Author Interviews, Cannabis, Heart Disease / 29.05.2025
Smoking Marijuana, or Using Edibles, May Not Avoid Harmful Vascular Side Effects of Tobacco
MedicalResearch.com Interview with:
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Dr. Springer[/caption]
Matthew L. Springer, Ph.D.
Associate Professor of Medicine
Division of Cardiology
Cardiovascular Research Institute
Broad Center of Regeneration Medicine and Stem Cell Research
Center for Tobacco Control Research & Education
Helen Diller Family Comprehensive Cancer Center
University of California, San Francisco
MedicalResearch.com: What is the background for this study?
Response: It's been known for many years that chronic tobacco smokers have poor endothelial function, even if they have not smoked recently, and so do non-smokers who are frequently exposed to secondhand smoke. Endothelial dysfunction, even in otherwise outwardly healthy people, is an indication of unhealthy arteries and increased risk of cardiovascular disease later in life. I realized that many people who would presumably avoid secondhand smoke did not mind it if it came from cannabis, and I wondered if that could be true since both kinds of smoke included the thousands of chemicals that resulted from burning plant material.
A number of years ago, we developed a way to study changes in endothelial function in rats, using a technique very similar to how we measure it in humans, and we saw that, as in humans, even brief exposures to secondhand smoke from tobacco impaired vascular function in the rats. We subsequently showed that brief exposures to secondhand smoke from marijuana, and active smoking of marijuana, similarly impaired vascular function in the rats, even if the smoke was from marijuana lacking THC and the other cannabinoids. That again raised the question of whether the endothelial dysfunction observed in human tobacco smokers would also occur in human marijuana smokers, and whether secondhand smoke from marijuana should be avoided like secondhand smoke from tobacco.
These questions form the basis of our current study.. In our study, it is quite clear that chronic cannabis smokers had endothelial dysfunction similar to that of chronic tobacco smokers. Whether frequent exposure to secondhand marijuana smoke similarly impairs endothelial function like secondhand tobacco smoke is still unknown, and that's one of the major questions we want to answer next.
Dr. Springer[/caption]
Matthew L. Springer, Ph.D.
Associate Professor of Medicine
Division of Cardiology
Cardiovascular Research Institute
Broad Center of Regeneration Medicine and Stem Cell Research
Center for Tobacco Control Research & Education
Helen Diller Family Comprehensive Cancer Center
University of California, San Francisco
MedicalResearch.com: What is the background for this study?
Response: It's been known for many years that chronic tobacco smokers have poor endothelial function, even if they have not smoked recently, and so do non-smokers who are frequently exposed to secondhand smoke. Endothelial dysfunction, even in otherwise outwardly healthy people, is an indication of unhealthy arteries and increased risk of cardiovascular disease later in life. I realized that many people who would presumably avoid secondhand smoke did not mind it if it came from cannabis, and I wondered if that could be true since both kinds of smoke included the thousands of chemicals that resulted from burning plant material.
A number of years ago, we developed a way to study changes in endothelial function in rats, using a technique very similar to how we measure it in humans, and we saw that, as in humans, even brief exposures to secondhand smoke from tobacco impaired vascular function in the rats. We subsequently showed that brief exposures to secondhand smoke from marijuana, and active smoking of marijuana, similarly impaired vascular function in the rats, even if the smoke was from marijuana lacking THC and the other cannabinoids. That again raised the question of whether the endothelial dysfunction observed in human tobacco smokers would also occur in human marijuana smokers, and whether secondhand smoke from marijuana should be avoided like secondhand smoke from tobacco.
These questions form the basis of our current study.. In our study, it is quite clear that chronic cannabis smokers had endothelial dysfunction similar to that of chronic tobacco smokers. Whether frequent exposure to secondhand marijuana smoke similarly impairs endothelial function like secondhand tobacco smoke is still unknown, and that's one of the major questions we want to answer next.
Dr. Piper[/caption]
Brian J. Piper, PhD
Department of Medical Education
Center for Pharmacy Innovation & Outcomes
Geisinger College of Health Sciences
Scranton, PA 18509
MedicalResearch.com: What is the background for this study?
Dr. Piper: Tapentadol has an unusual mechanism of action. This opioid is similar to morphine in that it activates mu, the main opiate receptor which is important for pain. This drug also acts similar to an antidepressant like duloxetine (Cymbalta) with equal ability to block both the norepinephrine and the serotonin transporters (Figure 1). The combination of opioid and monoaminergic activity may influence both therapeutic and side effect profiles.
