The systems medicine of cannabinoids in pediatrics: the case for more pediatric studies

Abstract

Introduction:The legal and illicit use of cannabinoid-containing products is accelerating worldwide and is accompanied by increasing abuse problems. Due to legal issues, the USA will be entering a period of rapidly expanding recreational use of cannabinoids without the benefit of needed basic or clinical research. Most clinical cannabinoid research is focused on adults. However, the pediatric population is particularly vulnerable since the central nervous system is still undergoing developmental changes and is potentially susceptible to cannabinoid-induced alterations. Research design and methods: This review focuses on the systems medicine of cannabinoids with emphasis on the need for future studies to include pediatric populations and mother-infant dyads. Results and conclusion: Systems medicine integrates omics-derived data with traditional clinical medicine with the long-term goal of optimizing individualized patient care and providing proactive medical advice. Omics refers to large-scale data sets primarily derived from genomics, epigenomics, proteomics, and metabolomics.

Pediatric Brain on Cannabinoids: Adverse Effects of Cannabinoid Products in Children and Adolescents

“…In the brain, the endocannabinoid system is involved in sleep regulation, anxiety control, reward reaction, appetite control, neuroprotection and neural development. During adolescence, eCB and their respective receptors play a vital role in neurodevelopment processes such as pruning and synaptic plasticity [17,18]. During fetal growth and development and during continued maturation post birth, eCB play an important role in central nervous system (CNS) development with neuro progenitor cells which are multipotent stem cells that can form new cells in the nervous system.…”

“…There is also a tendency for breast feeding moms to increase their cannabis use during the postpartum period and this increase translates to enhanced levels of THC in breast milk [83]. Because there is so little information on cannabis use during pregnancy and postpartum use while breast feeding, the clinician may want to consider harm reduction approach to reduce cannabis use during pregnancy and postpartum [18]. The perception during pregnancy and with postpartum mothers using cannabis that little harm is to come from cannabis use is simply not known and further research is urgently needed.…”