Kratom: A systematic review of toxicological issues

@inproceedings{Kerrigan2021KratomAS,
  title={Kratom: A systematic review of toxicological issues},
  author={Sarah Kerrigan and Stephanie Basiliere},
  year={2021}
}
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Kratom (Mitragyna speciosa) Validation: Quantitative Analysis of Indole and Oxindole Alkaloids Reveals Chemotypes of Plants and Products.
Many consumers are turning to kratom (Mitragyna speciosa) to self-manage pain and opioid addiction. In the United States, an array of capsules, powders, and loose-leaf kratom products are readily…
Clinical Pharmacology of the Dietary Supplement Kratom (Mitragyna speciosa)
TLDR
Until studies are conducted that define kratom's role in treating opioid withdrawal and/or other central nervous system conditions, kratom will likely remain available as a dietary supplement for the foreseeable future.
Kratom Use Within the Context of the Evolving Opioid Crisis and the COVID-19 Pandemic in the United States
TLDR
This report highlights how converging factors have led to a surge in interest in kratom as a potential harm reduction agent in the treatment of pain and opioid use disorder.

References

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A Case of Kratom Overdose in a Pediatric Patient
TLDR
The case of kratom overdose in a pediatric patient is presented and it is shown that kratom toxicity in the pediatric population is not known.
A Case of Kratom-induced Seizures
TLDR
A case of kratom-induced tonic-clonic seizures in a 27-year-old Caucasian male with a psychiatric history of anxiety, attention-deficit/hyperactivity disorder, benzodiazepine use disorder, and opioid use disorder is reported, highlighting the life-threatening complications of Kratom that is easily available online.
CYP450-Mediated Metabolism of Mitragynine and Investigation of Metabolites in Human Urine.
TLDR
Recombinant cytochrome P450 enzymes (rCYPs) were used to investigate the isoforms involved in the metabolism of mitragynine and found four rCYP enzymes (2C18, 2C19, 2D6 and 3A4) were found to contribute to the metabolism.
Case series: Mitragynine blood and tissue concentrations in fatalities from 2017 to 2018 in Orange County, CA, USA
Development of an ELISA for Detection of Mitragynine and its Metabolites in Human Urine.
Evaluating kratom alkaloids using PHASE
TLDR
The Public Health Assessment via Structural Evaluation (PHASE) protocol is applied to generate in silico binding profiles for 25 kratom alkaloids to facilitate the risk evaluation of kratom and demonstrates the ability of PHASE to identify potential safety signals and provide a tool for prioritizing experimental evaluation of high-risk compounds.
Evaluation of the mitragynine content, levels of toxic metals and the presence of microbes in kratom samples purchased in the Western Suburbs of Chicago
Identification of five mitragyna alkaloids in blood and tissues using liquid chromatography-quadrupole/time-of-flight mass spectrometry
TLDR
A validated LC–Q/TOF–MS method for the analysis of five Mitragyna alkaloids and metabolites that can serve as biomarkers of kratom use in blood and tissues is described.
Identification of metabolites and potential biomarkers of kratom in urine.
Kratom (Mitragyna Speciosa) Liver Injury: A Comprehensive Review
TLDR
Kratom likely causes liver injury based on the totality of low-quality human evidence, and, in the context of epidemiologic, animal, and mechanistic studies, it remains unclear which subgroups of users are at heightened risk.
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