Co-exposure of cannabinoids with amphetamines and biological, behavioural and health outcomes: a scoping review of animal and human studies

Abstract Rationale The growing prevalence of psychostimulant (including amphetamine) use and associated health harms, with limited treatment options, present a global challenge. There is an increasing availability and medical applications of cannabinoids, and growing interest in their therapeutic potential for addictive disorders. Objectives The objective of this study is to review available data regarding cannabis/cannabinoid co-use or exposure on amphetamine-related outcomes. Methods Towards the present scoping review, we systematically searched four databases (Medline, Web-of-Science, CINAHL Plus and PsycInfo) using cannabis/cannabinoid and amphetamine text-terms identifying peer-reviewed, English-language studies published in 2000–2020 involving multiple methods approaches among both human and animal study samples, assessing the association of co-use/administration of cannabis/cannabinoids products with non-medical amphetamines on biological, behavioural or health outcomes. Results Twenty-five articles were included. Pre-clinical studies (n = 15) found mostly protective effects of single or repeated cannabinoids administration on rodents in amphetamine addiction models, amphetamine-induced models of human mental disorders (e.g. schizophrenia) and amphetamine-induced neurotoxicity. Human studies (n = 10) were more heterogeneously designed (e.g. cross-sectional, case–control, longitudinal) and assessed natural ongoing cannabis and methamphetamine use or dependence, showing mostly enhanced harms in a diversity of outcomes (e.g. mental health, methamphetamine use, cognition). Conclusions While human studies suggest cannabis use as an adverse risk factor among non-medical amphetamine users, pre-clinical studies suggest therapeutic potential of cannabinoids, especially cannabidiol, to alleviate amphetamine addiction and harms, including treatment outcomes. Given increasing psychostimulant harms but lack of care options, rigorous, high-quality design studies should aim to translate and investigate pre-clinical study results for potential therapeutic benefits of cannabinoids for amphetamine use/abuse in human subjects.

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The Clinical and Biological Effects of Homeopathically Prepared Signaling Molecules: A Scoping Review

Homeopathy ◽

10.1055/s-0041-1732305 ◽

2021 ◽

Author(s):

Raj Kumar Manchanda ◽

Meeta Gupta ◽

Ankit Gupta ◽

Robbert van Haselen

Keyword(s):

Scoping Review ◽

Clinical Studies ◽

English Language ◽

Therapeutic Potential ◽

Polycystic Ovary ◽

Biological Effects ◽

Signaling Molecules ◽

Respiratory Allergies ◽

Wide Range ◽

External Stimuli

Abstract Background Signaling molecules such as cytokines and interleukins are key mediators for the immune response in responding to internal or external stimuli. Homeopathically prepared signaling molecules have been used therapeutically for about five decades. However, these types of products are not available in many countries and their usage by homoeopaths is also infrequent. The aim of this scoping review is to map the available pre-clinical and clinical data related to the therapeutic use of homeopathically prepared signaling molecules. Methods We conducted a scoping review of clinical and pre-clinical studies of therapeutically used signaling molecules that have been prepared in accordance with an officially recognized homeopathic pharmacopoeia. Articles in peer-reviewed journals reporting original clinical or pre-clinical research of homeopathically prepared signaling molecules such as interleukins, cytokines, antibodies, growth factors, neuropeptides and hormones, were eligible. Non-English language papers were excluded, unless we were able to obtain an English translation. An appraisal of eligible studies took place by rating the direction of the outcomes on a five-point scale. The quality of the papers was not systematically assessed. Results Twenty-eight eligible papers, reporting findings for four different manufacturers' products, were identified and reviewed. Seventeen papers reported pre-clinical studies, and 11 reported clinical studies (six experimental, five observational). A wide range of signaling molecules, as well as normal T-cell expressed specific nucleic acids, were used. A majority of the products (21 of 28) contained two or more signaling molecules. The most common clinical indications were psoriasis, vitiligo, rheumatoid arthritis, respiratory allergies, polycystic ovary syndrome, and herpes. The direction of the outcomes was positive in 26 papers and unclear in two papers. Conclusion This scoping review found that there is a body of evidence on the use of homeopathically prepared signaling molecules. From a homeopathy perspective, these substances appear to have therapeutic potential. Further steps to explore this potential are warranted.

