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IACM-Bulletin of 3 March 2024

Science/Human: Inhaled cannabis may help against acute migraine according to a placebo-controlled study

According to a 4-arm placebo-controlled study with 92 participants cannabis reduced migraine pain. Investigators of the University of California in San Diego, USA, treated adults with migraine up to 4 separate migraine attacks, 1 each with vaporized cannabis flowers with 6% THC, with 11% CBD, with 6% THC+11% CBD, and a placebo in a randomized order. The primary endpoint was pain relief and secondary endpoints were pain freedom and most bothersome symptom freedom, all assessed at 2 hours post-vaporization.

THC+CBD was superior to placebo at achieving pain relief (67% vs 47%) pain freedom (35% vs. 16%) at 2 hours, as well as sustained pain freedom at 24 hours. THC-dominant was superior to placebo for pain relief (69% vs. 47%) but not pain freedom at 2 hours. CBD-dominant was not superior to placebo for pain relief, pain freedom at 2 hours. There were no serious adverse events. Authors concluded, that “acute migraine treatment with 6% THC+11% CBD was superior to placebo at 2 hours post-treatment with sustained benefits at 24 and 48 hours.”

Schuster NM, Wallace MS, Marcotte TD, Buse DC, Lee E, Liu L, Sexton M. Vaporized Cannabis versus Placebo for Acute Migraine: A Randomized Controlled Trial. medRxiv [Preprint]. 2024:2024.02.16.24302843.

Science/Human: Regular cannabis users may experience a slightly increased risk for heart attack and stroke

In a population-based, cross-sectional study of 2016 to 2020 data from the Behavioral Risk Factor Surveillance Survey from 27 American states and 2 territories with 434,104 respondents daily cannabis use was associated with a slightly increased risk for cardiovascular diseases in adults 18 to 74 years old. Among the respondents, the prevalence of daily and nondaily cannabis use was 4% and 7.1%, respectively.

The adjusted odds ratio for the association of daily cannabis use and coronary heart disease, myocardial infarction, and stroke was 1.16, 1.25 , and 1.42, respectively. Relationships between cannabis use and cardiovascular outcomes were similar for men above the age of 55 years and women above the age of 65 years. Authors from the University of California in San Francisco and Massachusetts General Hospital in Boston, USA, concluded that cannabis use “is associated with adverse cardiovascular outcomes, with heavier use (more days per month) associated with higher odds of adverse outcomes.”

Jeffers AM, Glantz S, Byers AL, Keyhani S. Association of Cannabis Use With Cardiovascular Outcomes Among US Adults. J Am Heart Assoc. 2024:e030178.

Thailand: The new government will ban the recreational use of cannabis

Thailand will ban the recreational use of cannabis by the end of this year but continue to allow its use for medical purposes, the health minister said. After Thailand became the first country in Southeast Asia to free up medicinal use in 2018, and then recreational use in 2022, tens of thousands of cannabis shops have sprung up in an industry projected to be worth up to 1.2 billion US dollars by next year.

Reuters of 29 Februray 2024

USA: New York will allow adults to cultivate their own cannabis

The New York state Cannabis Control Board adopted rules that would allow anyone 21 or older to cultivate their own cannabis plants at home. The proposed regulations were approved nearly three years after cannabis was legalized in New York and include a provision that would allow retail cannabis store owners and operators to sell starter plants to customers.

Times Union of 16 Februrary 2024

Science/Human: Mixed influence of cannabis use on outcomes after coronary artery bypass surgery

Utilising data from the National Inpatient Sample database from 2008 to 2018 with 343,796 patients there was a nonsignificant decreased odds of in-hospital mortality among cannabis users (odds ratio = 0.41), significantly decreased odds of home discharge (OR = 1.50) and increased odds of longer stay in hospital (mean 10.4 versus 9.8 days).

Division of Cardiothoracic Surgery, Rhode Island Hospital, Warren Alpert  Medical School of Brown University, Providence, USA.

Bellam KG, et al. J Surg Res. 2024 Mar;295:442-448.

Science/Animal: A novel regulator of brain inflammation targeted by CBD

In studies with rats the cyclin-dependent kinase regulatory subunit 1B (CKS1B) was intensified “as a novel regulator of neuroinflammation; and reveals its involvement in the anti-inflammatory effects of CBD. Interventions targeting CKS1B expression are potentially promising for treating in ischemic stroke.”

NMPA Key Laboratory for Research and Evaluation of Drug Metabolism & Guangdong Provincial Key Laboratory of New Drug Screening, Guangzhou, China.

Chen K, et al. Exp Neurol. 2024 Mar;373:114654.

Science/Animal: THC and CBD exert their analgesic activity by different receptors

Studies with a nematode (Caenorhabditis elegans) “revealed CBD and THC are targeting different systems, namely the vanilloid and cannabinoid systems, respectively”, when it comes to analgesic effects.

Département de Biomédecine Vétérinaire, Faculté de Médecine Vétérinaire, Université de Montréal, Québec, Canada.

Boujenoui F, et al. Neurochem Res. 2024;49(4):935-948.

Science/Animal: Nanoparticles with CBD may help in the prevention of ulcerative colitis

CBD nanoparticles significantly improved the histological damage of colon in mice with ulcerative colitis, “increased the expression level of tight junction protein ZO-1, and effectively restored the intestinal mucosal barrier function and intestinal mucosal permeability. More importantly, CBD NPs significantly improved the species composition, abundance and amount of short chain fatty acids of intestinal flora in UC mice, thus effectively maintaining the balance of intestinal flora.”

College of Food Science and Engineering, Hainan University, Haikou, China.

