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Effect of Cannabistilbene I in Attenuating Angiotensin II-Induced Cardiac Hypertrophy: Insights into Cytochrome P450s and Arachidonic Acid Metabolites Modulation. 大麻芪 I 在减轻血管紧张素 II 诱导的心肌肥大中的作用:洞察细胞色素 P450s 和花生四烯酸代谢物的调节作用。
IF 3.1 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2025-04-01 Epub Date: 2024-09-26 DOI: 10.1089/can.2024.0148
Ahmad H Alammari, Fadumo Ahmed Isse, Conor O'Croinin, Neal M Davies, Ayman O S El-Kadi

Introduction: This research investigated the impact of Cannabistilbene I on Angiotensin II (Ang II)-induced cardiac hypertrophy and its potential role in cytochrome P450 (CYP) enzymes and arachidonic acid (AA) metabolic pathways. Cardiac hypertrophy, a response to increased stress on the heart, can lead to severe cardiovascular diseases if not managed effectively. CYP enzymes and AA metabolites play critical roles in cardiac function and hypertrophy, making them important targets for therapeutic intervention. Methods: Adult human ventricular cardiomyocyte cell line (AC16) was cultured and treated with Cannabistilbene I in the presence and absence of Ang II. The effects on mRNA expression related to cardiac hypertrophic markers and CYP were analyzed using real-time polymerase chain reaction, while CYP protein levels were measured by Western blot analysis. AA metabolites were quantified using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Results: Results showed that Ang II triggered hypertrophy, as evidenced by the increase in hypertrophic marker expression, and enlarged the cell surface area, effects that were alleviated by Cannabistilbene I. Gene expression analysis indicated that Cannabistilbene I upregulated CYP1A1, leading to increased enzymatic activity, as evidenced by 7-ethoxyresorufin-O-deethylase assay. Furthermore, LC-MS/MS analysis of AA metabolites revealed that Ang II elevated midchain (R/S)-hydroxyeicosatetraenoic acid (HETE) concentrations, which were reduced by Cannabistilbene I. Notably, Cannabistilbene I selectively increased 19(S)-HETE concentration and reversed the Ang II-induced decline in 19(S)-HETE, suggesting a unique protective role. Conclusion: This study provides new insights into the potential of Cannabistilbene I in modulating AA metabolites and reducing Ang II-induced cardiac hypertrophy, revealing a new candidate as a therapeutic agent for cardiac hypertrophy.

简介:这项研究调查了大麻二苯乙烯 I 对血管紧张素 II(Ang II)诱导的心脏肥大的影响,以及它在细胞色素 P450(CYP)酶和花生四烯酸(AA)代谢途径中的潜在作用。心脏肥大是心脏压力增加的一种反应,如果得不到有效控制,会导致严重的心血管疾病。CYP 酶和 AA 代谢产物在心脏功能和心肌肥大中起着关键作用,因此成为治疗干预的重要目标。研究方法培养成人心室心肌细胞系(AC16),并在有或没有 Ang II 的情况下用大麻双酚 I 处理。使用实时聚合酶链式反应分析其对心脏肥大标志物和 CYP 相关 mRNA 表达的影响,并通过 Western 印迹分析测定 CYP 蛋白水平。采用液相色谱-串联质谱法(LC-MS/MS)对 AA 代谢物进行定量。结果显示基因表达分析表明,Cannabistilbene I 上调了 CYP1A1,导致酶活性增加,这在 7-ethoxyresorufin-O-deethylase 检测中得到了证明。此外,LC-MS/MS 对 AA 代谢物的分析表明,Ang II 升高了中链(R/S)-羟基二十碳四烯酸(HETE)的浓度,而大麻二苯乙烯 I 则降低了这一浓度。值得注意的是,大麻二苯乙烯 I 选择性地增加了 19(S)-HETE 的浓度,并逆转了 Ang II 诱导的 19(S)-HETE 的下降,这表明它具有独特的保护作用。结论这项研究为了解大麻二苯乙烯 I 在调节 AA 代谢物和减轻 Ang II 诱导的心肌肥厚方面的潜力提供了新的视角,揭示了一种治疗心肌肥厚的新候选药物。
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引用次数: 0
Circulating Endocannabinoids Are Associated with Mental Alertness During Ultra-Endurance Exercise. 循环内源性大麻素与超耐力运动中的精神警觉性有关。
IF 3.1 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2025-04-01 Epub Date: 2024-12-27 DOI: 10.1089/can.2024.0169
Sebastiaan Dalle, Chiel Poffé, Wout Lauriks, Ruben Robberechts, Myrthe Stalmans, Romano Terrasi, Giulio G Muccioli, Katrien Koppo

Introduction: Ultra-endurance exercise events result in central fatigue, impacting on mental alertness and decision making. Endocannabinoids are typically elevated during endurance exercise and have been implicated in central processes such as learning and memory, but their role in central fatigue has never been studied. Materials and Methods: Twenty-four recreational male ultrarunners participated in a 100-km trail run, and 18 of them completed at least 60 km and were included in the analyses. A cognitive test battery to assess median reaction time (MRT) and median movement time during a reaction time task and median response latency during a rapid visual information processing task was completed prior to and immediately after the trail. Blood serum samples pre- and postexercise were analyzed for endocannabinoids and related lipids (anadamide: AEA; 2-arachidonoylglycerol: 2-AG; palmitoylethanolamide: PEA; oleoylethanolamide: OEA; stearoylethanolamine: SEA) via liquid chromatography-mass spectrometry. Results: Ultra-endurance exercise worsened all cognitive parameters and increased abundance of AEA, PEA, OEA, and SEA but not 2-AG. Interestingly, the exercise-induced change in MRT showed moderate, positive correlations with the change in different endocannabinoids, that is, AEA (r = 0.5164, p = 0.0338), PEA (r = 0.5466, p = 0.0251), and OEA (r = 0.5442, p = 0.0239). Conclusion: These results indicate a potential role of endocannabinoids on mental alertness following ultra-endurance exercise.

