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Thompson MD, Reiner-Link D, Berghella A, Rana BK, Rovati GE, Capra V, Gorvin CM, Hauser AS. G protein-coupled receptor (GPCR) pharmacogenomics. Crit Rev Clin Lab Sci 2024:1-44. [PMID: 39119983 DOI: 10.1080/10408363.2024.2358304] [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: 06/15/2023] [Revised: 09/03/2023] [Accepted: 05/18/2024] [Indexed: 08/10/2024]
Abstract
The field of pharmacogenetics, the investigation of the influence of one or more sequence variants on drug response phenotypes, is a special case of pharmacogenomics, a discipline that takes a genome-wide approach. Massively parallel, next generation sequencing (NGS), has allowed pharmacogenetics to be subsumed by pharmacogenomics with respect to the identification of variants associated with responders and non-responders, optimal drug response, and adverse drug reactions. A plethora of rare and common naturally-occurring GPCR variants must be considered in the context of signals from across the genome. Many fundamentals of pharmacogenetics were established for G protein-coupled receptor (GPCR) genes because they are primary targets for a large number of therapeutic drugs. Functional studies, demonstrating likely-pathogenic and pathogenic GPCR variants, have been integral to establishing models used for in silico analysis. Variants in GPCR genes include both coding and non-coding single nucleotide variants and insertion or deletions (indels) that affect cell surface expression (trafficking, dimerization, and desensitization/downregulation), ligand binding and G protein coupling, and variants that result in alternate splicing encoding isoforms/variable expression. As the breadth of data on the GPCR genome increases, we may expect an increase in the use of drug labels that note variants that significantly impact the clinical use of GPCR-targeting agents. We discuss the implications of GPCR pharmacogenomic data derived from the genomes available from individuals who have been well-phenotyped for receptor structure and function and receptor-ligand interactions, and the potential benefits to patients of optimized drug selection. Examples discussed include the renin-angiotensin system in SARS-CoV-2 (COVID-19) infection, the probable role of chemokine receptors in the cytokine storm, and potential protease activating receptor (PAR) interventions. Resources dedicated to GPCRs, including publicly available computational tools, are also discussed.
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Affiliation(s)
- Miles D Thompson
- Krembil Brain Institute, Toronto Western Hospital, Toronto, Ontario, Canada
| | - David Reiner-Link
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Alessandro Berghella
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Brinda K Rana
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - G Enrico Rovati
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milan, Italy
| | - Valerie Capra
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milan, Italy
| | - Caroline M Gorvin
- Institute of Metabolism and Systems Research (IMSR), University of Birmingham, Birmingham, United Kingdom
| | - Alexander S Hauser
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Foyzun T, Whiting M, Velasco KK, Jacobsen JC, Connor M, Grimsey NL. Single nucleotide polymorphisms in the cannabinoid CB 2 receptor: Molecular pharmacology and disease associations. Br J Pharmacol 2024; 181:2391-2412. [PMID: 38802979 DOI: 10.1111/bph.16383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/26/2024] [Accepted: 03/09/2024] [Indexed: 05/29/2024] Open
Abstract
Preclinical evidence implicating cannabinoid receptor 2 (CB2) in various diseases has led researchers to question whether CB2 genetics influence aetiology or progression. Associations between conditions and genetic loci are often studied via single nucleotide polymorphism (SNP) prevalence in case versus control populations. In the CNR2 coding exon, ~36 SNPs have high overall population prevalence (minor allele frequencies [MAF] ~37%), including non-synonymous SNP (ns-SNP) rs2501432 encoding CB2 63Q/R. Interspersed are ~27 lower frequency SNPs, four being ns-SNPs. CNR2 introns also harbour numerous SNPs. This review summarises CB2 ns-SNP molecular pharmacology and evaluates evidence from ~70 studies investigating CB2 genetic variants with proposed linkage to disease. Although CNR2 genetic variation has been associated with a wide variety of conditions, including osteoporosis, immune-related disorders, and mental illnesses, further work is required to robustly validate CNR2 disease links and clarify specific mechanisms linking CNR2 genetic variation to disease pathophysiology and potential drug responses.
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Affiliation(s)
- Tahira Foyzun
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - Maddie Whiting
- Department of Pharmacology and Clinical Pharmacology, School of Medical Sciences, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Department of Medicine, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Kate K Velasco
- Department of Pharmacology and Clinical Pharmacology, School of Medical Sciences, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Department of Medicine, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Jessie C Jacobsen
- School of Biological Sciences, Faculty of Science, University of Auckland, Auckland, New Zealand
- Centre for Brain Research, University of Auckland, Auckland, New Zealand
| | - Mark Connor
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - Natasha L Grimsey
- Department of Pharmacology and Clinical Pharmacology, School of Medical Sciences, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Centre for Brain Research, University of Auckland, Auckland, New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, Auckland, New Zealand
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Jain N, Moorthy A. Cannabinoids in rheumatology: Friend, foe or a bystander? Musculoskeletal Care 2022; 20:416-428. [PMID: 35476898 PMCID: PMC9322323 DOI: 10.1002/msc.1636] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVES Cannabinoids have gained popularity recently with special emphasis on their use for chronic pain. Although NICE guidelines advise against their usage for management of chronic pain, almost all rheumatologists encounter a few patients in their daily practice who either use them or are curious about them. We reviewed the mechanism of action of cannabinoids, current knowledge about their role in rheumatology and potential drug interactions with common drugs used in Rheumatology. We attempted to answer the question "If cannabinoids are friend, foe or just a mere bystander?" METHODS We adhered to a search strategy for writing narrative reviews as per available guidelines. We searched PubMed with the search terms "Cannabinoids", "Rheumatology" and "Chronic pain" for published articles and retrieved 613 articles. The abstracts and titles of these articles were screened to identify relevant studies focusing on mechanism of actions, adverse effects and drug interactions. We also availed the services of a musculoskeletal librarian. RESULTS Despite the NHS guidelines against the usage of cannabinoids and associated significant stigma, cannabinoids are increasingly used for the management of pain in rheumatology without prescription. Cannabinoids act through two major receptors CB1 and CB2, which are important modulators of the stress response with potential analgesic effects. Their role in various rheumatological diseases including Rheumatoid arthritis, Osteoarthritis and Fibromyalgia have been explored with some benefits. However, in addition to the adverse effects, cannabinoids also have some potential interactions with common drugs used in rheumatology, which many users are unaware of. CONCLUSION While the current studies and patient reported outcomes suggest cannabinoids to be a "friend" of rheumatology, their adverse events and drug interactions prove to be a "Foe". We were unable to arrive at a definite answer for our question posed, however on the balance of probabilities we can conclude cannabinoids to be a "foe". Under these circumstances, a disease and drug focussed research is need of the hour to answer the unresolved question.
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Affiliation(s)
- Nibha Jain
- Department of Rheumatology, University of Leicester, Leicester, UK.,University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Arumugam Moorthy
- University Hospitals of Leicester NHS Trust, Leicester, UK.,College of Life Sciences, University of Leicester, Leicester, UK.,Tamil Nadu Dr MGR Medical University, Chennai, India.,New Vision University, Georgia
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4
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Rastegar M, Samadizadeh S, Yasaghi M, Moradi A, Tabarraei A, Salimi V, Tahamtan A. Functional variation (Q63R) in the cannabinoid CB2 receptor may affect the severity of COVID-19: a human study and molecular docking. Arch Virol 2021; 166:3117-3126. [PMID: 34514519 PMCID: PMC8435402 DOI: 10.1007/s00705-021-05223-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 07/16/2021] [Indexed: 12/18/2022]
Abstract
Evidence supports a role of host genetic diversity in the clinical course of coronavirus disease 2019 (COVID-19). Variation in the cannabinoid CB2 receptor gene (CNR2) could affect the regulatory action of endocannabinoids on the immune system, resulting in an increased risk of various inflammatory diseases. The present study investigated the relationship between the CNR2-Q63R variant and COVID-19 severity. A total of 200 Iranian COVID-19 patients were enrolled in the study and genotyped using a TaqMan assay. The co-dominant, dominant, recessive, over-dominant, and additive inheritance models were analyzed using SNPStats software. In silico molecular docking was also performed to simulate the effects of the Q63R variation on CB2 binding with a ligand and with the G-protein. A significant difference in the Q63R allele and genotype distribution was found between expired and discharged COVID-19 patients in co-dominant, recessive, and additive inheritance models. The molecular docking results showed that the predicted structure of mutant CB2 (63R type) could not bind to the G-protein in the correct position. The data indicated that the Q63R variation in the CNR2 gene may affect the severity of COVID-19. Identification of genes related to susceptibility and severity of COVID-19 may lead to specific targets for drug repurposing or development.
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Affiliation(s)
- Mostafa Rastegar
- Department of Microbiology, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Saeed Samadizadeh
- Department of Microbiology, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mohammad Yasaghi
- Department of Microbiology, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Abdolvahab Moradi
- Department of Microbiology, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Alijan Tabarraei
- Department of Microbiology, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Vahid Salimi
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Tahamtan
- Department of Microbiology, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran. .,Infectious Diseases Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
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Cannabinoid Type-2 Receptor Agonist, JWH133 May Be a Possible Candidate for Targeting Infection, Inflammation, and Immunity in COVID-19. IMMUNO 2021. [DOI: 10.3390/immuno1030020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The COVID-19 pandemic, caused by SARS-CoV-2, is a deadly disease affecting millions due to the non-availability of drugs and vaccines. The majority of COVID-19 drugs have been repurposed based on antiviral, immunomodulatory, and antibiotic potential. The pathogenesis and advanced complications with infection involve the immune-inflammatory cascade. Therefore, a therapeutic strategy could reduce infectivity, inflammation, and immune modulation. In recent years, modulating the endocannabinoid system, particularly activation of the cannabinoid type 2 (CB2) receptor is a promising therapeutic target for modulation of immune-inflammatory responses. JWH133, a selective, full functional agonist of the CB2 receptor, has been extensively studied for its potent anti-inflammatory, antiviral, and immunomodulatory properties. JWH133 modulates numerous signaling pathways and inhibits inflammatory mediators, including cytokines, chemokines, adhesion molecules, prostanoids, and eicosanoids. In this study, we propose that JWH133 could be a promising candidate for targeting infection, immunity, and inflammation in COVID-19, due to its pharmacological and molecular mechanisms in numerous preclinical efficacy and safety studies, along with its immunomodulatory, anti-inflammatory, organoprotective, and antiviral properties. Thus, JWH133 should be investigated in preclinical and clinical studies for its potential as an agent or adjuvant with other agents for its effect on viremia, infectivity, immune modulation, resolution of inflammation, reduction in severity, and progression of complications in COVID-19. JWH133 is devoid of psychotropic effects due to CB2 receptor selectivity, has negligible toxicity, good bioavailability and druggable properties, including pharmacokinetic and physicochemical effects. We believe that JWH133 could be a promising drug and may inspire further studies for an evidence-based approach against COVID-19.
