Pre-clinical and clinical pharmacology & safety of kratom (Mitragyna speciosa)

In 2022, Frontiers in Pharmacology hosted the Research Topic "The Pharmacology of Kratom and Its Alkaloids,” centered on the pharmacology of kratom, its currently known compounds, as well as unidentified ingredients. Since then, kratom has become an increasingly diverse product in the US and globally, with an increased need for further research to answer novel questions raised in the last 3 years. While the prevalence of use is estimated to range from 0.6 to more than 10% depending on the country, the pharmacological and toxicological properties of kratom products are still being researched both in pre-clinical mechanistic and clinical settings. This Research Topic is centered on the pre-clinical and clinical pharmacology, pharmacokinetics, and toxicology of kratom alkaloids and semi-synthetic and synthetic derivatives— focusing specifically on newly emerging pharmacological and toxicological properties to distinguish between natural kratom and enriched or semi-synthetic derivatives.

While kratom has attracted many investigations in recent years, there is a rapidly changing commercial market for kratom products and those that are sold as "kratom". Semi-synthetic and synthetic derivatives of kratom alkaloids may differ substantially in their pharmacology and toxicology from the native kratom leaf. The complex pharmacology of kratom further has revealed that, while mitragynine remains the predominantly present alkaloid, other alkaloids may contribute substantially to the clinical presentation, potential therapeutic effects, and toxicity of products.

This Research Topic is primarily concerned with the emergence of diverse kratom products and their pharmacology and toxicology relative to native kratom leaf products. All pre-clinical and clinical original research investigations are welcome as well as research resulting from surveys, case or observational studies, reviews, and opinion articles that help to advance our understanding of the differences in pharmacology and toxicology of diverse kratom products and their derivatives. Submission of Reviews and Original Research articles, as well as Opinion and Perspective papers covering new insights regarding the following are encouraged:

• Novel pharmacological and/or toxicological investigations into kratom products. These may relate to known activities (opioid, serotonergic, adrenergic) but must provide new insights to either the molecular/cellular mechanism or clinical symptom presentation.
• Clinical investigations such as observational studies, case reports, and surveys that provide new insights into the effects of kratom on health in humans, i.e. adverse effects/toxicity, neurological effects/altered mental status. These may also relate to uses of kratom for withdrawal from substance dependence or as a mitigation strategy in the prevention of escalating substance use. Of particular interest are differing effects of kratom products based on their composition (powdered leaf, extracts, concentrates, or isolates).
• Potential interactions of kratom or its constituents with other substances and drugs that are of clinical significance. This includes CYP enzyme interactions, other metabolic enzymes, pharmacokinetic alterations, or alike processes.

_{Topic Editor Oliver Grundmann serves as an expert witness in civil and criminal litigation involving kratom products. All other Topic Editors declare no competing interests with regards to the Research Topic subject.}

Article types and fees

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Data Report
• Editorial
• FAIR² Data
• FAIR² DATA Direct Submission
• General Commentary
• Hypothesis and Theory
• Methods
• Mini Review
• ... View all formats

Articles that are accepted for publication by our external editors following rigorous peer review incur a publishing fee charged to Authors, institutions, or funders.

Article types

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Data Report
• Editorial
• FAIR² Data
• FAIR² DATA Direct Submission
• General Commentary
• Hypothesis and Theory
• Methods
• Mini Review
• Opinion
• Original Research
• Perspective
• Review
• Systematic Review
• Technology and Code

Keywords: Mitragyna speciosa, mitragynine, natural product, drug interactions, safety, toxicity

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.