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Cannabidiol Treatment Might Promote Resilience to Cocaine and Methamphetamine Use Disorders: A Review of Possible Mechanisms

Molecules ◽

10.3390/molecules24142583 ◽

2019 ◽

Vol 24 (14) ◽

pp. 2583 ◽

Cited By ~ 12

Author(s):

Claudia Calpe-López ◽

M. Pilar García-Pardo ◽

Maria A. Aguilar

Keyword(s):

Crack Cocaine ◽

Therapeutic Potential ◽

Protective Effects ◽

Drug Induced ◽

Addictive Disorders ◽

Stimulant Use ◽

Methamphetamine Use ◽

Intracellular Signalling Pathways ◽

Promising Treatment ◽

Psychostimulant Abuse

Currently, there are no approved pharmacotherapies for addiction to cocaine and other psychostimulant drugs. Several studies have proposed that cannabidiol (CBD) could be a promising treatment for substance use disorders. In the present work, the authors describe the scarce preclinical and human research about the actions of CBD on the effects of stimulant drugs, mainly cocaine and methamphetamine (METH). Additionally, the possible mechanisms underlying the therapeutic potential of CBD on stimulant use disorders are reviewed. CBD has reversed toxicity and seizures induced by cocaine, behavioural sensitization induced by amphetamines, motivation to self-administer cocaine and METH, context- and stress-induced reinstatement of cocaine and priming-induced reinstatement of METH seeking behaviours. CBD also potentiated the extinction of cocaine- and amphetamine-induced conditioned place preference (CPP), impaired the reconsolidation of cocaine CPP and prevented priming-induced reinstatement of METH CPP. Observational studies suggest that CBD may reduce problems related with crack-cocaine addiction, such as withdrawal symptoms, craving, impulsivity and paranoia (Fischer et al., 2015). The potential mechanisms involved in the protective effects of CBD on addiction to psychostimulant drugs include the prevention of drug-induced neuroadaptations (neurotransmitter and intracellular signalling pathways changes), the erasure of aberrant drug-memories, the reversion of cognitive deficits induced by psychostimulant drugs and the alleviation of mental disorders comorbid with psychostimulant abuse. Further, preclinical studies and future clinical trials are necessary to fully evaluate the potential of CBD as an intervention for cocaine and methamphetamine addictive disorders.

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The Potential of Milk-derived Exosomes for Drug Delivery

Current Drug Delivery ◽

10.2174/1567201817666200817112503 ◽

2020 ◽

Vol 17 ◽

Author(s):

Shuyuan Li ◽

Yue Tang ◽

Yushun Dou

Keyword(s):

Drug Delivery ◽

Oral Delivery ◽

Therapeutic Potential ◽

Current Knowledge ◽

Biological Fluids ◽

Drug Loading ◽

Drug Carriers ◽

Current Application ◽

Therapeutic Benefits ◽

Loading Methods

Background: Exosomes, one of the extracellular vesicles, are widely present in all biological fluids and play an important role in intercellular communication. Because of its hydrophobic lipid bilayer and aqueous hydrophilic core structure, it is considered a possible alternative to liposome drug delivery systems. Not only do they protect the cargo like liposomes during delivery, they are less toxic and better tolerated. However, due to the lack of sources and methods for obtaining enough exosomes, the therapeutic application of exosomes as drug carriers is limited. Methods: A literature search was performed using the ScienceDirect and PubMed electronic databases to obtain information from published literature on milk exosomes related to drug delivery. Results: Here, we briefly reviewed the current knowledge of exosomes, expounded the advantages of milk-derived exosomes over other delivery vectors, including a higher yield, the oral delivery characteristic and additional therapeutic benefits. The purification and drug loading methods of milk exosomes, and the current application of milk exosomes were also introduced. Conclusion: The emergence of milk-derived exosomes is expected to break through the limitations of exosomes as therapeutic carriers of drugs. We hope to raise awareness of the therapeutic potential of milk-derived exosomes as a new drug delivery system.

