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IACM-Bulletin of 9 April 2023

Science/Human: A considerable number of patients with inflammatory bowel disease use cannabis

According to a survey with 162 adults suffering from inflammatory bowel disease 37% reported use of cannabis. Investigators of the Department of Medicine at the School of Medicine of the University of Puerto Rico Medical Sciences Campus in San Juan, USA, found out that 63% use it to relieve their symptoms and many patients did not inform their physician of their cannabis use.

Among cannabis users, 48% had discussed use with their physician, but 88% said they would feel comfortable discussing medical cannabis for inflammatory bowel disease. Most saw improvement of their symptoms (85.7%). Authors concluded that a “considerable number of patients with IBD use medical cannabis for their disease, unknown to their physician.”

Velez-Santiago A, Alvarez-Torres E, Martinez-Rodriguez R, Candal-Rivera E, Muniz-Camacho L, Ramos-Burgos L, Torres EA. A Survey of Cannabis Use among Patients with Inflammatory Bowel Disease (IBD). Int J Environ Res Public Health. 2023;20(6):5129.

Science/Human: CBD may enhance sugar utilisation of the brain and ameliorate cognition according to a case report

CBD improved the mental state of a 19-year-old student with a marked cognitive decline within 6 months, anhedonia, ambivalence, social withdrawal, poverty of speech, and brief intermittent psychotic symptoms (delusions and hallucinations). Investigators of the Brain and Mind Centre of the Faculty of Medicine and Health, The University of Sydney, Australia, and academic institutions in Mannheim and Cologne, Germany, contributed to the Research. The patient was diagnosed with Clinically High-Risk mental state, and investigators decided to treat him with 600 mg of oral CBD per day over 4 weeks.

The physicians observed no relevant side effects but a significant clinical improvement. In addition, positron emission tomography showed a considerable increase in cerebral glucose uptake in various brain regions. Authors concluded that “this finding suggests that cannabidiol may enhance cerebral glucose utilization, possibly via activation of peroxisome proliferator-activated receptor-gamma (PPAR-γ) by its endogenous ligand anandamide or related N-acylethanolamines.”

Koethe D, Rohleder C, Kracht L, Leweke FM. Cannabidiol enhances cerebral glucose utilization and ameliorates psychopathology and cognition: A case report in a clinically high-risk mental state. Front Psychiatry. 2023;14:1088459.

Science/Human: Topical CBD may improve chronic lower extremity pain in elite athletes

According to a retrospective analysis of data from 20 individuals who were all previously professional athletes topical CBD reduced chronic lower extremity pain resulting from acute lower extremity injuries. Investigators of Louisiana State University Health Sciences Center at Shreveport, USA, administered 10 mg of topical CBD twice daily by controlled dispenser.

There was a significant improvement in self-reported pain levels and pain-related disability, including family and home responsibilities, life support activities, occupational activities, recreational activities, self-care, sexual function, and social activities. Authors wrote that “topical administration of CBD was tolerated well by this population and resulted in only minor adverse effects.”

Hall N, James B, Bhuiyan MAN, Crane E, Falgout C, Murnane KS. Topical cannabidiol is well tolerated in individuals with a history of elite physical performance and chronic lower extremity pain. J Cannabis Res. 2023;5(1):11.

Science/Human: A treatment with a cannabis extract improved metabolic parameters in diabetic patients

A new sublingual spray (CBDEX10) containing 0.1 mg CBD and 0.01 mg THC per puff improved lipid and glycaemic control in a placebo-controlled trial in 50 patients with diabetes type 2. Investigators of the Department of Clinical Pharmacy of the School of Pharmacy at Shahid Beheshti University of Medical Sciences in Tehran, Iran, randomly allocated 25 patients to 2 puffs twice daily and 25 patients to the placebo.

A statistically significant decline in total cholesterol, triglyceride, LDL-cholesterol, Hb A1 and insulin secretion was observable in the patients treated with the cannabis extract at the end of the 8-week treatment period. There were no serious adverse effects.

Afshar S, Khalili S, Amin G, Abbasinazari M. A Phase I Randomized, Double-blind, Placebo-controlled Study on Efficacy and Safety Profile of a Sublingually Administered Cannabidiol /Delta 9-tetrahydrocannabidiol (10: 1) Regimen in Diabetes Type 2 Patients. Iran J Pharm Res. 2023;21(1):e132647.

