Pharmacological and Toxicological effects of Cannabis

Main Article Content

Sarayut Radapong
Praw Suppajariyawat
Methin Phadungkit

Abstract

      Cannabis sativa L. is a plant with several varieties, which have different physical characteristics. The main phyto-chemical compounds in cannabis are cannabinoids; the two well-known groups of constituents are Δ9-tetrahydro-cannabinol (THC) and cannabidiol (CBD). The THC/CBD proportion can cause the drug addiction and be used as a criteria for identification of cannabis strains. From the literature reviews, cannabis and its active compounds presented various interesting pharmacological effects. THC and its derivatives showed analgesic effects, especially pain from neurological disorders, enhancing appetite and reducing nausea from chemotherapy, protecting and stimulating the production of brain cells. CBD, on the other hand, was found to relieve epilepsy, reducing anxiety in children with autism or patients with a history of cannabis use. Both THC and CBD were also shown anti-cancer activity. However, its toxicity was reported, especially THC, causing acute and chronic toxicity in laboratory animals received high doses and prolonged period. Abnormalities were also found in long-term cannabis use including lung, coronary artery disorders and bone loss. Whereas, CBD has not been reported any toxicity or serious side effects in clinical trial.

Downloads

Download data is not yet available.

Article Details

Section
Review Articles

References

Small E, Cronquist A. A practical and natural taxonomy for Cannabis. Taxon 1976; 25(4): 405-35.

Hillig KW. Genetic evidence for speciation in Cannabis (Cannabaceae). Genet Resour Crop Evol 2005; 52(2): 161-80.

Watts G. Cannabis confusions. BMJ 2006; 332(7534): 175-6.

Piomelli D, Russo EB. The Cannabis sativa versus Cannabis indica debate: an interview with Ethan Russo, MD. Cannabis Cannabinoid Res 2016; 1(1): 44-6.

Woodbridge M, ผู้แต่ง. วารุณี เศวตประวิชกุล, สุชาดา นิลกำแหง วิลคินส์, ธรรศ ธารีสุชีวกุล, ผู้แปล ข้อมูลเบื้องต้นเกี่ยวกับกัญชาทางการแพทย์: หนังสือแนะนำการใช้กัญชาเพื่อบำบัดโรค. กรุงเทพฯ: องค์การเภสัชกรรม; 2562.

ประภัสสร ทิพรัตน์. พืชกัญชา: ความรู้ทั่วไปและการตรวจสอบสารสำคัญ. [ออนไลน์]. 2563; [สืบค้น 10 ก.พ. 2563]; [17 หน้า]. เข้าถึงได้ที่: URL: https://www.oncb.go.th/ncsmi/cannabis4/พืชกัญชา%20%20ความรู้ทั่วไปและการตรวจสอบสารสำคัญ.pdf.

Pollio A. The name of Cannabis: a short guide for Nonbotanists. Cannabis Cannabinoid Res 2016; 1(1): 234-8.

ราชบัณฑิตยสถาน. หนังสืออนุกรมวิธานพืช อักษร ก. พิมพ์ครั้งที่ 2. กรุงเทพฯ: หจก. อรุณการพิมพ์; 2547.

Anderson LC. Leaf variation among Cannabis species from a controlled garden. Bot Mus Lealf Harv Univ 1980; 28(1): 61-9.

McPartland JM. Cannabis systematics at the levels of family, genus, and species. Cannabis Cannabinoid Res 2018; 3(1): 203-12.

Hanus LO, Meyer SM, Munoz E, Taglialatela-Scafati O, Appendino G. Phytocannabinoids: a unified critical inventory. Nat Prod Rep 2016; 33(12): 1357-92.

Hill AJ, Williams CM, Whalley BJ, Stephens GJ. Phytocannabinoids as novel therapeutic agents in CNS disorders. Pharmacol Ther 2012; 133(1): 79-97.

Moreau M, Ibeh U, Decosmo K, Bih N, Yasmin-Karim S, Toyang N, et al. Flavonoid derivative of Cannabis demonstrates therapeutic potential in preclinical models of metastatic pancreatic cancer. Front Oncol 2019; 9: 660. (9 pages).

Bonini SA, Premoli M, Tambaro S, Kumar A, Maccarinelli G, Memo M, et al. Cannabis sativa: a comprehensive ethnopharmacological review of a medicinal plant with a long history. J Ethnopharmacol 2018; 227: 300-15.

