Cannabis: medicine, food or illicit drug? / Cannabis: gyógyszer, élelmiszer vagy kábítószer?

Összefoglaló. A kender (Cannabis sativa) gyógyhatásainak megítélése napjainkban változóban van, egyúttal igen ellentmondásos. Munkánk célja a kenderrel és készítményeivel kapcsolatos jogszabályi környezet alakulásának a kender gyógyászati alkalmazásának történetével párhuzamos bemutatása. A kenderrel és tartalomanyagaival kapcsolatos, jelenleg hatályos hazai jogszabályok és nemzetközi egyezmények áttekintése mellett bemutatjuk a kender alkalmazásának történetét a szakirodalmi adatok és a gyógyszerkincs átalakulásának tükrében. A kender ipari pályafutása textilipari alapanyagként kezdodött, de már ezt megelozoen is alkalmazták kábítószerként és gyógyászati célokra. A 20. század során a pszichoaktív szerként való felhasználás vált elterjedtebbé, de a növény hatóanyagainak jobb megismerésével a gyógyászati alkalmazás súlya is nott. Jelenleg a kender több vegyülete (kannabidiol, tetrahidrokannabinol) van forgalomban gyógyszerként világszerte, de félszintetikus kannabinoidot (nabilon) tartalmazó készítmények és különbözo kannabisztermékek is forgalomban vannak gyógyszerként. Napjainkban alkalmazására jellemzo, hogy a racionális gyógyászati használat mellett jelentos a túlzó elvárásokon alapuló, szakszerutlen alkalmazás. Ez részben a kenderrel kapcsolatos jogi szabályozás anomáliáival is magyarázható. Ennek következménye, hogy élelmiszerként elérhetok a kender epilepsziaellenes hatóanyagát tartalmazó termékek, amelyeket számos gyógyhatás reményében használnak orvosi kontroll nélkül. Megállapítható, hogy az új tudományos eredmények, a területen érdekelt vállalkozások céljai, a fogyasztói igények, a piaci realitás és a jogi szabályozás nem minden esetben és szempontból van összhangban. A kannabinoidok hosszabb távú jövojét a bizonyítékokon alapuló gyógyászatban nagyban befolyásolják azok a kutatások, amelyek segítségével pontosabb kép alkotható haszon-kockázat profiljukról. Orv Hetil. 2021; 162(45): 1808-1817. Summary. The opinion about the medicinal value of cannabis (Cannabis sativa) is changing but still remains controversial. The aim of our work was to present the evolution of the regulatory environment of Cannabis and its preparations in parallel with its history as medicine. We reviewed the current national legislation and international conventions on Cannabis and its constituents along with the historical and contemporary medicinal application of Cannabis. The utilisation of Cannabis started in the textile industry, but it was applied for recreational and medicinal purposes beforehand. During the 20th century, it was best known for its psychoactivity whereas its medicinal importance increased after elucidating the bioactivities of the active compounds of the plant. Currently different phytocannabinoids (cannabidiol, tetrahydrocannabinol) are marketed as medicines, but semisynthetic cannabinoids and different cannabis-based products are also approved as medicines. Today, there is a trend that goes beyond the rational and medicinal application thus results in improper form of utilisation. This phenomenon could partly be explained by the anomalies of legislative regulations. As a result, products containing the antiepileptic component of cannabis are available as food and used for different medicinal purposes without medical supervision. Evidently, there is no harmony between the new scientific discoveries, the goals of companies involved, the demands of consumers, market realities and current laws in several aspects. Ongoing studies will help to clarify the benefit-risk profiles of cannabinoids and provide major influence on the future of these compounds in the evidence-based medicine. Orv Hetil. 2021; 162(45): 1808-1817.

Ecdysteroid-containing food supplements from Cyanotis arachnoidea on the European market: evidence for spinach product counterfeiting.