简介:超耐力运动项目导致中枢疲劳,影响精神警觉性和决策能力。内源性大麻素在耐力运动中通常会升高,并且与学习和记忆等中枢过程有关,但它们在中枢疲劳中的作用从未被研究过。材料与方法:24名娱乐性男性超跑者参加了100公里越野跑,其中18人至少跑了60公里,并被纳入分析。在实验前后分别进行认知测试,以评估快速视觉信息处理任务中的中位反应时间(MRT)和中位运动时间以及中位反应延迟。对运动前后的血清样本进行内源性大麻素及相关脂质(阿纳达胺:AEA;2-arachidonoylglycerol: 2-AG;palmitoylethanolamide:豌豆;oleoylethanolamide: OEA;脂酰乙醇胺(SEA),液相色谱-质谱联用。结果:超耐力运动使所有认知参数恶化,AEA、PEA、OEA和SEA的丰富度增加,但2-AG没有增加。有趣的是,运动引起的MRT变化与不同内源性大麻素的变化呈中度正相关,即AEA (r = 0.5164, p = 0.0338)、PEA (r = 0.5466, p = 0.0251)和OEA (r = 0.5442, p = 0.0239)。结论:这些结果提示内源性大麻素对超耐力运动后精神警觉性的潜在作用。
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引用次数: 0
SGIP1 Deletion in Mice Attenuates Mechanical Hypersensitivity Elicited by Inflammation. 小鼠缺失 SGIP1 可减轻炎症引起的机械超敏反应。
IF 3.1 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2025-04-01 Epub Date: 2024-07-09 DOI: 10.1089/can.2024.0020
Oleh Durydivka, Martin Kuchar, Jaroslav Blahos

Background: Activation of cannabinoid receptor 1 (CB1R) in the nervous system modulates the processing of acute and chronic pain. CB1R activity is regulated by desensitization and internalization. SH3-containing GRB2-like protein 3-interacting protein 1 (SGIP1) inhibits the internalization of CB1R. This causes increased and prolonged association of the desensitized receptor with G protein-coupled receptor kinase 3 (GRK3) and beta-arrestin on the cell membrane and results in decreased activation of extracellular signal-regulated kinase 1/2 (ERK1/2) pathway. Genetic deletion of SGIP1 in mice leads to altered CB1R-related functions, such as decreased anxiety-like behaviors, modified cannabinoid tetrad behaviors, reduced acute nociception, and increased sensitivity to analgesics. In this work, we asked if deletion of SGIP1 affects chronic nociception and analgesic effect of Δ9-tetrahydrocannabinol (THC) and WIN 55,212-2 (WIN) in mice. Methods: We measured tactile responses of hind paws to increasing pressure in wild-type and SGIP1 knock-out mice. Inflammation in the paw was induced by local injection of carrageenan. To determine the mechanical sensitivity, the paw withdrawal threshold (PWT) was measured using an electronic von Frey instrument with the progression of the applied force. Results: The responses to mechanical stimuli varied depending on the sex, genotype, and treatment. SGIP1 knock-out male mice exhibited lower PWT than wild-type males. On the contrary, the female mice exhibited comparable PWT. Following THC or WIN treatment in male mice, SGIP1 knock-out males exhibited PWT lower than wild-type males. THC treatment in SGIP1 knock-out females resulted in PWT higher than after THC treatment of wild-type females. However, SGIP1 knock-out and wild-type female mice exhibited similar PWT after WIN treatment. Conclusions: We provide evidence that SGIP1, possibly by interacting with CB1R, is involved in processing the responses to chronic pain. The absence of SGIP1 results in enhanced sensitivity to mechanical stimuli in males, but not females. The antinociceptive effect of THC is superior to that of WIN in SGIP1 knock-out mice in the carrageenan-induced model of chronic pain.

