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Marihuana and the Lung

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Marihuana and Medicine

Abstract

Habitual marijuna use may lead to the following effects on the lung: acute and chronic bronchitis; extensive microscopic abnormalities in the cells lining the bronchial passages, some of which may be premalignant; overexpression of molecular markers of progression to lung cancer in bronchial tissue; abnormally increased accumulation of inflammatory cells (alveolar macrophages) in the lung; and impairment in the function of these immune-effector cells (reduced ability to kill microorganisms and tumor cells) and in their ability to produce protective inflammatory cytokines. Clinically, the major pulmonary consequences that may ensue from regular marijuana use are pulmonary infections and respiratory cancer. Infections of the lung are more likely in marijuana users because of a combination of smoking-related damage to the ciliated cells in the bronchial passages (the lung’s first line of defense against inhaled microorganisms) and marijuana-related impairment in the function of alveolar macrophages (the principal immune cells in the lung responsible for defending it against infection). Patients with pre-existing immune deficits caused by AIDS or cancer chemotherapy might be expected to be particularly vulnerable to marijuana-related pulmonary infections. Furthermore, biochemical, cellular, genetic, animal, and human studies all suggest that marijuana is an important risk factor for the development of respiratory cancer. However, proof that habitual use of marijuana does in fact lead to respiratory cancer must await the results of well-designed case-control epidemiologic studies that should now be feasible after the passage of 30 years since the inititation of widespread marijuana use among young individuals in our society in the mid-1960s.

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References

  1. Hoffmann, D., Brunneman, D. K., Gori, G. B., and Wynder, E. L. (1975) On the carcinogenicity of marijuana smoke. Recent. Adv. Phytochem. 9, 63–81.

    Article  CAS  Google Scholar 

  2. Novotny, M., Lee, M. L., and Bartle, K. D. (1976) A possible chemical basis for the higher mutagenicity of marijuana smoke as compared to tobacco smoke. Experientia. 32, 280–282.

    Article  PubMed  CAS  Google Scholar 

  3. Dinissenko, M. F., Pao, A., Tang, M-S, and Pfeifer, G. P. (1996) Preferential formation of benz[ajpyrene adducts at lung cancer mutational hotspots in p53. Science 274, 430–32.

    Article  Google Scholar 

  4. Roy, P. E., Magnan-Lapointe, F., Huy, N. D., and Boutet, M. (1976) Chronic inhalation of marijuana and tobacco in drugs: pulmonary pathology. Research Communications in Chemical Pathology and Phamacology. 14: 305–307.

    CAS  Google Scholar 

  5. Fligiel, S. E. G., Beals, T. F., Tashkin, D. P., Paule, M. G., Scallet, A. C., Ali SF, Bailey JR, and Slikker W Jr. (1991) Marijuana exposure and pulmonary alterations in primates. Pharmacol. Biochem. Behay. 40, 637–642.

    Article  CAS  Google Scholar 

  6. Fleischman, R. W., Baker, J. R., and Rosenkrantz, H. (1979) Pulmonary pathologic changes in rats exposed to marijuana smoke for one year. Toxicol. Appl. Pharmacol. 47, 557–566.

    Article  PubMed  CAS  Google Scholar 

  7. Rosenkrantz, H. and Fleischman, R. W. (1979) Effects of cannabis on lung. In: Nahas, G. and Payton, W. D. H. (eds.) Marijuana: Biological Effects. Oxford, England, Pergamon Press, pp. 279–299.

    Google Scholar 

  8. Huber, G. L, Mahajan, V. K. (1988) The comparative response of the lung to marihuana or tobacco smoke inhalation. In: Marijuana: An International Research Report. Proceedings of Melbourne Symposium on Cannabis 2–4 September, 1987. (Cheser G, Consroe P, Musty R., eds.) National Campaign Against Drug Abuse. Monograph Series No. 7, Australian Government Publishing Service, Canberra, pp. 19–24.

    Google Scholar 

  9. Chopra, G. S. (1973) Studies on psycho-clinical aspects of long-term marihuana use in 124 cases. Int. J. Addict. 8, 1015–1026.

    PubMed  CAS  Google Scholar 

  10. Hall, J. A. S. (1975) Testimony in marijuana-hashish epidemic and its impact on United States security, In: Hearings of the Committee on the Judiciary, United States Senate. Government Printing Office, pp. 147–154.

