Whole-blood transcriptomic findings in emergency department patients with suspected cannabinoid hyperemesis syndrome: a pilot study.
6 affiliations
- 1Department of Emergency Medicine, The George Washington University Medical Center, Washington, DC, USA.
- 2Center for Cannabis and Cannabinoids, Jane and Terry Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences and Department of Anesthesiology and Perioperative Medicine, University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA, USA.
- 3Department of Microbiology, Immunology, and Tropical Medicine and Department of Medicine, Division of Genomic Medicine, The George Washington University Medical Center, 2300 I Street NW, Ross Hall 205, Washington, DC, 20037, USA.
- 4Department of Emergency Medicine, Henry Ford Hospital, Detroit, MI, USA.
- 5Department of Emergency Medicine, Duke University Hospital, Durham, NC, USA.
- 6Department of Microbiology, Immunology, and Tropical Medicine and Department of Medicine, Division of Genomic Medicine, The George Washington University Medical Center, 2300 I Street NW, Ross Hall 205, Washington, DC, 20037, USA. [email protected].
Abstract
Background
Cannabinoid hyperemesis syndrome (CHS) is a paradoxical and increasingly prevalent disorder characterized by recurrent vomiting in people with chronic cannabis use. Despite its growing clinical impact, the underlying mechanisms remain poorly understood.Methods
Genome-wide RNA sequencing was used to characterize transcriptomic differences and identify potential pathways involved in CHS pathogenesis. In this pilot study, whole blood RNA sequencing was performed on 7 patients with suspected CHS and 7 matched controls. Differentially expressed genes (DEGs) were identified, annotated and analyzed by automated and manual analysis. RNA sequences were further analyzed by digital isotyping for HLA Class I and II allele usage.Results
Suspected CHS was associated with marked activation of the adaptive immune system, including upregulation of B-cell related immunoglobin transcripts and altered expression of T cell, monocyte, and neutrophil-related transcripts. DEGs also suggested increased matrix degradation, and reduced adhesion and protease inhibitor transcripts. Digital HLA isotyping revealed increased MHC Class I expression, Class II allele restriction, and down-regulation of IgE receptor transcripts, a known response to elevated IgE levels in allergic hypersensitivity.Conclusions
Together, these preliminary findings identify immune-related signals in ED patients with suspected CHS, and lay the groundwork for future studies with larger, prospectively phenotyped cohorts to identify biomarkers, clarify immune triggers, and develop targeted therapies.
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BibTeX
@article{meltzer2026wholeblood,
title = {{Whole-blood transcriptomic findings in emergency department patients with suspected cannabinoid hyperemesis syndrome: a pilot study.}},
author = {Andrew Meltzer and Ziva D Cooper and Ryan Heidish and Aditya Loganathan and Tarun Loganathan and Taylor Bolden and Isabella Lagunazad and John Perkins and Kevin Jaatinen and Jacob Adelman and Joseph Miller and Stephanie A Eucker and Eileen Phillips and Timothy A McCaffrey},
journal = {Journal of cannabis research},
year = {2026},
month = jul,
doi = {10.1186/s42238-026-00477-x},
url = {https://europepmc.org/article/MED/42902438},
note = {CC BY},
}
RIS
TY - JOUR
TI - Whole-blood transcriptomic findings in emergency department patients with suspected cannabinoid hyperemesis syndrome: a pilot study.
AU - Andrew Meltzer
AU - Ziva D Cooper
AU - Ryan Heidish
AU - Aditya Loganathan
AU - Tarun Loganathan
AU - Taylor Bolden
AU - Isabella Lagunazad
AU - John Perkins
AU - Kevin Jaatinen
AU - Jacob Adelman
AU - Joseph Miller
AU - Stephanie A Eucker
AU - Eileen Phillips
AU - Timothy A McCaffrey
PY - 2026
DA - 2026/07/01
JO - Journal of cannabis research
DO - 10.1186/s42238-026-00477-x
UR - https://europepmc.org/article/MED/42902438
AB - Background Cannabinoid hyperemesis syndrome (CHS) is a paradoxical and increasingly prevalent disorder characterized by recurrent vomiting in people with chronic cannabis use. Despite its growing clinical impact, the underlying mechanisms remain poorly understood.Methods Genome-wide RNA sequencing was used to characterize transcriptomic differences and identify potential pathways involved in CHS pathogenesis. In this pilot study, whole blood RNA sequencing was performed on 7 patients with suspected CHS and 7 matched controls. Differentially expressed genes (DEGs) were identified, annotated and analyzed by automated and manual analysis. RNA sequences were further analyzed by digital isotyping for HLA Class I and II allele usage.Results Suspected CHS was associated with marked activation of the adaptive immune system, including upregulation of B-cell related immunoglobin transcripts and altered expression of T cell, monocyte, and neutrophil-related transcripts. DEGs also suggested increased matrix degradation, and reduced adhesion and protease inhibitor transcripts. Digital HLA isotyping revealed increased MHC Class I expression, Class II allele restriction, and down-regulation of IgE receptor transcripts, a known response to elevated IgE levels in allergic hypersensitivity.Conclusions Together, these preliminary findings identify immune-related signals in ED patients with suspected CHS, and lay the groundwork for future studies with larger, prospectively phenotyped cohorts to identify biomarkers, clarify immune triggers, and develop targeted therapies.
SN - 2522-5782
ER -