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Yuan CY, Zhou V, Sauber G, Stollenwerk T, Komorowski R, López A, Tolón RM, Romero J, Hillard CJ, Drobyski WR. Signaling through the type 2 cannabinoid receptor regulates the severity of acute and chronic graft-versus-host disease. Blood 2021; 137:1241-1255. [PMID: 33027805 PMCID: PMC7933769 DOI: 10.1182/blood.2020004871] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 09/23/2020] [Indexed: 12/24/2022] Open
Abstract
Graft-versus-host disease (GVHD) pathophysiology is a complex interplay between cells that comprise the adaptive and innate arms of the immune system. Effective prophylactic strategies are therefore contingent upon approaches that address contributions from both immune cell compartments. In the current study, we examined the role of the type 2 cannabinoid receptor (CB2R), which is expressed on nearly all immune cells, and demonstrated that absence of the CB2R on donor CD4+ or CD8+ T cells or administration of a selective CB2R pharmacological antagonist exacerbated acute GVHD lethality. This was accompanied primarily by the expansion of proinflammatory CD8+ T cells, indicating that constitutive CB2R expression on T cells preferentially regulated CD8+ T-cell alloreactivity. Using a novel CB2ReGFP reporter mouse, we observed significant loss of CB2R expression on T cells, but not macrophages, during acute GVHD, indicative of differential alterations in receptor expression under inflammatory conditions. Therapeutic targeting of the CB2R with the agonists Δ9-tetrahydrocannabinol (THC) and JWH-133 revealed that only THC mitigated lethal T cell-mediated acute GVHD. Conversely, only JWH-133 was effective in a sclerodermatous chronic GVHD model where macrophages contributed to disease biology. In vitro, both THC and JWH-133 induced arrestin recruitment and extracellular regulated kinase phosphorylation via CB2R, but THC had no effect on CB2R-mediated inhibition of adenylyl cyclase. This study shows that the CB2R plays a critical role in the regulation of GVHD and suggests that effective therapeutic targeting is dependent upon agonist signaling characteristics and receptor selectivity in conjunction with the composition of pathogenic immune effector cells.
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Affiliation(s)
| | | | | | | | - Richard Komorowski
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI; and
| | - Alicia López
- Faculty of Experimental Sciences, Universidad Francisco de Vitoria, Madrid, Spain
| | - Rosa María Tolón
- Faculty of Experimental Sciences, Universidad Francisco de Vitoria, Madrid, Spain
| | - Julian Romero
- Faculty of Experimental Sciences, Universidad Francisco de Vitoria, Madrid, Spain
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Turu G, Soltész-Katona E, Tóth AD, Juhász C, Cserző M, Misák Á, Balla A, Caron MG, Hunyady L. Biased Coupling to β-Arrestin of Two Common Variants of the CB 2 Cannabinoid Receptor. Front Endocrinol (Lausanne) 2021; 12:714561. [PMID: 34484125 PMCID: PMC8415483 DOI: 10.3389/fendo.2021.714561] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/08/2021] [Indexed: 01/14/2023] Open
Abstract
β-arrestins are partners of the G protein-coupled receptors (GPCRs), regulating their intracellular trafficking and signaling. Development of biased GPCR agonists, selectively targeting either G protein or β-arrestin pathways, are in the focus of interest due to their therapeutic potential in different pathological conditions. The CB2 cannabinoid receptor (CB2R) is a GPCR involved in various functions in the periphery and the central nervous system. Two common occurring variants of CB2R, harboring Q63R or L133I missense mutations, have been implicated in the development of a diverse set of disorders. To evaluate the effect of these mutations, we characterized the binding profile of these mutant CB2 receptors to G proteins and β-arrestin2. Although their ability to inhibit cAMP signaling was similar, the Q63R mutant had increased, whereas the L133I mutant receptor had decreased β-arrestin2 binding. In line with these observations, the variants also had altered intracellular trafficking. Our results show that two common variants of the CB2 receptor have biased signaling properties, which may contribute to the pathogenesis of the associated disorders and may offer CB2R as a target for further development of biased receptor activation strategies.
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Affiliation(s)
- Gábor Turu
- Department of Physiology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- MTA-SE Laboratory of Molecular Physiology, Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary
- Department of Cell Biology, Duke University Medical Center, Duke University School of Medicine, Durham, NC, United States
- *Correspondence: Gábor Turu, ; László Hunyady,
| | - Eszter Soltész-Katona
- Department of Physiology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- MTA-SE Laboratory of Molecular Physiology, Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary
| | - András Dávid Tóth
- Department of Physiology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- MTA-SE Laboratory of Molecular Physiology, Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary
| | - Cintia Juhász
- Department of Physiology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Miklós Cserző
- Department of Physiology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- MTA-SE Laboratory of Molecular Physiology, Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary
| | - Ádám Misák
- Department of Physiology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - András Balla
- Department of Physiology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- MTA-SE Laboratory of Molecular Physiology, Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary
| | - Marc G. Caron
- Department of Cell Biology, Duke University Medical Center, Duke University School of Medicine, Durham, NC, United States
| | - László Hunyady
- Department of Physiology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- MTA-SE Laboratory of Molecular Physiology, Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary
- *Correspondence: Gábor Turu, ; László Hunyady,
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Nagoor Meeran MF, Sharma C, Goyal SN, Kumar S, Ojha S. CB2 receptor-selective agonists as candidates for targeting infection, inflammation, and immunity in SARS-CoV-2 infections. Drug Dev Res 2020; 82:7-11. [PMID: 33190277 PMCID: PMC7753678 DOI: 10.1002/ddr.21752] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 09/22/2020] [Accepted: 10/19/2020] [Indexed: 02/06/2023]
Abstract
The COVID-19 pandemic caused by SARS-CoV-2 is a deadly disease afflicting millions. The pandemic continues affecting population due to nonavailability of drugs and vaccines. The pathogenesis and complications of infection mainly involve hyperimmune-inflammatory responses. Thus, therapeutic strategies rely on repurposing of drugs aimed at reducing infectivity and inflammation and modulate immunity favourably. Among, numerous therapeutic targets, the endocannabinoid system, particularly activation of cannabinoid type-2 receptors (CB2R) emerged as an important one to suppress the hyperimmune-inflammatory responses. Recently, potent antiinflammatory, antiviral and immunomodulatory properties of CB2R selective ligands of endogenous, plant, and synthetic origin were showed mediating CB2R selective functional agonism. CB2R activation appears to regulate numerous signaling pathways to control immune-inflammatory mediators including cytokines, chemokines, adhesion molecules, prostanoids, and eicosanoids. Many CB2R ligands also exhibit off-target effects mediating activation of PPARs, opioids, and TRPV, suggestive of adjuvant use with existing drugs that may maximize efficacy synergistically and minimize therapeutic doses to limit adverse/ side effects. We hypothesize that CB2R agonists, due to immunomodulatory, antiinflammatory, and antiviral properties may show activity against COVID-19. Based on the organoprotective potential, relative safety, lack of psychotropic effects, and druggable properties, CB2R selective ligands might make available promising candidates for further investigation.
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Affiliation(s)
- M F Nagoor Meeran
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box - 17666, Al Ain, United Arab Emirates
| | - Charu Sharma
- Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box - 17666, Al Ain, United Arab Emirates
| | - Sameer N Goyal
- Shri Vile Parle Kelvani Mandal's Institute of Pharmacy, Dhule, Maharashtra, 424 001, India
| | - Sanjay Kumar
- Division of Hematology, Division of Nephrology, Mayo Clinic, Rochester, Minnesota, USA
| | - Shreesh Ojha
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box - 17666, Al Ain, United Arab Emirates
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Haspula D, Clark MA. Cannabinoid Receptors: An Update on Cell Signaling, Pathophysiological Roles and Therapeutic Opportunities in Neurological, Cardiovascular, and Inflammatory Diseases. Int J Mol Sci 2020; 21:E7693. [PMID: 33080916 PMCID: PMC7590033 DOI: 10.3390/ijms21207693] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 10/14/2020] [Accepted: 10/15/2020] [Indexed: 12/16/2022] Open
Abstract
The identification of the human cannabinoid receptors and their roles in health and disease, has been one of the most significant biochemical and pharmacological advancements to have occurred in the past few decades. In spite of the major strides made in furthering endocannabinoid research, therapeutic exploitation of the endocannabinoid system has often been a challenging task. An impaired endocannabinoid tone often manifests as changes in expression and/or functions of type 1 and/or type 2 cannabinoid receptors. It becomes important to understand how alterations in cannabinoid receptor cellular signaling can lead to disruptions in major physiological and biological functions, as they are often associated with the pathogenesis of several neurological, cardiovascular, metabolic, and inflammatory diseases. This review focusses mostly on the pathophysiological roles of type 1 and type 2 cannabinoid receptors, and it attempts to integrate both cellular and physiological functions of the cannabinoid receptors. Apart from an updated review of pre-clinical and clinical studies, the adequacy/inadequacy of cannabinoid-based therapeutics in various pathological conditions is also highlighted. Finally, alternative strategies to modulate endocannabinoid tone, and future directions are also emphasized.