    Google Scholar 

  11. Rubin, V. and Comitas, L. (1975) Respiratory function and hematology. In: Ganja in Jamaica: A Medical Anthropological Study of Chronic Marihuana Use. The Hague, Mouton, pp. 87–102.

    Google Scholar 

  12. Boulougouris, J. C., Panayiotopoulos, C. P., Antypas, E, Liakos, A., and Stefanis, C. (1976) Effects of chronic hashish use on medical status in 44 users compared with 38 controls. Ann. NYAcad. Sci. 282, 168–172.

    Article  CAS  Google Scholar 

  13. Tashkin, D. P., Coulson, A. H., Clark, V A, Simmons, M., Bourque, L. B., Duann, S., Spivey, G. H., and Gong, H: Respiratory symptoms and lung function in habitual, heavy smokers of marijuana alone, smokers of marijuana and tobacco, smokers of tobacco alone, and nonsmokers. Am. Rev. Respir Dis. 135, 209–216.

    Google Scholar 

  14. Bloom, J. W., Kaltenborn, W. T., Paoletti, P., Camilli, A., and Lebowitz, M. S. (1987) Respiratory effects of non-tobacco cigarettes. Br. Med. J. 295, 516–518.

    Google Scholar 

  15. Tashkin, D. P., Simmons, M. S., Sherrill, D., and Coulson, A. H. Heavy habitual marijuana smoking does not cause an accelerated decline in FEVI with age: a longitudinal study. Am. J. Respir. Crit. Care Med. 155, 141–148.

    Google Scholar 

  16. Gong, H. Jr, Fligiel, S., Tashkin, D. P., and Barbers, R. G. (1987) Tracheobronchial changes in habitual, heavy smokers of marijuana with and without tobacco. Am. Rev. Respir. Dis. 136, 142–149.

    Article  PubMed  Google Scholar 

  17. Fligiel, S. E. G, Roth, M. D., Kleerup, E. C., Barsky, S. H., Simmons, M. S., and Tashkin, D. P. (1997) Tracheobronchial histopathology in habitual smokers of cocaine, marijuana and/or tobacco. Chest. 112, 319–326.

    Article  PubMed  CAS  Google Scholar 

  18. Roth, M. D., Kleerup, E. C., Arora, A., Barsky, S., and Tashkin, D. P. (1998) Airway inflammation in young marijuana and tobacco smokers. Am. Rev. Respir. Crit. Care Med. 157, 928–937.

    Article  CAS  Google Scholar 

  19. Auerbach, O., Stout, A. P. Hammond, E. D.,and Garfinkel, L. (1961) Changes in bronchial epithleium in relation to cigarette smoking and its relation to lung cancer. N. Engl. J. Med. 265, 253–267.

    Article  PubMed  CAS  Google Scholar 

  20. Tennant, F. S. Jr. (1980) Histopathologic and clinical abnormalities of the respiratory system in chronic hashish smokers. Subst. Alcohol. Actions Misuse 1, 93–100.

    PubMed  Google Scholar 

  21. Barsky, S. H., Roth, M. D., Kleerup, E. C., Simmon, M., and Tashkin, D. P. (1998) Molecular alterations in bronchial epithelium of habitual smokers of marijuana, cocaine and/or tobacco. J. Natl. Cancer Inst. (in press).

    Google Scholar 

  22. Barbers, R. G., Gong, H. Jr, Tashkin, D. P., Oishi, J., and Wallace, J. M. (1987) Differential examination of bronchoalveolar lavage cells in tobacco cigarette and marijuana smokers. Am. Rev. Respir. Dis. 135, 1271–1275.

    PubMed  CAS  Google Scholar 

  23. Beals, T. F., Fligiel, S. E. G., Stuth, S., and Tashkin, D. P. (1989) Morphological alterations of alveolar macrophages from marijuana smokers. Am. Rev. Respir. Dis. 139 (Part 2), A336.

    Google Scholar 

  24. Sherman, M. P., Campbell, L. A., Gong, H. Jr, Roth, M. D., and Tashkin, D. P. (1991) Respiratory burst and microbicidal characteristics of pulmonary alveolar macrophages recovered from smokers of marijuana alone, smokers of tobacco alone, smokers of marijuana and tobacco and nonsmokers. Am. Rev. Respir. Dis. 144, 1351–1356.

