BACKGROUND Kratom is a psychoactive substance that is isolated from the plant Mitragyna speciosa.The leaves can be chewed fresh or dried,smoked,or infused similar to herbal teas.The plant leaves have been used by nati...BACKGROUND Kratom is a psychoactive substance that is isolated from the plant Mitragyna speciosa.The leaves can be chewed fresh or dried,smoked,or infused similar to herbal teas.The plant leaves have been used by natives of Southeast Asia for centuries.The substance has been used for its stimulant activity at low doses,and as an opium substitute at higher doses due to a morphine like effect.CASE SUMMARY A 37-year-old female with a history of depression and obesity(body mass index:32)presented to emergency room with a week-long history of nausea,decreased appetite,fatigue,and two days of jaundice.On admission bilirubin was markedly elevated.Her condition was thought to be due to consumption of Kratom 2 wk before onset of symptoms.Liver biopsy showed changes mimicking primary biliary cholangitis.Patient’s symptoms and jaundice improved quickly.CONCLUSION The use of Kratom has been on the rise in recent years across the United States and Europe.Several case reports have associated adverse health impact of Kratom-containing products including death due to its ability to alter levels of consciousness.Only a few case reports have highlighted the hepatotoxic effects of Kratom.Even fewer reports exist describing the detailed histopathological changes.展开更多
Mitragynine (MG) and its major metabolites 7-hydroxymitragynine (7-OH-MG) are two of the major components of the plant extract Kratom, which is a tree planted in Southeast Asia. Kratom has long been used by opioid-dep...Mitragynine (MG) and its major metabolites 7-hydroxymitragynine (7-OH-MG) are two of the major components of the plant extract Kratom, which is a tree planted in Southeast Asia. Kratom has long been used by opioid-dependent individuals as an alternative to their unavailable opioid of choice and chronic pain medication, as a stealth-to-urine drug screening opiate substitute while in opioid recovery treatment and recreationally, alone or as a booster. In this study, a direct infusion method was utilized and electrospray ionization triple quadrupole mass spectrometer was used as the detector for data acquisition. Pharmacokinetic study was conducted to investigate the effect of mitragynine and 7-hydroxymitragynine and major fragments of both compounds were proposed.展开更多
Kratom(Mitragyna speciosa)is a plant that grows well in tropical climates such as in Southeast Asia.Traditionally,people discovered it possessed a stimulating effect that relieved tiredness.Furthermore,it contains ana...Kratom(Mitragyna speciosa)is a plant that grows well in tropical climates such as in Southeast Asia.Traditionally,people discovered it possessed a stimulating effect that relieved tiredness.Furthermore,it contains analgesic and medicinal properties for the treatment of pain,diarrhea,muscle discomfort,and blood pressure and to enhance stamina.Nevertheless,long term or regular consumption of kratom leads to addiction.This is because the main alkaloid of kratom,mitragynine,binds to opioid receptors and exerts a euphoric effect similar to that of morphine,which may lead to death.Due to this reason,kratom has been listed as a regulated substance in many countries including the United States,Thailand,Malaysia,Bhutan,Finland,Lithuania,Denmark,Poland,Sweden,Australia,and Myanmar.Usages of kratom carry two pharmacological effects depending on dosage.Low-dose kratom exerts a stimulating effect that refreshes the user.Highdose kratom exerts sedative effects that can lead to addiction similar to that of morphine.Despite the euphoric effect of kratom,the beneficial values of kratom to human health is indisputable.Therefore,a complete banning of kratom may cause a loss to pharmaceutical industry.Rather,a controlled or selective usage of kratom will be a better choice.展开更多
Objective: Kratom is widely available and literature exploring the effects of prenatal kratom exposure is lacking. This study aims to report a validated method for the detection of mitragynine in the umbilical cord an...Objective: Kratom is widely available and literature exploring the effects of prenatal kratom exposure is lacking. This study aims to report a validated method for the detection of mitragynine in the umbilical cord and report our observations for specimens received at a national commercial reference laboratory. Study Design: Assays were validated according to the recommendations of ANSI/ASB. A retrospective evaluation of records at a national reference laboratory was conducted to determine prevalence and co-exposure to other substances of abuse. Result: Mitragynine was detected in 19 of 4456 specimens (0.43%) with concentrations ranging from 4 to >50 ng/g. Thirteen (13) of these specimens were positive for only mitragynine while the other 6 were also positive for either marijuana or opiates. Conclusion: Umbilical cord is a suitable specimen type for the surveillance of maternal kratom use and can be used to identify exposed neonates for further investigations into short- or long- term health consequences.展开更多