背景:激活神经系统中的大麻素受体 1(CB1R)可调节急性和慢性疼痛的处理过程。CB1R 的活性受脱敏和内化调节。含 SH3 的类 GRB2 蛋白 3 交互蛋白 1(SGIP1)可抑制 CB1R 的内化。这导致脱敏后的受体与细胞膜上的 G 蛋白偶联受体激酶 3(GRK3)和β-arrestin 的结合增加并延长,并导致细胞外信号调节激酶 1/2(ERK1/2)通路的激活减少。小鼠遗传性缺失 SGIP1 会导致 CB1R 相关功能的改变,如焦虑样行为减少、大麻素四分体行为改变、急性痛觉减弱以及对镇痛剂的敏感性增加。在这项研究中,我们想知道 SGIP1 的缺失是否会影响小鼠的慢性痛觉以及 Δ9-四氢大麻酚(THC)和 WIN 55,212-2 (WIN)的镇痛效果。研究方法我们测量了野生型小鼠和 SGIP1 基因敲除小鼠后爪对压力增加的触觉反应。通过局部注射卡拉胶诱发小鼠爪部炎症。为了确定小鼠的机械敏感性,我们使用冯-弗雷(von Frey)电子仪器测量了小鼠爪子的退缩阈值(PWT),并测量了施加力的递增。结果显示动物对机械刺激的反应因性别、基因型和治疗方法而异。敲除 SGIP1 的雄性小鼠的 PWT 低于野生型雄性小鼠。相反,雌性小鼠的脉搏波速度相当。雄性小鼠经 THC 或 WIN 处理后,SGIP1 基因敲除雄性小鼠的脉搏波速度低于野生型雄性小鼠。对 SGIP1 基因敲除雌性小鼠进行 THC 处理后,其脉搏波速度高于对野生型雌性小鼠进行 THC 处理后的脉搏波速度。然而,SGIP1 基因敲除雌性小鼠和野生型雌性小鼠在 WIN 处理后表现出相似的脉搏波速度。结论我们提供的证据表明,SGIP1 可能通过与 CB1R 相互作用,参与处理对慢性疼痛的反应。SGIP1 的缺失会导致雄性小鼠对机械刺激的敏感性增强,而雌性小鼠则不会。在角叉菜胶诱导的慢性疼痛模型中,THC 对 SGIP1 基因敲除小鼠的抗痛觉作用优于 WIN。
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引用次数: 0
Letter to the Editor: Response to Dr. Mousavi's Comments on Ogunsola et al.
IF 3.1 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2025-04-01 Epub Date: 2025-03-10 DOI: 10.1089/can.2025.0008
Ayobami S Ogunsola, Samuel Smith, Eniola A Olatunji, Mercy C Udeh, Ibraheem M Karaye
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引用次数: 0
Commercial Cannabidiol for Community-Based Young Adolescents: Predicting Medicinal Use. 针对社区青少年的商业大麻二酚:预测医疗用途。
IF 3.1 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2025-04-01 Epub Date: 2024-05-07 DOI: 10.1089/can.2024.0015
Natasha E Wade, Tam T Nguyen-Louie, Alexander L Wallace, Ryan M Sullivan, Susan F Tapert

Objectives: Cannabidiol (CBD) is rising in popularity, including as a potential medicinal product. Yet data on use of commercial CBD for medicinal or health reasons in adolescents are lacking. In this study we aim to detail characteristics of adolescents given commercial CBD for health reasons (health CBD [hCBD]) and to investigate predictors of use. Materials and Methods: The Adolescent Brain Cognitive Development (ABCD) Study is a population-based cohort study following U.S. healthy, community-based adolescents annually, with data from 2018 to 2022 (11- to 15-year-olds; N=11,189). Participants and caregivers completed questionnaires, including whether adolescents were given CBD with parent or doctor's permission. Participants reported past-month pain, attention problems, externalizing symptoms, internalizing symptoms, and total mental health problems. Caregivers reported youth sociodemographics, sleep problems, whether the youth had mental health treatment or sought medical treatment, and rules about recreational cannabis use. We describe youth given hCBD, and run generalized estimating equations predicting odd ratios (ORs) and 95% confidence intervals of adolescents given hCBD by mental health, physical health, or sociodemographics of factors. Results: Of the 11,189 participants across up to three waves of data, 48% were female. Mean age across waves was 12.8 years old (SD=1). In total, 307 (2.8%) were given hCBD. Common administration methods were oil (42%), topical (31%), and edibles (29%). Increased hCBD odds were associated with being older (OR=1.32 [1.17-1.49]), White (relative to Black, OR=05.97 [2.81-12.65] or Hispanic, OR=1.82 [1.17-2.82]), parents with some college (relative to no high school diploma, OR=3.55 [1.09-11.6]), internalizing symptoms (OR=1.81 [1.13-2.91]), mental health treatment (OR=1.76 [1.3-2.38]), pain (OR=1.38 [1.09-1.76]), medical treatment (OR=1.39 [1.08-1.79]), and sleep problems (OR=1.69 [1.27-2.25]). Rules against recreational cannabis decreased odds of hCBD (OR=1.75 [1.30-2.36]). Conclusions: Findings indicate some healthy adolescents are given hCBD, and predictors of use include mental and physical health concerns, being White, older, and parents with some college education. Providers should ask if their youth patients are being given CBD medicinally, and transparently discuss potential benefits, consequences, and unknowns of CBD.