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Affiliation(s)
- Dhanush Haspula
- Molecular Signaling Section, Laboratory of Bioorganic Chemistry, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892, USA;
| | - Michelle A. Clark
- Department of Pharmaceutical Sciences, College of Pharmacy, Nova Southeastern University, Fort Lauderdale, FL 33314, USA
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10
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The Endocannabinoid System in Pediatric Inflammatory and Immune Diseases. Int J Mol Sci 2019; 20:ijms20235875. [PMID: 31771129 PMCID: PMC6928713 DOI: 10.3390/ijms20235875] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 11/19/2019] [Accepted: 11/20/2019] [Indexed: 12/26/2022] Open
Abstract
Endocannabinoid system consists of cannabinoid type 1 (CB1) and cannabinoid type 2 (CB2) receptors, their endogenous ligands, and the enzymes responsible for their synthesis and degradation. CB2, to a great extent, and CB1, to a lesser extent, are involved in regulating the immune response. They also regulate the inflammatory processes by inhibiting pro-inflammatory mediator release and immune cell proliferation. This review provides an overview on the role of the endocannabinoid system with a major focus on cannabinoid receptors in the pathogenesis and onset of inflammatory and autoimmune pediatric diseases, such as immune thrombocytopenia, juvenile idiopathic arthritis, inflammatory bowel disease, celiac disease, obesity, neuroinflammatory diseases, and type 1 diabetes mellitus. These disorders have a high social impact and represent a burden for the healthcare system, hence the importance of individuating more innovative and effective treatments. The endocannabinoid system could address this need, representing a possible new diagnostic marker and therapeutic target.
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11
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Tahamtan A, Rezaiy S, Samadizadeh S, Moradi A, Tabarraei A, Javid N, Oladnabi M, Naeimi MH. Cannabinoid CB2 Receptor Functional Variation (Q63R) Is Associated with Multiple Sclerosis in Iranian Subjects. J Mol Neurosci 2019; 70:26-31. [DOI: 10.1007/s12031-019-01395-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 08/01/2019] [Indexed: 02/02/2023]
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12
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CB2 Receptor Stimulation and Dexamethasone Restore the Anti-Inflammatory and Immune-Regulatory Properties of Mesenchymal Stromal Cells of Children with Immune Thrombocytopenia. Int J Mol Sci 2019; 20:ijms20051049. [PMID: 30823385 PMCID: PMC6429305 DOI: 10.3390/ijms20051049] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 02/21/2019] [Accepted: 02/22/2019] [Indexed: 01/17/2023] Open
Abstract
Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by antibody-mediated platelet destruction, with a complex and unclear pathogenesis. The impaired immunosuppressive capacity of mesenchymal stromal cells in ITP patients (ITP-MSCs) might play a role in the development of the disease. Correcting the MSC defects could represent an alternative therapeutic approach for ITP. High-dose dexamethasone (HD-Dexa) is the mainstay of the ITP therapeutic regimen, although it has several side effects. We previously demonstrated a role for cannabinoid receptor 2 (CB₂) as a mediator of anti-inflammatory and immunoregulatory properties of human MSCs. We analyzed the effects of CB₂ stimulation, with the selective agonist JWH-133, and of Dexa alone and in combination on ITP-MSC survival and immunosuppressive capacity. We provided new insights into the pathogenesis of ITP, suggesting CB₂ receptor involvement in the impairment of ITP-MSC function and confirming MSCs as responsive cellular targets of Dexa. Moreover, we demonstrated that CB₂ stimulation and Dexa attenuate apoptosis, via Bcl2 signaling, and restore the immune-modulatory properties of MSCs derived from ITP patients. These data suggest the possibility of using Dexa in combination with JWH-133 in ITP, reducing its dose and side effects but maintaining its therapeutic benefits.
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Abstract
: Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disorder defined as low platelet count with normal bone marrow in the absence of other causes of thrombocytopenia. It is caused by autoantibodies binding to several platelet surface antigens which lead to premature destruction of the platelet by the reticuloendothelial system. ITP can be primary or secondary, and it is known to be associated with various infections and drugs. K2/Spice, or synthetic marijuana, acts on cannabinoid receptors CB1 (cannabinoid type-1) and CB2 (cannabinoid type-2) with increased binding capacity compared to marijuana. A white male was brought to the emergency department with signs of acute drug toxicity. His urine drug test was negative but he admitted to a year long history of synthetic marijuana use. His platelet count was 12,000/mm and he was diagnosed with ITP. After receiving 2 doses of oral dexamethasone his platelets improved. Synthetic cannabinoids are widely available and used psychoactive drugs. Little is known about the complete chemical composition of the synthetic products thus there is relatively little information available on the pharmacodynamic and pharmacokinetic effects. A high index of suspicion is needed to diagnose toxicity to these drugs since there are no readily available on-site lab tests. Currently there exists 1 case report of ITP induced by K2/Spice. Here, we discuss another case of K2/Spice a as a potential cause of immune thrombocytopenia.
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Bruni N, Della Pepa C, Oliaro-Bosso S, Pessione E, Gastaldi D, Dosio F. Cannabinoid Delivery Systems for Pain and Inflammation Treatment. Molecules 2018; 23:molecules23102478. [PMID: 30262735 PMCID: PMC6222489 DOI: 10.3390/molecules23102478] [Citation(s) in RCA: 167] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 09/21/2018] [Accepted: 09/25/2018] [Indexed: 01/15/2023] Open
Abstract
There is a growing body of evidence to suggest that cannabinoids are beneficial for a range of clinical conditions, including pain, inflammation, epilepsy, sleep disorders, the symptoms of multiple sclerosis, anorexia, schizophrenia and other conditions. The transformation of cannabinoids from herbal preparations into highly regulated prescription drugs is therefore progressing rapidly. The development of such drugs requires well-controlled clinical trials to be carried out in order to objectively establish therapeutic efficacy, dose ranges and safety. The low oral bioavailability of cannabinoids has led to feasible methods of administration, such as the transdermal route, intranasal administration and transmucosal adsorption, being proposed. The highly lipophilic nature of cannabinoids means that they are seen as suitable candidates for advanced nanosized drug delivery systems, which can be applied via a range of routes. Nanotechnology-based drug delivery strategies have flourished in several therapeutic fields in recent years and numerous drugs have reached the market. This review explores the most recent developments, from preclinical to advanced clinical trials, in the cannabinoid delivery field, and focuses particularly on pain and inflammation treatment. Likely future directions are also considered and reported.
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Affiliation(s)
| | - Carlo Della Pepa
- Department of Drug Science and Technology, University of Turin, 10125 Turin, Italy.
| | | | - Enrica Pessione
- Department of Life Sciences and Systems Biology, University of Turin, 10123 Turin, Italy.
| | - Daniela Gastaldi
- Department of Molecular Biotechnology and Health Sciences, University of Turin, 10125 Turin, Italy.
| | - Franco Dosio
- Department of Drug Science and Technology, University of Turin, 10125 Turin, Italy.
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15
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Study of cannabinoid receptor 2 Q63R gene polymorphism in Lebanese patients with rheumatoid arthritis. Clin Rheumatol 2018; 37:2933-2938. [DOI: 10.1007/s10067-018-4217-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 07/10/2018] [Accepted: 07/12/2018] [Indexed: 10/28/2022]
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Cannabinoid Receptor 2 Functional Variant Contributes to the Risk for Pediatric Inflammatory Bowel Disease. J Clin Gastroenterol 2018; 52:e37-e43. [PMID: 27875353 DOI: 10.1097/mcg.0000000000000755] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
GOALS We conducted a case-control association analysis to establish the role of a common CB2 functional variant, Q63R, in the susceptibility to inflammatory bowel disease (IBD). BACKGROUND Endocannabinoids may limit intestinal inflammation through cannabinoid receptor 1 and/or 2 (CB1, CB2). STUDY We genotyped 217 pediatric IBD patients [112 Crohn's disease (CD), 105 ulcerative colitis (UC)] and 600 controls for the CB2-Q63R variant by Taqman assay. Data were collected from clinical records on age at diagnosis, disease activity, duration and location, extraintestinal manifestations, therapy, clinical relapses, and need for surgery. RESULTS We found a significant association of the CB2-R63 variant with IBD (allele frequencies, P=0.04; genotype distributions, P=0.0006), in particular with CD (allele frequencies, P=0.002; genotype distributions, P=0.00005) and with UC only for genotype distributions (P=0.03). RR carriers showed an increased risk for developing IBD [odds ratio (OR)=1.82; P=0.0002 for IBD; OR=2.02; P=10 for CD; OR=1.63; P=0.02 for UC at 95% confidence interval]. Upon genotype-phenotype evaluation, RR patients showed an increased frequency of moderate-to-severe disease activity at diagnosis in the case of both CD and UC (P=0.01 and P=0.02, respectively) and also an earlier clinical relapse in UC (P=0.04). In UC, all the clinical features related to the CB2 risk allele were still significantly associated with the variant when analyzed using a multivariate logistic regression model (P=0.001). CONCLUSIONS The CB2-Q63R variant contributes to the risk for pediatric IBD, in particular CD. The R63 variant is associated with a more severe phenotype in both UC and CD. Taken together, our data point toward the involvement of the CB2 receptor in the pathogenesis and clinical features of pediatric IBD.
