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IACM-Bulletin of 14 January 2024

Science/Human: Cannabis use in schizophrenia may be associated with different effects on aspects of cognition

investigators of the Faculty of Medicine and Pharmacy at Hassan II University in Casablanca, Morocco, compared two groups of patients diagnosed with schizophrenia, 50 cannabis users and 49 non-users .

The results of the study suggest that patients without cannabis use performed better in the test of psychomotor function, attention and verbal memory, while cannabis using patients performed better in the test of working memory, visual memory and emotional recognition. They did not find a relationship of cannabis with executive function.

Rachid H, Saif Z, Raoui S, Serhier Z, Agoub M. Does cannabis affect cognitive functioning in patients with schizophrenia? Schizophr Res Cogn. 2023;36:100299.

Science/Human: Lifetime cannabis use has only limited psychological social effects

In a sample of 4,078 American adult twins first assessed decades ago researchers found only small effects of cannabis use on psychiatric and social outcomes. Investigators of the University of Colorado School of Medicine in Aurora, USA, compared each twin to their cotwin, which inherently controls for shared genes and environments.

“This study suggests that lifetime exposure to cannabis has few persistent effects on mental health and other psychosocial outcomes. The notable exceptions are cannabis use disorder, tobacco frequency, and illicit drug use, for which lifetime cannabis frequency causes small increases. “

Zellers S, Alexander J, Ellingson JM, Schaefer JD, Corley RP, Iacono W, Hewitt JK, Hopfer CJ, McGue MK, Vrieze S. Limited psychological and social effects of lifetime cannabis use frequency: Evidence from a 30-year community study of 4,078 twins. Journal of Psychopathology and Clinical Science. 2024;133(1):115–128.

Science/Human: Some doctors prescribe cannabinoids to children with cerebral palsy

According to an anonymous online survey by investigators of the Institute of Social and Preventive Medicine at the University of Bern, Switzerland, some doctors prescribe cannabis-based medicines to children with cerebral palsy. Seventy physicians from Europe, North America, and Australia completed the survey, of whom 47 had experience with treating children with cerebral palsy with cannabinoids .

The most common indication was epilepsy (69%), followed by spasticity (64%) and pain (63%). The preparations and doses prescribed varied considerably. Half of the participants evaluated the effect of the cannabinoids as moderate. Authors noted: “Despite the lack of evidence to date, cannabinoids are used to treat children with cerebral palsy in a wide variety of indications.”

Hunziker S, Morosoli F, Zuercher K, Tscherter A, Grunt S. Prescription Practices of Cannabinoids in Children with Cerebral Palsy Worldwide-A Survey of the Swiss Cerebral Palsy Registry. Children (Basel). 2023;10(12):1838.

Science/Human: Cannabis may increase appetite but not body weight in inflammatory bowel disease

A case series of 149 patients with inflammatory bowel disease were initiating treatment with cannabis for disease-related symptoms, at the inflammatory bowel disease clinic of a tertiary referral medical center in Israel. investigators  of the School of Public Health at the Faculty of Medicine of Tel Aviv University, Israel, wrote that 50 were “treated for improvement of nutritional status.”

A modest increase in appetite after 3 months was detected among all patients enrolled, but there were no significant differences in energy or macronutrient intake, and in patients' body mass index . A significant appetite improvement after 3 months was detected among 34% of patients, but this was not associated with increased caloric intake or BMI at 3 or 6 months. Among patients without increased appetite after 3 months of cannabis therapy, BMI decreased at 6 months.

Fliss Isakov N, Seidenberg C, Meiri D, Yackobovitch-Gavan M, Maharshak N, Hirsch A. Medical Cannabis Increases Appetite but Not Body Weight in Patients with Inflammatory Bowel Diseases. Nutrients. 2023;16(1):78.

News in Brief

Science/Animal: Cannabigerol (CBG) may protect the liver against the development of insulin resistance

In a rat model of insulin resistance results “suggest that CBG treatment may modulate sphingolipid metabolism in the liver and plasma, potentially protecting the liver against the development of metabolic disorders such as insulin resistance.”

Department of Physiology, Medical University of Bialystok, Poland.

Bzdęga W. et al. Nutrients. 2023;15(20):4350.

Science/Animal: CBD may improve mitochondrial function in skeletal muscle of exhaustive exercise training rats

Mitochondria are the main organelles responsible for the energy supply. In studies with rats exercise training induced mitochondrial dysfunction in skeletal muscle, which was improved by CBD. “Our results indicate that skeletal muscle mitochondrial structure and function were improved after CBD intervention,” authors noted.

Harbin Sport University, Harbin, China.

Si J, et al. Chem Biol Interact. 2024:110855.

Science/Animal: CBD may attenuate chronic inflammation in colitis

In a study with mice with colitis CBD “protects against inflammation and colitis symptoms induced by DSS, providing an alternative approach” to the management of inflammatory bowel disease.” DSS = dextran sulfate sodium.

School of Food Science, Washington State University, Pullman, USA.

Sun Q, et al. Mol Nutr Food Res. 2024:e2300446.

Science/Animal: Cannabis may stimulate appetite by effects on certain brain cells

Scientists observed augmented activity on nerve cells with CB1 receptors in the mediobasal hypeathalamus (MPH), a certain brain region, when mice anticipated or consumed food. “Based on these results, we conclude that MBH neurons contribute to the appetite stimulatory properties of inhaled cannabis.”

Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, USA.

Wheeler EC, et al. Sci Rep. 2023;13(1):22970.

