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THC degradation does not impair the accuracy of THC doses aerosolized by the metered-dose SyqeAir inhaler: a 24-month stability trial. 四氢大麻酚降解不会影响SyqeAir吸入器雾化四氢大麻酚剂量的准确性:一项为期24个月的稳定性试验。
Pub Date : 2022-10-24 DOI: 10.1186/s42238-022-00166-5
Joshua Aviram, Daniella Atzmony, Anna Frenklakh, Asaf Kroll, Ilana Zaks, Arno Hazekamp

Background: Although the worldwide use of medical cannabis (MC) is on the rise, there is insufficient data regarding the long-term stability of phytocannabinoids in the plant material under different storage conditions. Specifically, there is insufficient data on the effect of storage conditions on the availability of (-)-∆9-trans-tetrahydrocannabinol (THC) in vaporized cannabis. The Syqe inhaler delivers metered doses of phytocannabinoids by inhalation and utilizes accurate quantities of ground cannabis inflorescence packaged in tamper-proof cartridges. We aimed to assess the stability of phytocannabinoids in ground cannabis before and after packaging in Syqe cartridges as well as the reproducibility of THC delivery in the aerosolized dose.

Methods: Ground MC inflorescence was stored under different temperature and humidity conditions, before or after being packaged in Syqe cartridges. Concentrations of the major phytocannabinoids therein were analyzed at different time points using ultra-high performance liquid chromatography (U-HPLC). THC doses aerosolized via the Syqe inhaler were evaluated using cartridges stored for up to 2 years at 25°C. Every vapor chip contains 13.5±0.9 mg of ground MC powder.

Results: No significant changes were observed in phytocannabinoid concentrations in ground cannabis inflorescence after 3 months of bulk storage in a polypropylene container and sealed in an aluminum foil pouch at 5°C. In contrast, significant changes in phytocannabinoid concentrations were found when ground inflorescence was stored in the cartridges at 25°C for 2 years. Specifically, CBGA, THCA, and total THC concentrations decreased from 0.097±0.023, 2.7±0.3, and 2.80±0.16 mg/chip at baseline to 0.044±0.007 (55% decrease), 1.50±0.27 (44% decrease), and 2.20±0.083 (21% decrease) mg/chip following 2 years, respectively, while CBN and THC concentrations increased from 0.005±0.005 and 0.44±0.11 mg/chip at baseline to 0.14±0.006 (2700% increase) and 0.88±0.22 (100% increase) mg/chip following 2 years, respectively. Storage at 30°C revealed a steeper change in phytocannabinoid concentrations within an even shorter period. Despite the significant change of relative cannabinoid composition within the cartridge, the actual THC dose present in the aerosol remained relatively stable throughout this period and within the dosage range of 500mcg±25% required for pharmaceutical-grade inhalers.

Conclusions: MC powder in Syqe cartridges may be stored at room temperature for at least 2 years after production without affecting the aerosolized THC dose delivered to patients by more than ±25%. Future studies should analyze additional phytocannabinoids and terpenes in the cannabis inflorescence and assess the stability of different cannabis cultivars following storage in Syqe cartridges.

背景:虽然世界范围内医用大麻(MC)的使用量正在上升,但关于植物材料中植物大麻素在不同储存条件下的长期稳定性的数据不足。具体而言,关于储存条件对汽化大麻中(-)-∆9-反式四氢大麻酚(THC)可得性的影响的数据不足。Syqe吸入器通过吸入提供计量剂量的植物大麻素,并利用精确数量的地面大麻花序包装在防篡改的药筒中。我们的目的是评估Syqe药筒包装前后磨碎大麻中植物大麻素的稳定性以及四氢大麻酚在雾化剂量中传递的再现性。方法:在Syqe药筒包装前和包装后,分别在不同温度和湿度条件下保存地面的MC花序。采用超高高效液相色谱法(uhplc)分析了不同时间点大麻素中主要植物素的浓度。通过Syqe吸入器雾化的THC剂量使用在25°C下储存长达2年的药筒进行评估。每个蒸汽片含有13.5±0.9毫克的MC粉。结果:在聚丙烯容器中大量储存3个月,并在铝箔袋中密封5°C后,磨碎的大麻花序中的植物大麻素浓度没有明显变化。相比之下,当地面花序在25°C下储存2年时,发现植物大麻素浓度发生了显著变化。其中,CBGA、THCA和总THC浓度分别从基线时的0.097±0.023、2.7±0.3和2.80±0.16 mg/片下降至0.044±0.007(下降55%)、1.50±0.27(下降44%)和2.20±0.083(下降21%)mg/片,CBN和THC浓度分别从基线时的0.005±0.005和0.44±0.11 mg/片上升至0.14±0.006(增加2700%)和0.88±0.22(增加100%)mg/片。在30°C的储存中,植物大麻素浓度在更短的时间内发生了更大的变化。尽管药筒内的相对大麻素成分发生了显著变化,但在此期间,气溶胶中存在的实际THC剂量保持相对稳定,并且在药用级吸入器所需的500mcg±25%的剂量范围内。结论:Syqe药筒中的MC粉在生产后可在室温下保存至少2年,而不影响给患者的四氢大麻酚雾化剂量超过±25%。未来的研究应该分析大麻花序中的其他植物大麻素和萜烯,并评估不同大麻品种在Syqe药筒中储存后的稳定性。
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引用次数: 0
Role of the endocannabinoid system in the pathophysiology of endometriosis and therapeutic implications. 内源性大麻素系统在子宫内膜异位症病理生理学中的作用及治疗意义。
Pub Date : 2022-10-07 DOI: 10.1186/s42238-022-00163-8
Harshavardhan Lingegowda, Bailey J Williams, Katherine G Spiess, Danielle J Sisnett, Alan E Lomax, Madhuri Koti, Chandrakant Tayade