Sirikantaramas S, Taura F. Cannabinoids: biosynthesis and biotechnological applications. In: Chandra S, Lata H, ElSohly MA, editors. Cannabis sativa L - botany and biotechnology. Champaign, Illinois: Springer International Publishing; 2017. p. 183-206.

กรมการแพทย์ กระทรวงสาธารณสุข. คำแนะนำการใช้กัญชาทางการแพทย์. ฉบับปรับปรุงครั้งที่ 1/2562. [ออนไลน์]. 2562; [สืบค้น 10 ก.พ. 2563]; [18 หน้า]. เข้าถึงได้ที่: URL: https://www.

chiangmaihealth.go.th/cmpho_web/document/19060915600

PDF.

Lu H-C, Mackie K. An introduction to the endogenous cannabinoid system. Biol Psychiatry 2016; 79(7): 516-25.

Whiting PF, Wolff RF, Deshpande S, Di Nisio M, Duffy S, Hernandez AV, et al. Cannabinoids for medical use: a systematic review and meta-analysis. JAMA 2015; 313(24): 2456-73.

Aran A, Cassuto H, Lubotzky A, Wattad N, Hazan E. Brief report: cannabidiol-rich cannabis in children with autism spectrum disorder and severe behavioral problems-a retrospective feasibility study. J Autism Dev Disord 2019; 49(3): 1284-8.

Scherma M, Satta V, Collu R, Boi MF, Usai P, Fratta W, et al. Cannabinoid CB1/CB2 receptor agonists attenuate hyperactivity and body weight loss in a rat model of activity-based anorexia. Br J Pharmacol 2017; 174(16): 2682-95.

Szaflarski JP, Bebin EM, Cutter G, DeWolfe J, Dure LS, Gaston TE, et al. Cannabidiol improves frequency and severity of seizures and reduces adverse events in an open-label add-on prospective study. Epilepsy Behav 2018; 87: 131-6.

Lim K, See YM, Lee J. A systematic review of the effectiveness of medical cannabis for psychiatric, movement and neurodegenerative disorders. Clin Psychopharmacol Neurosci 2017; 15(4): 301-12.

Daris B, Verboten MT, Knez Z, Ferk P. Cannabinoids in cancer treatment: therapeutic potential and legislation. Bosn J Basic Med Sci 2019; 19(1): 14-23.

Svendsen KB, Jensen TS, Bach FW. Does the cannabinoid dronabinol reduce central pain in multiple sclerosis? Randomised double blind placebo controlled crossover trial. BMJ. 2004; 329(7460): 253. (8 pages).

Nurmikko TJ, Serpell MG, Hoggart B, Toomey PJ, Morlion BJ, Haines D. Sativex successfully treats neuropathic pain characterised by allodynia: a randomised, double-blind, placebo-controlled clinical trial. Pain 2007; 133(1-3): 210-20.

Rice J, Cameron M. Cannabinoids for treatment of MS symptoms: state of the evidence. Curr Neurol Neurosci Rep 2018; 18(8): 50. (10 pages).

US FDA. FDA approves first drug comprised of an active ingredient derived from marijuana to treat rare, severe forms of epilepsy. [online]. 2018; [cited 2020 Feb 10]; [3 screens]. Available from: URL: https://www.fda.gov/news-events/press-announcements/fda-approves-firstdrug-comprised-active-ingredient-derived-marijuana-treat-rare-severe-forms.

Suliman NA, Taib CNM, Moklas MAM, Basir R. Delta-9-Tetrahydrocannabinol (Δ9-THC) induce neurogenesis and improve cognitive performances of male sprague dawley rats. Neurotoxic Res 2018; 33(2): 402-11.

Bilkei-Gorzo A, Albayram O, Draffehn A, Michel K, Piyanova A, Oppenheimer H, et al. A chronic low dose of Δ9-tetrahydrocannabinol (THC) restores cognitive function in old mice. Nat Med 2017; 23(6): 782-7.

Aso E, Juves S, Maldonado R, Ferrer I. CB2 cannabinoid receptor agonist ameliorates Alzheimer-like phenotype in AβPP/PS1 mice. J Alzheimers Dis 2012; 35(4): 847-58.

Chakravarti B, Ravi J, Ganju RK. Cannabinoids as therapeutic agents in cancer: current status and future implications. Oncotarget 2014; 5(15): 5852-72.