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Effects of Extracellular Vesicles Derived from Mesenchymal Stem/Stromal Cells on Liver Diseases

Current Stem Cell Research & Therapy ◽

10.2174/1574888x14666190308123714 ◽

2019 ◽

Vol 14 (5) ◽

pp. 442-452 ◽

Cited By ~ 1

Author(s):

Wenjie Zheng ◽

Yumin Yang ◽

Russel Clive Sequeira ◽

Colin E. Bishop ◽

Anthony Atala ◽

...

Keyword(s):

Regenerative Medicine ◽

Extracellular Vesicles ◽

Stromal Cells ◽

Liver Diseases ◽

Therapeutic Potential ◽

Mechanisms Of Action ◽

Therapeutic Effects ◽

Chronic Liver Injury ◽

Mediated Effects ◽

Therapeutic Benefits

Therapeutic effects of Mesenchymal Stem/Stromal Cells (MSCs) transplantation have been observed in various disease models. However, it is thought that MSCs-mediated effects largely depend on the paracrine manner of secreting cytokines, growth factors, and Extracellular Vesicles (EVs). Similarly, MSCs-derived EVs also showed therapeutic benefits in various liver diseases through alleviating fibrosis, improving regeneration of hepatocytes, and regulating immune activity. This review provides an overview of the MSCs, their EVs, and their therapeutic potential in treating various liver diseases including liver fibrosis, acute and chronic liver injury, and Hepatocellular Carcinoma (HCC). More specifically, the mechanisms by which MSC-EVs induce therapeutic benefits in liver diseases will be covered. In addition, comparisons between MSCs and their EVs were also evaluated as regenerative medicine against liver diseases. While the mechanisms of action and clinical efficacy must continue to be evaluated and verified, MSCs-derived EVs currently show tremendous potential and promise as a regenerative medicine treatment for liver disease in the future.

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The impact of Active Labour Market Policies on health outcomes: a Scoping review

European Journal of Public Health ◽

10.1093/eurpub/ckz026 ◽

2019 ◽

Author(s):

Vanessa Puig-Barrachina ◽

Pol Giró ◽

Lucía Artazcoz ◽

Xavier Bartoll ◽

Imma Cortés-Franch ◽

...

Keyword(s):

Health Outcomes ◽

Labour Market ◽

Scoping Review ◽

Labour Market Policies ◽

Active Labour Market Policies ◽

Active Labour ◽

The Impact

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Assessing the indirect effects of COVID-19 on healthcare delivery, utilization and health outcomes: a scoping review

European Journal of Public Health ◽

10.1093/eurpub/ckab047 ◽

2021 ◽

Author(s):

Charlotte M Roy ◽

E Brennan Bollman ◽

Laura M Carson ◽

Alexander J Northrop ◽

Elizabeth F Jackson ◽

...

Keyword(s):

Health Outcomes ◽

Health Effects ◽

Scoping Review ◽

Cardiovascular Health ◽

Healthcare Delivery ◽

Final Analysis ◽

High Income ◽

Future Research ◽

Published Data ◽

Local Health

Abstract Background The COVID-19 pandemic and global efforts to contain its spread, such as stay-at-home orders and transportation shutdowns, have created new barriers to accessing healthcare, resulting in changes in service delivery and utilization globally. The purpose of this study is to provide an overview of the literature published thus far on the indirect health effects of COVID-19 and to explore the data sources and methodologies being used to assess indirect health effects. Methods A scoping review of peer-reviewed literature using three search engines was performed. Results One hundred and seventy studies were included in the final analysis. Nearly half (46.5%) of included studies focused on cardiovascular health outcomes. The main methodologies used were observational analytic and surveys. Data were drawn from individual health facilities, multicentre networks, regional registries, and national health information systems. Most studies were conducted in high-income countries with only 35.4% of studies representing low- and middle-income countries (LMICs). Conclusion Healthcare utilization for non-COVID-19 conditions has decreased almost universally, across both high- and lower-income countries. The pandemic’s impact on non-COVID-19 health outcomes, particularly for chronic diseases, may take years to fully manifest and should be a topic of ongoing study. Future research should be tied to system improvement and the promotion of health equity, with researchers identifying potentially actionable findings for national, regional and local health leadership. Public health professionals must also seek to address the disparity in published data from LMICs as compared with high-income countries.

