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Anhydroecgonine Methyl Ester (AEME), also known as methylecgonidine, is the main pyrolysis product of smoking cocaine (cocaine base paste or basuco, crack, or freebase). This review aims to synthesize the available scientific evidence on the toxicokinetic and toxicodynamic effects of AEME. A search of scientific articles published in Science Direct, SCOPUS, and MEDLINE up to May 2024 was conducted. Twenty-four articles, including 13 experimental animal studies, 2 clinical trials, and 3 observational studies, were reviewed. AEME is readily deposited in the alveoli; its absorption improves in combination with cocaine and has a broad tissue distribution. It is metabolized primarily in the liver, with a half-life of approximately one hour, and is mainly excreted through urine. Moreover, AEME acts as a partial agonist of M1 and M3 muscarinic cholinergic receptors, influences dopaminergic system neuroadaptation, increases the production of reactive oxygen species, imbalances the activity of glutathione-associated enzymes, and reduces melatonin levels, affecting its antioxidant regulatory properties. When combined with cocaine, AEME activates the non-apoptotic pathway of caspase-9 and then, the apoptotic pathway via caspase-8, reducing neuronal viability in half the time of cocaine. AEME plays a significant role in cocaine toxicity and AEME itself.

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Crack cocaine smokers inhale, alongside with cocaine, its pyrolysis product, anhydroecgonine methyl ester (AEME). We have previously described AEME neurotoxic effect and its additive effect when co-incubated with cocaine. Our aim was to evaluate, the effect of AEME, cocaine and AEME-cocaine combination on glutathione peroxidase (GPx), glutathione reductase (GR) and glutathione S-transferase (GST) activities after 3 and 6 h of exposure, periods previous to neuronal death. Lipid peroxidation was evaluated through malonaldehyde (MDA) levels at 3, 6, 24 and 48 h of exposure. All treated groups reduced neuronal viability after 24 h of exposure. AEME and cocaine decreased GPx, GR and GST activities after 3 and 6 h, with an increase in MDA levels after 48 h. AEME-cocaine combination decreased the enzymes activities after 3 and 6 h, showing an additive effect in MDA levels after 48 h. These data show that the glutathione-related enzymes imbalance caused by AEME, cocaine or AEME-cocaine combination exposure preceded neuronal death and lipid peroxidation. Moreover, the additive effect on lipid peroxidation observed with AEME-cocaine exposure after 48 h, suggest a higher neurotoxic effect after crack cocaine use when compared to cocaine alone.

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INTRODUCTION: Currently, hair straightening has become a regular hair treatment for women but likewise for men. Several studies have shown that thermal straightening has an influence on the concentration of ethyl glucuronide and of drugs of abuse content in hair. Heat treatment of hair may decrease concentrations of cocaine (COC) and of cocaethylene (CE) in hair and increase concentrations of benzoylecgonine (BZE). The goal of this study was to evaluate the influence of thermal straightening on anhydroecgonine methyl ester (AEME), a known cocaine smoking marker, in hair. METHOD: 42 positive COC hair samples were treated in vitro with iron plates heated to 200°C. During this treatment one lock of hair was put sequentially 30 times in contact with a hair straightener during 2s, the other lock was not treated. The hair samples were analyzed by a validated GC/MS method for AEME, COC and its metabolites BZE, norcocaine (NC), ecgonine methyl ester (EME) and CE. RESULTS: After treatment, a median increase of concentrations was observed for AEME (110.3%) and BZE (27.6%) whereas a median decrease was found for COC (56.9%), NC (46.7%), EME (33.3%) and CE (41.7%). The median BZE/COC ratio of 0.6 in not treated hair increased to 1.5 in treated hair. CONCLUSION: Regarding our in vitro results, AEME may be produced by thermal hair straightening. Therefore, the presence of AEME in hair should not be used as an irrefutable prove of cocaine smoking. Our study shows that for the interpretation of AEME results in hair, potential heat treatment of hair should be considered. A ratio BZE/COC higher 1 appears to be a good marker to identify thermal treatment of hair before collection. Finally, thermal straightening should be documented during hair collection and should also be considered for the interpretation of COC results in hair.