目的:大麻二酚(CBD)越来越受欢迎,包括作为一种潜在的药用产品。然而,目前还缺乏有关青少年因医疗或健康原因使用商用 CBD 的数据。在这项研究中,我们旨在详细了解因健康原因而服用商用 CBD(健康 CBD [hCBD])的青少年的特征,并调查使用的预测因素。材料和方法:青少年脑认知发展(ABCD)研究是一项基于人群的队列研究,每年对美国健康的社区青少年进行跟踪调查,数据时间为 2018 年至 2022 年(11 至 15 岁;N=11189)。参与者和照顾者填写了调查问卷,包括青少年是否在家长或医生允许下服用 CBD。参与者报告了过去一个月的疼痛、注意力问题、外化症状、内化症状和全部心理健康问题。照护者报告了青少年的社会人口统计学特征、睡眠问题、青少年是否接受过心理健康治疗或寻求过医疗治疗以及关于娱乐性使用大麻的规定。我们描述了服用 hCBD 的青少年的情况,并通过广义估计方程预测了服用 hCBD 的青少年在心理健康、身体健康或社会人口统计学因素方面的奇数比 (OR) 和 95% 的置信区间。研究结果在多达三波数据的 11,189 名参与者中,48% 为女性。各次数据的平均年龄为 12.8 岁(SD=1)。共有 307 人(2.8%)服用了 hCBD。常见的给药方法有精油(42%)、外用药(31%)和食用药(29%)。年龄较大(OR=1.32 [1.17-1.49])、白人(相对于黑人,OR=05.97 [2.81-12.65]或西班牙裔,OR=1.82 [1.17-2.82])、父母有一些大学学历(相对于没有高中文凭,OR=3.55[1.09-11.6])、内化症状(OR=1.81[1.13-2.91])、心理健康治疗(OR=1.76[1.3-2.38])、疼痛(OR=1.38[1.09-1.76])、医疗(OR=1.39[1.08-1.79])和睡眠问题(OR=1.69[1.27-2.25])。禁止娱乐性吸食大麻的规定降低了患 hCBD 的几率(OR=1.75 [1.30-2.36])。结论:研究结果表明,一些健康的青少年会吸食大麻,吸食大麻的预测因素包括身心健康问题、白人、年龄较大以及父母受过一定的大学教育。医疗服务提供者应询问他们的青少年患者是否正在服用 CBD,并以透明的方式讨论 CBD 的潜在益处、后果和未知因素。
{"title":"Commercial Cannabidiol for Community-Based Young Adolescents: Predicting Medicinal Use.","authors":"Natasha E Wade, Tam T Nguyen-Louie, Alexander L Wallace, Ryan M Sullivan, Susan F Tapert","doi":"10.1089/can.2024.0015","DOIUrl":"10.1089/can.2024.0015","url":null,"abstract":"<p><p><b>Objectives:</b> Cannabidiol (CBD) is rising in popularity, including as a potential medicinal product. Yet data on use of commercial CBD for medicinal or health reasons in adolescents are lacking. In this study we aim to detail characteristics of adolescents given commercial CBD for health reasons (health CBD [hCBD]) and to investigate predictors of use. <b>Materials and Methods:</b> The Adolescent Brain Cognitive Development (ABCD) Study is a population-based cohort study following U.S. healthy, community-based adolescents annually, with data from 2018 to 2022 (11- to 15-year-olds; <i>N</i>=11,189). Participants and caregivers completed questionnaires, including whether adolescents were given CBD with parent or doctor's permission. Participants reported past-month pain, attention problems, externalizing symptoms, internalizing symptoms, and total mental health problems. Caregivers reported youth sociodemographics, sleep problems, whether the youth had mental health treatment or sought medical treatment, and rules about recreational cannabis use. We describe youth given hCBD, and run generalized estimating equations predicting odd ratios (ORs) and 95% confidence intervals of adolescents given hCBD by mental health, physical health, or sociodemographics of factors. <b>Results:</b> Of the 11,189 participants across up to three waves of data, 48% were female. Mean age across waves was 12.8 years old (SD=1). In total, 307 (2.8%) were given hCBD. Common administration methods were oil (42%), topical (31%), and edibles (29%). Increased hCBD odds were associated with being older (OR=1.32 [1.17-1.49]), White (relative to Black, OR=05.97 [2.81-12.65] or Hispanic, OR=1.82 [1.17-2.82]), parents with some college (relative to no high school diploma, OR=3.55 [1.09-11.6]), internalizing symptoms (OR=1.81 [1.13-2.91]), mental health treatment (OR=1.76 [1.3-2.38]), pain (OR=1.38 [1.09-1.76]), medical treatment (OR=1.39 [1.08-1.79]), and sleep problems (OR=1.69 [1.27-2.25]). Rules against recreational cannabis decreased odds of hCBD (OR=1.75 [1.30-2.36]). <b>Conclusions:</b> Findings indicate some healthy adolescents are given hCBD, and predictors of use include mental and physical health concerns, being White, older, and parents with some college education. Providers should ask if their youth patients are being given CBD medicinally, and transparently discuss potential benefits, consequences, and unknowns of CBD.</p>","PeriodicalId":9386,"journal":{"name":"Cannabis and Cannabinoid Research","volume":" ","pages":"e353-e361"},"PeriodicalIF":3.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141075454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Health Care Providers' Knowledge, Attitudes, and Practices Toward Medicinal Cannabis: The Case of Lebanon.
IF 3.1 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2025-04-01 Epub Date: 2024-06-19 DOI: 10.1089/can.2024.0013
Bassima Hazimeh, Ibrahim Bou-Orm, Mohamad Mroueh, Walid Ammar