    Article  PubMed  CAS  Google Scholar 

  25. Baldwin, G. C., Tashkin, D. P., Buckley, D. M., Park, A. N., Dubinett, S. M., and Roth, M. D. (1997)Habitual smoking of marijuana and cocaine impairs alveolar macrophage function and cytokine production. Am. J. Respir. Crit. Care. Med. 156, 1606–1613.

    Google Scholar 

  26. Bouaboula, M., Rinaldi, M., Carayon, P., Carillon, C., Delpech, B., Shire, D., LeFur, G., and Casellas, P. (1993) Cannabinoid-receptor expression in human leukocytes. Eur. J. Biochem. 214, 173–80.

    Article  PubMed  CAS  Google Scholar 

  27. Huber, G. L., Simmons, G. A., McCarthy, C. R.,Cutting, M. B., Laguarda, R., and Pereira, W. (1975) Depressant effect of marihuana smoke on antibactericidal activity of pulmonary alveolar macrophages. Chest. 68, 769–773.

    CAS  Google Scholar 

  28. Huber, G. L., Pochay, V. E., Pereira, W., Shea, J. W., Hinds, W. C., First, M. W., and Sornberger, G. C. (1980) Marijuana, tetrahydrocannabinol, and pulmonary antibacterial defenses. Chest 77, 403–410.

    Article  PubMed  CAS  Google Scholar 

  29. Klein, T. S., Kawakami, Y., Newton, C., and Friedman, H. (1991) Marijuana components suppress induction and cytolytic function of murine cytotoxic T cells in vitro and in vivo. J. Toxicol. Environ. Health. 32, 465–77.

    Article  CAS  Google Scholar 

  30. Kusher, D. I., Dawson, L. O., Taylor, A. C., and Djeu, J. Y. (1994) Effect of the psychoactive metabolite of marijuana, delta-9-tetrahydrocannabinol (THC), on synthesis of tumor necrosis factor by human large granular lymphocytes. Cellular Immunol. 154, 99–108.

    Article  CAS  Google Scholar 

  31. Tindall, B. Philipot, C. R., Cooper, D. A., Gold, J., Donovan, B., Penny, R., and Barnes, T. (1988) The Sydney AIDS project: Development of acquired immune deficiency syndrome in a group of HIV seropositive homosexual men. Aust. NZ J. Med.

    Google Scholar 

  32. Newton, C. A., Klein, T. W., and Friedman, H. (1994) Secondary immunity to Legionella pneumophilia and Thl activity are suppressed by 09-tetrahydrocannabinol injection. Infection and Immun. 62, 4015–20.

    CAS  Google Scholar 

  33. Denning, D. W., Follansbee, S. E., Scolaro, M., Norris, S., Edelstein, H., and Stevens, D. A. (1991) Pulmonary aspergillosis in the acquired immunodeficiency syndrome. N. Engl. J. Med. 324, 654–662.

    Article  PubMed  CAS  Google Scholar 

  34. Caiaffa, W. T., Vlahov, D., Graham, N. M., Astemborski, J., Solomon, L., Nelson, K. E., and Munoz, A. (1994) Drug smoking, Pneumocystis carinii pneumonia, and immunosuppresion increase risk of bacterial pneumonia in human immunodeficiency virus-seropositive infection drug users. Am. Rev. Respir. Dis. 150, 1493–1498.

    Article  CAS  Google Scholar 

  35. Newell, G. R., Mansell, P. W., Wilson, M. B., Lynch, H. K., Spitz, M. R., and Hersh, E. M. (1985) Risk factor analysis among men referred for possible acquired immune deficiency syndrome. Preventive Medicine 14, 81–91.

    Article  PubMed  CAS  Google Scholar 

  36. Tindall, B., Philipot, C. R., Cooper, D. A., gold, J., Donuvan, B., Penny, R., and Barnes, T. (1988) The Sydney AIDS project: Development of acquired immune deficiency syndrome in a group of HIV seropositive homosexual men. Aust. NZ J. Med.

    Google Scholar 

  37. Wu, T-C, Tashkin, D. P., Djahed, B., and Rose, J. E. (1988) Pulmonary hazards of smoking marijuana as compared with tobacco. N. Engl. J. Med. 318, 347–351.