Endometriosis patients experience debilitating chronic pain, and the first-line treatment is ineffective at managing symptoms. Although surgical removal of the lesions provides temporary relief, more than 50% of the patients experience disease recurrence. Despite being a leading cause of hysterectomy, endometriosis lacks satisfactory treatments and a cure. Another challenge is the poor understanding of disease pathophysiology which adds to the delays in diagnosis and overall compromised quality of life. Endometriosis patients are in dire need of an effective therapeutic strategy that is both economical and effective in managing symptoms, while fertility is unaffected. Endocannabinoids and phytocannabinoids possess anti-inflammatory, anti-nociceptive, and anti-proliferative properties that may prove beneficial for endometriosis management, given that inflammation, vascularization, and pain are hallmark features of endometriosis. Endocannabinoids are a complex network of molecules that play a central role in physiological processes including homeostasis and tissue repair, but endocannabinoids have also been associated in the pathophysiology of several chronic inflammatory diseases including endometriosis and cancers. The lack of satisfactory treatment options combined with the recent legalization of recreational cannabinoids in some parts of the world has led to a rise in self-management strategies including the use of cannabinoids for endometriosis-related pain and other symptoms. In this review, we provide a comprehensive overview of endocannabinoids with a focus on their potential roles in the pathophysiology of endometriosis. We further provide evidence-driven perspectives on the current state of knowledge on endometriosis-associated pain, inflammation, and therapeutic avenues exploiting the endocannabinoid system for its management.

子宫内膜异位症患者会经历令人衰弱的慢性疼痛,而一线治疗对控制症状效果不佳。虽然手术切除病灶可以暂时缓解症状,但 50%以上的患者会复发。尽管子宫内膜异位症是导致子宫切除术的主要原因之一,但目前仍缺乏令人满意的治疗方法和治愈手段。另一个挑战是人们对疾病病理生理学的认识不足,导致诊断延误,整体生活质量下降。子宫内膜异位症患者迫切需要一种既经济又能有效控制症状,同时不影响生育能力的有效治疗策略。鉴于炎症、血管化和疼痛是子宫内膜异位症的标志性特征,内源性大麻素和植物大麻素具有抗炎、抗痛觉和抗增生的特性,可能对子宫内膜异位症的治疗有益。内源性大麻素是一个复杂的分子网络,在包括平衡和组织修复在内的生理过程中发挥着核心作用,但内源性大麻素也与包括子宫内膜异位症和癌症在内的几种慢性炎症性疾病的病理生理学有关。由于缺乏令人满意的治疗方案,再加上最近大麻素在世界上一些地区的合法化,导致了自我管理策略的兴起,包括使用大麻素治疗子宫内膜异位症相关疼痛和其他症状。在这篇综述中,我们全面概述了内源性大麻素,重点关注它们在子宫内膜异位症病理生理学中的潜在作用。我们还将从证据驱动的角度,进一步介绍子宫内膜异位症相关疼痛、炎症的知识现状,以及利用内源性大麻素系统治疗子宫内膜异位症的途径。
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引用次数: 0
C. elegans as a test system to study relevant compounds that contribute to the specific health-related effects of different cannabis varieties. 秀丽隐杆线虫作为一个测试系统来研究相关化合物,有助于不同大麻品种的特定健康影响。
Pub Date : 2022-10-03 DOI: 10.1186/s42238-022-00162-9
Monique van Es-Remers, Jesus Arellano Spadaro, Eefje Poppelaars, Hye Kyong Kim, Marieke van Haaster, Marcel de Wit, Eva ILiopoulou, Marjolein Wildwater, Henrie Korthout

Background: The medicinal effects of cannabis varieties on the market cannot be explained solely by the presence of the major cannabinoids Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD). Evidence for putative entourage effects caused by other compounds present in cannabis is hard to obtain due to the subjective nature of patient experience data. Caenorhabditis elegans (C. elegans) is an objective test system to identify cannabis compounds involved in claimed health and entourage effects.

Methods: From a medicinal cannabis breeding program by MariPharm BV, the Netherlands a set of 12 varieties were selected both THC rich varieties as well as CBD rich varieties. A consecutive extraction process was applied resulting in a non-polar (cannabinoid-rich) and polar (cannabinoid-poor) extract of each variety. The test model C. elegans was exposed to these extracts in a broad set of bioassays for appetite control, body oscillation, motility, and nervous system function.

