Bisconti Mario, De Palma Angela, Pacifici Roberta, Rotolo Maria Concetta, Pichini Simona, Brascia Debora, Trabucco Xenia, Pellegrini Manuela, Carrozzi Laura, Pistelli Francesco, Marulli Giuseppe
Unit of Thoracic Surgery, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, 70124 Bari, Italy.
Unit of Pneumology, Hospital "Vito Fazzi", 73100 Lecce, Italy.
J Clin Med. 2023 Jul 28;12(15):4956. doi: 10.3390/jcm12154956.
Cannabis can be related to respiratory diseases, but the relationship between smoking marijuana and the development of a pneumothorax has scarcely been investigated. We aimed to analyze, in patients with a history of cannabis smoking abuse submitted to lung apicectomy for a primary spontaneous pneumothorax (PSP), the correlation between the presence of cannabinoids in the resected lung and the detection of bullous emphysema within the same tissue. Patients undergoing lung apicectomy for a PSP were prospectively enrolled, and the correlation between the presence of cannabinoids in the resected lung tissue and histological finding of bullous emphysema was investigated with Fisher's exact test. There were 21 male patients, with a median age of 27 years. The cannabinoids found by the toxicological examination in surgical specimens were mainly delta-9-tetrahydrocannabinol (THC), cannabinol (CBN), and cannabidiol (CBD). In 14/21 patients, cannabinoids were detected in the resected lung tissue, and bullous emphysema was present in 13/14 of these (93%), while bullous emphysema was found in only 1/7 (14%) of the remaining patients who were negative for cannabinoids in the lung tissue, and the difference was found to be statistically significant ( < 0.0009). Our study demonstrated the presence of bullous emphysema in most cannabinoid-positive patients and its absence in most of those who were cannabinoid-negative, supporting the correlation between cannabinoids in the lung tissue and bullous emphysema with the development of a "secondary" spontaneous pneumothorax.
大麻可能与呼吸系统疾病有关，但吸食大麻与气胸发生之间的关系几乎未被研究过。我们旨在分析因原发性自发性气胸（PSP）接受肺尖切除术且有大麻吸食史的患者中，切除肺组织中大麻素的存在与同一组织中肺大疱性肺气肿检测之间的相关性。前瞻性纳入因PSP接受肺尖切除术的患者，采用Fisher精确检验研究切除肺组织中大麻素的存在与肺大疱性肺气肿组织学表现之间的相关性。共有21例男性患者，中位年龄27岁。手术标本毒理学检查发现的大麻素主要为Δ-9-四氢大麻酚（THC）、大麻酚（CBN）和大麻二酚（CBD）。在21例患者中的14例中，切除肺组织中检测到大麻素，其中13/14（93%）存在肺大疱性肺气肿，而肺组织中大麻素阴性的其余7例患者中仅1/7（14%）发现肺大疱性肺气肿，差异具有统计学意义（<0.0009）。我们的研究表明，大多数大麻素阳性患者存在肺大疱性肺气肿，而大多数大麻素阴性患者不存在，这支持了肺组织中大麻素与肺大疱性肺气肿以及“继发性”自发性气胸发生之间的相关性。
