Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Universidad de Buenos Aires, Buenos Aires, Argentina.
Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina.
Curr Pharm Des. 2024;30(28):2222-2228. doi: 10.2174/0113816128287272240529072040.
Cannabidiol (CBD) is the principal non-hallucinogenic compound of Cannabis plants with high clinical interest because CBD has been described as having anti-inflammatory, analgesic and anticonvulsant properties. CBD is considered a multitarget compound as it can interact with a wide range of targets, explaining their multiplicity of effects. Some clinical studies have indicated certain side effects of CBD, including somnolence, anemia and diarrhea, while the elevation of transaminases is considered as an exclusion criterion from the trial. Since the red blood cells (RBCs) are a source of transaminase, we assayed effect on RBCs stability.
We performed experiments with RBCs obtained from human peripheral blood with normal hematological parameters exposed to CBD in the range of therapeutic uses. We evaluated RBCs morphological changes, membrane fragility and hemoglobin release as a reflection of hemolysis.
CBD induced an increase in the hemoglobin release (3.27 μg/10 RBC), without altered RBC osmotic fragility. When RBCs suspensions were incubated with CBD the initial number of elements (RBCs + vesicles) was increased up to 65% after 20 min and returned to basal level after 40 min of incubation. In the first 20 min, the accounts of elements were enriched in the smaller vesicles that disappeared after the remaining 20 minutes.
These results suggest that CBD affects the indemnity of erythrocytes , inducing the formation of hemolytic vesicles that can provide the basis for the development of anemia, transaminase elevation and underlying tissular iron overload in patients chronically treated with CBD.
大麻素（CBD）是大麻植物中主要的非致幻性化合物，具有很高的临床应用价值，因为 CBD 被描述为具有抗炎、镇痛和抗惊厥特性。CBD 被认为是一种多靶点化合物，因为它可以与广泛的靶点相互作用，从而解释其多种作用。一些临床研究表明 CBD 有一定的副作用，包括嗜睡、贫血和腹泻，而转氨酶升高被认为是试验排除标准。由于红细胞（RBC）是转氨酶的来源，我们检测了 CBD 对 RBC 稳定性的影响。
我们用正常人外周血中的 RBC 进行实验，暴露于治疗范围内的 CBD。我们评估 RBC 的形态变化、膜脆性和血红蛋白释放，以反映溶血。
CBD 诱导血红蛋白释放增加（3.27 μg/10 RBC），但不改变 RBC 的渗透脆性。当 RBC 悬浮液与 CBD 孵育时，初始元素数（RBC+囊泡）在 20 分钟内增加到 65%，并在 40 分钟孵育后恢复到基础水平。在最初的 20 分钟内，元素的数量在较小的囊泡中富集，这些囊泡在剩余的 20 分钟内消失。
这些结果表明 CBD 影响红细胞的代偿能力，诱导形成溶血性囊泡，这可能为 CBD 慢性治疗患者发生贫血、转氨酶升高和潜在组织铁过载提供依据。