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Figure 1. Biological mechanism of action of the atypical opioid tapentadol involves binding to the mu opiate receptor, blocking the norepinephrine transporter (NET), and blocking the serotonin transporter (SERT) [1].[/caption]Tapentadol is approved in the US for moderate to severe acute pain, moderate to severe chronic pain, and neuropathic pain associated with diabetic peripheral neuropathy. However, tapentadol is not generally considered first-line for any of these indications. Although this agent has a high potential for abuse and is classified as a Schedule II substance, a manufacturer of extended release tapentadol (Grunenthal) has conducted a misinformation campaign claiming tapentadol has a “minimum potential of abuse”, does not cause respiratory depression (a well-known opioid effect), does not cause any euphoric feelings, has no street value, and is not an opioid [2]. Prior pharmacoepidemiological studies have examined the use patterns of other prescription opioids that can be misused like oxycodone [3], fentanyl [4], meperidine [5] and methadone [6] but there is limited national information about the use of tapentadol.
Dr. Steenson[/caption]
Dr. Simon Steenson PhD
Postdoctoral Research Associate
Department of Nutritional Sciences
King’s College London
MedicalResearch.com: What is the background for this study?
Response: Chronic constipation is something that can be embarrassing, but it affects 1 in 10 people globally. It has a big impact on people’s quality of life and treating constipation has substantial costs for the healthcare system. Dried fruits are recommended for managing constipation, but there are very few studies that have actually tested whether following this advice is helpful. To fill this gap in our knowledge, we completed the largest clinical trial to date to see whether dried fruits and fruit juices could benefit constipation symptoms.
Dr. Corley[/caption]
Douglas Corley, MD, PhD
Chief Research Officer, The Permanente Medical Group
Kaiser Permanente, Northern California
MedicalResearch.com: What is the background for this study?
Response: Kaiser Permanente Northern California (KPNC) is an integrated health care system that designs and implements population-based programs that support cancer prevention and early detection. In 2006, KPNC began to implement a comprehensive colorectal cancer screening program with the goal of increasing member screening rates, preventing colorectal cancer through polyp removal, and reducing cancer mortality. The initiative identifies whether screening-eligible KPNC members are up to date with their colorectal cancer screening test by either a colonoscopy or by stool-based tests, such as a fecal immunochemical testing (FIT) kit. If they are not up to date with screening, it mails them a FIT kit for at-home testing. Members can also choose other options for colorectal cancer screening, such as a colonoscopy, through their physician.
Shani Vaknine[/caption]
Shani Vaknine, Ph.D. candidate
Brain and Behavioral Sciences
The Hebrew University
MedicalResearch.com: What is the background for this study?
Response: We’ve long known that maternal stress during pregnancy can affect her baby’s development, but the molecular mechanisms behind this remained unclear. In our study, we explored how psychosocial stress experienced by the mother in late pregnancy influences tiny molecular fragments in the newborn’s blood. These fragments, called transfer RNA fragments or tRFs, were considered for many years to be disposable, but have recently been shown to have important biological functions.
Dr. Moyland[/caption]
Cynthia Moylan, MD
Associate Professor of Medicine,
Division of Gastroenterology
Duke University Health System
MedicalResearch.com: What is the background for this study?
Response: Metabolic dysfunction can lead to several health problems including metabolic dysfunction associated steatotic liver disease (MASLD), is driven by different factors, including: a person’s behavioral or lifestyle factors, environmental factors, and genetics. Limited research exists regarding genetic , epigenetic, or other factors that might impact development of metabolic dysfunction and MASLD. Our group has previously shown that alterations in DNA methylation (a type of epigenetic change), identifiable both in liver tissue and in blood, associate with MASLD and its progression to more severe liver disease. Whether DNA methylation that impacts imprinted gene expression also associates with metabolic dysfunction and MASLD risk remains largely unknown.
In this project, we explored imprinted genes: imprinting is a normal process that regulates genes by silencing one parental copy (either the maternal or the paternal) so that only one copy is expressed. Imprinting is an important biological process for development and has a disproportionate impact on disease - in fact, imprinted genes are hypothesized to affect 1-6% of the human genome. We sought to explore how altered DNA methylation of imprint control regions (ICRs) that help ‘control’ these imprinted genes might impact development of metabolic dysfunction in children (and hence potentially even in adults).
Luke Cavanah B.S.[/caption]
Luke Cavanah, BS
Department of Medical Education
Geisinger College of Health Sciences
Scranton, PA, 18509
MedicalResearch.com: What is the background for this study?
Response: Almost a third of patients with medication-treated major depressive disorder will fail at least two depressants—many patients failing more.1 Esketamine is an intranasal medication that was FDA-approved in 2019 for such patients when used in conjunction with an oral antidepressant.2 Esketamine also is unique from the more traditional oral antidepressants in its mechanism of action, quick onset, and evidence for treatment of acute suicidality.3 While esketamine has been of much interest for these last few years, a recent study found low and geographically variable use of this medication within the Medicaid population.4 We were interested in investigating esketamine treatment utilization among Medicare patients in 2019 and 2020.
