Topic 27: Endocannabinoids Flashcards

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1
Q

What are cannabinoid receptors?

A

THC was first isolated in 1964

the receptor responsible for THC binding was only identified in 1988: significant THC binding was observed in the cortex, basal ganglia, hippocampus, and cerebellum

in 1990 researchers had cloned the gene for the brain cannabinoid receptor (termed CB1 receptor)

endogenous ligands for the cannabinoid receptors (endocannabinoids) were first identified in 1992

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2
Q

What are CB1 receptors in the CNS?

A

two receptors for cannabinoids are found in humans:
CB1 is expressed widely in the CNS
CB2 is expressed primarily on immune cells: only in microglia in the CNS

cannabinoid receptors are G-protein coupled receptors: most Gi-coupled, rarely Cs-coupled

putative CB3 receptor for CBD recently proposed: GPR55 antagonist

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3
Q

What are the characteristics of CB1 receptors?

A

CB1 receptors are G-protein coupled, primarily to Gi

inhibitory through effects on adenylate cyclase (decreased cAMP), GIRK (increased K+ efflux), and Ca2+ channels (decreased Ca2+ influx)

CB1 receptors are exclusively expressed presynaptically: present on glutamatergic, GABAergic, and monoaminergic nerve terminals

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4
Q

What are endocannabinoids?

A

THC is a specific partial agonist of the CB receptors

endocannabinoids are the endogenous ligands for the CB receptors, 6 putative endocannabinoids have been identified

anandamide was first identified in 1992

2-AG was identified in 1994-5; these two endocannabinoids are the best described in the CNS

like phytocannabinoids (from plants), endocannabinoids are highly lipophilic

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5
Q

What is the retrograde signaling of endocannabinoids?

A

endocannabinoids do not function as classic neurotransmitters

endocannabinoids are capable of free diffusion through membranes: they cannot eb packaged into secretory vesicles

primary function is retrograde signaling to modulate presynaptic neurotransmitter release

release from postsynaptic compartments is through activity-dependent synthesis mechanisms

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6
Q

What is endocannabinoid synthesis?

A

endocannabinoids are formed from arachidonoyl-containing phospholipids

2-AG is synthesized in activity dependent process (such as Gq signaling to phospholipase C - PLC) from the hydrolysis of diacylglycerol (DAG) by DAG lipase (DAGL)

anandamide is similarly synthesized by cleavage of phospholipids by phospholipases A2, C and D

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7
Q

What are the steps of the 2-AG synthesis?

A

PIP2 is cleaved by PLC into IP3 and DAG

DAG-lipase converts DAG to 2-AG

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8
Q

What is the depolarization-induced suppression of inhibition?

A

a specific form of short-term synaptic plasticity

post-synaptic depolarization can activate endocannabinoid synthesis (e.g., dendritic backpropagation of strong stimuli)

endocannabinoids are released and suppress presynaptic GABA release: net decrease in inhibitory transmission leads to increased output from cell

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9
Q

What is the metabolism of endocannabinoids?

A

two key enzymes are responsible for the breakdown of endocannabinoids

fatty-acid amide hydrolase (FAAH) metabolizes anandamide

monoacyglycerol lipase (MAGL) metabolizes 2-AG

both are normally expressed to attenuate endocannabinoid signaling

activity dependent expression can regulate cannabinoid signaling

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10
Q

What are the genetic variants of FAAH?

A

a common genetic variant in FAAH (P129T) decreases the rate of breakdown of anandamide (~20% of North Americans): increased level of anandamide throughout the brain

FAAH P129T variant is associated with a greatly reduced risk of anxiety disorder and PTSD

FAAH P129T mice show decreased anxiety in tests such as the elevated plus maze and more rapid extinction conditioned fear responses: decreased anxiety and increased fear extinction in humans carrying the mutation

FAAH P129T is also overrepresented in problem users of street drugs, suggesting increased risk of drug and alcohol abuse: BUT associates with decreased craving and withdrawal in cannabis users

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11
Q

How are endocannabinoids involved in stress and anxiety?

A

endocannabinoids are highly involved in regulation of the physiological response to psychological stressors

acute stress activates two distinct pathways:
neuronal response: activation of the sympathetic nervous system via descending pathways from hypothalamus
neuroendocrine response: activation of the hypothalamic-pituitary-adrenal axis (HPA axis) leading to release of glucocorticoid hormones

excess activity of the HPA axis is implicated in a number of psychiatric disorders including depression, anxiety, bipolar

in many systems anandamide functions as a tonic (steady-state) regulator of activity while 2-AG functions as a phasic (on demand) regulator

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12
Q

How is the HPA axis regulated?

A

hypothalamic release of CRH leads to pituitary release of ACTH into circulation, and stimulates adrenal release of cortisol

negative feedback is provided by cortisol to the hypothalamus to attenuate stress signaling: this feedback process may be impaired in depression and anxiety disorders

the limbic system provides a number of modulatory inputs to the hypothalamus that are critical in HPA response to psychological stressors

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13
Q

What is the limbic control of the HPA axis?

A

under steady-state conditions CB1 antagonism results in an increase in glucocorticoid release

suggestive of steady-state endocannabinoid suppression of the HPA axis

microinjection of CB1 antagonists into the hypothalamic paraventricular nucleus (PVN) does not affect glucocorticoid release

direct microinjection into the basolateral amygdala (BLA) increases glucocorticoid release

BLA projections indirectly provide excitatory input to the PVN

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14
Q

How is FAAH impacted by the stress response?

