Cannabinoids: The Separation of Central From Peripheral Effects On A Structural Basis
Cannabinoids: The Separation of Central From Peripheral Effects On A Structural Basis
Cannabinoids: The Separation of Central From Peripheral Effects On A Structural Basis
moved from the Merck Index in 1950 and even from the In-
Abstract dian Pharmacopoeia in 1966 when the social controversy in
Western countries was probably reaching its height. In the
A brief history of the therapeutic uses and U. K. the possession of cannabis is controlled by the 'Misuse
legal problems of cannabis as well as the component can- of Drugs Act' of 1971 and it is not available for prescription
nabinoids is given. This is followed by a discussion of or for experimental purposes except on a Home Office Li-
drug development from 1-tetrahydrocannabinol and its cence. Under this Act the pure cannabinoids are classified
synthetic analogues. The controversy of whether the as class A drugs equivalent to heroin whilst herbal cannabis
pharmacological effects are of central or peripheral ori- is classified as class B. The criminal penalties are consider-
gin is included. Then, the potentials for the development ably less for possession of class B drugs. The difficulties
ously been published [for example (8—10)1. The numbering in mice but using the cataleptic test, the effects of THC were
system used in Fig. 1 is reproduced from (8) and treats the inhibited by aspirin, a cyclooxygenase inhibitor (26), and
cannabinoids as aryl-substituted meroterpenes. Thus for reversed by the administration of PG's and these authors
the first time the pharmacologist and physician could be suggested the involvement of PG's in some of the properties
provided with pure materials of proven structure for biolog- of the cannabinoids.
ical investigations. The vast majority ofthese investigations
involved THC for which a number of new applications were Despite the contradictions concerning the
found and synthetic programmes based upon that structure mechanism of action of THC, certain structure-activity rela-
have led to the marketing of new drugs. tions were tentatively assembled on a qualitative rather
than a quantitative basis (27— 29) and these were devoted to
Drug Development from THC the central hallucinogenic effects of THC or from animal
models believed to correlate with hallucinicity in man. The
The pharmacological and therapeutic ef- most significant of these observations were that firstly a
fects of THC have been reviewed (11—13) and it was these tricyclic structure is required for activity, the aromatic ring
results which led to the development of synthetic analogues is necessary for high activity, removal of the phenolic group
related to that hallucinogenic cannabinoid. Cannabis or its of the benzene ring (C-5') reduces or in some cases
active principle THC were used in the treatment of diverse abolishes activity, that the double bond in the terpene ring
disease conditions including glaucoma, as an anti-convul- is not a requirement for activity, and that the C-3' phenolic
sant, to reduce body temperature, as an anti-emetic, an group is essential for central actions. Synthetic derivatives
hypotensive agent, in the treatment of muscle spasticity,
and as a sedative (14). The drug was also used for the relief
of pain and for the treatment of inflammatory and related
OH3 OH3
conditions (15).
fl')
mediated (18) via the CNS when it was shown that the effect
of the drug was decreased in the denervated eye. In con-
trast, the case for peripheral involvement has also been
H3OlH3O
R
H
3O' OH OH2)rcO H3
proposed as a mechanism of action. It is known that high H H, n 6: cannabinot ICBH) H H, n = 4: cannabidiot ceoi
doses of prostaglandins (PG's) cause a rise in lOP (19, 20) H = COOH, n 4: cannabinolic acid H = cOOH, n 6: cannabidiolic acid
and the demonstration that THC blocked the release of R = H, n 2: cannabivarol H = H, n 2: cannabidvarot
arachidonic acid-induced increase in TOP in the rabbit H COOH, n 2: cannabivarolic acid H = COOH, n 2: cannabidvarotic acid
whilst the administration of PGE2 reversed this effect (21) H H, n 0: cannaborcinot H = H, n = 0: cannabidiorcinot
H 3O'f)
H30 H3C
fluid dynamics may also be involved. THC reduces fluid pro-
duction in the rabbit eye (22) and this may be due to effects
upon secretory mechanisms such as carbonic anhydrase HO 'iO H2)0— OH3
(23) inhibition. R
H H, n 4: cannabigerot ICBO)
Another interesting example is the use of H = COOH, n 4: cannabigerotic acid
THC in the treatment of anxiety and as a sedative. Clinical H H, n 2: cannabigerovarot
trials have demonstrated that sedation is the most common
effect of THC (24). However, in animal experiments when a Fig. 1 The cannabinoid constituents of Cannabis sativa L. The major
mechanism has been sought both central and peripheral compounds as currently known are illustrated but the cannabis plant
contains in addition a number of compounds including cannabichromen,
modes of action have been proposed. It has been de-
cannabicydol, cannabicitran, flavonoids, and an alkaloid. These substances
monstrated that the effects of THC can be reversed in this are not generally available to the pharmacologist and are not included in this
respect by the administration of RO-151788, a ben- review. An alternative numbering system is also popular in the literature of
zodiazepine receptor antagonist (25), in mice, suggesting the cannabinoids. This system treats the cannabinoids as dibenzopyrans and,
that the natural benzodiazepine receptor in the CNS is in- according to Orombie and Orombie (8), may also be used as opposed to the
volved with this aspect of the effects of THC. However, also numbering system generally used in their original review (8).
