Cannabinoids determination in bronchoalveolar lavages of cannabis smokers with lung disease
-
Maria Concetta Rotolo
and
Mario Bisconti
Abstract
Background
Cannabis smoke affects the lungs similarly to tobacco smoke, causing symptoms such as increased cough, sputum, hyperinflation and chronic bronchitis. Chronic use can also cause serious lung diseases and airway obstruction. We developed and validated a method for the identification and quantification of cannabinol (CBN), cannabidiol (CBD), Δ-9-tetrahydrocannabinol (THC) and its metabolites 11-hydroxy-THC (11-OH-THC) and 11-nor-9-carboxy-THC (THC-COOH) in bronchoalveolar lavages (BALs) from hospitalized former or current tobacco smoking patients with lung disease and a long history of cannabis consumption and limited current tobacco use.
Methods
For the extraction of cannabinoids from BALs, a 1 mL sample was added with 300 µL of 0.1 N NaOH and 3 mL of hexane/ethyl acetate (9:1). The solvent was then evaporated to dryness. Trimethylsilyl derivatives were prepared and then analyzed by gas chromatography/mass spectrometry.
Results
The method was linear for the analytes under investigation with coefficients of determination of at least 0.99. Absolute analytical recovery was always better than 80%, imprecision and inaccuracy was always under 15%. Six cases out of 15 were positive for THC, CBN and CBD. In two BALs samples, the presence of 11-OH-THC was also measured while THC-COOH was not detected. In the six positive cases, the last cannabis smoking occurred in the previous 2–14 days.
Conclusions
This is the first time that cannabinoids have been detected in BALs, demonstrating the presence of a drug with its metabolites in a target organ of consumers who present with a lung disease. This occurrence let us hypothesize a role of cannabinoids in the development of the disease and prompted an investigation on possible associations between cannabis smoking and clinical outcomes in patients with lung disease and eventually evaluate a cytotoxic effect of cannabinoids themselves.
Acknowledgments
The authors thank Michele Sciotti, Simonetta di Carlo and Antonella Bacosi for technical assistance.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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©2019 Walter de Gruyter GmbH, Berlin/Boston
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Articles in the same Issue
- Frontmatter
- Editorial
- Can Grail find the trail to early cancer detection?
- Reviews
- Aberrant glycosylation and cancer biomarker discovery: a promising and thorny journey
- Application of NMR metabolomics to search for human disease biomarkers in blood
- Mini Review
- Host-response biomarkers for the diagnosis of bacterial respiratory tract infections
- Opinion Paper
- Diabetes alert dogs: a narrative critical overview
- EFLM Paper
- Documenting metrological traceability as intended by ISO 15189:2012: A consensus statement about the practice of the implementation and auditing of this norm element
- General Clinical Chemistry and Laboratory Medicine
- Commutability of external quality assessment materials for serum sodium and potassium measurements
- Standardization of measurement procedures for serum uric acid: 8-year experience from Category 1 EQA program results in China
- Next-generation rapid serum tube technology using prothrombin activator coagulant: fast, high-quality serum from normal samples
- Cannabinoids determination in bronchoalveolar lavages of cannabis smokers with lung disease
- A new method for the determination of ammonium in the vitreous humour based on capillary electrophoresis and its preliminary application in thanatochemistry
- Reference Values and Biological Variations
- Defining reference intervals for a serum growth differentiation factor-15 (GDF-15) assay in a Caucasian population and its potential utility in diabetic kidney disease (DKD)
- Cancer Diagnostics
- Preanalytical stability of [-2]proPSA in whole blood stored at room temperature before separation of serum and plasma: implications to Phi determination
- Cardiovascular Diseases
- A de novo mutation of SMYD1 (p.F272L) is responsible for hypertrophic cardiomyopathy in a Chinese patient
- Infectious Diseases
- Analyzing the capability of PSP, PCT and sCD25 to support the diagnosis of infection in cancer patients with febrile neutropenia
- Mid-regional pro-adrenomedullin predicts poor outcome in non-selected patients admitted to an intensive care unit
- Validation of Mycobacterium tuberculosis real-time polymerase chain reaction for diagnosis of tuberculous meningitis using cerebrospinal fluid samples: a pilot study
- Letters to the Editor
- Methodological issues are important in cannabinoids determination in bronchoalveolar lavage
- Clarifying methodological issues in cannabinoids determination in bronchoalveolar lavages
- Letter to the Editor relating to Clin Chem Lab Med 2018;56(7):1090–1099
- Authors’ reply to the Letter by Infantino et al. commenting on Bonroy et al.: Anti-DFS70 in different settings, CCLM 2018;56:1090–9
- High-sensitivity cardiac troponin-I analytical imprecisions evaluated by internal quality control or imprecision profile
- Procalcitonin as guide to therapy in endovascular infections: caveat emptor!
- A new suggested approach in screening for Bence Jones protein and potential kidney damage
- Establishing assay-specific 97.5th percentile upper reference limit for serum D-2-hydroxyglutarate for the management of patients with acute myeloid leukemia
- Parallel algorithm for myeloproliferative neoplasms testing: the frequency of double mutations is found in the JAK2/MPL genes more often than the JAK2/CALR genes, but is there a clinical benefit?
- CGH array for the identification of a compound heterozygous mutation in the CYP1B1 gene in a patient with bilateral anterior segment dysgenesis
- A very rare interference with the valproate method on the Beckman DxC 800 general chemistry analyser
- Congress Abstracts
- 5th EFLM Conference on Preanalytical Phase Zagreb (HR), 22-23 March 2019