Background: In 2020, the Lebanese parliament legalized cannabis for medical and industrial use, sparking diverse reactions among health care professionals (HCP). Few studies have been conducted to reflect the position of HCP on the topic, and no previous studies targeted all physicians with relevant specialties or had a large sample size. The current study aimed to assess the knowledge, attitude, and practice of the Lebanese medical community toward medicinal cannabis (MC). Methods: A cross-sectional study was conducted targeting HCP from different backgrounds and specialties. The survey questionnaire was disseminated through different scientific societies in the Lebanese Order of Physicians and other professional bodies. An online survey was shared with oncologists, rheumatologists, psychiatrists, neurologists, pharmacists, and psychotherapists across different geographic regions. It covered questions about sociodemographic details, knowledge, attitude, and practice related to MC. Descriptive and bivariate analyses were performed. A total of 202 HCP responded to the survey, yielding a response rate of 34%. Results: Eighteen percent of the participants described their level of knowledge about the indications of MC as good. Twenty-five percent of the respondents are willing to prescribe, and 30% "may consider" it. Among those willing to prescribe, the majority may consider MC to treat chronic pain, palliative care, post-traumatic stress disorder, epilepsy, and anxiety. Respondents' knowledge about the side effects of MC is as follows: driving difficulties (82%), addiction (69%), drug interactions (65%), and weight gain (43%). Willingness to prescribe varies by medical specialty, previous clinical experience with MC, and gender. The majority of the participants expressed concerns about the potential harm of using MC and indicated that legalization would negatively impact society. Sixty-nine percent of the respondents reported not receiving any formal education about MC and agreed on the need to expand knowledge about its indications and side effects. The majority agreed that MC should be dispensed based on a prescription from a physician with special training and recognized the importance of establishing a national registry for patients undergoing MC treatment, as well as the necessity of guidelines for approval. Conclusion: The current data indicate that attitudes toward prescribing MC vary by medical specialty, gender, and clinical experience. Implementation of effective educational strategies in Lebanon to enhance HCP knowledge about MC and promote its proper use is crucial.

{"title":"Health Care Providers' Knowledge, Attitudes, and Practices Toward Medicinal Cannabis: The Case of Lebanon.","authors":"Bassima Hazimeh, Ibrahim Bou-Orm, Mohamad Mroueh, Walid Ammar","doi":"10.1089/can.2024.0013","DOIUrl":"https://doi.org/10.1089/can.2024.0013","url":null,"abstract":"<p><p><b>Background:</b> In 2020, the Lebanese parliament legalized cannabis for medical and industrial use, sparking diverse reactions among health care professionals (HCP). Few studies have been conducted to reflect the position of HCP on the topic, and no previous studies targeted all physicians with relevant specialties or had a large sample size. The current study aimed to assess the knowledge, attitude, and practice of the Lebanese medical community toward medicinal cannabis (MC). <b>Methods:</b> A cross-sectional study was conducted targeting HCP from different backgrounds and specialties. The survey questionnaire was disseminated through different scientific societies in the Lebanese Order of Physicians and other professional bodies. An online survey was shared with oncologists, rheumatologists, psychiatrists, neurologists, pharmacists, and psychotherapists across different geographic regions. It covered questions about sociodemographic details, knowledge, attitude, and practice related to MC. Descriptive and bivariate analyses were performed. A total of 202 HCP responded to the survey, yielding a response rate of 34%. <b>Results:</b> Eighteen percent of the participants described their level of knowledge about the indications of MC as good. Twenty-five percent of the respondents are willing to prescribe, and 30% \"may consider\" it. Among those willing to prescribe, the majority may consider MC to treat chronic pain, palliative care, post-traumatic stress disorder, epilepsy, and anxiety. Respondents' knowledge about the side effects of MC is as follows: driving difficulties (82%), addiction (69%), drug interactions (65%), and weight gain (43%). Willingness to prescribe varies by medical specialty, previous clinical experience with MC, and gender. The majority of the participants expressed concerns about the potential harm of using MC and indicated that legalization would negatively impact society. Sixty-nine percent of the respondents reported not receiving any formal education about MC and agreed on the need to expand knowledge about its indications and side effects. The majority agreed that MC should be dispensed based on a prescription from a physician with special training and recognized the importance of establishing a national registry for patients undergoing MC treatment, as well as the necessity of guidelines for approval. <b>Conclusion:</b> The current data indicate that attitudes toward prescribing MC vary by medical specialty, gender, and clinical experience. Implementation of effective educational strategies in Lebanon to enhance HCP knowledge about MC and promote its proper use is crucial.</p>","PeriodicalId":9386,"journal":{"name":"Cannabis and Cannabinoid Research","volume":"10 2","pages":"e362-e370"},"PeriodicalIF":3.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Kratom Alkaloids, Cannabinoids, and Chronic Pain: Basis of Potential Utility and Role in Therapy. 苦藤生物碱、大麻素和慢性疼痛:潜在效用和治疗作用的基础。
IF 3.1 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2025-04-01 Epub Date: 2023-07-19 DOI: 10.1089/can.2023.0064
Daniel J Farkas, Ziva D Cooper, Laila N Heydari, Amanda C Hughes, Scott M Rawls, Sara Jane Ward

Introduction: Chronic neuropathic pain is as a severe detriment to overall quality of life for millions of Americans. Current pharmacological treatment options for chronic neuropathic pain are generally limited in efficacy and may pose serious adverse effects such as risk of abuse, nausea, dizziness, and cardiovascular events. Therefore, many individuals have resorted to methods of pharmacological self-treatment. This narrative review summarizes the existing literature on the utilization of two novel approaches for the treatment of chronic pain, cannabinoid constituents of Cannabis sativa and alkaloid constituents of Mitragyna speciosa (kratom), and speculates on the potential therapeutic benefits of co-administration of these two classes of compounds. Methods: We conducted a narrative review summarizing the primary motivations for use of both kratom and cannabis products based on epidemiological data and summarize the pre-clinical evidence supporting the application of both kratom alkaloids and cannabinoids for the treatment of chronic pain. Data collection was performed using the PubMed electronic database. The following word combinations were used: kratom and cannabis, kratom and pain, cannabis and pain, kratom and chronic pain, and cannabis and chronic pain. Results: Epidemiological evidence reports that the self-treatment of pain is a primary motivator for use of both kratom and cannabinoid products among adult Americans. Further evidence shows that use of cannabinoid products may precede kratom use, and that a subset of individuals concurrently uses both kratom and cannabinoid products. Despite its growing popularity as a form of self-treatment of pain, there remains an immense gap in knowledge of the therapeutic efficacy of kratom alkaloids for chronic pain in comparison to that of cannabis-based products, with only three pre-clinical studies having been conducted to date. Conclusion: There is sufficient epidemiological evidence to suggest that both kratom and cannabis products are used to self-treat pain, and that some individuals actively use both drugs, which may produce potential additive or synergistic therapeutic benefits that have not yet been characterized. Given the lack of pre-clinical investigation into the potential therapeutic benefits of kratom alkaloids against forms of chronic pain, further research is warranted to better understand its application as a treatment alternative.

