Biochemical and haematological changes in synthetic cannabinoids and marijuana users; a retrospective evaluation
DOI:
https://doi.org/10.1590/s2175-97902026e20713Keywords:
Synthetic cannabinoids, Marijuana, Hematological parameters, Biochemical parameters, Neutrophil lymphocyte ratio, Platelet eosinophil ratioAbstract
Toxic and hazardeus substances have negative effects on both the environment and human health. In this study, we aimed to determine the relationship between use of synthetic cannabinoids and complete blood count parameters, neutrophil/ lymphocyte ratio (NLR), platelet/eosinophil ratio (PER) and platelet/lymphocyte ratio (PLR). 104 patients aged 18-65 years were evaluated retrospectively. Patients were divided into 3 groups; in control group (Group 1) no metabolites detected in urine samples, Group 2 positive for bonsai and Group3 positive for marijuana metabolites. Neutrophils, NLR and PER were higher, while %lymphocyte and %eosinophil were lower in Group 2 than Group 1 (p<0.05). The %eosinophil were lower, in contrast PER was higher in Group 2 compared to Group 3 (p<0.05). The findings of our study showed that bonsai consuming decreased lymphocyte percentage, eosinophil percentage while increasing neutrophil percentage, NLR and PER. We also found that marijuana consumption increased neutrophil percentage and NLR, and reduced lymphocyte percentage values. We believe that further research is needed to fully elucidate the effects of cannabinoid use on blood parameters.
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Alshaarawy O. Total and differential white blood cell count in cannabis users: results from the cross-sectional National Health and Nutrition Examination Survey, 2005–2016. J Cannabis Res. 2019;2(1):1.
Ameri A. The effects of cannabinoids on the brain. Prog Neurobiol. 1999;58(4):315-48.
Artuç S, Doğan KH, Demirci Ş. Synthetic cannabinoids: a new trend in drugs of abuse. Adli J Forensic Med. 2014;19(3):198-205.
Carayon P, Marchand J, Dussossoy D, Derocq J-M, Jbilo O, Bord A, et al. Modulation and functional involvement of CB2 peripheral cannabinoid receptors during B-cell differentiation. Blood. 1998;92(10):3605-15.
Cıcek E, Demırel B, Cıcek IE, Kıraç AS, Eren I. Increased neutrophil-lymphocyte and platelet-lymphocyte ratios in male heroin addicts: A prospective controlled study. Clinical Psychopharmacol Neurosci. 2018;16(2):190.
Clinical Drug Testing in Primary Care: Substance Abuse and Mental Health Services Administration; 2012 [citad 2020 Apr 22] Available from: https://store.samhsa.gov/system/files/sma12-4668.pdf.
Barrales-Cureño HJ, López-Valdez LG, Reyes C, Cetina-Alcalá VM, Vasquez-García I, Diaz-Lira OF, et al. Chemical Characteristics, Therapeutic Uses, and Legal Aspects of the Cannabinoids of Cannabis sativa: A Review. Braz Arch Biol Technol. 2020; 63.
Çakır U, Can Tuman T, Yıldırım O. Increased neutrophil/lymphoctye ratio in patients with bipolar disorder: a preliminary study. Psychiatria Danubina. 2015;27(2):0-184.
Duffy BK, Gurm HS, Rajagopal V, Gupta R, Ellis SG, Bhatt DL. Usefulness of an elevated neutrophil to lymphocyte ratio in predicting long-term mortality after percutaneous coronary intervention. Am J Cardiol. 2006;97(7):993-6.
Elbistanli MS, Koçak HE, Acipayam H, Yigider AP, Keskin M, Kayhan FT. The predictive value of neutrophil-lymphocyte and platelet-lymphocyte ratio for the effusion viscosity in otitis media with chronic effusion. J Craniofacial Surg. 2017;28(3):244-7.
Eledo B, Dioka C, Amilo G, Ifeanyichukwu M, Onuoha E. Evaluation of some haematological parameters among marijuana smokers ın Yenagoa, Nigeria. Evaluation. 2015;5(12).
Gonçalves J, Rosado T, Soares S, Simao AY, Caramelo D, Luis A, et al. Cannabis and its secondary metabolites: Their use as therapeutic drugs, toxicological aspects, and analytical determination. Medicines. 2019;6(1):31.
Grambow E, Strüder D, Klar E, Hinz B, Vollmar B. Differential effects of endogenous, phyto and synthetic cannabinoids on thrombogenesis and platelet activity. BioFactors. 2016;42(6):581-90.
Gurney SM, Scott K, Kacinko S, Presley B, Logan B. Pharmacology, toxicology, and adverse effects of synthetic cannabinoid drugs. Forensic Sci Rev. 2014;26(1):53-78.
Guzel D, Yazici AB, Yazici E, Erol A. Alterations of the hematologic cells in synthetic cannabinoid users. J Clin Lab Anal. 2017;31(6):221-31.
Halazun KJ, Hardy MA, Rana AA, Woodland IV DC, Luyten EJ, Mahadev S, et al. Negative impact of neutrophil-lymphocyte ratio on outcome after liver transplantation for hepatocellular carcinoma. Ann Surg. 2009;250(1):141-51.
Kevser E. The Toxicities of Bonsai. Osmangazi J Med. 2017;39(3):130-9.
Kwong TC, Magnani B, Rosano TG, Shaw LM. The clinical toxicology laboratory: Contemporary practice of poisoning evaluation: AACC Press; 2013.
Koltai H, Poulin P, Namdar D. Promoting cannabis products to pharmaceutical drugs. Eur J Pharm Sci. 2019;132:118-20.
Oka S, Ikeda S, Kishimoto S, Gokoh M, Yanagimoto S, Waku K, et al. 2-Arachidonoylglycerol, an endogenous cannabinoid receptor ligand, induces the migration of EoL-1 human eosinophilic leukemia cells and human peripheral blood eosinophils. J leukocyte Biol. 2004;76(5):1002-9.
Oseni BS, Togun VA, Taiwo OF. Effect of marijuana smoking on some hematological parameters of smokers. World J Med Sci. 2006;1(2):82-5.
Seely KA, Lapoint J, Moran JH, Fattore L. Spice drugs are more than harmless herbal blends: a review of the pharmacology and toxicology of synthetic cannabinoids. Prog Neuro-psychopharmacol Biol Psychiatry. 2012;39(2):234-43.
Seely KA, Prather PL, James LP, Moran JH. Marijuana-based drugs: innovative therapeutics or designer drugs of abuse? Mol Interventions. 2011;11(1):36.
Semiz M, Yildirim O, Canan F, Demir S, Hasbek E, Tuman TC, et al. Elevated neutrophil/lymphocyte ratio in patients with schizophrenia. Psychiatria Danubina. 2014;26(3):0-225.
Soder HE, Berumen AM, Gomez KE, Green CE, Suchting R., Wardle MC, et al. Elevated Neutrophil to Lymphocyte Ratio in Older Adults with Cocaine Use Disorder as a Marker of Chronic Inflammation. Clin Psychopharmacol Neurosci. 2020;18(1):32.
Uzbay T. Addictive Substances and Their Properties. J Contin Educ. 2006;16-33.
Valk P, Verbakel S, Vankan Y, Hol S, Mancham S, Ploemacher R, et al. Anandamide, a natural ligand for the peripheral cannabinoid receptor is a novel synergistic growth factor for hematopoietic cells. Blood. 1997;90(4):1448-57.
Voudoukis E, Karmiris K, Koutroubakis IE. Multipotent role of platelets in inflammatory bowel diseases: a clinical approach. World J Gastroenterol. 2014;20(12):3180.
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