intimal hyperplasia in atherosclerotic VAAs and the adjacent arteries. CONCLUSION The distribution patterns of lipid molecules were different between the FMD-associated and atherosclerotic VAAs. The diffuse accumulation of lysoPCs in the visceral arteries may be a predisposition for the formation of FMD-associated VAAs.
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Affiliation(s)
- Hiroki Tanaka
- Division of Vascular Surgery, Hamamatsu University School of Medicine
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Fibromuscular dysplasia presenting as hemorrhagic shock due to spontaneous rupture of a right gastroepiploic artery aneurysm. Am J Emerg Med 2015; 34:677.e3-5. [PMID: 26166380 DOI: 10.1016/j.ajem.2015.06.054] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 06/21/2015] [Indexed: 11/20/2022] Open
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