慢性神经性疼痛严重损害了数百万美国人的整体生活质量。目前慢性神经性疼痛的药物治疗方案通常疗效有限,并可能造成严重的不良反应,如滥用、恶心、头晕和心血管事件的风险。因此,许多人都采取了药物自我治疗的方法。本文综述了现有文献对两种治疗慢性疼痛的新方法的利用,大麻的大麻素成分和米特拉基纳(kratom)的生物碱成分,并推测了这两类化合物共同使用的潜在治疗益处。方法:基于流行病学数据,我们进行了一项叙述性综述,总结了使用克拉托姆和大麻产品的主要动机,并总结了支持克拉托姆生物碱和大麻素用于治疗慢性疼痛的临床前证据。使用PubMed电子数据库进行数据收集。使用了以下单词组合:kratom和大麻,kratom和疼痛,大麻和疼痛,kratom和慢性疼痛,大麻和慢性疼痛。结果:流行病学证据报告,疼痛的自我治疗是美国成年人使用克拉托姆和大麻素产品的主要动机。进一步的证据表明,大麻素产品的使用可能先于kratom使用,并且一部分人同时使用kratom和大麻素产品。尽管它作为一种自我治疗疼痛的形式越来越受欢迎,但与基于大麻的产品相比,克拉托姆生物碱对慢性疼痛的治疗效果的知识仍然存在巨大差距,迄今为止只进行了三次临床前研究。结论:有足够的流行病学证据表明,kratom和大麻产品都用于自我治疗疼痛,并且一些个体积极使用这两种药物,可能产生潜在的附加或协同治疗益处,尚未被描述。鉴于缺乏临床前研究对克拉通生物碱对慢性疼痛的潜在治疗益处,进一步的研究是必要的,以更好地了解其作为一种治疗选择的应用。
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引用次数: 0
Absence of Evidence for Sustained Effects of Daily Cannabidiol Administration on Anandamide Plasma Concentration in Individuals with Cocaine Use Disorder: Exploratory Findings from a Randomized Controlled Trial. 没有证据表明每日服用大麻二酚对可卡因使用障碍患者的苯甲酰胺血浆浓度有持续影响:一项随机对照试验的探索性发现。
IF 3.1 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2025-04-01 Epub Date: 2024-05-21 DOI: 10.1089/can.2023.0273
Francois-Olivier Hebert, Violaine Mongeau-Pérusse, Elie Rizkallah, Amani Mahroug, Hamzah Bakouni, Florence Morissette, Suzanne Brissette, Julie Bruneau, Simon Dubreucq, Didier Jutras-Aswad

Background: Cannabidiol (CBD) has been proposed to have a therapeutic potential over a wide range of neuropsychiatric disorders, including substance use disorders. Pre-clinical evidence suggests that CBD can increase anandamide (AEA) plasma concentration, possibly mediating some of its therapeutic properties. Whether CBD exerts such an effect on AEA in individuals with cocaine use disorder (CUD) remains unknown. Aims: To explore the sustained effects of daily CBD administration on AEA plasma concentrations compared with placebo in CUD. Methods: We used data from a randomized, double-blind, placebo-controlled trial evaluating CBD's efficacy in CUD. Seventy-eight individuals were randomized to receive a daily oral dose of 800 mg CBD (n = 40) or a placebo (n = 38). Participants stayed in an inpatient detoxification setting for 10 days, after which they were followed in an outpatient setting for 12 weeks. AEA plasma concentration was measured at baseline and at 23-h post CBD ingestion on day 8 and week 4. A generalized estimating equation model was used to assess CBD's effects on AEA, and sensitivity analyses were computed using Bayesian linear regressions. Results: Sixty-four participants were included in the analysis. Similar mean AEA plasma concentrations in both treatment groups (p = 0.357) were observed. At day 8, mean AEA plasma concentrations (± standard deviation) were 0.26 (± 0.07) ng/mL in the CBD group and 0.29 (± 0.08) ng/mL in the placebo group (p = 0.832; Bayes factor [BF] = 0.190). At week 4, they were 0.27 (± 0.09) ng/mL in the CBD group and 0.30 (± 0.09) ng/mL in the placebo group (p = 0.181; BF = 0.194). Conclusion: While not excluding any potential acute and short-term effect, daily CBD administration did not exert a sustained impact on AEA plasma concentrations in individuals with CUD compared with placebo. Registration: clinicaltrials.gov (NCT02559167).