A

under conditions of stress anandamide levels in the BLA drop as a result of FAAH induction

decreased anandamide levels release inhibitory tone leading to excitatory output to the PVN

CB1 agonists administered to the BLA suppress stress-induced activation of the HPA axis

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15
Q

What is the quick negative feedback pathway of glucocorticoids?

A

rapid feedback in the PVN can be blocked by microinjection of CB1 antagonists

role of endocannabinoids in controlling negative feedback

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16
Q

What is the slow negative feedback pathway of glucocorticoids?

A

slower mechanisms for negative feedback involve the limbic system

2-AG levels increase resulting in inhibition of GABA interneurons

cortical output to the BNST is disinhibited

net increase in inhibitory output from the BNST to the PVN attenuates stress response

17
Q

How do endocannabinoids modulate activation in response to stress?

A

AEA inhibits amygdala activation

FAAH induction releases AEA inhibitory tone on stress

18
Q

How do endocannabinoids modulate recovery from stress?

A

2-AG synthesis in the PVN contributes to rapid negative feedback

2-AG synthesis in the PFC and HC contribute to slow negative feedback

19
Q

How are endocannabinoids involved in appetite?

A

CB1 is proposed to function downstream of ghrelin to initiate orexigenic effects in the PVN

GHSR signaling (via Gq, PLC, PKC) induces DAGL activity
2-AG synthesis increases and signals to presynaptic CB1 receptors

CB1 antagonists can block the orexigenic effects of ghrelin

CB1 agonism notably increases appetite, increases craving for highly rewarding food, and increased hedonic value of food

“munchies”

20
Q

What is cannabidiol?

A

in contrast to THC, CBD has a distinct pharmacological profile

CBD has a very low affinity for CB receptor

CBD is a weak CB1 antagonist and a CB2 inverse agonist but may act indirectly

CBD paradoxically potentiates the effects of THC at the B1 receptor by unknown mechanisms

CBD is also a 5-HT1A receptor agonist: contribute to antidepressant and anxiolytic effects

possible inhibitor of FAAH

21
Q

What are the therapeutic effects of CBD?

A

CBD or high-CBD strains of cannabis have been developed for therapeutic use

high CBD cannabis is being explored as an anti-convulsant for treatment resistant epilepsy

CBD has marked antipsychotic effects in animal models of schizophrenia

CBD is a potent antioxidant and has been shown to neuroprotective in models of ischemic stroke

selective breeding of cannabis for recreational use has resulted in current strains being high-THC, low-CBD but this trend is being reversed by current medical marijuana producers

22
Q

What is Rimonabent?

A

synthetic CB1 antagonist

orexilytic

23
Q

What is Nabilone?

A

synthetic THC analogue (PO)

antiemetic, adjunct analgesic for neuropathic pain

24
Q

What is Dronabinol?

A

THC, PO

antiemetic, orexigenic

25
Q

What is Naboximol/Sativex?

A

THC/CBD 1:1

mouth spray

MS symptoms including spasticity, neuropathic pain

26
Q

What is cannabis tolerance?

A

tolerance to cannabis has been difficult to demonstrate in humans

in animals, THC administration results in decreased CB1 receptor expression

long-term, heavy users of cannabis self report decreases in the subjective high

patterns of escalating drug use are diminished relative to other abused drugs (even in heavy users)

27
Q

What is cannabis dependence?

A

dependence has likewise been difficult to demonstrate in humans

many suggest psychological, not physiological dependence drives addictions (e.g. behavioral tolerance rather than pharmacodynamic tolerance)

28
Q

What is the self-administration of cannabis in animal models?

A

for yours researchers struggled to demonstrate operant self-administration of THC in animals

THC administration often produces an aversive stimulus initially in animals

THC self-administration has been demonstrated in squirrel monkeys first trained on the operant procedure with cocaine

29
Q

How does cannabis interact with mesolimbic dopamine?

A

THC administration increases VTA firing rates and subsequent dopamine release in the NAc

the mechanisms may be dependent on opioid receptors (animal models)

Naltrexone abolishes THC self-administration and blocks NAc dopamine release

aversive effects of THC administration are abolished in kappa-opioid receptor knockout mice

however, in human trials naltrexone administration increased the positive subjective effects of inhaled THC administration in regular heavy marijuana users

30
Q

What is cannabis withdrawal?

A

craving and difficulty stopping use are key indicators of dependence in humans

THC withdrawal can be precipitated in animals

administration of CB1 antagonist after a period of prolonged administration causes wet-dog shakes, excessive self-grooming, hyperactivity

31
Q

What are the withdrawal symptoms of cannabis?

A

irritability

anxiety

depressed mood

sleep difficulties

decreased appetite

32
Q

What is cannabis-related psychosis?

A

a major concern with the use of cannabis is the occurrence of psychosis

much contrasting literature has resulted in a lively debate on causality

like cocaine and amphetamines cannabis can precipitate psychosis in predisposed patients

alcohol, cannabis, amphetamine, or cocaine use is often a precipitant for the first psychotic episode in schizophrenia

cannabis is neither necessary nor sufficient to cause psychosis or schizophrenia

cannabis use interacts with genetic risk factors for SCZ

early cannabis use interacts with genetic risk leading to increased risk and earlier onset of psychosis

33
Q

What are the two models of cannabis related psychosis in adolescence?

A

adolescent cannabis use is causal in developing psychosis/precipitating psychosis in vulnerable individuals

preclinical changes in schizophrenia are likely to predispose towards drug use