Results: Exposing C. elegans to extracts with a high concentration of cannabinoids (> 1 μg/mL) reduces the life span of C. elegans dramatically. Exposing the nematodes to the low-cannabinoid (< 0.005 μg/mL) polar extracts, however, resulted in significant effects with respect to appetite control, body oscillation, motility, and nervous system-related functions in a dose-dependent and variety-dependent manner.

Discussion: C. elegans is a small, transparent organism with a complete nervous system, behavior and is due to its genetic robustness and short life cycle highly suitable to unravel entourage effects of Cannabis compounds. Although C. elegans lacks an obvious CB1 and CB2 receptor it has orthologs of Serotonin and Vanilloid receptor which are also involved in (endo)cannabinoid signaling.

Conclusion: By using C. elegans, we were able to objectively distinguish different effects of different varieties despite the cannabinoid content. C. elegans seems a useful test system for studying entourage effects, for targeted medicinal cannabis breeding programs and product development.

背景:市场上大麻品种的药用作用不能仅仅通过主要大麻素Δ9-tetrahydrocannabinol (THC)和大麻二酚(CBD)的存在来解释。由于患者经验数据的主观性质,很难获得大麻中存在的其他化合物引起的假定伴随效应的证据。秀丽隐杆线虫(秀丽隐杆线虫)是一个客观的测试系统,以确定大麻化合物涉及声称的健康和随从效应。方法:从荷兰MariPharm BV的药用大麻育种项目中,选择了12个富含四氢大麻酚和CBD的品种。连续提取过程应用导致非极性(大麻素丰富)和极性(大麻素贫乏)提取物的每个品种。实验模型秀丽隐杆线虫暴露于这些提取物中,用于食欲控制、身体振荡、运动和神经系统功能的广泛生物测定。结果:秀丽隐杆线虫暴露于高浓度大麻素(> 1 μg/mL)提取物中,可显著降低秀丽隐杆线虫的寿命。然而,将线虫暴露于低大麻素(< 0.005 μg/mL)极性提取物中,在食欲控制、身体振荡、运动和神经系统相关功能方面产生了显著的影响,且呈剂量依赖性和品种依赖性。讨论:秀丽隐杆线虫是一种小型透明的生物,具有完整的神经系统和行为,由于其遗传稳健性和生命周期短,非常适合解开大麻化合物的随行效应。虽然秀丽隐杆线虫缺乏明显的CB1和CB2受体,但它具有5 -羟色胺和香草素受体的同源物,它们也参与(内)大麻素信号传导。结论:采用秀丽隐杆线虫,可以客观地区分不同品种大麻素含量的不同效果。秀丽隐杆线虫似乎是一个有用的测试系统,研究随从效应,有针对性的药用大麻育种计划和产品开发。
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引用次数: 1
Shifts in therapeutic practices and decline of medicinal cannabis in Indian North-Eastern Frontier (1826-1925). 印度东北边境治疗实践的转变和药用大麻的减少(1826-1925)。
Pub Date : 2022-09-28 DOI: 10.1186/s42238-022-00159-4
Gita Bania

Background: The emergence of colonial medicine in the North-Eastern Frontier witnessed different phases of consistent competition and resistance. Herbs such as cannabis provided native physicians with a coherent power to resist colonial medical intervention. Before British rule, cannabis assumed great significance in the socio-economic, cultural, and religious spheres. The colonizers' bioprospection of cannabis shifted the production and use of cannabis from a medical and recreational plant to an industrial and commercial commodity. British policies on cannabis caused its ban leading to natives' reliance on colonial cannabis products. As a result, the native medical practitioners resisted for reviving cannabis in the indigenous therapeutics. This paper mainly aims to investigate the decline of medicinal cannabis in indigenous therapeutics, causing subtle resistance of the native physicians of the North-Eastern Frontier.

Methods: This paper follows a nomadology method based on primary and secondary sources to understand the impact on native physicians after the ban on private use, cultivation, and sale of cannabis. The primary sources/data have been collected from the Directorate of Archives: Government of Assam and Directorate of State Archives and Research Centre, Kolkata, West Bengal. Secondary sources have been collected from books, articles, and theses accessed from various libraries and websites.

Results: Ban on cannabis led to dual responses from the indigenous population of the frontier. First is the interest of the native physicians resisting the revival of cannabis in indigenous therapeutics. The second is the interest of the frontier's elites, who viewed cannabis as a "dangerous drug." The British policies of control and restrictions on cannabis, the rift of response from the natives, and the over-powering of the indigenous therapeutics by the colonial medical system led to the decline of medicinal uses of cannabis in the North-Eastern Frontier.

Discussions: Various pre-colonial and colonial factors helped colonial medical practices to get the upper hand over indigenous therapeutics. Such a shift led to the decline of indigenous medicinal cannabis causing native resistance, which was patient and silent.

Conclusions: British ban on cannabis resulted in a rift of native responses, resistance, and decline of cannabis in the indigenous therapeutics of the North-Eastern Frontier.