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Wang J, Xu J, Liu J, Zhu H, Peng Y, Ding ZM, Hua H. Genetic Variant Q63R of Cannabinoid Receptor 2 Causes Differential ERK Phosphorylation in Human Immune Cells. Genet Test Mol Biomarkers 2018; 22:320-326. [DOI: 10.1089/gtmb.2018.0005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jingru Wang
- Lilly China Research and Development Center (LCRDC), Eli Lilly & Company, Shanghai, China
| | - Juehua Xu
- Lilly China Research and Development Center (LCRDC), Eli Lilly & Company, Shanghai, China
| | - Jie Liu
- Lilly China Research and Development Center (LCRDC), Eli Lilly & Company, Shanghai, China
| | - Huang Zhu
- Lilly China Research and Development Center (LCRDC), Eli Lilly & Company, Shanghai, China
| | - Yanyan Peng
- Lilly China Research and Development Center (LCRDC), Eli Lilly & Company, Shanghai, China
| | - Zhi-Ming Ding
- Lilly China Research and Development Center (LCRDC), Eli Lilly & Company, Shanghai, China
| | - Haiqing Hua
- Lilly China Research and Development Center (LCRDC), Eli Lilly & Company, Shanghai, China
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Kaplan BLF. Endocannabinoid engagement of CB 2 regulates RSV-induced immunity. Virulence 2018; 9:494-495. [PMID: 29338583 PMCID: PMC7000200 DOI: 10.1080/21505594.2017.1421830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Barbara L F Kaplan
- a Center for Environmental Health Sciences, Department of Basic Sciences , College of Veterinary Medicine, Mississippi State University , Mississippi State, MS , United States
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Tahamtan A, Samieipoor Y, Nayeri FS, Rahbarimanesh AA, Izadi A, Rashidi-Nezhad A, Tavakoli-Yaraki M, Farahmand M, Bont L, Shokri F, Mokhatri-Azad T, Salimi V. Effects of cannabinoid receptor type 2 in respiratory syncytial virus infection in human subjects and mice. Virulence 2017; 9:217-230. [PMID: 28992427 PMCID: PMC5955186 DOI: 10.1080/21505594.2017.1389369] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
An accumulating body of evidence suggests that the endocannabinoid system plays a significant role in pathophysiological processes and impacts disease severity. Here we investigate the possible role of a cannabinoid receptor type 2 (CB2) functional variant in determining disease severity and the potential pharmacological therapeutic effects of CB2 activation in viral respiratory infection. The common missense variant (CAA/CGG; Q63R) of the gene-encoding CB2 receptor (CNR2) was evaluated in 90 inpatient and 90 outpatient children with acute respiratory tract infection (ARTI). The frequency distribution of respiratory syncytial virus (RSV)-the main cause of severe cases of bronchiolitis and pneumonia in children-was studied in all collected samples. The mechanism through which CB2 affects clinical outcomes in case of RSV infection was studied in Balb/c mice model using AM630 as a CB2 antagonist. The potential therapeutic effect of CB2 activation during RSV infection was studied using a selective agonist, JWH133. The CB2 Q63R variation was associated with increased risk of hospitalization in children with ARTI. Children carrying the QQ genotype were more prone to developing severe ARTI (OR = 3.275, 95% CI: 1.221–8.705; p = 0.019). Of all the children enrolled in the study, 83 patients (46.1%) were found positive for RSV infection. The associated risk of developing severe ARTI following RSV infection increased more than two-fold in children carrying the Q allele (OR = 2.148, 95% CI: 1.092–4.224; p = 0.026). In mice, the blockade of CB2 by AM630 during RSV infection enhanced the influx of BAL cells and production of cytokines/chemokines while exaggerating lung pathology. CB2 activation by JWH133 reduces the influx of BAL cells and production of cytokines/chemokines while alleviating lung pathology. Collectively, CB2 is associated with RSV severity during infancy and may serve as a therapeutic target in RSV infection through the alleviation of virus-associated immunopathology.
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Affiliation(s)
- Alireza Tahamtan
- a Department of Virology , School of Public Health, Tehran University of Medical Sciences , Tehran , Iran
| | - Yazdan Samieipoor
- a Department of Virology , School of Public Health, Tehran University of Medical Sciences , Tehran , Iran
| | - Fatemeh Sadat Nayeri
- b Fetal and Neonatal Research Center , Tehran University of Medical Sciences , Tehran , Iran
| | | | - Anahita Izadi
- c Bahrami Children Hospital , Tehran University of Medical Sciences , Tehran , Iran
| | - Ali Rashidi-Nezhad
- d Maternal, Fetal and Neonatal Research Center , Tehran University of Medical Sciences , Tehran , Iran
| | | | - Mohammad Farahmand
- a Department of Virology , School of Public Health, Tehran University of Medical Sciences , Tehran , Iran
| | - Louis Bont
- f University Medical Center Utrecht (UMCU), Wilhelmina Children's Hospital (WKZ) , Department of Pediatrics , Utrecht , The Netherlands
| | - Fazel Shokri
- g Department of Immunology , School of Public Health, Tehran University of Medical Sciences , Tehran , Iran
| | - Talat Mokhatri-Azad
- a Department of Virology , School of Public Health, Tehran University of Medical Sciences , Tehran , Iran
| | - Vahid Salimi
- a Department of Virology , School of Public Health, Tehran University of Medical Sciences , Tehran , Iran
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Sagnelli C, Uberti-Foppa C, Hasson H, Bellini G, Minichini C, Salpietro S, Messina E, Barbanotti D, Merli M, Punzo F, Coppola N, Lazzarin A, Sagnelli E, Rossi F. Cannabinoid receptor 2-63 RR variant is independently associated with severe necroinflammation in HIV/HCV coinfected patients. PLoS One 2017; 12:e0181890. [PMID: 28759568 PMCID: PMC5536321 DOI: 10.1371/journal.pone.0181890] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 07/07/2017] [Indexed: 12/20/2022] Open
Abstract
Objective This is the first study to analyze the impact of the rs35761398 variant of the CNR2 gene leading to the substitution of GLN (Q) of codon 63 of the cannabinoid receptor 2 (CB2) with ARG (R) on the clinical presentation of chronic hepatitis in HIV/HCV coinfected patients. Methods Enrolled in this study were 166 consecutive HIV/HCV coinfected patients, naïve for HCV treatment. A pathologist unaware of the patients’ condition graded liver fibrosis, necroinflammation (Ishak) and steatosis. All patients were screened for the CB2 rs35761398 polymorphism. Results Of the 166 HIV/HCV coinfected patients, 72.9% were males, 42.5% were infected with HCV-genotype-3 and 60.2% had been intravenous drug users. The median age was 40.6 years and the immunological condition good (median CD4+ cells/mm3 = 507, IQR: 398.0–669.5). Thirty-five (21.1%) patients were naive for ART and 131(78.9%) were on ART. The CB2-RR variant was detected in 45.8% of patients, QR in 38.6% and QQ in 15.7%. Patients with CB2-RR showed a necroinflammation score (HAI) ≥9 more frequently than those with CB2-QQ or CB2-QR (32.9% vs. 11.5% and 14.1%, respectively, p≤0.001). In the multivariate analysis, the CB2-RR variant (p = 0.03) and liver fibrosis were both identified as independent predictors of the entity of liver necroinflammation (p = 0.0001). Conclusion This study shows interesting interplay between the CB2-RR variant and liver necroinflammation in chronic hepatitis patients with HIV/HCV coinfection, an observation of clinical value that coincides with the interest in the use of the CB2 agonists and antagonists in clinical practice emerging from the literature.
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Affiliation(s)
- Caterina Sagnelli
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Caterina Uberti-Foppa
- Department of Infectious Diseases, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy
| | - Hamid Hasson
- Department of Infectious Diseases, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy
| | - Giulia Bellini
- Department of Pediatrics, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Carmine Minichini
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Stefania Salpietro
- Department of Infectious Diseases, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy
| | - Emanuela Messina
- Department of Infectious Diseases, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy
| | - Diletta Barbanotti
- Department of Infectious Diseases, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy
| | - Marco Merli
- Department of Infectious Diseases, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy
| | - Francesca Punzo
- Department of Pediatrics, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Nicola Coppola
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Adriano Lazzarin
- Department of Infectious Diseases, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy
| | - Evangelista Sagnelli
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania Luigi Vanvitelli, Naples, Italy
- * E-mail: ,
| | - Francesca Rossi
- Department of Pediatrics, University of Campania Luigi Vanvitelli, Naples, Italy
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Rodriguez-Sanchez IP, Guindon J, Ruiz M, Tejero ME, Hubbard G, Martinez-de-Villarreal LE, Barrera-Saldaña HA, Dick EJ, Comuzzie AG, Schlabritz-Loutsevitch NE. The endocannabinoid system in the baboon (Papio spp.) as a complex framework for developmental pharmacology. Neurotoxicol Teratol 2016; 58:23-30. [PMID: 27327781 PMCID: PMC5897907 DOI: 10.1016/j.ntt.2016.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 05/19/2016] [Accepted: 06/16/2016] [Indexed: 12/22/2022]
Abstract
INTRODUCTION The consumption of marijuana (exogenous cannabinoid) almost doubled in adults during last decade. Consumption of exogenous cannabinoids interferes with the endogenous cannabinoid (or "endocannabinoid" (eCB)) system (ECS), which comprises N-arachidonylethanolamide (anandamide, AEA), 2-arachidonoyl glycerol (2-AG), endocannabinoid receptors (cannabinoid receptors 1 and 2 (CB1R and CB2R), encoded by CNR1 and CNR2, respectively), and synthesizing/degrading enzymes (FAAH, fatty-acid amide hydrolase; MAGL, monoacylglycerol lipase; DAGL-α, diacylglycerol lipase-alpha). Reports regarding the toxic and therapeutic effects of pharmacological compounds targeting the ECS are sometimes contradictory. This may be caused by the fact that structure of the eCBs varies in the species studied. OBJECTIVES First: to clone and characterize the cDNAs of selected members of ECS in a non-human primate (baboon, Papio spp.), and second: to compare those cDNA sequences to known human structural variants (single nucleotide polymorphisms and haplotypes). MATERIALS AND METHODS Polymerase chain reaction-amplified gene products from baboon tissues were transformed into Escherichia coli. Amplicon-positive clones were sequenced, and the obtained sequences were conceptually translated into amino-acid sequences using the genetic code. RESULTS Among the ECS members, CNR1 was the best conserved gene between humans and baboons. The phenotypes associated with mutations in the untranslated regions of this gene in humans have not been described in baboons. One difference in the structure of CNR2 between humans and baboons was detected in the region with the only known clinically relevant polymorphism in a human receptor. All of the differences in the amino-acid structure of DAGL-α between humans and baboons were located in the hydroxylase domain, close to phosphorylation sites. None of the differences in the amino-acid structure of MAGL observed between baboons and humans were located in the area critical for enzyme function. CONCLUSION The evaluation of the data, obtained in non-human primate model of cannabis-related developmental exposure should take into consideration possible evolutionary-determined species-specific differences in the CB1R expression, CB2R transduction pathway, and FAAH and DAGLα substrate-enzyme interactions.
