Cannabis and Cannabinoid Research最新文献

Introduction: The endocannabinoid system plays a crucial role in gastrointestinal homeostasis; although some gastrointestinal adverse events have been reported with therapeutic cannabinoids in children, the complete profile of gastrointestinal adverse events in the pediatric population remains unknown. Through a systematic review and meta-analysis, we aimed to identify the prevalence of gastrointestinal adverse events from therapeutic cannabinoids in children. Materials and Methods: A literature search of OVID MEDLINE, EMBASE, CINAHL, Web of Science, and The Cochrane Library was performed from inception to May 19, 2023. Selected studies included randomized controlled trials, retrospective cohort studies, uncontrolled before-after studies, and observational retrospective studies in English, French, or Spanish that reported gastrointestinal adverse events in the pediatric population under therapeutic cannabinoid interventions. The study was registered with PROSPERO and followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guidelines. A random-effects model was used to pool and analyze the extracted data. Extracted data included the presence of adverse gastrointestinal events by analyzing the type of cannabinoid, duration of treatment, dosage, and type of study. A subgroup meta-analysis was also performed, focusing on patients' conditions. Results: Twenty-five studies were included, comprising 1,201 pediatric patients receiving therapeutic cannabinoids, of whom 451 experienced gastrointestinal adverse events, representing a cumulative prevalence of 33.91% (95% confidence interval [CI]: 21.49% to 49.04%). Interventional studies reported a higher prevalence of GI adverse events (47.36%; 95% CI: 31% to 64%) compared with observational studies (17.6%; 95% CI: 8.5% to 32.7%). As most studies focused on patients with epilepsy, a subanalysis was performed within this population, revealing that patients with Dravet syndrome had a higher prevalence of diarrhea compared with other types of epilepsy (21.75%; 95% CI: 8.52% to 45.34% vs. 5.95%; 95% CI: 3.11% to 11.1%). Discussion: This systematic review and meta-analysis showed a high prevalence of gastrointestinal adverse events in children receiving therapeutic cannabinoids, with some populations, such as those with Dravet syndrome, being at higher risk than others. With the increased public discourse of cannabinoids being "natural" and mistakenly equating them as "risk-free," this information can help clinicians educate patients and the broader public on the adverse effects profile of these treatments.

Background: Eicosanoids-lipid mediators derived from polyunsaturated fatty acids such as arachidonic acid-have a notable role in inflammatory signaling. Cannabidiol (CBD) and Δ9-tetrahydrocannabinol (THC) have been shown in preclinical studies to modulate inflammatory pathways the modulating the enzymes that generate eicosanoids, namely lipoxygenase (LOX), cyclooxygenase (COX), and cytochrome P450 (CYP450). Methods: This present study aimed to investigate how CBD and THC effect plasma levels of eicosanoids generated through LOX, COX, and cytochrome P450 (CYP450) pathways. Using plasma sample data from multiple clinical studies, we tested the hypothesis that high-CBD cannabis use would increase eicosanoid levels compared with high-THC cannabis. Results: Following cannabis use, high-CBD cannabis led to a rise in plasma eicosanoids, particularly lipoxins, while high-THC cannabis did not. Conclusions: CBD promoted anti-inflammatory eicosanoid production via the 15-LOX pathway, therefore supporting the potential role of CBD as a therapeutic candidate for inflammatory diseases.