背景:殖民医学在东北边境的出现经历了不同阶段的持续竞争和抵抗。大麻等草药为当地医生提供了抵抗殖民医疗干预的连贯力量。在英国统治之前,大麻在社会经济、文化和宗教领域具有重要意义。殖民者对大麻的生物展望使大麻的生产和使用从一种医疗和娱乐植物转变为一种工业和商业商品。英国对大麻的政策导致了它的禁令,导致当地人对殖民地大麻产品的依赖。因此,土著医生反对在土著疗法中重新使用大麻。本文主要旨在调查药用大麻在本土治疗中的下降,引起东北边境本土医生的微妙抵抗。方法:本文采用基于一手资料和二手资料的nomadology方法,了解禁止私人使用、种植和销售大麻后对当地医生的影响。主要来源/数据收集自档案馆:阿萨姆邦政府和西孟加拉邦加尔各答国家档案馆和研究中心。二手资料收集自各种图书馆和网站上的书籍、文章和论文。结果:大麻禁令导致边境土著居民的双重反应。首先是本土医生的利益,他们抵制大麻在本土疗法中的复兴。其次是边疆精英的利益,他们认为大麻是一种“危险的毒品”。英国对大麻的控制和限制政策,当地人的反应分歧,以及殖民地医疗系统对土著疗法的过度压制,导致了东北边境大麻药用用途的下降。讨论:殖民前和殖民时期的各种因素使殖民时期的医疗实践比土著疗法占上风。这种转变导致土著药用大麻的减少,引起土著抵抗,这种抵抗是耐心和沉默的。结论:英国对大麻的禁令导致了东北边境土著治疗中大麻的反应,抵抗和下降。
{"title":"Shifts in therapeutic practices and decline of medicinal cannabis in Indian North-Eastern Frontier (1826-1925).","authors":"Gita Bania","doi":"10.1186/s42238-022-00159-4","DOIUrl":"https://doi.org/10.1186/s42238-022-00159-4","url":null,"abstract":"<p><strong>Background: </strong>The emergence of colonial medicine in the North-Eastern Frontier witnessed different phases of consistent competition and resistance. Herbs such as cannabis provided native physicians with a coherent power to resist colonial medical intervention. Before British rule, cannabis assumed great significance in the socio-economic, cultural, and religious spheres. The colonizers' bioprospection of cannabis shifted the production and use of cannabis from a medical and recreational plant to an industrial and commercial commodity. British policies on cannabis caused its ban leading to natives' reliance on colonial cannabis products. As a result, the native medical practitioners resisted for reviving cannabis in the indigenous therapeutics. This paper mainly aims to investigate the decline of medicinal cannabis in indigenous therapeutics, causing subtle resistance of the native physicians of the North-Eastern Frontier.</p><p><strong>Methods: </strong>This paper follows a nomadology method based on primary and secondary sources to understand the impact on native physicians after the ban on private use, cultivation, and sale of cannabis. The primary sources/data have been collected from the Directorate of Archives: Government of Assam and Directorate of State Archives and Research Centre, Kolkata, West Bengal. Secondary sources have been collected from books, articles, and theses accessed from various libraries and websites.</p><p><strong>Results: </strong>Ban on cannabis led to dual responses from the indigenous population of the frontier. First is the interest of the native physicians resisting the revival of cannabis in indigenous therapeutics. The second is the interest of the frontier's elites, who viewed cannabis as a \"dangerous drug.\" The British policies of control and restrictions on cannabis, the rift of response from the natives, and the over-powering of the indigenous therapeutics by the colonial medical system led to the decline of medicinal uses of cannabis in the North-Eastern Frontier.</p><p><strong>Discussions: </strong>Various pre-colonial and colonial factors helped colonial medical practices to get the upper hand over indigenous therapeutics. Such a shift led to the decline of indigenous medicinal cannabis causing native resistance, which was patient and silent.</p><p><strong>Conclusions: </strong>British ban on cannabis resulted in a rift of native responses, resistance, and decline of cannabis in the indigenous therapeutics of the North-Eastern Frontier.</p>","PeriodicalId":15172,"journal":{"name":"Journal of Cannabis Research","volume":" ","pages":"52"},"PeriodicalIF":0.0,"publicationDate":"2022-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9520865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40382089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Medical cannabis authorization patterns, safety, and associated effects in older adults. 老年人医用大麻授权模式、安全性及其相关影响。
Pub Date : 2022-09-22 DOI: 10.1186/s42238-022-00158-5
Laura MacNair, Maja Kalaba, Erica N Peters, Matthew T Feldner, Graham M L Eglit, Lucile Rapin, Cynthia El Hage, Erin Prosk, Mark A Ware

Background: Use of medical cannabis is increasing among older adults. However, few investigations have examined cannabis use in this population.

Methods: We assessed the authorization patterns, safety, and effects of medical cannabis in a sub-analysis of 201 older adults (aged ≥ 65 years) who completed a 3-month follow-up during this observational study of patients who were legally authorized a medical cannabis product (N = 67). Cannabis authorization patterns, adverse events (AEs), Edmonton Symptom Assessment Scale-revised (ESAS-r), and Brief Pain Inventory Short Form (BPI-SF) data were collected.