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Effectiveness of Tai Chi for Health Promotion of Older Adults: A Scoping Review of Meta-Analyses

American Journal of Lifestyle Medicine ◽

10.1177/15598276211001291 ◽

2021 ◽

pp. 155982762110012

Author(s):

Fei-Chi Yang ◽

Aishwarya B. Desai ◽

Pelareh Esfahani ◽

Tatiana V. Sokolovskaya ◽

Doreen J. Bartlett

Keyword(s):

Older Adults ◽

Health Promotion ◽

Health Outcomes ◽

Scoping Review ◽

General Health ◽

Tai Chi ◽

Well Being ◽

Cochrane Library ◽

Care Providers ◽

Meta Analyses

Background. Tai Chi is a form of exercise that is accessible to people from different socioeconomic backgrounds, making it a potentially valuable activity for health promotion of older adults. Purpose. The objective of this scoping review was to summarize the current knowledge about the effectiveness of Tai Chi for older adults across a range of general health outcomes from published, peer reviewed, unique meta-analyses. Methods. Meta-analyses were retrieved from Medline, Embase, AMED, CINAHL, SPORTDiscus, PsychINFO, Web of Science, PubMed Health, and the Cochrane Library from database inception to late August 2019. Multistage deduplication and screening processes identified eligible full-length meta-analyses. Two people independently appraised 27 meta-analyses based on the GRADE system and organized results into 3 appendices subsequently collated into heterogeneous, statistically significant, and statistically insignificant tables. Results. “High” and “moderate” quality evidence extracted from these meta-analyses demonstrated that practicing Tai Chi can significantly improve balance, cardiorespiratory fitness, cognition, mobility, proprioception, sleep, and strength; reduce the incidence of falls and nonfatal stroke; and decrease stroke risk factors. Conclusions. Health care providers can now recommend Tai Chi with high level of certainty for health promotion of older adults across a range of general health outcomes for improvement of overall well-being.

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Robust Step Detection from Different Waist-Worn Sensor Positions: Implications for Clinical Studies

Digital Biomarkers ◽

10.1159/000511611 ◽

2020 ◽

Vol 4 (1) ◽

pp. 50-58

Author(s):

Matthias Tietsch ◽

Amir Muaremi ◽

Ieuan Clay ◽

Felix Kluge ◽

Holger Hoefling ◽

...

Keyword(s):

Clinical Study ◽

Clinical Studies ◽

Neurological Diseases ◽

Human Gait ◽

Robust Solution ◽

Step Detection ◽

Study Protocols ◽

Study Results ◽

Wide Range ◽

The Impact

Analyzing human gait with inertial sensors provides valuable insights into a wide range of health impairments, including many musculoskeletal and neurological diseases. A representative and reliable assessment of gait requires continuous monitoring over long periods and ideally takes place in the subjects’ habitual environment (real-world). An inconsistent sensor wearing position can affect gait characterization and influence clinical study results, thus clinical study protocols are typically highly proscriptive, instructing all participants to wear the sensor in a uniform manner. This restrictive approach improves data quality but reduces overall adherence. In this work, we analyze the impact of altering the sensor wearing position around the waist on sensor signal and step detection. We demonstrate that an asymmetrically worn sensor leads to additional odd-harmonic frequency components in the frequency spectrum. We propose a robust solution for step detection based on autocorrelation to overcome sensor position variation (sensitivity = 0.99, precision = 0.99). The proposed solution reduces the impact of inconsistent sensor positioning on gait characterization in clinical studies, thus providing more flexibility to protocol implementation and more freedom to participants to wear the sensor in the position most comfortable to them. This work is a first step towards truly position-agnostic gait assessment in clinical settings.