Background: The literature supports the benefits of medical cannabis for core and comorbid symptoms in autistic individuals and anxiety-related symptoms in individuals without autism. However, no study has specifically investigated how cannabidiol (CBD)-rich cannabis affects anxiety subtypes in autistic children or its relationship with restricted and repetitive behaviors and interests (RRBI). Understanding the effects of CBD-rich cannabis treatment on anxiety subtypes and RRBI could offer more precise treatment approaches to managing anxiety symptoms and reducing RRBI frequency in autistic children. Objectives: To examine (1) the impact of CBD-rich cannabis treatment on autistic children's (1a) anxiety levels and subtypes and (1 b) RRBI and subtypes and (2) whether changes in anxiety explain changes in RRBI following cannabis treatment. Method: In this open-label study, we analyzed data from 65 autistic children (5-12 years) who had participated in research on the effects of CBD-rich cannabis on children with autism. Their parents completed the Repetitive Behavior Scale-revised to assess the frequency and severity of six subgroups of their children's recurrent behaviors and the Screen for Child Anxiety-Related Emotional Disorders for symptoms related to five types of anxiety disorders. They completed these assessments at three time points: (T1) before treatment, (T2) after 3 months, and (T3) after 6 months of treatment. Results: The results indicated reduced RRBI and symptoms related to various anxiety subtypes in autistic children following 6 months of CBD-rich cannabis treatment. Specifically, we observed significant differences in the autistic children's overall anxiety and in some anxiety subtypes (i.e., general, social, panic, and separation anxieties). Significant improvements were observed in RRBI, including the total score, and specifically in compulsive, ritualistic, and sameness behaviors. Our findings revealed that reduced anxiety, particularly within the panic- and separation-related subtypes, predicted a subsequent decrease in RRBI, specifically sameness behaviors, following cannabis treatment. Conclusions: The findings of the cannabis treatment's potential benefits for alleviating anxiety symptoms, leading to reduced RRBI, may provide evidence for the meaningful relationship between these variables and for the potential benefits of cannabis treatment for autistic children. We strongly recommend further double-blind, placebo-controlled studies using standardized assessments to validate these findings.

Background: Cannabis use is becoming increasingly prevalent worldwide, yet the full spectrum of its effects largely remain unknown. Although cannabis have immunomodulatory properties, there remains a significant gap in our understanding of the potential impact of marijuana use on COVID-19 outcomes. The purpose of this study is to evaluate the effect of chronic cannabis use on severe COVID-19. Materials and Methods: National Inpatient Sample Database was used to sample individuals admitted with the diagnosis of COVID-19. Patients were divided into two groups based on cannabis use. Baseline demographics and comorbidities were collected using ICD-10 codes. Patients with missing data or age under 18 were excluded. Propensity matching using R was performed to match cannabis users to non-cannabis users 1:1 on age, race, gender, and 17 other comorbidities. The primary outcome was severe COVID-19 infection, defined as a composite of acute respiratory failure, intubation, acute respiratory distress syndrome (ARDS), or severe sepsis with multiorgan failure. Results: Out of 322,214 patients included in the study, 2,603 were cannabis users. Cannabis users were younger and had higher prevalence of tobacco use. On initial analysis, cannabis users had significantly lower rates of severe COVID-19 infection, intubation, ARDS, acute respiratory failure, severe sepsis with multiorgan failure, mortality, and shorter length of hospital stay. After 1:1 matching, cannabis use was associated with lower rates of severe COVID-19 infection, intubation, ARDS, acute respiratory failure, severe sepsis with multiorgan failure, mortality, and shorter length of hospital stay. Conclusion: Cannabis users had better outcomes and mortality compared with non-users. The beneficial effect of cannabis use may be attributed to its immunomodulatory effects.

Introduction: Following the introduction of metabolic dysfunction-associated steatotic liver disease (MASLD) as a replacement term for nonalcoholic fatty liver disease, the relationship between MASLD and cannabis use has yet to be established. With the global rise in cannabis consumption, understanding its impact on MASLD is critical for clinical guidance. Our study investigated the association between cannabis use, MASLD, and clinically significant fibrosis (CSF) among U.S. adults. Methods: Data were collected from the National Health and Nutrition Examination Survey for the period 2017 to 2018 to conduct a cross-sectional analysis. The diagnosis of hepatic steatosis and CSF was based on median values of the controlled attenuation parameter and liver stiffness measurement, with thresholds of 285 dB/m and 8.6 kPa, respectively. Information on cannabis use was obtained through self-report questionnaires. Multinomial logistic regression models and subgroup analyses were used to investigate the association between cannabis use and MASLD with CSF. Results: Our study assessed data from 2,756 U.S. adults (51.1% female; 32.2% white; mean age 39.41 ± 11.83 years), who had complete information on liver stiffness measurements through transient elastography alongside reported cannabis use. Results indicated that cannabis use overall was not associated with liver stiffness in patients with MASLD. However, among females, cannabis use was associated with MASLD accompanied by CSF, with an adjusted odds ratio (OR) of 0.47 (95% confidence interval [CI]: 0.24-0.91). Heavy cannabis use (9 to 30 times per month) was associated with MASLD accompanied by CSF among female participants, with an adjusted OR of 0.12 (95% CI: 0.02-0.88). Conclusion: In our study, cannabis use did not show a significant association with liver stiffness in patients diagnosed with MASLD. However, heavy cannabis consumption in women was associated with MASLD accompanied by CSF. These findings suggest that the effects of cannabis on liver health may differ based on gender and frequency of cannabis use, emphasizing the need for further research in this area.