背景:大麻二酚(CBD)被认为对包括药物使用障碍在内的多种神经精神疾病具有治疗潜力。临床前证据表明,大麻二酚可提高雄酰胺(AEA)的血浆浓度,这可能是其某些治疗特性的介导因素。CBD 是否会对可卡因使用障碍(CUD)患者的 AEA 产生这种影响,目前仍不得而知。目的:与安慰剂相比,探讨每日服用 CBD 对 CUD 患者 AEA 血浆浓度的持续影响。方法我们使用了一项评估 CBD 对 CUD 疗效的随机、双盲、安慰剂对照试验的数据。78 人被随机分配到每天口服 800 毫克 CBD(40 人)或安慰剂(38 人)。参试者在住院戒毒环境中住院 10 天,之后在门诊环境中随访 12 周。第 8 天和第 4 周,分别在基线和摄入 CBD 后 23 小时测量 AEA 血浆浓度。使用广义估计方程模型评估 CBD 对 AEA 的影响,并使用贝叶斯线性回归计算敏感性分析。研究结果64名参与者参与了分析。观察到两个治疗组的平均 AEA 血浆浓度相似(p = 0.357)。在第 8 天,CBD 组的平均 AEA 血浆浓度(± 标准偏差)为 0.26(± 0.07)纳克/毫升,安慰剂组为 0.29(± 0.08)纳克/毫升(p = 0.832;贝叶斯因子 [BF] = 0.190)。第 4 周时,CBD 组为 0.27(± 0.09)纳克/毫升,安慰剂组为 0.30(± 0.09)纳克/毫升(p = 0.181;贝叶斯因子 = 0.194)。结论:虽然不排除任何潜在的急性和短期效应,但与安慰剂相比,每天服用 CBD 不会对 CUD 患者的 AEA 血浆浓度产生持续影响。注册:clinicaltrials.gov (NCT02559167)。
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引用次数: 0
Legalization of Smokable Medical Cannabis and Changes in the Dispensed Amount of Δ-9 Tetrahydrocannabinol Per Patient. 可吸食医用大麻的合法化与每位患者获得的 Δ-9 四氢大麻酚配药量的变化。
IF 3.1 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2025-04-01 Epub Date: 2024-10-07 DOI: 10.1089/can.2024.0073
Sebastian Jugl, Ruba Sajdeya, Melanie Buhlmann, Robert L Cook, Joshua D Brown, Almut G Winterstein, Amie J Goodin

Introduction: Florida's medical cannabis (marijuana) program is among the largest in the United States. Smokable cannabis forms were not legally available in this program until 2019, and five years after other forms of cannabis were available. This study assessed changes in Δ-9 tetrahydrocannabinol (THC) dispensed per patient following legalization of smokable cannabis in Florida. Materials and Methods: This quasi-experimental study used data from the Florida Department of Health Office of Medical Marijuana Use Reports on THC dispensing from April 6, 2018, through March 13, 2020. Certified medical cannabis user during the study period was included. The exposure was the dispensed amount of THC from legalized smokable forms of medical cannabis (statute identified as SB182), effective as of March 2019. Changes in level and trend of average milligram (mg) of dispensed THC per certified patient with 95% confidence intervals (CIs), before and after SB182, were calculated by fitting a generalized least squares linear model and allowing a 17-week phase-in period. Results: The number of certified patients increased by 24.8% from 197,107 (March 22, 2019) to 246,079 (July 19, 2019) and to 325,868 by March 13, 2020. Assuming that a 20% THC concentration in smokable products, there was a significant level increase in the mean weekly dispensed THC amount per certified patient of 138.45 mg (95% CI: 102.69-174.20), translating to a 42.18% increase (95% CI: 33.14-50.28), from the pre-policy period. We noted a continuous increase of 5.62 mg per certified patient per week (95% CI: 4.35-6.89) throughout the 35 weeks following the policy, when compared with the period before. Assuming 10% THC concentration in smokable products, we observed a significant level increase of 35.10 mg (95% CI: 5.31-64.88), corresponding to an increase of 10.70% (95% CI: 1.70-18.89), and a trend increase of 2.23 mg per certified patient per week (95% CI: 1.18-3.29). Discussion: The expansion of the Florida medical cannabis program to include smokable cannabis forms was associated with a significant increase in the mean amount of weekly dispensed THC per certified patient. Findings suggest that the dispensed amount of THC after legalization of smokable medical cannabis far exceeds the maximum recommended daily dose, based on extrapolation from oral cannabis product dosing recommendations from one expert consensus statement, raising questions about the safety, and need for consumer education.