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Affiliation(s)
- Iram P Rodriguez-Sanchez
- Universidad Autónoma de Nuevo León, Facultad de Medicina, Departamento de Genética, Monterrey, Nuevo León, Mexico
| | - Josee Guindon
- Department of Pharmacology and Neurobiology, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Marco Ruiz
- Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center at the Permian Basin, Odessa, TX, USA
| | - M Elizabeth Tejero
- Laboratorio de Nutrigenética y Nutrigenómica, Instituto Nacional de Medicina Genómica (INMEGEN), México, D.F., Mexico
| | - Gene Hubbard
- Department of Pathology, University of Texas at San Antonio, San Antonio, TX, USA
| | | | - Hugo A Barrera-Saldaña
- Universidad Autónoma de Nuevo León, Facultad de Medicina, Departamento de Bioquímica y Medicina Molecular, Monterrey, Nuevo León, Mexico
| | - Edward J Dick
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX, USA
| | - Anthony G Comuzzie
- Department of Genetics, Texas Biomedical Research Institute, San Antonio, TX, USA
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Coppola N, Zampino R, Bellini G, Stanzione M, Capoluongo N, Marrone A, Macera M, Adinolfi LE, Giudice EMD, Gentile I, Sagnelli E, Rossi F. CB2-63 polymorphism and immune-mediated diseases associated with HCV chronic infection. Dig Liver Dis 2016; 48:1364-1369. [PMID: 27476469 DOI: 10.1016/j.dld.2016.07.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Revised: 06/23/2016] [Accepted: 07/03/2016] [Indexed: 12/11/2022]
Abstract
AIMS To evaluate whether CB2 variants are associated with the presence of immune-mediated disorders (IMDs) in patients with chronic HCV infection. METHODS One hundred and sixty-eight anti-HCV/HCV-RNA-positive patients were enrolled, 81 with signs of IMDs and 87 without. In the IMDs group, 22 (27.2%) showed ANA positivity (titers ≥1:160), 3 (3.7%) SMA positivity (titers ≥1:160), 24 (29.6%) had cryoglobulinemia, 25 (30.9%) autoimmune thyroiditis, 4 (4.9%) psoriasis, 2 (2.5%) B-cell non-Hodgkin lymphoma and 1 (1.2%) autoimmune hemolytic anemia. All patients were screened for the CNR2 rs35761398 single nucleotide polymorphism using a TaqMan Assay. RESULTS Compared with the 87 patients without IMDs, the 81 with IMDs were more frequently females (65% vs. 45%, p=0.01), but no significant difference was found in the initial demographic, epidemiological, serological, biochemical or virological data. Instead, the prevalence of patients with the CB2-63 RR variant was significantly higher in the IMD than in the non-IMD group (49.4% vs. 24.1%, p=0.001). A logistic regression analysis including the CB2-63 receptor (RR vs. QR or QQ), age and sex identified the CB2-63 RR as the only independent predictor of IMDs (p=0.005). CONCLUSIONS The data suggest a significant, previously unknown, independent association between the CB2-63 RR variant and IMDs in anti-HCV-positive patients. The study was approved by the Ethics Committee of the Azienda Ospedaliera Universitaria of the Second University of Naples (n° 214/2012).
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Affiliation(s)
- Nicola Coppola
- Department of Mental Health and Public Medicine, Second University of Naples, Italy.
| | - Rosa Zampino
- Internal Medicine and Hepatology, Second University of Naples, Italy
| | - Giulia Bellini
- Department of Experimental Medicine, Second University of Naples, Italy
| | - Maria Stanzione
- Department of Clinical and Experimental Medicine and Surgery, Second University of Naples, Naples, Italy
| | - Nicolina Capoluongo
- Department of Mental Health and Public Medicine, Second University of Naples, Italy
| | - Aldo Marrone
- Internal Medicine and Hepatology, Second University of Naples, Italy
| | - Margherita Macera
- Department of Mental Health and Public Medicine, Second University of Naples, Italy
| | | | | | - Ivan Gentile
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - Evangelista Sagnelli
- Department of Mental Health and Public Medicine, Second University of Naples, Italy
| | - Francesca Rossi
- Department of Woman, Child and of General and Specialized Surgery, Second University of Naples, Italy
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Rossi F, Bellini G, Luongo L, Manzo I, Tolone S, Tortora C, Bernardo ME, Grandone A, Conforti A, Docimo L, Nobili B, Perrone L, Locatelli F, Maione S, Del Giudice EM. Cannabinoid Receptor 2 as Antiobesity Target: Inflammation, Fat Storage, and Browning Modulation. J Clin Endocrinol Metab 2016; 101:3469-78. [PMID: 27294325 DOI: 10.1210/jc.2015-4381] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
CONTEXT Obesity is associated with a low-grade inflammatory state and adipocyte (ADP) hyperplasia/hypertrophy. Obesity inhibits the "browning" of white adipose tissue. Cannabinoid receptor 2 (CB2) agonists reduce food intake and induce antiobesity effect in mice. A common missense CB2 variant, Q63R, causes CB2-reduced function. OBJECTIVE To evaluate the influence of CB2 receptor on the modulation of childhood obesity and of ADP activity and morphology. DESIGN CB2-Q63R variant was analyzed in obese Italian children. The effects of an inflammatory stimulus and those of drugs selectively acting on CB2 were investigated on in vitro ADPs obtained from mesenchymal stem cells of adult healthy donors or from sc adipose biopsies of adult nonobese and obese subjects. SETTING Department of Women, Child and General and Specialist Surgery of the Second University of Naples. PATIENTS OR OTHER PARTICIPANTS A total of 501 obese Italian children (age 11 ± 2.75). Twelve healthy bone marrow donors (age 36.5 ± 15); and 17 subjects, 7 lean (age 42 ± 10) and 10 obese (age 37.8 ± 12) underwent sc adipose tissue biopsies. MAIN OUTCOME MEASURES Effects of CB2 stimulation on adipokine, perilipin, and uncoupling protein-1 expression. RESULTS The less-functional CB2-R63 variant was significantly associated with a high z-score body mass index. CB2 blockade with AM630 reverse agonist increased inflammatory adipokine release and fat storage and reduced browning. CB2 stimulation with JWH-133 agonist reversed all of the obesity-related effects. CONCLUSION CB2 receptor is a novel pharmacological target that should be considered for obesity.
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Affiliation(s)
- Francesca Rossi
- Department of Women, Child and General and Specialist Surgery (F.R., I.M., A.G., B.N., L.P., E.M.d.G.) and Department of Experimental Medicine (G.B., L.L., I.M., C.T., S.M.), Division of Pharmacology Leonardo Donatelli, The Second University of Naples, 80138 Naples, Italy; The Endocannabinoid Research Group (L.L., S.M.), 80078 Pozzuoli, Naples, Italy; Division of General and Obesity Surgery (S.T., L.D.), The Second University of Naples, 80131 Naples, Italy; Department of Onco-Hematology (M.E.B., A.C., F.L.), Istituto di Ricovero e Cura a Caarattere Scientifico Bambino Gesù Children's Hospital, 00165 Rome, Italy; and University of Pavia (F.L.), 27100 Pavia, Italy
| | - Giulia Bellini
- Department of Women, Child and General and Specialist Surgery (F.R., I.M., A.G., B.N., L.P., E.M.d.G.) and Department of Experimental Medicine (G.B., L.L., I.M., C.T., S.M.), Division of Pharmacology Leonardo Donatelli, The Second University of Naples, 80138 Naples, Italy; The Endocannabinoid Research Group (L.L., S.M.), 80078 Pozzuoli, Naples, Italy; Division of General and Obesity Surgery (S.T., L.D.), The Second University of Naples, 80131 Naples, Italy; Department of Onco-Hematology (M.E.B., A.C., F.L.), Istituto di Ricovero e Cura a Caarattere Scientifico Bambino Gesù Children's Hospital, 00165 Rome, Italy; and University of Pavia (F.L.), 27100 Pavia, Italy
| | - Livio Luongo
- Department of Women, Child and General and Specialist Surgery (F.R., I.M., A.G., B.N., L.P., E.M.d.G.) and Department of Experimental Medicine (G.B., L.L., I.M., C.T., S.M.), Division of Pharmacology Leonardo Donatelli, The Second University of Naples, 80138 Naples, Italy; The Endocannabinoid Research Group (L.L., S.M.), 80078 Pozzuoli, Naples, Italy; Division of General and Obesity Surgery (S.T., L.D.), The Second University of Naples, 80131 Naples, Italy; Department of Onco-Hematology (M.E.B., A.C., F.L.), Istituto di Ricovero e Cura a Caarattere Scientifico Bambino Gesù Children's Hospital, 00165 Rome, Italy; and University of Pavia (F.L.), 27100 Pavia, Italy
| | - Iolanda Manzo
- Department of Women, Child and General and Specialist Surgery (F.R., I.M., A.G., B.N., L.P., E.M.d.G.) and Department of Experimental Medicine (G.B., L.L., I.M., C.T., S.M.), Division of Pharmacology Leonardo Donatelli, The Second University of Naples, 80138 Naples, Italy; The Endocannabinoid Research Group (L.L., S.M.), 80078 Pozzuoli, Naples, Italy; Division of General and Obesity Surgery (S.T., L.D.), The Second University of Naples, 80131 Naples, Italy; Department of Onco-Hematology (M.E.B., A.C., F.L.), Istituto di Ricovero e Cura a Caarattere Scientifico Bambino Gesù Children's Hospital, 00165 Rome, Italy; and University of Pavia (F.L.), 27100 Pavia, Italy
| | - Salvatore Tolone
