⌬9-Tetrahydrocannabinol (THC) is the active metabolite of cannabis. THC causes cell death in vitro through the activation of complex signal transduction pathways. However, the role that the cannabinoid 1 and 2 receptors (CB1-R and CB2-R) play in this process is less clear. We therefore investigated the role of the CB-Rs in mediating apoptosis in 3 leukemic cell lines and performed microarray and immunoblot analyses to establish further the mechanism of cell death. We developed a novel flow cytometric technique of measuring the expression of functional receptors and used combinations of selective CB1-R and CB2-R antagonists and agonists to determine their individual roles in this process. We have shown that THC is a potent inducer of apoptosis, even at 1 ؋ IC 50 (inhibitory concentration 50%) concentrations and as early as 6 hours after exposure to the drug. These effects were seen in leukemic cell lines (CEM, HEL-92, and HL60) as well as in peripheral blood mononuclear cells. Additionally, THC did not appear to act synergistically with cytotoxic agents such as cisplatin. One of the most intriguing findings was that THC-induced cell death was preceded by significant changes in the expression of genes involved in the mitogen-activated protein kinase (
Introduction⌬9-Tetrahydrocannabinol (THC) is the active metabolite of cannabis. Although its analgesic and antiemetic effects in cancer patients has been known for some time, its application has been restricted for social reasons. 1 Interest in this field has intensified with the findings that THC may selectively induce tumor regression both in vitro and in vivo. [2][3][4] Recently, clinical trials using this drug have commenced in Spain. The mechanism underlying its cytotoxic activity has not been elucidated; however, a number of studies have suggested that cannabinoid receptors are involved in this process. 5,6 Two different receptors have been cloned, each with distinct function and distribution. Most is known about the cannabinoid-1 receptor (CB1-R), which is predominantly found in the brain, with highest densities in the hippocampus and cerebellum. It is involved with the psychotropic effects of cannabis; however, CB1-R has also been described at lower levels, in other sites such as the eyes, testis, and lung. 7 The second cannabinoid receptor (CB2-R) is expressed in the immune system 8 and thought to regulate cellular development and immune function. Both receptor subtypes have been identified in tumors at varying concentrations and have been implicated in the cytotoxic process, although alternative receptorindependent mechanisms have also been suggested. 2,4,9,10 There is no clear correlation between these studies, which may be because these studies measured receptor level (by mRNA and with nonfunctional-specific antibodies) rather than receptor functionality. Indeed, measuring and correlating functional receptors with THC efficacy may be more appropriate than assessing mRNA levels. Nevertheless, the uses of small molecules that specifically agonize and antag...