Science/Cells: CBD mediates the attenuation of pro-inflammatory mediators in psoriasis

“CBD provides anti-inflammatory effects in T cells isolated from patients with psoriasis. Our results could be the impetus for future investigations regarding the immunomodulatory properties of CBD and its utilization for development of CBD-containing antipsoriatic agents.”

Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.

Tsiogkas SG, et al. Cannabis Cannabinoid Res. 2024 Jan 5. [in press]

Science/Human: Cannabis treatment under the supervision of a doctor usually is associated with only rare adverse effects (AE)

According to an analysis of data from 2991 adult patients results “revealed clinically significant improvements in pain interference and tiredness, anxiety, and well-being from baseline. There were 79 AE reports (77 patients), 16 met the regulatory definition of seriousness, in which only 8 AEs were certainly or probably related to MC. Conclusions: MC directed by physicians appears to be safe and effective within 3 months of initiation for a variety of medical indications.” MC = medical cannabis.

Medical Cannabis Program in Oncology, Cedars Cancer Center, McGill University Health Centre, Montreal, Canada.

Vigano A, et al. Cannabis Cannabinoid Res. 2023;8(6):1106-1116.

Science/Cells: Cannabis extracts show antifungal and antibacterial activity

Investigators looked at activity of different cannabis extracts against fungi and bacteria. “All the extracts of the analysed cannabis varieties showed antibacterial and antifungal activities. In addition, plants belonging to the same chemotype showed different antimicrobial activity, demonstrating that the classification of cannabis strains based solely on THC and CBD content is not sufficient to justify their biological activities and that other compounds present in the extracts are involved in their action against pathogens. Cannabis extracts act in synergy with chemical fungicides, allowing to reduce its doses.”

Instituto de Investigaciones Biológicas, Mar del Plata, Argentina.

Vozza Berardo ME, et al. J Ethnopharmacol. 2024;318(Pt A):116839.

Science/Human: Cannabis users need higher doses of opiates after surgery

According to an analysis of 34,521 patients “cannabis users undergoing surgeries were found to have significantly higher postoperative opioid consumption and pain scores than nonusers. Cannabis use did not have a clinically meaningful association with hypoxia or composite pulmonary complications.”

Department of Outcomes Research, Cleveland, USA.

Ekrami E, et al. Anesth Analg. 2024 Jan 8. [in press]

Science/Animal: Activation of the endocannabinoid system is important during the acute phase of brain injury

In a study with rats “findings show that focal brain injury rapidly triggers widespread parenchymal and extraparenchymal neuroinflammation.” Activation of endocannabinoid signaling “during acute phase of the brain injury is important for initiation of adaptive anti-inflammatory processes and prevention of chronic pathologic neuroinflammation in distant uninjured structures.”

Department of Molecular Neurobiology, Moscow, Russia.

Karan AA, et al. Exp Neurol. 2024:114679.

Science/Animal: Beta-caryophyllene increases the levels of the endocannabinoid 2-AG

In a study with rats undergoing acute pain beta-caryophyllene was shown to inhibit the activity of the enzyme MAGL (monoacylglycerol lipase), which results in an increased level of the endocannabinoid 2-AG (2-arachidonoylglycerol). This new mechanism may explain anti-inflammatory and pain inhibiting effects of beta-caryophyllene.

Departments of Anesthesiology, Aurora, USA.

Klawitter J, et al. Mol Pharmacol. 2024;105(2):75-83.

Science/Review: Research progress in the management of blood vessel diseases with CBD

CBD “can inhibit abnormal proliferation and apoptosis of vascular smooth muscle and endothelial cells; these effects suggest CBD as a therapeutic agent for atherosclerosis, stress-induced hypertension, diabetes-related vasculopathy, ischemia-reperfusion injury, and vascular damage caused by smoking and alcohol abuse.”

School of Chinese PLA, Beijing, China.

Guo Y, et al. J Cardiothorac Surg. 2024;19(1):6.

Science/Review: Chronic pain and cannabis-based medicines

“Clinically, there is moderate evidence that cannabis-based medicines (CBM) can contribute to a significant reduction in pain, especially the associated pain effect, and improvement in physical function and sleep quality in a proportion of patients with chronic pain. The analgesic effect appears to be largely independent of the cause of pain. In this context, CBM preferentially regulates stress-associated pain processing.”

Anesthesiology, Hannover, Germany.

Karst M, et al. Pharmacopsychiatry. 2024 Jan 10. [in press]

Science/Review: Cannabinoids and the endocannabinoid system in early SARS-CoV-2 infection and Long COVID-19

“This review highlights the potential for future research to bridge this gap by investigating cannabinoids and the endocannabinoid system as a potential treatment strategy for both early and post-SARS-CoV-19 infection.”

Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, Canada.

Scott C, et al. J Clin Med. 2023;13(1):227.

Science/Review: Cannabinoids may limit the growth of tumours

“This review discusses current knowledge on the promising applications of cannabinoids in treating three different side effects of cancer-chemotherapy-induced nausea and vomiting, cancer-associated pain, and tumor development. The findings suggest that cannabinoids can be used to address some side effects of cancer and to limit the growth of tumors, though a lack of supporting clinical trials presents a challenge for use on actual patients.”

School of Medicine, Stanford University, Palo Alto, USA.

Bathula PP, Maciver MB. Int J Mol Sci. 2023;25(1):74.

Science/Review: CBD may suppress inflammation by blocking the NLRP3 Inflammasome

“Finally, we emphasize the capacity of cannabidiol to suppress inflammation by blocking the NLRP3 signaling pathway, which indicates that cannabidiol is a quite promising anti-inflammatory compound.”

Office of China National Narcotics Control Commission, China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Nanjing, China.

Chu FX, et al. Inflamm Res. 2024 Jan 8. [in press]