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What do you mean by engagement? – evaluating the use of community engagement in the design and implementation of chronic disease-based interventions for Indigenous populations – scoping review

International Journal for Equity in Health ◽

10.1186/s12939-020-01346-6 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Sahr Wali ◽

Stefan Superina ◽

Angela Mashford-Pringle ◽

Heather Ross ◽

Joseph A. Cafazzo

Keyword(s):

Chronic Disease ◽

Health Outcomes ◽

Community Engagement ◽

Participatory Research ◽

Scoping Review ◽

Indigenous Health ◽

Well Being ◽

Indigenous Populations ◽

Local Context ◽

Engagement Strategies

Abstract Background Indigenous populations have remained strong and resilient in maintaining their unique culture and values, despite centuries of colonial oppression. Unfortunately, a consequential result of facing years of adversity has led Indigenous populations to experience a disproportionate level of poorer health outcomes compared to non-Indigenous populations. Specifically, the rate of Indigenous chronic disease prevalence has significantly increased in the last decade. Many of the unique issues Indigenous populations experience are deeply rooted in their colonial history and the intergenerational traumas that has subsequently impacted their physical, mental, emotional and spiritual well-being. With this, to better improve Indigenous health outcomes, understanding the local context of their challenges is key. Studies have begun to use modes of community engagement to initiate Indigenous partnerships and design chronic disease-based interventions. However, with the lack of a methodological guideline regarding the appropriate level of community engagement to be used, there is concern that many interventions will continue to fall short in meeting community needs. Objective The objective of this study was to investigate the how various community engagement strategies have been used to design and/or implement interventions for Indigenous populations with chronic disease. Methods A scoping review guided by the methods outlined by Arksey and O’Malley was conducted. A comprehensive search was completed by two reviewers in five electronic databases using keywords related to community engagement, Indigenous health and chronic disease. Studies were reviewed using a descriptive-analytical narrative method and data was categorized into thematic groups reflective of the main findings. Results We identified 23 articles that met the criteria for this scoping review. The majority of the studies included the use a participatory research model and the procurement of study approval. However, despite the claimed use of participatory research methods, only 6 studies had involved community members to identify the area of priority and only five had utilized Indigenous interview styles to promote meaningful feedback. Adapting for the local cultural context and the inclusion of community outreach were identified as the key themes from this review. Conclusion Many studies have begun to adopt community engagement strategies to better meet the needs of Indigenous Peoples. With the lack of a clear guideline to approach Indigenous-based participatory research, we recommend that researchers focus on 1) building partnerships, 2) obtaining study approval and 3) adapting interventions to the local context.

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Freely Available Virtual Reality Experiences as Tools to Support Mental Health Therapy: a Systematic Scoping Review and Consensus Based Interdisciplinary Analysis

Journal of Technology in Behavioral Science ◽

10.1007/s41347-021-00214-6 ◽

2021 ◽

Author(s):

Paul Best ◽

Matilde Meireles ◽

Franziska Schroeder ◽

Lorna Montgomery ◽

Alan Maddock ◽

...

Keyword(s):

Mental Health ◽

Virtual Reality ◽

Stress Reduction ◽

Scoping Review ◽

Therapeutic Potential ◽

Behavioural Therapy ◽

Therapeutic Interventions ◽

Health Practitioner ◽

Case Formulation ◽

Therapeutic Value

AbstractThe primary purpose of this article is to review the potential therapeutic value of freely available VR content as an addition to the practitioners ‘toolkit’. Research has shown that virtual reality (VR) may be useful to extend existing guided imagery-based practices found in traditional mental health therapy. However, the use of VR technology within routine mental health practice remains low, despite recent reductions in equipment costs. A systematic scoping review and interdisciplinary analysis of freely available VR experiences was performed across two popular online databases (SteamVR and Oculus.com). A total of 1785 experiences were retrieved and screened for relevance with 46 meeting the inclusion criteria. VR content was then reviewed for potential therapeutic value by an interdisciplinary panel with experience across a number of therapeutic interventions including cognitive behavioural therapy, Rogerian counselling, mindfulness-based therapies. and family therapy. Eleven (22%) of the 50 freely available VR experiences were reported to have therapeutic potential as tools to support routine mental health therapy. These included support with the following mental health issues—low mood, social anxiety, stress reduction and fear of heights. Guidance of a qualified mental health practitioner was recommended in all cases to maximise the benefit of the VR experiences retrieved. While the quality is variable, freely available VR experiences may contain valuable content that could support mental health therapy. This includes as a homework activity or as an initial setting for case formulation and behavioural experiments.

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