Klinische Pädiatrie: Offener Zugang
Offener Zugang

Abstrakt

Explaining Contemporary Patterns of Cannabis Teratology

Albert Stuart Reece and Gary Kenneth Hulse

Cannabis has been shown to be teratogenic in cells, animals and humans. Particular targets of prenatal exposure include brain, heart and blood vessels and chromosomal segregation. Three longitudinal clinical studies report concerning cortical dysfunction persisting into adolescence and beyond, which are pertinent to the autism epidemic. Increased rates of congenital heart defects, gastroschisis, anencephaly and others have been reported. The pattern of neuroteratology seen after cannabis exposure strongly suggests a spectrum of dysfunction from mild to moderate to very severe. Downs syndrome, atrial septal defect (secundum type), ventricular septal defect and anotia / microtia were noted to be more common in prenatally cannabis exposed children in a large US epidemiological study which would appear to have been confirmed by recent experience in Colorado and other USA states. Studies in cells, together with the above mentioned epidemiology, implicate cannabidiol, cannabichromene, cannabidivarin and other cannabinoids in significant genotoxicity and / or epigenotoxicity. Notch signalling has recently been shown to be altered by cannabinoids, which is highly pertinent to morphogenesis of the neuraxis and cardiovasculature, and also to congenital and inheritable cancer induction. It is felt that subtle neurobehavioural psychosocial and educational deficits will likely be the most common expression of cannabinoid teratology at the population level. The far reaching implications of this wide spectrum of neuroteratological, pediatric cardiological and other defects and deficits should be carefully considered in increasingly liberal paradigms. Hence it is shown that the disparate presentations of cannabis teratology relate directly and closely to the distribution of CB1R’s across the developing embryo and account for the polymorphous clinical presentations.