- Department of Women, Child and General and Specialist Surgery (F.R., I.M., A.G., B.N., L.P., E.M.d.G.) and Department of Experimental Medicine (G.B., L.L., I.M., C.T., S.M.), Division of Pharmacology Leonardo Donatelli, The Second University of Naples, 80138 Naples, Italy; The Endocannabinoid Research Group (L.L., S.M.), 80078 Pozzuoli, Naples, Italy; Division of General and Obesity Surgery (S.T., L.D.), The Second University of Naples, 80131 Naples, Italy; Department of Onco-Hematology (M.E.B., A.C., F.L.), Istituto di Ricovero e Cura a Caarattere Scientifico Bambino Gesù Children's Hospital, 00165 Rome, Italy; and University of Pavia (F.L.), 27100 Pavia, Italy
| | - Chiara Tortora
- Department of Women, Child and General and Specialist Surgery (F.R., I.M., A.G., B.N., L.P., E.M.d.G.) and Department of Experimental Medicine (G.B., L.L., I.M., C.T., S.M.), Division of Pharmacology Leonardo Donatelli, The Second University of Naples, 80138 Naples, Italy; The Endocannabinoid Research Group (L.L., S.M.), 80078 Pozzuoli, Naples, Italy; Division of General and Obesity Surgery (S.T., L.D.), The Second University of Naples, 80131 Naples, Italy; Department of Onco-Hematology (M.E.B., A.C., F.L.), Istituto di Ricovero e Cura a Caarattere Scientifico Bambino Gesù Children's Hospital, 00165 Rome, Italy; and University of Pavia (F.L.), 27100 Pavia, Italy
| | - Maria Ester Bernardo
- Department of Women, Child and General and Specialist Surgery (F.R., I.M., A.G., B.N., L.P., E.M.d.G.) and Department of Experimental Medicine (G.B., L.L., I.M., C.T., S.M.), Division of Pharmacology Leonardo Donatelli, The Second University of Naples, 80138 Naples, Italy; The Endocannabinoid Research Group (L.L., S.M.), 80078 Pozzuoli, Naples, Italy; Division of General and Obesity Surgery (S.T., L.D.), The Second University of Naples, 80131 Naples, Italy; Department of Onco-Hematology (M.E.B., A.C., F.L.), Istituto di Ricovero e Cura a Caarattere Scientifico Bambino Gesù Children's Hospital, 00165 Rome, Italy; and University of Pavia (F.L.), 27100 Pavia, Italy
| | - Anna Grandone
- Department of Women, Child and General and Specialist Surgery (F.R., I.M., A.G., B.N., L.P., E.M.d.G.) and Department of Experimental Medicine (G.B., L.L., I.M., C.T., S.M.), Division of Pharmacology Leonardo Donatelli, The Second University of Naples, 80138 Naples, Italy; The Endocannabinoid Research Group (L.L., S.M.), 80078 Pozzuoli, Naples, Italy; Division of General and Obesity Surgery (S.T., L.D.), The Second University of Naples, 80131 Naples, Italy; Department of Onco-Hematology (M.E.B., A.C., F.L.), Istituto di Ricovero e Cura a Caarattere Scientifico Bambino Gesù Children's Hospital, 00165 Rome, Italy; and University of Pavia (F.L.), 27100 Pavia, Italy
| | - Antonella Conforti
- Department of Women, Child and General and Specialist Surgery (F.R., I.M., A.G., B.N., L.P., E.M.d.G.) and Department of Experimental Medicine (G.B., L.L., I.M., C.T., S.M.), Division of Pharmacology Leonardo Donatelli, The Second University of Naples, 80138 Naples, Italy; The Endocannabinoid Research Group (L.L., S.M.), 80078 Pozzuoli, Naples, Italy; Division of General and Obesity Surgery (S.T., L.D.), The Second University of Naples, 80131 Naples, Italy; Department of Onco-Hematology (M.E.B., A.C., F.L.), Istituto di Ricovero e Cura a Caarattere Scientifico Bambino Gesù Children's Hospital, 00165 Rome, Italy; and University of Pavia (F.L.), 27100 Pavia, Italy
| | - Ludovico Docimo
- Department of Women, Child and General and Specialist Surgery (F.R., I.M., A.G., B.N., L.P., E.M.d.G.) and Department of Experimental Medicine (G.B., L.L., I.M., C.T., S.M.), Division of Pharmacology Leonardo Donatelli, The Second University of Naples, 80138 Naples, Italy; The Endocannabinoid Research Group (L.L., S.M.), 80078 Pozzuoli, Naples, Italy; Division of General and Obesity Surgery (S.T., L.D.), The Second University of Naples, 80131 Naples, Italy; Department of Onco-Hematology (M.E.B., A.C., F.L.), Istituto di Ricovero e Cura a Caarattere Scientifico Bambino Gesù Children's Hospital, 00165 Rome, Italy; and University of Pavia (F.L.), 27100 Pavia, Italy
| | - Bruno Nobili
- Department of Women, Child and General and Specialist Surgery (F.R., I.M., A.G., B.N., L.P., E.M.d.G.) and Department of Experimental Medicine (G.B., L.L., I.M., C.T., S.M.), Division of Pharmacology Leonardo Donatelli, The Second University of Naples, 80138 Naples, Italy; The Endocannabinoid Research Group (L.L., S.M.), 80078 Pozzuoli, Naples, Italy; Division of General and Obesity Surgery (S.T., L.D.), The Second University of Naples, 80131 Naples, Italy; Department of Onco-Hematology (M.E.B., A.C., F.L.), Istituto di Ricovero e Cura a Caarattere Scientifico Bambino Gesù Children's Hospital, 00165 Rome, Italy; and University of Pavia (F.L.), 27100 Pavia, Italy
| | - Laura Perrone
- Department of Women, Child and General and Specialist Surgery (F.R., I.M., A.G., B.N., L.P., E.M.d.G.) and Department of Experimental Medicine (G.B., L.L., I.M., C.T., S.M.), Division of Pharmacology Leonardo Donatelli, The Second University of Naples, 80138 Naples, Italy; The Endocannabinoid Research Group (L.L., S.M.), 80078 Pozzuoli, Naples, Italy; Division of General and Obesity Surgery (S.T., L.D.), The Second University of Naples, 80131 Naples, Italy; Department of Onco-Hematology (M.E.B., A.C., F.L.), Istituto di Ricovero e Cura a Caarattere Scientifico Bambino Gesù Children's Hospital, 00165 Rome, Italy; and University of Pavia (F.L.), 27100 Pavia, Italy
| | - Franco Locatelli
- Department of Women, Child and General and Specialist Surgery (F.R., I.M., A.G., B.N., L.P., E.M.d.G.) and Department of Experimental Medicine (G.B., L.L., I.M., C.T., S.M.), Division of Pharmacology Leonardo Donatelli, The Second University of Naples, 80138 Naples, Italy; The Endocannabinoid Research Group (L.L., S.M.), 80078 Pozzuoli, Naples, Italy; Division of General and Obesity Surgery (S.T., L.D.), The Second University of Naples, 80131 Naples, Italy; Department of Onco-Hematology (M.E.B., A.C., F.L.), Istituto di Ricovero e Cura a Caarattere Scientifico Bambino Gesù Children's Hospital, 00165 Rome, Italy; and University of Pavia (F.L.), 27100 Pavia, Italy
| | - Sabatino Maione
- Department of Women, Child and General and Specialist Surgery (F.R., I.M., A.G., B.N., L.P., E.M.d.G.) and Department of Experimental Medicine (G.B., L.L., I.M., C.T., S.M.), Division of Pharmacology Leonardo Donatelli, The Second University of Naples, 80138 Naples, Italy; The Endocannabinoid Research Group (L.L., S.M.), 80078 Pozzuoli, Naples, Italy; Division of General and Obesity Surgery (S.T., L.D.), The Second University of Naples, 80131 Naples, Italy; Department of Onco-Hematology (M.E.B., A.C., F.L.), Istituto di Ricovero e Cura a Caarattere Scientifico Bambino Gesù Children's Hospital, 00165 Rome, Italy; and University of Pavia (F.L.), 27100 Pavia, Italy
| | - Emanuele Miraglia Del Giudice
- Department of Women, Child and General and Specialist Surgery (F.R., I.M., A.G., B.N., L.P., E.M.d.G.) and Department of Experimental Medicine (G.B., L.L., I.M., C.T., S.M.), Division of Pharmacology Leonardo Donatelli, The Second University of Naples, 80138 Naples, Italy; The Endocannabinoid Research Group (L.L., S.M.), 80078 Pozzuoli, Naples, Italy; Division of General and Obesity Surgery (S.T., L.D.), The Second University of Naples, 80131 Naples, Italy; Department of Onco-Hematology (M.E.B., A.C., F.L.), Istituto di Ricovero e Cura a Caarattere Scientifico Bambino Gesù Children's Hospital, 00165 Rome, Italy; and University of Pavia (F.L.), 27100 Pavia, Italy
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Choi HS, Ji MH, Kim SJ, Ahn HS. Platelet count recovery after intravenous immunoglobulin predicts a favorable outcome in children with immune thrombocytopenia. Blood Res 2016; 51:95-101. [PMID: 27382553 PMCID: PMC4931943 DOI: 10.5045/br.2016.51.2.95] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Revised: 03/20/2016] [Accepted: 04/27/2016] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Childhood immune thrombocytopenic purpura (ITP) is a common acquired bleeding disorder. Even though most children recover, either spontaneously or with therapy, 10-20% of newly diagnosed ITP cases have a chronic course beyond 12 months. This study evaluated whether clinical and laboratory findings can predict the response to intravenous immunoglobulin (IVIG) and progression to persistent or chronic ITP in children. METHODS During the period between March 2003 and June 2015, we retrospectively analyzed 72 children, newly diagnosed with ITP, who received IVIG treatment. Peripheral blood counts were obtained at diagnosis and at 1, 3, 6, and 12 months after IVIG treatment. RESULTS After 6 months of IVIG treatment, 14 of 72 patients (19.4%) had persistent ITP, and after 12 months, 7 of 40 patients (17.5%) had chronic ITP. Age at diagnosis, gender, history of viral infection, or vaccination before disease onset were not statistically correlated with platelet recovery at 6 and 12 months. However, a platelet count recovery of ≥100×10(3)/µL at 1 and 3 months was significantly correlated with platelet recovery at 6 (P<0.001 and P<0.001, respectively) and 12 (P=0.007 and P=0.004, respectively) months. CONCLUSION This study demonstrated that early platelet count recovery, at 1 and 3 months after IVIG treatment, predicts a short disease duration and a favorable outcome in children with newly diagnosed ITP. Further investigation in a larger group of patients is warranted to validate these findings.