Results: The most common symptoms for which medical cannabis was authorized were pain (159, 85.0%) and insomnia (9, 4.8%). At baseline and at the 3-month follow-up, cannabidiol (CBD)-dominant products were authorized most frequently (99, 54%), followed by balanced products (76, 42%), and then delta-9-tetrahydrocannabinol (THC)-dominant products (8, 4.4%). The most frequent AEs were dizziness (18.2%), nausea (9.1%), dry mouth (9.1%), and tinnitus (9.1%). Significant reductions in ESAS-r scores were observed over time in the domains of drowsiness (p = .013) and tiredness (p = .031), but not pain (p = .106) or well-being (p = .274). Significant reductions in BPI-SF scores over time were observed for worst pain (p = .010), average pain (p = .012), and overall pain severity (p = 0.009), but not pain right now (p = .052) or least pain (p = .141).

Conclusions: Overall, results suggest medical cannabis was safe, well-tolerated, and associated with clinically meaningful reductions in pain in this sample of older adults. However, the potential bias introduced by the high subject attrition rate means that all findings should be interpreted cautiously and confirmed by more rigorous studies.

背景:老年人使用医用大麻的人数正在增加。然而,很少有调查调查了这一人群的大麻使用情况。方法:我们对201名老年人(年龄≥65岁)进行了亚分析,评估了医用大麻的授权模式、安全性和效果,这些老年人在这项观察性研究中完成了为期3个月的随访,这些患者被合法授权使用医用大麻产品(N = 67)。收集大麻授权模式、不良事件(ae)、埃德蒙顿症状评估量表修订版(ESAS-r)和简短疼痛量表短表(BPI-SF)数据。结果:医用大麻最常见的症状是疼痛(159例,85.0%)和失眠(9例,4.8%)。在基线和3个月的随访中,大麻二酚(CBD)主导产品被授权的频率最高(99.54%),其次是平衡产品(76.42%),然后是δ -9-四氢大麻酚(THC)主导产品(8.4.4%)。最常见的ae是头晕(18.2%)、恶心(9.1%)、口干(9.1%)和耳鸣(9.1%)。随着时间的推移,在困倦(p = 0.013)和疲劳(p = 0.031)领域观察到ESAS-r分数显著降低,但在疼痛(p = 0.106)或健康(p = 0.274)方面没有观察到。随着时间的推移,最严重疼痛(p = 0.010)、平均疼痛(p = 0.012)和整体疼痛严重程度(p = 0.009)的BPI-SF评分显著下降,但目前疼痛(p = 0.052)或最小疼痛(p = 0.141)没有明显下降。结论:总体而言,结果表明医用大麻是安全的,耐受性良好,并且与临床意义上的老年人疼痛减轻有关。然而,高受试者流失率带来的潜在偏倚意味着所有的研究结果都应该谨慎解释,并通过更严格的研究来证实。
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引用次数: 1
Semi-quantitative analysis of cannabinoids in hemp (Cannabis sativa L.) using gas chromatography coupled to mass spectrometry. 气相色谱-质谱联用半定量分析大麻中的大麻素。
Pub Date : 2022-09-22 DOI: 10.1186/s42238-022-00161-w
Luca De Prato, Matthew Timmins, Omid Ansari, Katinka X Ruthrof, Giles E St J Hardy, John Howieson, Graham O'Hara

Background: Hemp (Cannabis sativa L.) is a producer of cannabinoids. These organic compounds are of increasing interest due to their potential applications in the medicinal field. Advances in analytical methods of identifying and quantifying these molecules are needed.

Method: This study describes a new method of cannabinoid separation from plant material using gas chromatography-mass spectrometry (GC-MS) as the analytical tool to detect low abundance cannabinoids that will likely have implications for future therapeutical treatments. A novel approach was adopted to separate trichomes from plant material to analyse cannabinoids of low abundance not observed in raw plant extract. Required plant sample used for analysis was greatly reduced compared to other methods. Derivatisation method was simplified and deconvolution software was utilised to recognise unknown cannabinoid compounds of low abundance.

Results: The method produces well-separated spectra and allows the detection of major and minor cannabinoids. Ten cannabinoids that had available standards could be identified and quantified and numerous unidentified cannabinoids or pathway intermediates based on GC-MS spectra similarities could be extracted and analysed simultaneously with this method.

Conclusions: This is a rapid novel extraction and analytical method from plant material that can identify major and minor cannabinoids using a simple technique. The method will be of use to future researchers seeking to study the multitude of cannabinoids whose values are currently not understood.

背景:大麻(Cannabis sativa L.)是大麻素的生产者。这些有机化合物由于其在医学领域的潜在应用而日益引起人们的兴趣。需要在鉴定和定量这些分子的分析方法上取得进展。方法:本研究描述了一种从植物材料中分离大麻素的新方法,使用气相色谱-质谱(GC-MS)作为检测低丰度大麻素的分析工具,这可能对未来的治疗有影响。采用了一种新的方法来分离毛状体从植物材料分析大麻素的低丰度未观察到的原料植物提取物。与其他方法相比,大大减少了分析所需的植物样品。简化衍生化方法,利用反褶积软件识别未知的低丰度大麻素化合物。结果:该方法具有良好的分离光谱,可检测出主要大麻素和次要大麻素。该方法可对已有标准的10种大麻素进行鉴定和定量,并可根据GC-MS谱相似性同时提取和分析许多未确定的大麻素或途径中间体。结论:这是一种从植物材料中快速提取和分析大麻素的新方法,技术简单,可鉴别大麻素的主要成分和次要成分。该方法将用于未来的研究人员寻求研究大量大麻素,其价值目前尚不清楚。
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引用次数: 0
The association between cannabis and codeine use: a nationally representative cross-sectional study in Canada. 大麻与可待因使用之间的关系:加拿大一项具有全国代表性的横断面研究。
Pub Date : 2022-09-09 DOI: 10.1186/s42238-022-00160-x
Ria Garg, Kam Shojania, Mary A De Vera

Background: Due to the growing use of cannabis for the purposes of pain relief, evidence is needed on the impact of cannabis use on concurrent analgesic use. Therefore, our objective was to evaluate the association between the use of cannabis and codeine.