Phytoecdysteroids like 20-hydroxyecdysone ("ecdysterone") can exert a mild, non-hormonal anabolic/adaptogenic activity in mammals, and as such, are frequently used in food supplements. Spinach is well-known for its relatively low ecdysteroid content. Cyanotis arachnoidea, a plant native in China, is among the richest sources of phytoecdysteroids, and extracts of this plant are marketed in tons per year amounts via the internet at highly competitive prices. Here we report the investigation of a series of food supplements produced in Germany and claimed to contain spinach extracts. Twelve ecdysteroids including two new compounds were isolated and utilized as marker compounds. A comparative analysis of the products with Cyanotis and spinach extracts provides evidence that they were manufactured from Cyanotis extracts instead of spinach as stated. Based on the chromatographic fingerprints, 20-hydroxyecdysone 2- and 3-acetate are suggested as diagnostic markers for related quality control. This case appears to represent an unusual type of dietary supplement counterfeiting: undeclared extracts from alternative plants would supposedly 'guarantee' product efficacy.

[Dietary supplements on the domestic market adulterated with sildenafil and tadalafil]. / Szildenafillal és tadalafillal hamisított étrend-kiegészítok a hazai piacon.

Mandatory requirements regulating the manufacture and sale of dietary supplements are much less stringent than those related to pharmaceuticals. Hence, the sheer number and diversity of marketed products in this category has shown an unprecedented increase Europe-wide. Not surprising, that cases for incorrect marketing/promotion, incorrect recommendations for product use, as well as reported incidents of questionable product quality and/or deliberate adulterations have also become frequent in recent years. Typical adulterations consist of admixtures of synthetic pharmaceuticals to the matrix fraudulently declared to consist exclusively of extracts of various (medicinal) plants. In the present paper, the results of qualitative investigations of ten plant-based preparations, marketed in Hungary, and recommended as (or alleged to be) natural aphrodisiacs, are reported. Sildenafil and/or tadalafil or related analogs were detected in six of the ten products. These results highlight, once more, the unacceptable risks for the consumers of such adulterated dietary supplements.

[Ecdysteroid sources in the Carpathian basin. 11-hydroxy substituted ecdysteroids from the Serratula wolffii Andrae]. / Kárpát-medencei ekdiszteroid források 11-Hidroxi-származékok a Serratula Wolffii Andrae-ból.

Seven ecdysteroids have been isolated from the methanolic extract of the herb Serratula wolffii Andrae. The isolation process involved the removal of polar and apolar contaminants, and also included the separation of the target ecdysteroids from each other by using combined chromatographic methods. Isolation of the pure compounds required a minimum of 2 and a maximum of 7 consecutive chromatographic steps with different selectivity. Six of the isolated ecdysteroids showed the presence of an 11alpha-hydroxyl group on the steroidal skeleton, which structure may enhance the increasing effect of ecdysteroids on the protein synthesys of mammals, according to literature data. Ajugasterone C, one of these compounds was found to be present in remarkable amount in the plant. One ecdysteroid, 11 alpha-hydroxypoststerone was identified as a new natural compound.

[A novel analgesics made from Cannabis]. / Uj típusú analgetikum cannabisból.

Bayer AG has recently announced that it acquired exclusive rights for the marketing of GW Pharmaceuticals' new medicine Sativex in Europe and in other regions. Sativex is a sublingual spray on Cannabis extract basis, and is equipped with an electronic tool to facilitate accurate dosing and to prevent misuses. It is standardized for the THC and CBD. The new analgesic is proposed for the treatment of muscle spasticity and pains accompanying multiple sclerosis and as an efficient analgetic for neurogenic pain not responding well to opioids and to other therapies available. The entirely new mechanism of action through the recently discovered cannabinoid receptor system may offer a real therapeutic potential to the drug. Although the Government of Netherlands has authorized the sale of pharmaceutical grade Cannabis herb by pharmacies in the Netherlands, the availability on the pharmaceutical market of the registered preparation may render requests for the authorization of the smoking of Cannabis herb (marihuana) by individuals suffering of multiple sclerosis, neurogenic pain, AIDS wasting syndrome unnecessary. Nevertheless, the "old chameleon" plant Cannabis appears to gradually regain its previous status in mainstream therapy and pharmacy. As long as the plant Cannabis and its products continue to be classified as narcotic drugs, medical use of the new preparation will need close supervision.