Kratom is an herbal substance that produces opioid-like and stimulant-like effects. Kratom contains bioactive alkaloids that include mitragynine and 7-OH mitragynine. Both substances activate mu-opioid receptors as well as bind to adrenergic, dopaminergic, and serotonergic receptors, which may be responsible for the stimulant effects. There is no current approved use of kratom or kratom products by the USFDA, but it is currently being used by individuals for management of drug withdrawal, pain, fatigue, and mental health problems. Multiple serious but rare side-effects have been reported, including gastrointestinal, respiratory, psychiatric, cardiovascular issues. Thus, the USDEA considers it to be a Drug and Chemical of Concern and has warned the public against risks of Kratom use. As such, research on Kratom products is necessary to better understand risks and inform policy regarding regulation. Here, we sought to develop a method by which the pharmacologically active mitragynine and its active metabolite 7-OH mitragynine could be measured in various kratom products. The quantification of each utilized high pressure liquid chromatography with ultra-violet detection (HPLC-UV). An XBridge C18 column with 3.5 um particle size, 4.6 x 150 mm was used, and separation was achieved using a gradient elution with acetonitrile and 0.1% formic acid. The flow rate was 1 mL/min, and the oven temperature was set at 40oC. UV detection was at 254 nm. The 7-OH mitragynine peak was visible at 2.5 minutes and the mitragynine at 3.55 minutes. In conclusion, this method has potential to provide utility for detection and quantification of pharmacologically active compounds in kratom products.

No description available.

Chronic neuropathic pain is a leading cause of disability worldwide and is associated with immense economic burden. Of all chronic neuropathic pain conditions, chemotherapy-induced peripheral neuropathy (CIPN) persists as a monumental public health crisis, as it is the most common comorbidity among those receiving chemotherapy for cancer treatment. CIPN is unique compared to other forms of neuropathic pain in that it is severely dose-limiting, often leading to disruption or cessation of chemotherapeutic treatment and complicating an individual’s cancer prognosis. Current pharmacological treatments for combatting CIPN are widespread yet are all accompanied with the same hindrances – they are limited in therapeutic efficacy when administered chronically and are associated with severe risk for adverse effects. Therefore, there is a clear unmet need for novel pharmacotherapies for CIPN that achieve strong therapeutic efficacy while minimizing the susceptibility to adverse events.Here, we characterize the therapeutic efficacy and pharmacological mechanisms of a novel, plant-derived alkaloid mitragynine (MG), a constituent of the kratom plant (Mitragyna speciosa) in a mouse model of CIPN. Kratom products have emerged in the US in recent years as a popular form of self-treating pain, opioid withdrawal, and symptoms of anxiety and depression, but these intended uses are largely based on anecdotal reports in humans. MG possesses a unique, mixed pharmacological profile combining opioid, adrenergic, and serotonergic properties – resembling the pharmacology of current CIPN pharmacotherapies such as antidepressants. However, the relation of these pharmacological mechanisms of MG to the context of CIPN remain under characterized. Kratom products are also commonly used in combination with cannabis products, which are also used for self-treating pain, and play a significant role in palliative care for terminal cancer patients. Yet, interactions between kratom alkaloids and cannabinoid signaling have yet to be studied in the context of CIPN. Lastly, the basis of potential utility of individual kratom constituents such as MG on anxiety- and depression-like behaviors, which are heavily comorbid in individuals with CIPN, remain understudied. The present studies were conducted to explore the role of the kratom alkaloid MG on both pain and affective behaviors associated with CIPN, at the pharmacological, cellular, and molecular level. To accomplish this, we measured 1. Contributions of opioid and adrenergic signaling mechanisms to the therapeutic efficacy of MG in a mouse model of oxaliplatin-induced mechanical hypersensitivity using pharmacological inhibition. 2. Contributions of cannabinoid signaling to the therapeutic efficacy of MG in a mouse model of oxaliplatin-induced mechanical hypersensitivity and inflammatory pain using pharmacological and genetic approaches. 3. Effects of MG on affective behaviors associated with CIPN using mouse models of the tail-suspension test, elevated zero maze, and conditioned place preference. Overall, the findings from this dissertation support the hypothesis that MG displays therapeutic efficacy against nocifensive behavior of CIPN and pain-related affective behaviors. Opioid, adrenergic, and cannabinoid mechanisms all contribute to the effect of MG on oxaliplatin-induced mechanical hypersensitivity. MG is also capable of normalizing aberrant neurotrophic factor signaling associated with CIPN. Lastly, MG produces anxiolytic effects when repeatedly administered without developing a conditioned place preference, suggesting that it achieves therapeutic efficacy in a model of CIPN without risk of adverse events. / Biomedical Sciences

<div> <p>Historically, natural products from plants, fungi, bacteria and animals have played an important role in the discovery of new drugs. In fact, it has been found that 34% of new FDA-approved drugs over the last 30 years were derived from natural products or their derivatives. Because of the chemical and structural diversity of natural products, they continue to be one of the best options for discovering novel compounds and scaffolds; this is especially true for compounds targeting the µ-, δ-, and κ- opioid receptors. However, traditional opioids such as morphine cause many therapeutically limiting side effects. Therefore, there have been immense efforts to develop opioids that avoid these side effects, with “signal-biased” compounds being an intense area of interest. The research presented here investigates of the biased mechanisms of compounds found in and derived from <i>Mitragyna speciosa</i>, also known as kratom, and <i>Picralima nitida</i>, also known as akuamma. Kratom and akuamma compounds are examined for their therapeutic potential in treating alcohol abuse and pain, respectively, two prevalent conditions with extreme societal and economic costs.</p> </div> <br>

