Myth busting cannabinoid hyperemesis syndrome

• Published in: The American journal of emergency medicine Vol. 56; pp. 342 - 343
• Main Author: Russo, Ethan B.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-06-2022; Elsevier Limited
• Subjects: ABCA1 protein; Addictions; ATP-binding protein; Cannabinoids; Cannabinoids - adverse effects; Cannabis; Capsaicin receptors; Cholesterol; Contamination; Dementia disorders; Diabetes mellitus; Diagnosis; Dopamine D2 receptors; Dopamine receptors; Emergency medical care; Endocannabinoid system; Etiology; Female; Haplotypes; Heart diseases; Humans; Hyperemesis Gravidarum; Lipid metabolism; Marijuana; Marijuana Abuse - complications; Mental disorders; Metabolism; Nausea; Neem; Pesticides; Pregnancy; Psychosis; Syndrome; Tetrahydrocannabinol; Vomiting; Vomiting - chemically induced; Zygosity
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2021.09.021

A new pet theory has entered in scene without any scientific verification, hypothesizing that CHS can be ascribed to infection of cannabis with viruses or hops latent viroid [6], a type of single-stranded circular RNA with no protein. Five genes were identified with statistical significance in CHS patients affecting THC metabolism (CYP2C9), the dopaminergic system (COMT, DRD2), the TRPV1 receptor, and cholesterol metabolism (ABCA1), that seemingly shed light on CHS pathophysiology and numerous potential comorbidities: substance addiction, compulsive behaviors, depression, anxiety, and increased risk of psychosis, diabetes, coronary disease and dementia. Gene RSID Mutation Allele Zygosity Diplotype Haplotype P-value⁎ Control displaying Variant CHS Patients displaying Variant COMT rs4646316 Intron C > T Heterozygous CGGC/TGGC CGGC 0.012 10% 57.1% ABCA1 rs2230806 Synonymous C > T Homozygous CTTG/CTTG CTTG 0.012 20% 67.9% TRPV1 rs879207 Downstream A > G Heterozygous ATGG/GTGG ATGG 0.015 30% 71.5% DRD2 rs4648318 Intron T > C Heterozygous TCCC/CCCC TCCC 0.031 20% 60.7% CYP2C9 rs1934967 Intron C > T homozygous CTTG/CTTG CTTG 0.043 (⁎⁎0.011) 10% 46.4% (⁎⁎60%) TRPV1 rs11655540 Intron T > G Heterozygous TCAA/GCAA TCAA 0.066 30% 64.3% COMT rs165656 Intron C > T Heterozygous CCGG/TCGG CCGG 0.069 20% 53.6% CYP2C19 rs4494250 Intron G > A Heterozygous GCTT/ACTT GCTT 0.069 (⁎⁎0.007) 20% 53.6% (⁎⁎75%) CRY1 rs2287161 downstream G > C Heterozygous GTCG/CTCG GTCG 0.091 50% 78.6% Table 1 Summary of genomic testing results of cannabinoid hyperemesis syndrome patients versus controls1