导言:佛罗里达州的医用大麻(大麻)计划是美国最大的大麻计划之一。可吸食大麻直到 2019 年才在该计划中合法供应,比其他形式的大麻供应晚了五年。本研究评估了佛罗里达州可吸食大麻合法化后每位患者所配发的 Δ-9 四氢大麻酚 (THC) 的变化情况。材料和方法:这项准实验研究使用的数据来自佛罗里达州卫生部医用大麻使用办公室关于 2018 年 4 月 6 日至 2020 年 3 月 13 日期间四氢大麻酚配药情况的报告。研究对象包括在研究期间获得认证的医用大麻使用者。暴露量是自 2019 年 3 月起生效的合法化可吸食医用大麻(法规名称为 SB182)的四氢大麻酚配给量。通过拟合广义最小二乘法线性模型并允许 17 周的逐步适应期,计算出 SB182 之前和之后每位认证患者平均配发四氢大麻酚毫克 (mg) 的水平和趋势变化以及 95% 的置信区间 (CI)。结果显示获得认证的患者人数增加了 24.8%,从 197107 人(2019 年 3 月 22 日)增加到 246079 人(2019 年 7 月 19 日),到 2020 年 3 月 13 日增加到 325868 人。假设可吸食产品中的四氢大麻酚浓度为 20%,那么每位认证患者每周平均配发的四氢大麻酚数量将显著增加 138.45 毫克(95% CI:102.69-174.20),与政策实施前相比增加 42.18%(95% CI:33.14-50.28)。我们注意到,与政策实施前相比,在政策实施后的 35 周内,每名认证患者每周吸食量持续增加了 5.62 毫克(95% CI:4.35-6.89)。假定可吸入产品中的四氢大麻酚浓度为 10%,我们观察到显著水平增加了 35.10 毫克(95% CI:5.31-64.88),相当于增加了 10.70%(95% CI:1.70-18.89),每名认证患者每周增加 2.23 毫克(95% CI:1.18-3.29)。讨论:佛罗里达州医用大麻计划扩大到包括可吸食大麻形式,这与每位认证患者每周四氢大麻酚平均配给量的显著增加有关。研究结果表明,根据一份专家共识声明中对口服大麻产品剂量建议的推断,可吸入医用大麻合法化后的四氢大麻酚配给量远远超过了每日最大推荐剂量,从而引发了安全性问题以及消费者教育的必要性。
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引用次数: 0
Recent Cannabis Use and Accelerometer-Measured Physical Activity and Sedentary Behavior Among Young-to-Midlife Adults: An Analysis of the National Health and Nutrition Examination Survey from 2011 to 2014. 近期吸食大麻与加速计测量的中青年体力活动和久坐行为:2011年至2014年全国健康与营养调查分析》。
IF 3.1 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2025-04-01 Epub Date: 2024-05-13 DOI: 10.1089/can.2023.0244
Yuanxin Xue, Calvin Diep, Heather J Zhao, Duminda N Wijeysundera, Hance Clarke, Karim S Ladha

Introduction: Cannabis use has been associated with reduced physical activity and increased sedentary behavior in adolescents. In adults, however, there is no conclusive evidence of such an association, and existing studies have primarily relied on self-reported activity measures. As cannabis use increases globally, a deeper understanding of its relationship with activity levels may inform clinical counseling and guidelines. This study investigated the association between recent cannabis use and accelerometer-measured activity. Methods: Data were obtained from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2014. We included adults in the United States who responded to a cannabis questionnaire and had at least 4 days of activity data from an ActiGraph GT3X+ accelerometer, which comprised participants from 18 to 59 years. The primary exposure was any self-reported cannabis use in the past 30 days. The primary outcome was daily sedentary time and secondary outcomes were daily light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA). Analyses were performed with multivariable quasi-Poisson regression models. Results: Of 4666 included adults, 658 (14.1%) reported recent cannabis use. After covariate adjustment, recent cannabis use was not associated with daily sedentary time (adjusted incidence rate ratio [aIRR] 0.99, 95% confidence interval [CI]: 0.98-1.01) or daily MVPA time (aIRR 1.01, 95% CI: 0.98-1.04). Daily LPA time was 4% greater with recent cannabis use (aIRR 1.04, 95% CI: 1.01-1.06). Conclusion: Recent cannabis use in young to midlife adults was not associated with accelerometer-measured sedentary or MVPA time, but it was associated with a marginal increase in LPA time of unclear clinical significance. Our findings provide evidence against existing concerns that cannabis use independently promotes sedentary behavior and decreases physical activity. Future prospective studies are needed to determine if these findings generalize to specific populations using cannabis including chronic pain patients.

导言:在青少年中,吸食大麻与体力活动减少和久坐行为增加有关。但在成人中,还没有确凿的证据表明这种关联,现有的研究主要依赖于自我报告的活动量。随着大麻使用在全球范围内的增加,深入了解其与活动量之间的关系可为临床咨询和指导提供参考。本研究调查了近期使用大麻与加速计测量的活动量之间的关系。研究方法数据来自 2011 年至 2014 年的美国国家健康与营养调查(NHANES)。我们纳入了回答过大麻问卷并拥有 ActiGraph GT3X+ 加速计提供的至少 4 天活动数据的美国成年人,其中包括 18 至 59 岁的参与者。主要暴露是过去 30 天内任何自我报告的大麻使用情况。主要结果是每日久坐时间,次要结果是每日轻体力活动(LPA)和中到剧烈体力活动(MVPA)。分析采用多变量准泊松回归模型进行。结果显示在所纳入的 4666 名成年人中,有 658 人(14.1%)报告近期吸食过大麻。经过协变量调整后,近期吸食大麻与每日久坐时间无关(调整后发病率比 [aIRR] 0.99,95% 置信区间 [CI]:0.98-1.01)或每日 MVPA 时间(aIRR 1.01,95% 置信区间 [CI]:0.98-1.04)无关。近期吸食大麻者的每日 LPA 时间增加 4%(aIRR 1.04,95% CI:1.01-1.06)。结论最近吸食大麻的中青年人与加速计测量的久坐时间或 MVPA 时间无关,但与 LPA 时间的少量增加有关,其临床意义尚不明确。我们的研究结果提供了证据,反驳了现有的观点,即吸食大麻会独立地促进久坐行为并减少体力活动。今后还需要进行前瞻性研究,以确定这些发现是否适用于使用大麻的特定人群,包括慢性疼痛患者。
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引用次数: 0
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Cannabis and Cannabinoid Research
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