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BACKGROUND: Hair analysis is a suitable way to discriminate between coca chewers and consumers of manufactured cocaine using the coca alkaloids hygrine (HYG) and cuscohygrine (CUS) as markers. In the present preliminary study it was examined whether CUS and HYG can be detected in hair of occasional and moderate coca chewers or coca tea drinkers, whether CUS and HYG appear in hair of PACO consumers (smoking coca paste waste), and whether anhydroecgonine methyl ester (AEME) is a useful cocaine smoking marker in this context. METHOD: Three groups were included: 10 volunteers from Buenos Aires with occasional or moderate chewing of coca leaves or drinking coca tea, 20 Argentinean PACO smokers and 8 German cocaine users. The hair samples (1-4 segments) were analyzed by a validated LC-MS/MS method for cocaine (COC), norcocaine (NC), benzoylecgonine (BE), ecgonine methyl ester (EME), cocaethylene (CE), cinnamoylcocaine (CIN), tropacocaine (TRO), AEME, CUS and HYG. For comparison, eight samples of coca leaves or coca tea were analyzed. RESULTS: Only low concentrations of COC were found in hair of seven occasional users of coca leaves or coca tea (0.010-0.051 ng/mg). For three moderate chewers of coca leaves all compounds were detected including AEME but except TRO. The hair samples of PACO smokers contained much higher concentrations of COC (0.027-341 ng/mg, mean 37.4 ng/mg) and its metabolites. CUS was not found in these samples but traces of HYG were seen in 8 of 37 hair segments. AEME as a marker for coca smoking was detected in hair of 15 smokers. In comparison to COC, the concentrations of EME and CIN were higher for PACO smokers than for German cocaine consumers. AEME (56 ± 20 µg/g) was detected in all coca leave and coca tea samples which explains the detection of this substance in hair of coca chewers. Therefore, its use for differentiation between coca chewers and PACO smokers is limited. CONCLUSION: CUS remains to be the most suitable marker in hair for chewing coca leaves or drinking coca tea more frequently than two times per month since it does not appear in hair of Argentinean PACO smokers and German cocaine users. Contrary to a previous proposal, the ratios CIN/COC and EME/COC appeared not to be applicable as criteria for this purpose because of the higher concentration of these alkaloids in hair of PACO smokers. More research is needed to assess the value of AEME in hair of South American coca leave or cocaine users.

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Crack cocaine smokers inhale, alongside with cocaine, its pyrolysis product, anhydroecgonine methyl ester (AEME). We have previously described AEME neurotoxic effect and its additive effect when co-incubated with cocaine. Our aim was to evaluate, the effect of AEME, cocaine and AEME-cocaine combination on glutathione peroxidase (GPx), glutathione reductase (GR) and glutathione S-transferase (GST) activities after 3 and 6h of exposure, periods previous to neuronal death. Lipid peroxidation was evaluated through malonaldehyde (MDA) levels at 3, 6, 24 and 48h of exposure. All treated groups reduced neuronal viability after 24h of exposure. AEME and cocaine decreased GPx, GR and GST activities after 3 and 6h, with an increase in MDA levels after 48h. AEME-cocaine combination decreased the enzymes activities after 3 and 6h, showing an additive effect in MDA levels after 48h. These data show that the glutathione-related enzymes imbalance caused by AEME, cocaine or AEME-cocaine combination exposure preceded neuronal death and lipid peroxidation. Moreover, the additive effect on lipid peroxidation observed with AEME-cocaine exposure after 48h, suggest a higher neurotoxic effect after crack cocaine use when compared to cocaine alone.