News in brief

Science/Human: Cannabis users may need less opioids after surgery

Patients undergoing surgery following distal radius fracture needed less opioids in the follow-up, if they were cannabis users.

University of Colorado School of Medicine, Aurora, USA.

Lee N, et al. Plast Reconstr Surg Glob Open. 2023;11(4):e4901.

Science/Animal: Endocannabinoids reduce anxiety in a model of post-traumatic stress disorder

In a rat model of post-traumatic stress disorder increase of endocannabinoid levels through inhibition of their degradation by inhibition of the activity of FAAH (fatty acid amide hydrolyse) reduced anxiety -like symptoms.

Department of Anatomy and Neurobiology, University of California, Irvine, USA.

Fotio Y, et al. Psychopharmacology (Berl). 2023 Apr 5. [in press]

Science/Human: Cannabis use had no relevant effect on outcomes in opioid replacement therapy

In a study with 272 patients suffering from opioid use disorder, of whom 134 received methadone and 138 buprenorphine/naltrexone cannabis use had no effect on withdrawal symptoms and other outcomes of opioid replacement therapy.

Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Canada.

Elkrief L, et al. J Subst Use Addict Treat. 2023 Mar 30:209031.

Science/Animal: A combination of CBD and THC reduced chronic orthopaedic pain in a cat

A 10-year old male cat with chronic orthopaedic pain profited from treatment with a full spectrum cannabis oil containing CBD and THC.

Facultad de Veterinaria, Departamento de Clínicas y Hospital Veterinario, Universidad de la República, Montevideo, Uruguay.

Gutierre E, et al. Vet Med Sci. 2023 Mar 31. [in press]

Science/Animal: CBD may be helpful in the treatment of endometriosis

According to results of a study with a rat model of endometriosis CBD may improve symptoms by its anti-inflammatory, antioxidative and antiangiogenic effects.

Acibadem Health Group, Department of Obstetrics, Gynecology and Reproductive Medicine, Acibadem Kozyatagi Hospital, Istanbul, Turkey.

Okten SB, et al. Reprod Biomed Online. 2023 Feb 2:S1472-6483(23)00056-1.

Science/Animal: Cessation of THC use partially reverses impacts on male fertility in monkeys

In a study with 6 rhesus macaques discontinuation of chronic THC use partially restored adverse impacts to male reproductive health, THC-associated sperm differentially methylated regions in genes important for development, and expression of proteins important for male fertility.

Department of Urology, Oregon Health & Science University; Portland, USA.

Hedges JC, et al. Fertil Steril. 2023 Mar 24:S0015-0282(23)00167-X. Sie

Science: CBG shows antibacterial effects against Streptococcus mutans

CBG (cannabigerol) shows antibacterial effects against Streptococcus mutans by interfering with a bacterial intercellular signalling system referred to as quorum sensing.

The Biofilm Research Laboratory, The Institute of Biomedical and Oral Research (IBOR), The Faculty of Dental Medicine, The Hebrew University of Jerusalem, Israel.

Aqawi M, et al. Biomedicines. 2023;11(3):668.

Science/Human: A review shows that cannabis did not increase the risk of traffic accidents in older adults

A meta-analysis showed that the risk of motor vehicle collisions and culpability for accidents did not significantly differ between THC-positive and THC-negative older adults.

Neuropsychopharmacology Group, Sunnybrook Research Institute, Toronto, Canada.

Chinna-Meyyappan A, et al. Brain Sci. 2023;13(3):421.

Science/Human: Cannabis use has no major defects on behavioural indices of performance monitoring

In a study with 36 regular cannabis users and 34 controls, who participated in tests that allowed participants to learn from errors and adapt their behaviour. Authors found that “overall cannabis use might not be tightly coupled to behavioural indices of performance monitoring. There is evidence, however, that aspects of cannabis use predict impairments in learning from errors.”

Melbourne School of Psychological Sciences, The University of Melbourne, Australia.

Dali G, et al. PLoS One. 2023;18(3):e0283158.