Zhang X, et al. Mater Today Bio. 2024;25:100965.

Science/Animal: Citicoline and the activation of the CB1 Receptor show synergistic antidepressant-like effects

Results of studies studies with mice suggested a synergistic interaction between citicoline and cannabinoid CB1 receptors on the modulation of depression-like behaviors in mice. Citicoline is naturally occurring in cells and is available as a dietary supplement.

Department of Pharmacology and Toxicology, Faculty of Pharmacy and Pharmaceutical Sciences, Tehran Medical Sciences, Islamic Azad University, Iran.

Amanzade A, et al. Psychopharmacology (Berl). 2024 Feb 21. [in press]

Science/Animal: CBD may mitigate the lung damage caused by methotrexate

Studies with rats show “CBD's potential in mitigating MTX-induced lung damage, suggesting its therapeutic promise.” MTX (methotrexate) is an immunodepressant used in the treatment of autoimmune disorders such as ulcerative colitis.

Faculty of Veterinary Medicine, Department of Pathology, Burdur Mehmet Akif Ersoy University, Burdur, Turkey.

Ozmen O, et al. Basic Clin Pharmacol Toxicol. 2024 Feb 22. [in press]

Science/Animal: CBD shows beneficial effects against certain parasites

Cystic echinococcosis is a global parasitic zoonosis caused by infection with the larval stage of a parasite called Echinococcus granulosus sensu lato. Studies with mice demonstrated that CBD increased the efficacy of albendazole (ABZ), the main drug used in treating human cystic echinococcosis. Authors wrote that “further in vivo research will be conducted by changing the dose and frequency of CBD and CBD + ABZ treatments and new available CBD delivery systems will also be assayed to improve bioavailability in vivo.”

Instituto de Investigaciones en Producción Sanidad y Ambiente (IIPROSAM CONICET-UNMdP), Mar del Plata, Argentina.

Albani CM, et al. Trop Med Infect Dis. 2024;9(2):35.

Science/Human: Only minimal differences between patients with a psychotic disorder and healthy controls with regard to endocannabinoid concentrations

Blood samples were obtained from 18 patients and 16 healthy controls to measure blood plasma concentrations of the endocannabinoid’s anandamide and 2-AG. There were only minimal “relationships between 2-AG or anandamide plasma concentrations and dopaminergic, glutamatergic, or GABAergic measures in either group.”

Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), University of Maastricht, The Netherlands.

van Hooijdonk CFM, et al. Psychol Med. 2024 Feb 23:1-11.

Science/Animal: CBD may be protective against brain injury following heart damage

Studies with rats show that “CBD can be protective against brain injury caused by cardiac damage through antioxidant, anti-inflammatory, and anti-apoptotic mechanisms.”

Department of Neurology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey.

Dogan Unlu M, et al. Neurosci Lett. 2024;825:137689.

Science/Animal: CBD protects against acute aortic rupture

Acute aortic dissection or aortic rupture progresses rapidly and is associated with high mortality. In studies with mice CBD was shown to reduce morbidity and mortality associated with acute aortic dissection. “The CBD-induced effects were potentially mediated by suppressing macrophage infiltration and PMAIP1 (primarily expressed in macrophages)-induced VSMC apoptosis.”

Medical School of Chinese PLA, China.

Guo Y, et al. J Mol Cell Cardiol. 2024 Feb 20;189:38-51.

Science/Cells: CBG induces cell death in pancreatic cancer cells

Cannabigerol (CBG) was shown to induce autophagic cell death in human pancreatic ductal adenocarcinoma cell lines.

School of Pharmacy, University of Camerino, Italy.

Zeppa L, et al. Int J Mol Sci. 2024;25(4):2001.

Science/Cells: CBD may protect liver cells against lead exposure

In studies with liver cells exposed to lead CBD was shown to be protective. Authors wrote that “the increase in cell proliferation, and the reduction in the cellular uptake of toxic metals by CBD can be considered as strong evidence for the protective use of CBD in Pb exposures.”

Department of Medical Pharmacology, Faculty of Medicine, Yozgat Bozok University, Turkey.

Şahin S, et al. Sci Total Environ. 2024:170901.

Science/Cells: CBD may help to maintain muscle mass in cancer

According to studies with muscle cells “CBD could be used as an adjuvant in the treatment of cancer cachexia to help maintain muscle mass and improve patient quality of life.”

Unité de Nutrition Humaine UMR1019, Unité de Nutrition Humaine (UNH), Université Clermont Auvergne, France.

Le Bacquer O, et al. Am J Physiol Cell Physiol. 2024 Feb 26. [in press]

Science/Review: Cannabinoids may be helpful in wound healing

“Animal studies suggest application of cannabinoids may improve the healing of postsurgical and chronic wounds. There are few human studies which evaluate the effects of cannabinoids on wound healing and many of these are case series and observational studies. They do suggest cannabinoids may have some benefit.”

Departments of Otolaryngology Head and Neck Surgery The University of Oklahoma Health Sciences Center Oklahoma City Oklahoma USA.

Parikh AC, et al. Health Sci Rep. 2024;7(2):e1908.

Science/Review: Cannabis use during pregnancy may be associated with an increased risk of ADHD and Autism

Fourteen primary studies, consisting of ten on ADHD (attention deficit hyperactivity disorder) and four on ASD (autism spectrum disorder), with a total of 203,783 participants, were included in this study. Authors concluded from their analysis that this “study indicated that maternal prenatal cannabis exposure is associated with a higher risk of ADHD symptoms and ASD in offspring.”

School of Population Health, Curtin University, Bentley, Australia.

Tadesse AW, et al. J Psychiatr Res. 2024;171:142-151.