Background: The rapid diffusion of Novel Psychoactive Substances (NPS) constitutes an important challenge in terms of public health and a novelty in clinical settings, where these compounds may lead to erratic symptoms, unascertained effects and multi-intoxication scenarios, especially in emergency situations. The number of NPS available on the illicit drug market is astonishing: official reports suggest the appearance of a new drug every week. NPS may be enlisted in many different families such as synthetic phenethylamines, tryptamines, cathinones, piperazines, ketamine-like compounds, cannabimimetics and other plant-derived, medical products and derivatives. Therefore, healthcare services and professionals are often called to face this unknown 'galaxy' where NPS users seem to perceive traditional services 'unfitting' for their needs, requiring an attention which is quite different from known classic drug abusers. In this context, the Recreational Drugs European Network (ReDNet), a research project funded the European Commission and led by the University of Hertfordshire, aimed to explore the NPS galaxy and develop information tools for vulnerable individuals and professionals working with them. This initiative reported specific Technical Folders on new drugs and disseminated the collected information through innovative communication technologies (e.g. multimedia tools, social networking and mobile phone services) internationally. Aim and objectives: The aim of this work is to evaluate and contribute to expand the knowledge of health professionals on NPS. The key objectives are: 1) to assess the level of knowledge on NPS amongst a sample of Italian healthcare professionals; 2) to evaluate the effectiveness of dissemination tools developed by ReDNet, including an SMS-Email/mobile service (SMAIL); 3) to understand the clinical impact of NPS by providing four Technical Folders and collecting two clinical cases on NPS. Methodology: According to the objectives, the methodological approach has been articulated in the following three phases. Phase 1: investigating knowledge and preferred channels of information via an online survey among health professionals in Italy. This first Italian study on NPS awareness had been online from February to July 2011, recruiting participants from Departments of Addiction, Psychiatry and other services. Phase 2: evaluating the ReDNet initiative. An evaluation questionnaire was designed and disseminated online to assess the various resources provided by ReDNet project; it had been online from April to July 2013, targeting professionals registered to ReDNet services. This phase also investigated the SMAIL service, a mobile application that was the latest technological tool developed by ReDNet team. Phase 3: promoting evidence based work in clinical practice through the preparation of four Technical Folders and two case reports. Technical Folders followed the methodology optimised during the ReDNet experience, organising NPS data under specific headings, measured for the need of health professionals. Case reports were collected in a Dual Diagnosis Unit in Italy ('Casa di Cura Parco dei Tigli'); assessed patients revealed for the first time the use of NPS; clinical interviews were conducted to collect a full anamnesis while for the first time psychopathological characteristics were measured in NPS abusers, using a psychometric instrument (MMPI-2). Results: In Phase 1 Italian services, in particular interviewees (n=243) from Departments of Psychiatry and Addiction, showed a strong interest for the subject but a poor understanding of NPS: 26.7% of respondents did not know if their patients ever used NPS; at the same time they considered this phenomenon as very relevant to their profession (e.g. psychomotor agitation [75.7%], errors in the assessment [75.7%], management of the clients [72%]); in addition less of a quarter of them had reliable information on new substances. Interviewees also reported the need for easily accessible channels of information to expand their expertise in the field (including emails [70%] and dedicated websites [51.9%]). The ReDNet initiative (Phase 2) reached professionals (n=270) from European countries and various other regions; they appreciated the website above all (48.5%), which provided access to other information (in form of academic papers, news, technical folders, etc.). The integration of technological-based and classic educational resources was used to self-educate professionals (52.6%) and supply information for research (33.7%) with up-to-date and 3 reliable information; in the same Phase the SMAIL service was analysed in its first 557 searches: in the pilot period 122 professionals used SMS inquiries (95%), asking information on NPS while highlighting the increasing number of NPS available on the market. Technical folders (Phase 3) described two new phenethylamines (Bromo-dragonfly and 25I-NBOMe), a novel ethno drug (Kratom) and a new synthetic cathinone (alpha-PVP) whose severe effects were also described in one of the clinical cases. The first case report (Alice) involved a clubber who used mephedrone and other NPS with a severe worsening of her psychiatric disturbances; the second one (Marvin) described a patient who was referred by a psychiatric service and revealed himself as a 'psychonaut' with an intense abuse of alpha-PVP. Conclusions: The exploration of the NPS galaxy is a new challenge for healthcare professionals. In this study, Italian services seemed to be unprepared to face the emergency and requested rapid access to reliable information; the ReDNet project provided both technology-based and traditional resources to expand knowledge on NPS, making professionals more aware of emerging issues and helping especially clinicians working in the field (e.g. via SMAIL service and Technical Folders). Overall, it can be observed that effective information services on NPS targeted at professionals initiatives should include an online interface integrating up-to-date information, describing NPS through specific Technical Folders and disseminating scientific literature; the use of technological tools, including mobile applications, is an important strategy to support health professionals in their activity. Finally, more 'visual' guidelines, possibly in the form of a 'map' of these heterogeneous compounds, could be a useful framework to describe NPS to physicians and other professionals who are often unprepared and unconfident to face such an expanding galaxy.