Methods: We conducted a cross-sectional study using data from the nationally representative Canadian Tobacco, Alcohol and Drugs Survey (2017). The primary explanatory variable was self-reported use of cannabis within the past year. The outcome was the use of codeine-containing product(s) within the past year. We used multivariable binomial logistic regression models.

Results: Our study sample comprised 15,459 respondents including 3338 individuals who reported cannabis use within the past year of whom 955 (36.2%) used it for medical purposes. Among individuals who reported cannabis use, the majority were male (N = 1833, 62.2%). Self-reported use of cannabis was associated with codeine use (adjusted odds ratio [aOR] 1.89, 95% CI 1.36 to 2.62). Additionally, when limited to cannabis users only, we found people who used cannabis for medical purposes to be three times more likely to also report codeine use (adjusted odds ratio [aOR] 2.96, 95% CI 1.72 to 5.09).

Discussion: The use of cannabis was associated with increased odds of codeine use, especially among individuals who used it for medical purposes. Our findings suggest a potential role for healthcare providers to be aware of or monitor patients' use of cannabis, as the long-term adverse events associated with concurrent cannabis and opioid use remain unknown.

背景:由于大麻用于缓解疼痛的目的越来越多,需要证据证明大麻使用对并发镇痛药使用的影响。因此,我们的目的是评估使用大麻和可待因之间的关系。方法:我们使用具有全国代表性的加拿大烟草、酒精和毒品调查(2017年)的数据进行了横断面研究。主要的解释变量是过去一年内自我报告的大麻使用情况。结果是在过去一年内使用含有可待因的产品。我们使用多变量二项逻辑回归模型。结果:我们的研究样本包括15,459名受访者,其中包括3338名报告在过去一年内使用大麻的个人,其中955人(36.2%)将其用于医疗目的。在报告使用大麻的个人中,大多数是男性(N = 1833, 62.2%)。自我报告的大麻使用与可待因使用相关(调整优势比[aOR] 1.89, 95% CI 1.36至2.62)。此外,当仅限于大麻使用者时,我们发现以医疗为目的使用大麻的人报告使用可待因的可能性是其三倍(调整优势比[aOR] 2.96, 95% CI 1.72至5.09)。讨论:大麻的使用与可待因的使用几率增加有关,特别是在将其用于医疗目的的个人中。我们的研究结果表明,由于与大麻和阿片类药物同时使用相关的长期不良事件尚不清楚,医疗保健提供者应了解或监测患者使用大麻的情况。
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引用次数: 1
Weight stability in adults with obesity initiating medical marijuana treatment for other medical conditions. 成人肥胖患者开始使用医用大麻治疗其他疾病的体重稳定性
Pub Date : 2022-08-27 DOI: 10.1186/s42238-022-00157-6
Michelle R Lent, Meghan Visek, Paulina Syracuse, Karen L Dugosh, David S Festinger

Few studies have evaluated weight change in patients who initiate medical marijuana treatment to address diagnosed health concerns. The objective of this study was to examine whether patients initiating medical marijuana use for a qualifying health condition experienced changes in health and biopsychosocial functioning over time, including weight gain or loss. Specifically, this observational, longitudinal study evaluated changes in the body mass index (BMI) of adults with co-morbid obesity (body mass index [BMI] ≥ 30 kg/m2) and severe obesity (BMI ≥ 40 kg/m2) who were starting medical marijuana treatment for any of the 23 qualifying medical conditions at one of three dispensaries in Pennsylvania. Height and weight measurements were collected at baseline (prior to medical marijuana use) and then 90 days (± 14 days) later. Participants included in analyses (n = 52, M = 55.0 ± 13.6 years, 59.6% female) had a mean baseline BMI of 36.2 ± 5.4 kg/m2 and the majority sought medical marijuana for chronic pain (73.1%). No significant change in BMI was observed from baseline to month three (p > 0.05) in the sample. Additionally, no significant change in BMI was observed in the subset of patients with severe obesity (n = 12, p > 0.05). Our findings are limited by low follow-up rates and convenience sampling methodology but may help to mitigate weight gain concerns in the context of medical marijuana use.