Background: Cannabis is the most used federally controlled substance in the United States. Given the increasingly widespread use of cannabis, further examination of its health implications is needed. We evaluated the association of cannabis use and longitudinal kidney outcomes among a cohort of adults living in Baltimore, MD. Methods: We used data from healthy aging in neighborhoods of diversity across the life span study. Baseline cannabis use (obtained between 2004 and 2009) was categorized as never tried, tried, never used regularly (irregular use), regular use >6 months prior (former regular use), and regular use within the past 6 months (current regular use). The primary outcome was incident chronic kidney disease (CKD), defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m² at follow-up (2013-2017). Risk of rapid kidney function decline (decline in eGFR of >3 mL/min per 1.73 m² per year) and incident albuminuria (albumin-to-creatinine ratio [ACR] ≥ 30 mg/g) were also assessed. Multivariable logistic regression was used to evaluate the association of cannabis use with kidney outcomes. Results: Among 1,521 participants, the mean age was 48 years, 58% were female, and 58% were of Black race. Participants with current regular cannabis use were more likely to be younger, male, Black, and to concurrently use cigarettes, opiates, and/or cocaine. Compared with those with no history of cannabis use, participants with current regular cannabis use were not at higher risk of incident CKD (OR: 0.79 [95% CI: 0.37-1.68]), rapid kidney function decline (OR: 0.80 [95% CI: 0.43-1.49), or incident albuminuria (OR: 0.84 [95% CI: 0.38-1.87]) after adjustment for sociodemographics, health factors, and concurrent use of cigarette, opiate, or cocaine. Conclusion: In this Baltimore-based cohort of adults without CKD, there was no independent association between cannabis use and adverse kidney outcomes over time.

Objective: Cannabis use disorder (CUD) is one of the most common substance use disorders (SUDs) worldwide and is frequently associated with high rates of polysubstance use; however, despite rising rates of polysubstance use disorders (PUD), the characteristics of individuals with both CUD and PUD remain unclear. This study, therefore, aims to examine social and clinical characteristics of adults diagnosed with CUD and comorbid PUD. It also aims to assess whether psychiatric disorders are linked to higher odds of PUD among individuals with CUD. Methods: Using a nationally representative U.S. dataset, we assessed 972 individuals with past-year DSM-5 CUD, grouped as CUD only, CUD individuals with one additional SUD (CUD + 1), and CUD individuals with two or more SUDs (CUD + 2). Descriptive statistics summarized social and clinical presentations; multivariate logistic regression examined factors contributing to PUD, controlling for clinical diagnoses and childhood maltreatment. Results: Among CUD individuals, 89.3% (n = 868) used at least one other substance in the past year, with 34.2% (n = 332) using two or more. Both the CUD + 1 and CUD + 2 groups experienced significantly more severe childhood maltreatment than CUD only. After adjusting for controls, personality disorders were associated with membership in the CUD + 1 group (odds ratio [OR]: 1.88, p = 0.01); mood disorders were associated with a higher likelihood of being in the CUD + 1 group (OR: 1.50, p = 0.049) and CUD + 2 group (OR: 2.58, p = 0.005). Conclusion: Mood and personality disorders were highly prevalent and linked with PUD in CUD cases. We recommend screening for these disorders in complex CUD cases.