Velasco G, Sanchez C, Guzman M. Endocannabinoids and cancer. Handb Exp Pharmacol 2015; 231: 449-72.

ประกาศกระทรวงสาธารณสุข เรื่อง ระบุชื่อยาเสพติดให้โทษในประเภท 5 (พ.ศ. 2563). ราชกิจจานุเบกษา เล่ม 137 ตอนพิเศษ 290 ง (วันที่ 14 ธันวาคม 2563). หน้า 33-34.

Thompson GR, Rosenkrantz H, Schaeppi UH, Braude MC. Comparison of acute oral toxicity of cannabinoids in rats, dogs and monkeys. Toxicol Appl Pharmacol 1973; 25(3): 363-72.

Phillips RN, Turk RF, Forney RB. Acute toxicity of Δ9-tetrahydrocannabinol in rats and mice. Proc Soc Exp Biol Med 1971; 136(1): 260-3.

Bergamaschi MM, Queiroz RH, Zuardi AW, Crippa JA. Safety and side effects of cannabidiol, a Cannabis sativa constituent. Curr Drug Saf 2011; 6(4): 237-49.

Noble MJ, Hedberg K, Hendrickson RG. Acute cannabis toxicity. Clin Toxicol (Phila) 2019; 57(8): 735-42.

Thompson GR, Mason MM, Rosenkrantz H, Braude MC. Chronic oral toxicity of cannabinoids in rats. Toxicol Appl Pharmacol 1973; 25(3): 373-90.

Reece AS. Severe multisystem dysfunction in a case of high level exposure to smoked cannabis. BMJ Case Rep 2009; 2009. (7 pages).

Mukamal KJ, Maclure M, Muller JE, Mittleman MA. An exploratory prospective study of marijuana use and mortality following acute myocardial infarction. Am Heart J 2008; 155(3): 465-70.

Korantzopoulos P, Liu T, Papaioannides D, Li G, Goudevenos JA. Atrial fibrillation and marijuana smoking. Int J Clin Pract 2008; 62(2): 308-13.

Chan PC, Sills RC, Braun AG, Haseman JK, Bucher JR. Toxicity and carcinogenicity of Δ9-tetrahydrocannabinol in Fischer rats and B6C3F1 mice. Fundam Appl Toxicol 1996; 30(1): 109-17.

Marselos M, Karamanakos P. Mutagenicity, developmental toxicity and carcinogenicity of cannabis. Addict Biol 1999; 4(1): 5-12.

Aldington S, Harwood M, Cox B, Weatherall M, Beckert L, Hansell A, et al. Cannabis use and risk of lung cancer: a case-control study. Eur Respir J 2008; 31(2): 280-6.

Hashibe M, Ford DE, Zhang Z-F. Marijuana smoking and head and neck cancer. J Clin Pharmacol 2002; 42(S1): 103S-7S.

Sidney S, Quesenberry CP, Friedman GD, Tekawa IS. Marijuana use and cancer incidence (California, United States). Cancer Causes Control 1997; 8(5): 722-8.

Daling JR, Doody DR, Sun X, Trabert BL, Weiss NS, Chen C, et al. Association of marijuana use and the incidence of testicular germ cell tumors. Cancer 2009; 115(6): 1215-23.

Efird JT, Friedman GD, Sidney S, Klatsky A, Habel LA, Udaltsova NV, et al. The risk for malignant primary adult-onset glioma in a large, multiethnic, managed-care cohort: cigarette smoking and other lifestyle behaviors. J Neurooncol 2004; 68(1): 57-69.

Sharma P, Murthy P, Bharath MM. Chemistry, metabolism, and toxicology of cannabis: clinical implications. Iran J Psychiatry 2012; 7(4): 149-56.

วริศรา สุวรรณ. ความหลากหลายของสายพันธุ์กัญชา. [ออนไลน์]. 2562; [สืบค้น 5 พ.ย. 2563]; [4 หน้า]. เข้าถึงได้ที่: URL: https://erp.mju.ac.th/acticleDetail.aspx?qid=1065.

ส. สุทธิพันธ์. กัญชา สรรพยาแห่งความหวัง. [ออนไลน์]. 2563; [สืบค้น 5 พ.ย. 2563]; [23 หน้า]. เข้าถึงได้ที่ : URL: https://www.

satapornbooks.co.th/imgadmins/product_pdf/201910_01_

Kaancha.pdf.