很少有研究评估开始使用医用大麻治疗以解决诊断出的健康问题的患者的体重变化。本研究的目的是检查患者在符合条件的健康状况下开始使用医用大麻是否会随着时间的推移在健康和生物心理社会功能方面发生变化,包括体重增加或减少。具体来说,这项观察性纵向研究评估了在宾夕法尼亚州三家药房之一的23种符合条件的医疗条件中开始接受医用大麻治疗的成人共病肥胖(体重指数[BMI]≥30 kg/m2)和严重肥胖(BMI≥40 kg/m2)的体重指数(BMI)的变化。在基线(医用大麻使用前)和90天(±14天)后收集身高和体重测量。纳入分析的参与者(n = 52, M = 55.0±13.6岁,59.6%为女性)的平均基线BMI为36.2±5.4 kg/m2,大多数(73.1%)寻求医用大麻治疗慢性疼痛。从基线到第3个月,样本中BMI无显著变化(p > 0.05)。此外,重度肥胖患者亚组BMI无显著变化(n = 12, p > 0.05)。我们的研究结果受到低随访率和方便抽样方法的限制,但可能有助于减轻医用大麻使用背景下体重增加的担忧。
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引用次数: 0
Cannabidiol as a treatment for arthritis and joint pain: an exploratory cross-sectional study. 大麻二酚作为关节炎和关节疼痛的治疗:一项探索性横断面研究。
Pub Date : 2022-08-24 DOI: 10.1186/s42238-022-00154-9
Nicholas Frane, Erik Stapleton, Cesar Iturriaga, Maximillian Ganz, Vijay Rasquinha, Robert Duarte

Introduction: An estimated 54 million Americans currently suffer from debilitating arthritis. Patients who have exhausted conservative measures can be subject to chronic pain and resort to symptomatic management with anti-inflammatories, acetaminophen, and opioids. Cannabidiol (CBD) is a non-psychoactive cannabinoid that has shown promise in preclinical studies to reduce inflammation and pain associated with arthritis. The purpose of this study was to explore patient perceived effects of cannabidiol on symptoms of arthritis.

Methods: A novel anonymous questionnaire was created to evaluate perceived efficacy of cannabidiol for the treatment of arthritis. A self-selected convenience sample (N=428) was recruited through online methods including social media accounts and newsletters (The Arthritis Foundation and Savvy Cooperative) between May 5, 2020, and November 5, 2020. Statistical analysis was performed to determine differences between types of arthritis and improvements in quality-of-life symptoms. Furthermore, a regression analysis was performed to identify variables associated with decreasing or discontinuing other medications.

Results: CBD use was associated with improvements in pain (83%), physical function (66%), and sleep quality (66%). Subgroup analysis by diagnosis type (osteoarthritis, rheumatoid, or other autoimmune arthritis) found improvements among groups for physical function (P=0.013), favoring the osteoarthritis group. The overall cohort reported a 44% reduction in pain after CBD use (P<0.001). The osteoarthritis group had a greater percentage reduction (P=0.020) and point reduction (P<0.001) in pain compared to rheumatoid arthritis and other autoimmune arthritis. The majority of respondents reported a reduction or cessation of other medications after CBD use (N=259, 60.5%): reductions in anti-inflammatories (N=129, 31.1%), acetaminophen (N=78, 18.2%), opioids (N=36, 8.6%) and discontinuation of anti-inflammatories (N=76, 17.8%), acetaminophen (N=76, 17.8%), and opioids (N=81, 18.9%).

Conclusion: Clinicians and patients should be aware of the various alternative therapeutic options available to treat their symptoms of arthritis, especially in light of the increased accessibility to cannabidiol products. The present study found associations between CBD use and improvements in patient's arthritis symptoms and reductions in other medications. Future research should focus on exploring the benefits of CBD use in this patient population with clinical trials.

简介:目前估计有5400万美国人患有衰弱性关节炎。用尽保守措施的患者可能会出现慢性疼痛,并求助于抗炎药、对乙酰氨基酚和阿片类药物的症状管理。大麻二酚(CBD)是一种非精神活性大麻素,在临床前研究中显示出减少关节炎相关炎症和疼痛的希望。本研究的目的是探讨患者感知大麻二酚对关节炎症状的影响。方法:创建了一个新的匿名问卷来评估大麻二酚治疗关节炎的疗效。在2020年5月5日至2020年11月5日期间,通过社交媒体账户和时事通讯(The Arthritis Foundation和Savvy Cooperative)等在线方法招募了自选的便利样本(N=428)。进行统计分析以确定关节炎类型之间的差异和生活质量症状的改善。此外,进行回归分析以确定与减少或停止其他药物相关的变量。结果:CBD的使用与疼痛(83%)、身体功能(66%)和睡眠质量(66%)的改善有关。根据诊断类型(骨关节炎、类风湿或其他自身免疫性关节炎)进行的亚组分析发现,各组身体功能的改善(P=0.013)有利于骨关节炎组。整个队列报告说,使用CBD后疼痛减轻了44%(结论:临床医生和患者应该意识到治疗关节炎症状的各种替代治疗方案,特别是考虑到大麻二酚产品的可及性增加。目前的研究发现CBD的使用与患者关节炎症状的改善和其他药物的减少之间存在关联。未来的研究应侧重于通过临床试验探索在这一患者群体中使用CBD的益处。
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引用次数: 10
Cannabis consumption is associated with lower COVID-19 severity among hospitalized patients: a retrospective cohort analysis. 大麻消费与住院患者COVID-19严重程度较低相关:回顾性队列分析
Pub Date : 2022-08-05 DOI: 10.1186/s42238-022-00152-x
Carolyn M Shover, Peter Yan, Nicholas J Jackson, Russell G Buhr, Jennifer A Fulcher, Donald P Tashkin, Igor Barjaktarevic

Background: While cannabis is known to have immunomodulatory properties, the clinical consequences of its use on outcomes in COVID-19 have not been extensively evaluated. We aimed to assess whether cannabis users hospitalized for COVID-19 had improved outcomes compared to non-users.

