Medical Technology

Chronic Marijuana Use May Impair Donor Islet Cells

NEW YORK (Reuters Health). – Chronic marijuana users’ donor islet cells were not as effective in reverse diabetes in vitro and in mice, as compared to non-marijuana consumers The study suggests that transplanted cells may not work optimally.

Chronic marijuana use is defined as a frequency of four times a week for more than 3 years.

“We conducted this study due to the number of donors that are using marijuana has been increasing,” Dr. Ismail Al-Abdullah of City of Hope in Duarte, California, told Reuters Health by email. “The pancreatas in marijuana users had lower quality islets, lower insulin secretion, and appeared enlarged. We therefore decided to investigate further the effect of excessive marijuana use.”

As reported in PLOS One, Dr. Al-Abdullah and colleagues analyzed pancreatas received at City of Hope from 2006-2016 from 206 deceased donors. Donors were classified into two groups based on the medical and social histories recorded in the donor charts that were provided by organ procurement agencies at the time of placing the pancreas offer.

26 donors were part of the marijuana group. The average age of donors at death was 40. About 31 percent of them were women.

Subsets of donors that were matched were identified in both groups to limit bias effect estimates from the covariates of sex, age, and ethnicity.

Islets of marijuana users showed lower insulin secretion as compared to islets of non-users stimulated by high glucose (area under the curve, 3.41) and high glucose plus KCl (AUC, 4.48).

The average rate of reversed diabetes in diabetic mice was 35% for chronic marijuana users when they were transplanted into human islets. This was compared to 77% in non-users.

Immunofluorescent staining revealed that cannabinoid receptor type 1 (CB1R) was colocalized with insulin and enhanced significantly in beta cells from users versus non-users (CB1R intensity/islet area, 14.95 +/+/- 2.71 vs. 3.23).

CB1R expression, however, was not co-localized to the glucagon receptor and somatostatin.

In addition islets isolated from chronic users appeared hypertrophic as Dr. Al-Abdullah noted.

Dr. Al Abdullah said, “Our study provides a compelling case for a thorough evaluation of the lifestyles of donors such as marijuana use when the clinicians are looking at human islets for transplantation or research.”

“We are conducting a mechanistic research regarding the impact of cannabinoid on human islets,” he added. “We would like to have the chance to study the effects of other commonly used drugs to determine their potential negative effects on islets as well as other pancreatic tissues.”

Dr. Zoe Stewart Lewis, surgical director of the kidney and pancreas transplant programs and director of quality at the NYU Langone Transplant Institute, commented on the study in an email to Reuters Health. She explained that this procedure (taking lifestyle into account) is already standard care for organ donors. “All organ donors undergo a thorough medical and psychosocial assessment to determine the factors that can affect organ function or increase the risk of transmission of infection.

“While this is an intriguing area of study that merits further investigation but I believe it’s extremely premature to conclude that pancreas transplant organ utilization practices should be modified in response to the latest report,” she noted. “There are several key limitations, such as the small sample size and the fact that the study is looking at the function of isolated islets cells versus the functions of an entire organ.”

She also said that “additionally,” she stated, “the study involved islet cells from donors who were not in compliance with the accepted donor criteria for whole-organ pancreas transplants in donors older than 40 years and donors who were obese or overweight.”

She also said that further research is needed for pancreas transplant recipients to determine if the long-term use of marijuana has an impact on the allograft function.

SOURCE: PLOS One, online October 27, 2021.

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