Introduction: More adults can legally purchase cannabis in the United States than ever before. However, there is limited understanding as to how cannabis consumers make decisions about what products to purchase. Further insight is needed to guide policies that balance public health with profitable business strategies. Methods: Respondents were cannabis consumers participating in the legal adult-use market in Washington State. They were recruited through flyers posted in cannabis retail stores. Both the online survey and flyer were created by the Washington State Liquor and Cannabis Board and the Department of Health. Respondents answered questions on demographics, cannabis use patterns, and cannabis retail store employment status. Respondents also rated the importance of 10 different attributes when making a cannabis purchase: company/brand name, strain/cultivar name, production method, cost, tetrahydrocannabinol (THC), cannabidiol or terpene profile, perceived positive effects, perceived negative effects, flavor, and appearance/look. Linear regressions were conducted to predict the importance of each attribute by gender, age, cannabis use patterns, and cannabis retail employee status. Results: There were 437 survey respondents. All respondents were legal adult cannabis users and 137 reported they were employed at a cannabis retail store. Several group differences emerged. For example, cannabis retail employees rated THC concentration as less important (β = -1.67, p < 0.001) but brand name (β = 1.30, p < 0.001) and product appearance (β = 0.81, p = 0.001) as more important than nonretail employees. More frequent users rated cultivar/strain name (β = 0.50, p < 0.001), production method (β = 0.43, p < 0.001), price (β = 0.26 p = 0.01), and product appearance (β = 0.49, p < 0.001) as more important than less frequent users. Conclusions: Differences in purchasing decisions by subgroups have important public health, economic, and policy implications. For example, results showed that retail employees place less emphasis on THC relative to their nonemployee counterparts. If retail employees were to emphasize to customers about the attributes they focus on when purchasing cannabis (e.g., product appearance), this could help redirect market demand away from higher-THC products.

Introduction: Cannabis use has risen disproportionately among middle-aged and older U.S. adults, groups particularly vulnerable to adverse effects, including cannabis use disorder (CUD). Consumption patterns have diversified in recent years. The quantity of cannabis use, historically measured in limited ways (e.g., number of joints), is now considered a key risk factor for CUD. However, age-related differences in consumption patterns and their relationships with CUD remain understudied. This study investigated age-related differences in consumption patterns and examined the relationship between quantity of use-measured by milligrams of THC (mgTHC)-and self-reported CUD in individuals with regular cannabis use. Materials and Methods: A total of 4134 U.S. adults (ages 18+; 45.9% male, 54.1% female) who reported daily cannabis use completed an online survey assessing cannabis consumption patterns and self-reported Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition's CUD criteria. Pearson's chi-square tests and one-way analysis of variance examined differences in sex, reasons for use, methods of consumption, CUD severity, criteria count, and mgTHC with comparisons across three age-groups (18-49, 50-64, 65+). Regression models, adjusted for sex and reasons for use, analyzed age-specific associations between mgTHC and CUD. Results: Overall, over 70% reported using cannabis for both medical and recreational purposes. Middle-aged adults were more likely to report medical use than younger ones (18.1% vs. 13.7%; p < 0.001) and older adults (14.1%; p = 0.027). Older adults were more likely to report recreational-only use compared with middle-aged adults (15.8% vs. 10.5%; p = 0.002). Smoking buds was the most common consumption method across age-groups, while high-potency concentrate use declined with age. In the overall sample, daily mgTHC was associated with CUD severity, and middle-aged and older adults endorsed fewer CUD criteria than younger adults at all levels of mgTHC; however, age effects were not statistically significant. Discussion: Among daily cannabis consumers, middle-aged and older adults differed from younger consumers in methods of consumption and reasons for use. While both groups consumed lower quantities than their younger counterparts, no age-related differences were observed in the relationship between mgTHC consumption and CUD, contrasting with evidence suggesting that older cannabis consumers may be more vulnerable to cannabis-related negative outcomes.