Science/Animal: The metabolism of CBD may differ between carnivorous and herbivorous species

A review suggests that “the metabolism of CBD across species appears to be different in carnivorous species compared with omnivorous/herbivorous species (including humans) based on current information.”

Department of Molecular Medicine, Cornell University College of Veterinary Medicine, Ithaca, USA.

Schwark WS, et al. Am J Vet Res. 2023 Mar 29:1-9.

Science/Animal: CBD may improve the metabolic profile caused by maternal obesity in the offspring

Investigations with rats shows that maternal obesity results in a range of metabolic imbalances in the offspring, which can be attenuated by CBD.

Graduate Program in Biosciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil.

Rodrigues FDS, et al. Front Nutr. 2023;10:1150189.

Science/Animal: Activation of the CB2 receptor alleviates neuropathic pain by regulating microglia

In a study with rats intrathecal administration of a synthetic CB2 receptor agonist (PM226) attenuated mechanical and cold hyperalgesia in rats and prevented the transition of microglia to the proinflammatory stage.

Department of Anesthesiology and Perioperative Medicine, Second Affiliated Hospital of Zhengzhou University, China.

Zhou Y, et al. Front Mol Neurosci. 2023;16:1061220.

Science/Human: Daily CBD use reduced the prevalence of low testosterone levels in older men

In a study with 1061 individuals daily CBD use was associated with a significant decrease in daytime drowsiness and a decrease in the prevalence of low testosterone levels in males older than 40 years.

Midwest Allergy Sinus Asthma PC, Springfield, USA.

Kaufmann R, et al. Med Cannabis Cannabinoids. 2023;6(1):32-40.

Science/Cells: The endocannabinoid system promotes the proliferation of hepatic progenitor cells

The proliferation and differentiation of hepatic progenitor cells drive the homeostatic renewal of the liver under diverse conditions. This proliferation is promoted by the endocannabinoid system.

Laboratory of Physiologic Studies, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, USA.

Mukhopadhyay B, et al. Cell Death Discov. 2023;9(1):104.

Science/Animal: The endocannabinoid system mediates the antidepressant effects of transcranial magnetic stimulation

A study with mice demonstrates that the endocannabinoid system mediates the antidepressant effects and was involved in the regulation of local field potentials in the ventral hippocampus of high-frequency repetitive transcranial magnetic stimulation.

Department of Psychiatry, Xijing Hospital, Air Force Medical University, Xi'an, China.

Peng ZW, et al. J Affect Disord. 2023;331:217-228.

Science/Animal: CBG may be promising for the development of a transdermal application for pain management

In a study with mice CBG relieved pain due to arthritis and nerve pain. Researchers demonstrated that CBG can activate the CB2 receptor and the vanilloid 1 receptor and may be administered through the skin.

Innovation Research Institute of Traditional Chinese Medicine (IRI), Shanghai University of Traditional Chinese Medicine, Shanghai, China.

Wen Y, et al. Biomed Pharmacother. 2023;158:114163.

Science/Animal: Cannabis use in adolescence may cause loss of ovarian reserve in adulthood

Mice received THC from postnatal days 30-43 and ovaries were investigated on day 70. Authors noted that “adolescent treatment with THC depleted ovarian primordial follicle numbers by 50%.”

Department of Environmental and Occupational Health and Dept. of Medicine, University of California Irvine, USA.

Lim J, et al. Toxicol Sci. 2023 Mar 13:kfad027.

Science/Human: Therapeutic doses of CBD may cause liver damage according to a review

According to a review high dose CBD treatment with more than 1000 mg per day may sometimes cause drug induced liver injury and liver enzyme elevations. No cases of liver enzyme elevation was reported for daily doses below 300 mg per day.

Department of Public Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.

Lo LA, et al. J Intern Med. 2023 Mar 13. [in press]

Science/Animal: CBD may reduce stress in dogs during separation from their caregivers

In a placebo-controlled study, a population of dogs were either left alone in a familiar room (n = 21) or underwent a short car journey (n = 19). A single dose of CBD mitigated the stress associated with these situations.

Waltham Petcare Science Institute, Waltham on the Wolds, United Kingdom.

Hunt ABG, et al. Front Vet Sci. 2023 Feb 22;10:1112604.