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When burning crack cocaine, the pyrolysis of cocaine generates anhydroecgonine methyl ester (AEME). AEME has been shown to be highly neurotoxic but its effects on cognitive function and oxidative stress are still unknown. Thus, this study investigated the effects of AEME on spatial working memory and on parameters of oxidative stress in the prefrontal cortex, hippocampus, and striatum. First, 18 well-trained rats in 8-arm radial maze (8-RM) procedures received acute intracerebroventricular (icv) administration of AEME at doses of 10, 32, or 100 µg or saline (SAL) in a counterbalanced order and were tested 5 min later in 1-h delayed tasks in the 8-RM. Secondly, separated animals received acute icv administration of AEME at doses of 10 (n = 5), 32 (n = 5), or 100 µg (n = 5) or SAL (n = 5) for analysis of advanced oxidation protein products, thiobarbituric acid, catalase, glutathione peroxidase, and superoxide dismutase. A higher number of errors were seen in the 1-h post-delay performance after AEME 32 µg and AEME 100 µg when compared to SAL. In the striatum, animals receiving AEME 100 µg icv showed increased advanced oxidation protein products levels when compared to 10 µg, and also showed increased activity of glutathione peroxidase enzyme when compared to SAL but also comparing to AEME 32 µg and AEME 10 µg. These results showed that AEME impairs long-term spatial working memory and also induces greater protein oxidation and increased levels of antioxidant enzymes in the striatum.

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Crack cocaine has a high potential to induce cocaine addiction and its smoke contains cocaine's pyrolysis product anhydroecgonine methyl ester (AEME), a partial agonist at M1- and M3-muscarinic acetylcholine receptor and an antagonist at the remaining subtypes. No reports have assessed AEME's role in addiction. Adult male Wistar rats were intraperitoneally administered with saline, 3mg/kg AEME, 15mg/kg cocaine, or a cocaine-AEME combination on every other day during a period of 9 days. After a 7-days withdrawal period, a challenge injection of the respective drugs was performed on the 17th day. The locomotor activity was evaluated on days 1, 3, 5, 7, 9 and 17, as well as dopamine levels (9th day) and dopaminergic receptors proteins (D1R and D2R on the 17th day) in the caudate-putamen (CPu) and nucleus accumbens (NAc). AEME was not able to induce the expression of behavioral sensitization, but it substantially potentiates cocaine-effects, with cocaine-AEME combination presenting higher expression than cocaine alone. An increase in the dopamine levels in the CPu in all non-saline groups was observed, with the highest levels in the cocaine-AEME group. There was a decrease in D1R protein level in this brain region only for cocaine and cocaine-AEME groups. In the NAc, an increase in the dopamine levels was only observed for cocaine and cocaine-AEME groups, with no changes in both D1R and D2R protein levels. These behavioral and neurochemical data indicate that AEME alone does not elicit behavioral sensitization but it significantly potentiates cocaine effects when co-administered, resulting in dopamine increase in CPu and NAc, brain regions where dopamine release is mediated by cholinergic activity.

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Cocaine is the most commonly used illicit drug among those seeking care in Emergency Departments or drug detoxification centers. Cocaine, chemically known as benzoylmethylecgonine, is a naturally occurring substance found in the leaves of the Erythroxylum coca plant. The pharmacokinetics of cocaine is dependent on multiple factors, such as physical/chemical form, route of administration, genetics and concurrent consumption of alcohol. This review aims to discuss metabolomics of cocaine, namely by presenting all known metabolites of cocaine and their roles in the cocaine-mediated toxic effects.