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Affiliation(s)
- Hyoung Soo Choi
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Mi Hong Ji
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sung Jin Kim
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyo Seop Ahn
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
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Consolini R, Legitimo A, Caparello MC. The Centenary of Immune Thrombocytopenia - Part 1: Revising Nomenclature and Pathogenesis. Front Pediatr 2016; 4:102. [PMID: 27807534 PMCID: PMC5069646 DOI: 10.3389/fped.2016.00102] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 09/07/2016] [Indexed: 12/24/2022] Open
Abstract
The natural history of the immune thrombocytopenia (ITP) is interesting and intriguing because it traces different steps underlying autoimmune diseases. The review points out the main steps that have accompanied the stages of its history and the consequential changes related to its terminology. ITP is an autoimmune disease resulting from platelet antibody-mediated destruction and impaired megakaryocyte and platelet production. However, research advances highlight that a complex dysregulation of the immune system is involved in the pathogenesis of this condition. The review examines the role of the multiple immune components involved in the autoimmunity process, focusing on the more recent mechanisms, which could be new promising therapeutic targets for ITP patients.
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Affiliation(s)
- Rita Consolini
- Laboratory of Immunology, Department of Clinical and Experimental Medicine, Division of Pediatrics, University of Pisa , Pisa , Italy
| | - Annalisa Legitimo
- Laboratory of Immunology, Department of Clinical and Experimental Medicine, Division of Pediatrics, University of Pisa , Pisa , Italy
| | - Maria Costanza Caparello
- Laboratory of Immunology, Department of Clinical and Experimental Medicine, Division of Pediatrics, University of Pisa , Pisa , Italy
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The Cannabinoid Receptor 2 Q63R Variant Modulates the Relationship between Childhood Obesity and Age at Menarche. PLoS One 2015; 10:e0140142. [PMID: 26447698 PMCID: PMC4598176 DOI: 10.1371/journal.pone.0140142] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 09/21/2015] [Indexed: 01/08/2023] Open
Abstract
Background The ovary is an important site where gene variants modulate pubertal timing. The cannabinoid receptor 2 (CB2) is expressed in the ovary, plays a role in folliculogenesis and ovulation, and can be modulated by estrogens. Obesity is strictly associated with early menarche and is characterized by sex hormone and endocannabinoid derangement. Aim In this study, we investigated the role of the CB2 receptor in determining the age at menarche in obese girls. Methods We studied a cohort of 240 obese girls (age 11.9±3 years; BMI z-score 2.8±0.8). The age at menarche (if it had already occurred) was recorded at the time of the visit or via phonecall. The CNR2 rs35761398 polymorphism, which leads to the CB2 Q63R variant, was detected by the TaqMan assay. Results In total, 105 patients were homozygous for the R63-coding allele (RR), 113 were QR and 22 were QQ. Variance analysis revealed a significantly earlier age of menarche in subjects carrying the Q63 allele, which was also found after adjusting for BMI z-score (11±1.2 vs. 11.6±1.2 years, p = 0.0003). Logistic regression analysis demonstrated that patients homozygous for the Q allele had a 2.2-fold higher risk (odds ratio = 2.2; CI1.1–3.4; p = 0.02) of presenting with an early menarche (age at menarche <12 years). Conclusion We demonstrated for the first time the association between the CB2 Q63R functional variant and the age at menarche in a cohort of Italian obese girls.
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Coppola N, Zampino R, Bellini G, Stanzione M, Capoluongo N, Marrone A, Macera M, Pasquale G, Boemio A, Maione S, Adinolfi L, Del Giudice EM, Sagnelli E, Rossi F. The impact of the CB2-63 polymorphism on the histological presentation of chronic hepatitis B. Clin Microbiol Infect 2015; 21:609.e1-4. [DOI: 10.1016/j.cmi.2015.02.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 01/19/2015] [Accepted: 02/22/2015] [Indexed: 12/22/2022]
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Bellini G, Olivieri AN, Grandone A, Alessio M, Gicchino MF, Nobili B, Perrone L, Maione S, Miraglia del Giudice E, Rossi F. Association between cannabinoid receptor type 2 Q63R variant and oligo/polyarticular juvenile idiopathic arthritis. Scand J Rheumatol 2015; 44:284-7. [DOI: 10.3109/03009742.2015.1020863] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Clinical and laboratory predictors of chronic immune thrombocytopenia in children: a systematic review and meta-analysis. Blood 2014; 124:3295-307. [PMID: 25305206 DOI: 10.1182/blood-2014-04-570127] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Childhood immune thrombocytopenia (ITP) is a rare autoimmune bleeding disorder. Most children recover within 6 to 12 months, but individual course is difficult to predict. We performed a systematic review and meta-analysis to identify predictors of chronic ITP. We found 1399 articles; after critical appraisal, 54 studies were included. The following predictors of chronic ITP in children, assessed in at least 3 studies, have been identified: female gender (odds ratio [OR] 1.17, 95% confidence interval [CI] 1.04-1.31), older age at presentation (age ≥11 years; OR 2.47, 95% CI 1.94-3.15), no preceding infection or vaccination (OR 3.08, 95 CI 2.19-4.32), insidious onset (OR 11.27, 95% CI 6.27-20.27), higher platelet counts at presentation (≥20 × 10(9)/L: OR 2.15, 95% CI 1.63-2.83), presence of antinuclear antibodies (OR 2.87, 95% 1.57-5.24), and treatment with a combination of methylprednisolone and intravenous immunoglobulin (OR 2.67, 95% CI 1.44-4.96). Children with mucosal bleeding at diagnosis or treatment with intravenous immunoglobulin alone developed chronic ITP less often (OR 0.39, 95% CI 0.28-0.54 and OR 0.71, 95% CI 0.52-0.97, respectively). The protective effect of intravenous immunoglobulin is remarkable and needs confirmation in prospective randomized trials as well as future laboratory studies to elucidate the mechanism of this effect.
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Coppola N, Zampino R, Sagnelli C, Bellini G, Marrone A, Stanzione M, Capoluongo N, Boemio A, Minichini C, Adinolfi LE, Maione S, Giudice EMD, Sagnelli E, Rossi F. Cannabinoid receptor 2-63 QQ variant is associated with persistently normal aminotransferase serum levels in chronic hepatitis C. PLoS One 2014; 9:e99450. [PMID: 24940753 PMCID: PMC4062424 DOI: 10.1371/journal.pone.0099450] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 05/14/2014] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND AND AIM To evaluate in anti-HCV-positive patients the clinical impact of the rs35761398 variant of the CNR2 gene leading to the substitution of Gln (Q) of codon 63 of the cannabinoid receptor 2 (CB2) with Arg (R). PATIENTS AND METHODS 253 consecutive anti-HCV-/HCV-RNA-positive patients were enrolled, of whom 53 were HCV carriers with persistently normal ALT (PNALT group) and 200 had a history of steadily abnormal serum ALT values (abnormal ALT group). All patients were naive for antiviral therapy and were screened for the CNR2 rs35761398 polymorphism by a TaqMan assay. RESULTS Subjects in the PNALT group, compared with those in the abnormal ALT group were older (58.5±12 vs. 50.7±12.4 years, p = 0.001), more frequently female (66% vs. 42%, p = 0.003), with lower body mass index (BMI) (24.5±3.1 vs. 26.6±4.6, p = 0.003), and more frequently with HCV genotype 2 (43.1% vs 17.7%, p = 0.0002) and CB2-63 QQ variant (34% vs. 11%, p = 0.0001). Considering all 253 patients, no difference in the demographic, biochemical, or virological data was observed between patients in the different CB2-63 variants. The logistic regression analysis identified CB2-63 QQ, HCV genotype 2, older age and lower BMI as independent predictors of PNALT (p<0.00001). DISCUSSION The CB2-63 QQ variant in HCV patients was independently associated with the PNALT status.
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Affiliation(s)
- Nicola Coppola
- Department of Mental Health and Public Medicine, Second University of Naples, Naples, Italy
- * E-mail:
| | - Rosa Zampino
- Internal Medicine and Hepatology, Second University of Naples, Naples, Italy
| | - Caterina Sagnelli
- Department of Clinical and Experimental Medicine and Surgery, Second University of Naples, Naples, Italy
| | - Giulia Bellini
- Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - Aldo Marrone
- Internal Medicine and Hepatology, Second University of Naples, Naples, Italy
| | - Maria Stanzione
- Department of Clinical and Experimental Medicine and Surgery, Second University of Naples, Naples, Italy
| | - Nicolina Capoluongo
- Department of Mental Health and Public Medicine, Second University of Naples, Naples, Italy
| | - Adriana Boemio
- Internal Medicine and Hepatology, Second University of Naples, Naples, Italy
| | - Carmine Minichini
- Department of Mental Health and Public Medicine, Second University of Naples, Naples, Italy
| | - Luigi Elio Adinolfi
- Internal Medicine and Hepatology, Second University of Naples, Naples, Italy
| | - Sabatino Maione
- Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | | | - Evangelista Sagnelli
- Department of Mental Health and Public Medicine, Second University of Naples, Naples, Italy
| | - Francesca Rossi
- Department of Pediatrics, Second University of Naples, Naples, Italy
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Malfitano AM, Basu S, Maresz K, Bifulco M, Dittel BN. What we know and do not know about the cannabinoid receptor 2 (CB2). Semin Immunol 2014; 26:369-79. [PMID: 24877594 DOI: 10.1016/j.smim.2014.04.002] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 04/07/2014] [Indexed: 12/19/2022]
Abstract
It has been well appreciated that the endocannabinoid system can regulate immune responses via the cannabinoid receptor 2 (CB2), which is primarily expressed by cells of the hematopoietic system. The endocannabinoid system is composed of receptors, ligands and enzymes controlling the synthesis and degradation of endocannabinoids. Along with endocannabinoids, both plant-derived and synthetic cannabinoids have been shown to bind to and signal through CB2 via G proteins leading to both inhibitory and stimulatory signals depending on the biological process. Because no cannabinoid ligand has been identified that only binds to CB2, the generation of mice deficient in CB2 has greatly expanded our knowledge of how CB2 contributes to immune cell development and function in health and disease. In regards to humans, genetic studies have associated CB2 with a variety of human diseases. Here, we review the endocannabinoid system with an emphasis on CB2 and its role in the immune system.