S62 Planta Med. 57(1991). Supplement Issue 1 1991 Fred J. Evans
of THC have been developed using these principles as The central effects of a number of can-
guidelines for novel drug production. Amongst the first of nabinoids were recently re-evaluated to confirm the struc-
these compounds were the nitrogen-containing com- ture-activity base line as previously described (40). Iii these
pounds from the group of Pars and others (30) including the experiments the ring test in mice as originally described by
3,4-diaza-THC analogues. Several compounds were used Paton and Pertwee (41) was used. This test is said to be a
clinically, such as BW 146Y, levonanthradol (a nuclear ni- pharmacological model which is a direct correlate with hal-
trogen derivative, Fig. 2) and the most successful of all, lucinogenic actions in man (42) and should provide evi-
nabilone. All of these compounds in one form or another re- dence for the segregation of central effects on a structural
tained the principle of the three-ring structure as being nec- basis. A range of commercially available cannabinoids was
essary for activity. Nabilone is still in use today, it is mar- assessed. These included CBD, CBN, CBG, and the sup-
keted under the trade name of "Cesamet". The drug is man- posed cannabinoid biosynthetic precurser olivetol (OL). The
ufactured by the Lilly company and was introduced for the results confirmed previous structure-activity relationships
treatment of nausea mainly in patients undergoing radia- in that the tricyclic cannabinoid, THC, was shown to be the
tion therapy for cancer (31—33). The compound also has only compound which induced catalepsy in mice (Fig. 3).
some analgesic activity which would be of advantage in THC induced catalepsy at doses of 0.625 mg/kg to 25 mgI
these circumstances. However, the compound is not devoid kg, whilst the other cannabinoids, OL, CBN, CBD, and CBG
of central effects which include drowsiness, dizziness, di- were inactive up to tested doses of 100 mg/kg. Further ex-
vided co-ordination, and low blood pressure (34—36). In
the British National Formulary (BNF 1988), cautions in-
clude a warning that this drug may effect the patients ability
to operate machinery or to drive a car. Clearly there was no
complete separation of central from peripheral activity in 80
these compounds, although certain aspects of the multiple
70
effects of THC may have been selectively enhanced.
H3
a0
C
H3C—C—O. 0
4-,
(U
'-4
IH
H3C' OH3 -H
4-,
nabilone (evonanthradol (1) 0
—20
20 30 40 50
Fig.2 Synthetic analogues of Q'-THC. Nabilone is quoted as being Concentration (pg/nil)
available as a prescription-only drug in the BNF (1988). It is prescribed for the
treatment of sickness following radiation therapy in cancer patients and is an Fig. 4 Stimulation of phospholipase A2 activity by cannabinoids. Acid
analgesic. release in the absence of drugs: 0.07 0.006zmoI/min.
Separation of Centralfrom PeripheralEffects on a Structural Basis Planta Med. 57(1991). Supplement issue 1 1991 S63
mal models have confirmed this activity. Tests used in- THC 25 100
cluded the hot-plate test (49, 50), the tail flick test (51), PBQ- CBN >25 36
induced writhing (52), the acetic acid abdominal constric- 080 0.042 60
tion test (53, 54), and the tooth pulp test (55). Subsequently ORG 1.26 61
a mechanism of action involving non-opiate central recep- OL 0.63 100
Aspirin 15.0 62
tors has been proposed (49, 56). Sanders and others (53)
S64 Planta Med. 57(1991). Supplement Issue 1 1991 FredJ. Evans
Table 2 The effect of cannabinoids on PAF-induced rabbit platelet aggrega- lungs it has been suggested that inhibition of PG synthesis
tion. PAF (2.9 x 107M) introduced 1 mm after the introduction of the an- could be the mechanism of action; however, in healthy vol-
tagonists. unteers the administration of PG's had no effect upon the in-
Compound ED50 (M x 10-a) Maximum Inhibition (%) crease in specific airway conductance or forced expiratory
volume induced by THC (62). A more likely explanation is
TRC 8.0 60 that the cannabinoids have more than one target.