Methods: We conducted a retrospective analysis of 1831 patients admitted to two medical centers in Southern California with a diagnosis of COVID-19. We evaluated outcomes including NIH COVID-19 Severity Score, need for supplemental oxygen, ICU (intensive care unit) admission, mechanical ventilation, length of hospitalization, and in-hospital death for cannabis users and non-users. Cannabis use was reported in the patient's social history. Propensity matching was used to account for differences in age, body-mass index, sex, race, tobacco smoking history, and comorbidities known to be risk factors for COVID-19 mortality between cannabis users and non-users.

Results: Of 1831 patients admitted with COVID-19, 69 patients reported active cannabis use (4% of the cohort). Active users were younger (44 years vs. 62 years, p < 0.001), less often diabetic (23.2% vs 37.2%, p < 0.021), and more frequently active tobacco smokers (20.3% vs. 4.1%, p < 0.001) compared to non-users. Notably, active users had lower levels of inflammatory markers upon admission than non-users-CRP (C-reactive protein) (3.7 mg/L vs 7.6 mg/L, p < 0.001), ferritin (282 μg/L vs 622 μg/L, p < 0.001), D-dimer (468 ng/mL vs 1140 ng/mL, p = 0.017), and procalcitonin (0.10 ng/mL vs 0.15 ng/mL, p = 0.001). Based on univariate analysis, cannabis users had significantly better outcomes compared to non-users as reflected in lower NIH scores (5.1 vs 6.0, p < 0.001), shorter hospitalization (4 days vs 6 days, p < 0.001), lower ICU admission rates (12% vs 31%, p < 0.001), and less need for mechanical ventilation (6% vs 17%, p = 0.027). Using propensity matching, differences in overall survival were not statistically significant between cannabis users and non-users, nevertheless ICU admission was 12 percentage points lower (p = 0.018) and intubation rates were 6 percentage points lower (p = 0.017) in cannabis users.

Conclusions: This retrospective cohort study suggests that active cannabis users hospitalized with COVID-19 had better clinical outcomes compared with non-users, including decreased need for ICU admission or mechanical ventilation. However, our results need to be interpreted with caution given the limitations of a retrospective analysis. Prospective and observational studies will better elucidate the effects cannabis use in COVID-19 patients.

背景:虽然已知大麻具有免疫调节特性,但其使用对COVID-19结局的临床后果尚未得到广泛评估。我们的目的是评估因COVID-19住院的大麻使用者与非使用者相比是否有改善的结果。方法:我们对南加州两家医疗中心确诊为COVID-19的1831例患者进行了回顾性分析。我们评估的结果包括NIH COVID-19严重程度评分、补充氧气需求、ICU(重症监护病房)入院、机械通气、住院时间以及大麻使用者和非大麻使用者的院内死亡。患者的社会史中有大麻使用记录。倾向匹配用于解释大麻使用者和非使用者之间年龄、体重指数、性别、种族、吸烟史和已知的COVID-19死亡率危险因素的合并症的差异。结果:在入院的1831名COVID-19患者中,69名患者报告了活跃的大麻使用(占队列的4%)。与非使用者相比,活跃使用者更年轻(44岁对62岁,p < 0.001),更少患糖尿病(23.2%对37.2%,p < 0.021),更频繁地吸烟(20.3%对4.1%,p < 0.001)。值得注意的是,活跃使用者入院时的炎症标志物水平低于非使用者- crp (c反应蛋白)(3.7 mg/L vs 7.6 mg/L, p < 0.001),铁蛋白(282 μg/L vs 622 μg/L, p < 0.001), d -二聚体(468 ng/mL vs 1140 ng/mL, p = 0.017)和降钙素原(0.10 ng/mL vs 0.15 ng/mL, p = 0.001)。基于单变量分析,大麻使用者的结果明显优于非使用者,体现在较低的NIH评分(5.1 vs 6.0, p < 0.001)、较短的住院时间(4天vs 6天,p < 0.001)、较低的ICU入院率(12% vs 31%, p < 0.001)和较少的机械通气需求(6% vs 17%, p = 0.027)。使用倾向匹配,大麻使用者和非大麻使用者的总生存率差异无统计学意义,但大麻使用者的ICU住院率低12个百分点(p = 0.018),插管率低6个百分点(p = 0.017)。结论:这项回顾性队列研究表明,与非使用者相比,因COVID-19住院的活跃大麻使用者的临床结果更好,包括ICU住院或机械通气的需求减少。然而,考虑到回顾性分析的局限性,我们的结果需要谨慎解释。前瞻性和观察性研究将更好地阐明大麻使用对COVID-19患者的影响。
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引用次数: 5
期刊
Journal of Cannabis Research
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