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O crack é a forma fumada de administração da cocaína com o maior potencial para causar dependência. Até 80% da sua fumaça consiste no produto de pirólise da cocaína, a metilecgonidina (AEME). Apesar do vasto conhecimento acerca dos efeitos e prejuízos causados pela cocaína, nenhum trabalho avaliou os efeitos da AEME na farmacodependência, objetivo deste trabalho. Ratos adultos machos Wistar foram expostos à salina, à AEME 3 mg/kg, à cocaína 15 mg/kg e a associação entre cocaína e AEME, intraperitonealmente, em duas situações: 1) exposição prolongada (administração todos os dias, por 9 dias); 2) sensibilização comportamental dependente de contexto (administração em dias alternados, por 5 dias e 7 dias de abstinência, seguido do desafio). A dose de AEME foi definida pela avaliação da atividade locomotora em teste agudo. A AEME foi capaz de aumentar a atividade locomotora após exposição prolongada e potencializar a expressão da sensibilização comportamental dependente de contexto induzida pela cocaína. A concentração de dopamina e seus metabólitos aumentaram no caudado-putâmen em todos os grupos, sendo observado um sinergismo entre cocaína e AEME no grupo da associação. No núcleo accumbens, foi observado aumento de dopamina apenas nos grupos cocaína e associação. Paralelamente, houve aumento da relação p-CREB/CREB 60 minutos após a administração aguda de AEME 3 mg/kg e cocaína 15 mg/kg, tanto no caudado-putâmen quanto no núcleo accumbens, assim como nos grupos cocaína e associação após a sensibilização comportamental dependente de contexto. Com a finalidade de determinar o mecanismo de ação da AEME, foi realizado um estudo farmacológico detalhado dessa substância em células CHO-K1 de rato expressando heterologamente os receptores colinérgicos muscarínicos subtipos 1 a 5, uma vez que estudos anteriores sugeriram uma interação entre a AEME e os receptores colinérgicos muscarínicos. O ensaio de competição com [3H]NMS mostrou uma pequena preferência da AEME para o subtipo M2. Estudos funcionais (mobilização de cálcio) revelaram um efeito agonista parcial da AEME para os subtipos M1 e M3 e antagonista para os demais subtipos, dando suporte à hipótese colinérgica de ação da AEME. Nossos resultados indicam que a AEME isoladamente não foi capaz de causar sensibilização, mas potencializou a ação da cocaína quando coadministrada. O efeito antagonista da AEME em receptores subtipo M2 e M4 no caudado-putâmen, e M4 e M5 no núcleo accumbens causaram aumento de dopamina nessas regiões encefálicas, onde a atividade colinérgica medeia sua liberação

Crack cocaine is the smoked form of cocaine with the highest potential for addiction. Up to 80% of crack smoke consists of cocaines pyrolysis product anhydroecgonine methyl ester (AEME). Despite of many studies regarding cocaine effects and its hazardousness, few reports have assessed AEME's role in addiction, the aim of this study. Adult male Wistar rats were i.p. dosed with either saline, 3 mg/kg AEME, cocaine 15 mg/kg, or cocaine-AEME combination in two situations: 1) prolonged exposure (drugs administered every day for 9 days); 2) behavioral sensitization context specific (drugs administered in alternating days for 5 days, followed by 7-days abstinence period and a challenge injection). AEME dose was chosen based on locomotor activity after an acute test. AEME increased locomotor activity in the prolonged exposure and it potentiated cocaine-induced behavioral sensitization. Dopamine level and its metabolites were elevated in the caudate-putamen in all non-saline groups with a synergic effect between cocaine and AEME in the cocaine-AEME group. In the nucleus accumbens, dopamine was elevated only in cocaine and cocaine-AEME groups. At the same time, p-CREB/CREB ratio, increased 60 minutes after an acute administration of 3 mg/kg AEME and 15 mg/kg cocaine in both caudate-putamen and nucleus accumbens, the same result observed in both cocaine and cocaine-AEME groups after behavioral sensitization. Once previous studies suggested AEME interacts with muscarinic acetylcholine receptors, a detailed pharmacological analysis of AEME at rat muscarinic acetylcholine receptors subtypes 1-5 heterologously expressed in CHO-K1 cells was performed to determine a mechanism for the novel effects of AEME. [3H]NMS competition binding showed a slight preference for M2 subtype; functional studies (Ca2+ mobilization) revealed partial agonist effects at M1 and M3 and antagonist effects at the remaining subtypes, supporting the cholinergic hypothesis of AEME's effects. Our results indicate AEME alone does not elicit behavior sensitization but significantly potentiates cocaine sensitization when co-administered. AEME antagonism effects at M2 and M4 muscarinic acetylcholine receptors subtypes in the caudate-putamen, and M4 and M5 muscarinic acetylcholine receptors subtypes in the nucleus accumbens resulted in dopamine increase in these brain regions, where its release is mediated by cholinergic activity

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