CBN 5.6 76
CBD 2.8 77
CBG 5.2 100 Another suggestion has been the possibility
OL 9.4 86 that these compounds inhibit platelet-activating factor
(PAF). Recently the abilities of a number of cannabinoids to
inhibit human and rabbit platelet aggregation induced by a
1.6x103M ABC series of agonists including PAF were determined (63). PAF
8.OxlO4M ABA is a natural hormone and is a known mediator of the as-
4 O)(1O4M ABC
2.O,104M COG thmatic/allergenic response in the lungs. It will also induce
2.9x1070 PAP aggregation of blood platelets. CBD was found to antagonise
PAF-induced aggregation of rabbit platelets with an effec-
tive dose of 2.8 x 104M and was measurably more potent
than THC but was less potent than the standard PAF recep-
tor antagonists BN52021 and L652731 (Table 2, Fig. 7).
Both the cannabinoids were shown to inhibit PAF-induced
5HT release in this system but the effects were not dose-re-
lated in platelet-rich plasma. Although it is unlikely that the
cannabinoids are PAF receptor antagonists it is clear that in
this system, as was the case for the PBQ writhing experi-
The arachidonate cascade as a munoassay (69) as illustrated in Fig. 8. This effect was also
target for cannabinoid activity shown by measurement of thromboxane B2 (TXB2) release
from human polymorphonuclear cells when THC and CBD
The inhibition of arachidonate release and were compared for their abilities to prevent A23 187 stimu-
PG synthesis re-occurs constantly in the literature con- lation of TXB2 (Fig. 9).
cerned with the effects of THC in many different disease
conditions; for example, in glaucoma (21), sedation (26), A number of cannabinoids have been
and as an anti-emetic drug (65, 66). The central hal- examined for their effects upon a microsomal preparation
lucinogenic actions of THC have been correlated with its of cyclooxygenase (70). The cannabinoids were found to in-
ability to stimulate arachidonate mobilisation in cell culture hibit enzyme activity in the 30—40MM concentration range
(67). (Table 4). The effects of the same compounds on soybean
lipoxygenase were also determined and they were found to
The site of action of THC appears not to be inhibit the activity of that enzyme with ID50 of between 2.0—
phospholipase A2 itself. It has been shown with a range of 9.0 riM. There was evidence of competitive inhibition at low
natural cannabinoids used in studies with the enzyme in inhibitor/high substrate concentrations and non-competi-
cell-free systems that there was no difference in the abilities tive inhibition at high inhibitor/low substrate concentra-
of centrally active or non-active compounds to influence en- tions. The effective lipoxygenase inhibitory actions were
zyme activity (68). In fact THC, CBG, CBN, and CBD initially demonstrated in human polymorphonuclear cells stimu-
stimulated enzyme activity in low doses but at higher doses lated with A23187 and the cannabinoids prevented leuko-
enzyme inhibition was recorded (Fig. 4). Opposing effects triene B4 release with 1D50's of between 5 and 8 1iM (Fig. 10).
on arachidonate secretion would be expected depending These effects are characteristic of compounds which inter-
upon the dose of the cannabinoid at the site of action. This fere with peroxide activation of both cyclooxygenase and
effect has been demonstrated in human rheumatoid syno- lipoxygenase. The peripheral effects are therefore complex
vial cells in culture when stimulated with THC, CBN, and involving a dose related stimulation/inhibition of phos-
150
Fig. 8 Stimulation of PGE2 release by THC (E), CBN (•), and CBD (0) on
synovial cells.
DO
Ci,
80
-H
CD
200. 0)
'C
0 4.4
60
C
THC 5.,
C CD
0
0 DO
40
.30
0.4
150- 0
C 20
0
C4 -H
0 4-)
-H
C
0
.0
-H
10
100 .0
C
'\.. CflD
I
Cd
0
4-)
C 1 10
0)
0
C
0 Concentration of cannabinoid (,uM) Concentration of cannabinoid
1) ç,1M)
Acknowledgements
lam grateful to Dr. Tudor Evans, Dr. Maryln Bar-
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