文摘BACKGROUND Kratom is a psychoactive substance that is isolated from the plant Mitragyna speciosa.The leaves can be chewed fresh or dried,smoked,or infused similar to herbal teas.The plant leaves have been used by natives of Southeast Asia for centuries.The substance has been used for its stimulant activity at low doses,and as an opium substitute at higher doses due to a morphine like effect.CASE SUMMARY A 37-year-old female with a history of depression and obesity(body mass index:32)presented to emergency room with a week-long history of nausea,decreased appetite,fatigue,and two days of jaundice.On admission bilirubin was markedly elevated.Her condition was thought to be due to consumption of Kratom 2 wk before onset of symptoms.Liver biopsy showed changes mimicking primary biliary cholangitis.Patient’s symptoms and jaundice improved quickly.CONCLUSION The use of Kratom has been on the rise in recent years across the United States and Europe.Several case reports have associated adverse health impact of Kratom-containing products including death due to its ability to alter levels of consciousness.Only a few case reports have highlighted the hepatotoxic effects of Kratom.Even fewer reports exist describing the detailed histopathological changes.
文摘Mitragynine (MG) and its major metabolites 7-hydroxymitragynine (7-OH-MG) are two of the major components of the plant extract Kratom, which is a tree planted in Southeast Asia. Kratom has long been used by opioid-dependent individuals as an alternative to their unavailable opioid of choice and chronic pain medication, as a stealth-to-urine drug screening opiate substitute while in opioid recovery treatment and recreationally, alone or as a booster. In this study, a direct infusion method was utilized and electrospray ionization triple quadrupole mass spectrometer was used as the detector for data acquisition. Pharmacokinetic study was conducted to investigate the effect of mitragynine and 7-hydroxymitragynine and major fragments of both compounds were proposed.
文摘Kratom(Mitragyna speciosa)is a plant that grows well in tropical climates such as in Southeast Asia.Traditionally,people discovered it possessed a stimulating effect that relieved tiredness.Furthermore,it contains analgesic and medicinal properties for the treatment of pain,diarrhea,muscle discomfort,and blood pressure and to enhance stamina.Nevertheless,long term or regular consumption of kratom leads to addiction.This is because the main alkaloid of kratom,mitragynine,binds to opioid receptors and exerts a euphoric effect similar to that of morphine,which may lead to death.Due to this reason,kratom has been listed as a regulated substance in many countries including the United States,Thailand,Malaysia,Bhutan,Finland,Lithuania,Denmark,Poland,Sweden,Australia,and Myanmar.Usages of kratom carry two pharmacological effects depending on dosage.Low-dose kratom exerts a stimulating effect that refreshes the user.Highdose kratom exerts sedative effects that can lead to addiction similar to that of morphine.Despite the euphoric effect of kratom,the beneficial values of kratom to human health is indisputable.Therefore,a complete banning of kratom may cause a loss to pharmaceutical industry.Rather,a controlled or selective usage of kratom will be a better choice.
文摘Objective: Kratom is widely available and literature exploring the effects of prenatal kratom exposure is lacking. This study aims to report a validated method for the detection of mitragynine in the umbilical cord and report our observations for specimens received at a national commercial reference laboratory. Study Design: Assays were validated according to the recommendations of ANSI/ASB. A retrospective evaluation of records at a national reference laboratory was conducted to determine prevalence and co-exposure to other substances of abuse. Result: Mitragynine was detected in 19 of 4456 specimens (0.43%) with concentrations ranging from 4 to >50 ng/g. Thirteen (13) of these specimens were positive for only mitragynine while the other 6 were also positive for either marijuana or opiates. Conclusion: Umbilical cord is a suitable specimen type for the surveillance of maternal kratom use and can be used to identify exposed neonates for further investigations into short- or long- term health consequences.