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Affiliation(s)
- Anna Maria Malfitano
- Dipartimento di Medicina e Chirurgia, Università di Salerno Facoltà di Medicina, Baronissi Campus, Baronissi 84081, (SA), Italy; Dipartimento di Farmacia, Università di Salerno, Fisciano 84084, (SA), Italy
| | - Sreemanti Basu
- Blood Research Institute, BloodCenter of Wisconsin, Milwaukee, WI, USA
| | - Katarzyna Maresz
- Blood Research Institute, BloodCenter of Wisconsin, Milwaukee, WI, USA
| | - Maurizio Bifulco
- Dipartimento di Medicina e Chirurgia, Università di Salerno Facoltà di Medicina, Baronissi Campus, Baronissi 84081, (SA), Italy; Dipartimento di Farmacia, Università di Salerno, Fisciano 84084, (SA), Italy
| | - Bonnie N Dittel
- Blood Research Institute, BloodCenter of Wisconsin, Milwaukee, WI, USA.
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Abstract
Immune thrombocytopenia (ITP) is a heterogeneous disease which can be primary or secondary due to other conditions such as drugs. CB2 receptors (CB2R) also have a role in the ITP pathogenesis as CB2 receptor gene (CNR2) polymorphisms are associated with chronic immune thrombocytopenia and autoimmune diseases. K2 is synthetic marijuana which acts on cannabinoid receptors that are found on immune cells and thrombocytes. Here, we present a case who presented with ITP secondary to K2 usage and was successfully treated with 1 mg/kg prednisolone. This is the first ITP case in the literature due to K2. It is important in the era of the new drugs development of the CB2R mimetics.
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Affiliation(s)
- Erman Öztürk
- Department of Hematology, Istanbul Medeniyet University, Göztepe Training and Research Hospital , Istanbul , Turkey , and
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Coppola N, Zampino R, Bellini G, Macera M, Marrone A, Pisaturo M, Boemio A, Nobili B, Pasquale G, Maione S, Adinolfi LE, Perrone L, Sagnelli E, Miraglia Del Giudice E, Rossi F. Association between a polymorphism in cannabinoid receptor 2 and severe necroinflammation in patients with chronic hepatitis C. Clin Gastroenterol Hepatol 2014; 12:334-40. [PMID: 23707465 DOI: 10.1016/j.cgh.2013.05.008] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2013] [Revised: 04/15/2013] [Accepted: 05/04/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS The cannabinoid receptor 2 (CB2) has been implicated in liver disease. The single-nucleotide polymorphism rs35761398 in cannabinoid receptor 2 gene (CNR2), which encodes the CB2, substitutes glutamine (Q) 63 with arginine (R), and reduces the function of the gene product. We investigated the effects of CNR2 rs35761398 in patients with hepatitis C virus (HCV) infection. METHODS We studied 169 consecutive patients with asymptomatic chronic hepatitis (tested positive for anti-HCV and HCV RNA) at 2 liver units in southern Italy. First, liver biopsy samples were collected from July 2009 through December 2011. All patients were naive to antiviral therapy; CNR2 genotype was determined by polymerase chain reaction analysis. RESULTS Patients with the CB2-63 QQ variant had higher serum levels of aminotransferase than those with the CB2-63 QR or RR variants; they also had higher histologic activity index (HAI) scores (8.6 ± 3.8) than patients without the CB2-63 RR variant (5.3 ± 3.6; P < .005) or those with the CB2-63 QR variant (5.8 ± 3.3; P < .001). Patients with the different variants of CNR2 did not differ in fibrosis stage or steatosis score. Moderate or severe chronic hepatitis (HAI score, >8) was identified more frequently (55.5%) in patients with the CB2-63 QQ variant than in those with the 63 QR (20%; P < .005) or RR variants (17.4%; P < .005). In logistic regression analysis, the CB2-63 QQ variant and fibrosis score were independent predictors of moderate or severe chronic hepatitis (HAI score, >8; P < .0001). CONCLUSIONS The CB2-63 QQ variant of CNR2 is associated with more severe inflammation and hepatocellular necrosis in patients with HCV infection.
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Affiliation(s)
- Nicola Coppola
- Department of Mental Health and Public Medicine, Second University of Naples, Naples, Italy.
| | - Rosa Zampino
- Internal Medicine and Hepatology, Second University of Naples, Naples, Italy
| | - Giulia Bellini
- Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - Margherita Macera
- Department of Mental Health and Public Medicine, Second University of Naples, Naples, Italy
| | - Aldo Marrone
- Internal Medicine and Hepatology, Second University of Naples, Naples, Italy
| | | | - Adriana Boemio
- Internal Medicine and Hepatology, Second University of Naples, Naples, Italy
| | - Bruno Nobili
- Department of Pediatrics, Second University of Naples, Naples, Italy
| | - Giuseppe Pasquale
- Department of Mental Health and Public Medicine, Second University of Naples, Naples, Italy
| | - Sabatino Maione
- Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - Luigi Elio Adinolfi
- Internal Medicine and Hepatology, Second University of Naples, Naples, Italy
| | - Laura Perrone
- Department of Pediatrics, Second University of Naples, Naples, Italy
| | - Evangelista Sagnelli
- Department of Mental Health and Public Medicine, Second University of Naples, Naples, Italy
| | | | - Francesca Rossi
- Department of Pediatrics, Second University of Naples, Naples, Italy
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The cannabinoid receptor type 2 as mediator of mesenchymal stromal cell immunosuppressive properties. PLoS One 2013; 8:e80022. [PMID: 24312195 PMCID: PMC3842278 DOI: 10.1371/journal.pone.0080022] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 09/27/2013] [Indexed: 01/30/2023] Open
Abstract
Mesenchymal stromal cells are non-hematopoietic, multipotent progenitor cells producing cytokines, chemokines, and extracellular matrix proteins that support hematopoietic stem cell survival and engraftment, influence immune effector cell development, maturation, and function, and inhibit alloreactive T-cell responses. The immunosuppressive properties of human mesenchymal stromal cells have attracted much attention from immunologists, stem cell biologists and clinicians. Recently, the presence of the endocannabinoid system in hematopoietic and neural stem cells has been demonstrated. Endocannabinoids, mainly acting through the cannabinoid receptor subtype 2, are able to modulate cytokine release and to act as immunosuppressant when added to activated T lymphocytes. In the present study, we have investigated, through a multidisciplinary approach, the involvement of the endocannabinoids in migration, viability and cytokine release of human mesenchymal stromal cells. We show, for the first time, that cultures of human mesenchymal stromal cells express all of the components of the endocannabinoid system, suggesting a potential role for the cannabinoid CB2 receptor as a mediator of anti-inflammatory properties of human mesenchymal stromal cells, as well as of their survival pathways and their capability to home and migrate towards endocannabinoid sources.
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Cannabinoid CB2 receptor gene (CNR2) polymorphism is associated with chronic childhood immune thrombocytopenia in Egypt. Blood Coagul Fibrinolysis 2013; 24:247-51. [PMID: 23406660 DOI: 10.1097/mbc.0b013e32835aba1d] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Immune thrombocytopenia (ITP) is a heterogeneous autoimmune disorder characterized by thrombocytopenia with or without mucocutaneous bleeding manifestations. ITP patients have significant defects in immune self-tolerance: autoreactive T-lymphocyte clones are capable of directly damaging platelets and possibly megakaryocytes and are likely to proliferate under the influence of Th lymphocytes. The CB2 receptor is thought to be the principal cannabinoid receptor that mediates immune modulation by endocannabinoid. The later has shown a complex range of immunomodulatory effects, primarily suppressive effects on leukocytes and immune functions, including modulation of Th cell development, chemotaxis and cytokine secretion. In this study, we investigated the association between cannabinoid CB2 receptor gene (CNR2) Q63R polymorphism and the susceptibility to childhood ITP in Egyptian population. CNR2 genotyping in ITP patients revealed that 41% of patients had the QR(AA/GG) heterotype and 49% had the RR(AA/AA) homotype. There was a significantly higher frequency of homomutant genotype (RR) in ITP patients than in controls, which conferred more than two-fold increased risk of ITP among Egyptian children [odds ratio (OR) 2.352, 95% confidence interval (CI) 1.313-4.215]. There was a significant statistical difference in the distribution of CNR2 Q63R genotypes between chronic ITP patients group and the control groups. The homomutant genotype carried nearly three-fold increased risk for chronic ITP (OR 2.701, 95% CI 1.462-5.009). In conclusion, CNR2 Q63R polymorphism may represent a novel genetic risk factor in the pathophysiology of chronicity development of ITP in Egyptian children.
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McKenzie CGJ, Guo L, Freedman J, Semple JW. Cellular immune dysfunction in immune thrombocytopenia (ITP). Br J Haematol 2013; 163:10-23. [DOI: 10.1111/bjh.12480] [Citation(s) in RCA: 125] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Yacobovich J, Revel-Vilk S, Tamary H. Childhood Immune Thrombocytopenia—Who Will Spontaneously Recover? Semin Hematol 2013; 50 Suppl 1:S71-4. [DOI: 10.1053/j.seminhematol.2013.03.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Rossi F, Bellini G, Tolone C, Luongo L, Mancusi S, Papparella A, Sturgeon C, Fasano A, Nobili B, Perrone L, Maione S, Miraglia del Giudice E. The Cannabinoid Receptor type 2 Q63R variant increases the risk of celiac disease: Implication for a novel molecular biomarker and future therapeutic intervention. Pharmacol Res 2012; 66:88-94. [DOI: 10.1016/j.phrs.2012.03.011] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Revised: 03/14/2012] [Accepted: 03/16/2012] [Indexed: 11/26/2022]
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Schulze H, Gaedicke G. Immune thrombocytopenia in children and adults: what's the same, what's different? Haematologica 2012; 96:1739-41. [PMID: 22147771 DOI: 10.3324/haematol.2011.055830] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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