    Article  PubMed  CAS  Google Scholar 

  38. Marques–Magallanes, J. A., Tashkin, D. P., Serafian, T., Stegeman, J., and Roth, M. D. (1997) In vivo and in vitro activation of cytochrome P4501A1 by marijuana smoke. Presented by DP Tashkin at the 1997 Symposium on the Cannabinoids of the International Cannabinoid Research Society, Stone Mountain, GA, June, 1997, International Cannabinoid Research Society Program and Abstracts, ISBN# 09658053–0–1, p.78.

    Google Scholar 

  39. Wehner, F. C., Van Rensburg, S. J., and Theil, P. F. (1980) Mutagenicity of marijuana and Transkei tobacco smoke condensates in the Salmonella/microsome assay. Mutat. Res. 77, 135–142.

    Article  PubMed  CAS  Google Scholar 

  40. Cottrell (1973)

    Google Scholar 

  41. Leuchtenberger, C., and Leuchtenberger, R. (1976) Cytological and cytochemical studies of the effects of fresh marihuana cigarette smoke on growth and DNA metabolism of animal and human lung cultures. In: The Pharmacology of Marijuana ( Braude MC, Szara S eds.). Raven, New York, p. 595–612.

    Google Scholar 

  42. Roth, M. D., Zhu, L., Sharma, S., Stolina, M., Park, A. N., Chen, K., Tashkin, D. P., and Dubinett, S. M. (1997) L9–tetrahydrocannabinol inhibits antigen–presentation in vitro and anti–tumor immunity in vivo. Presented at the 1997 Symposium on the Cannabinoids of the International Cannabinoid Research Society, Stone Mountain, GA, June, 1997, International Cannabinoid Research Society Program and Abstracts, ISBN# 09658053–0–1, p. 79.

    Google Scholar 

  43. Zhu, L., Sharma, S., Stolina, M., Chen, K., Park, A., Roth, M., Tashkin, D. P., and Dubinett, S. M. (1997) THC-mediated inhibition of the antitumor immune response. Presented at the 19th Southern California Pulmonary Research Conference, Palm Springs, CA, January.

    Google Scholar 

  44. Taylor, F. M. III. (1988) Marijuana as a potential respiratory tract carcinogen: A retrospective analysis of a community hospital population. South. Med. J. 81, 1213–1216.

    Article  PubMed  Google Scholar 

  45. Sridhar, K. S., Raub, W. A., Weatherby, N. L., Metsch, L. R., Surratt, H. L., Inciardi, J. A., Duncan, R. C., Anwyl, R. S., and McCoy, C. B. (1994) Possible role of marijuana smoking as a carcinogen in the development of lung cancer at a young age. J. Psychoactive Drugs 26, 285–88.

    Article  PubMed  CAS  Google Scholar 

  46. Donald, P. J. (1991) Advanced malignancy in the young marijuana smoker. Adv. Exp. Med. Biol. 288, 33–46. 46. USDHEW. (1979)Smoking and Health. A Report of the Surgeon General. DHEW Publication No.(PHS) 7950066. Washington, DC: USGPO.

    Google Scholar 

  47. Endicott, J. N., Skipper, P., and Hernandez, L. (1993) Marijuana and head and neck cancer. Adv. Exp. Med. Biol. 335, 107–113.

    Article  PubMed  CAS  Google Scholar 

  48. Sidney, S., Beck, J. E., Tekawa, I. S., and Quesenberry, C. P., Jr. (1997) Marijuana use and cancer incidence. Am. J. Public Health 585–590.

    Google Scholar 

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Authors
  1. Donald P. Tashkin
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Editor information

Editors and Affiliations

  1. Department of Anesthesiology, New York University School of Medicine, USA

    Gabriel G. Nahas MD, PhD, DSc  & Kenneth M. Sutin MD, MS  & 

  2. Department of Biochemistry, Oxford University, USA

    David Harvey PhD

  3. Faculty of Pharmacy, University of Uppsala, Sweden

    Stig Agurell PhD, PharmD, DSc

  4. NYU School of Medicine, USA

    Nicholas Pace MD  & Robert Cancro MD  & 

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Tashkin, D.P. (1999). Marihuana and the Lung. In: Nahas, G.G., Sutin, K.M., Harvey, D., Agurell, S., Pace, N., Cancro, R. (eds) Marihuana and Medicine. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-710-9_28

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  • DOI: https://doi.org/10.1007/978-1-59259-710-9_28

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-4757-5717-0

  • Online ISBN: 978-1-59259-710-9

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