IACM-Bulletin of February 27, 2011

Science — THC improves taste and smell perception, appetite and sleep in cancer patients

At the Department of Agricultural, Food and Nutritional Science of the University of Alberta, Canada a pilot study investigated the effects of THC (dronabinol) on taste and smell perception as well as appetite, caloric intake, and quality of life in cancer patients. Adult advanced cancer patients, with poor appetite and chemosensory alterations were included in the study and randomized in a double-blinded manner to receive either THC or placebo capsules. 24 of the participants received 2.5 mg THC twice daily and 22 received a placebo for 18 days. Twenty-one patients completed the trial.

THC and placebo groups were comparable at baseline. Compared with placebo, THC-treated patients reported significantly improved and enhanced chemosensory perception and food 'tasted better'. Pre-meal appetite and proportion of calories consumed as protein significantly increased compared with placebo. THC-treated patients reported increased quality of sleep and relaxation. Quality of life scores and total caloric intake were improved in both THC and placebo groups. Researchers concluded that "THC may be useful in the palliation of chemosensory alterations and to improve food enjoyment for cancer patients."

(Source: Brisbois TD, de Kock IH, Watanabe SM, Mirhosseini M, Lamoureux DC, Chasen M, Macdonald N, Baracos VE, Wismer WV. Delta-9-tetrahydrocannabinol may palliate altered chemosensory perception in cancer patients: results of a randomized, double-blind, placebo-controlled pilot trial. Ann Oncol. 2011 Feb 22. [in press])

Spain — Sativex will be reimbursed for patients with spasticity due to multiple sclerosis

The pharmaceutical company Almirall announced that the Spanish Ministry of Health granted the reimbursement of the cannabis extract Sativex in Spain. It is a treatment designed for patients with MS-related spasticity who have not responded to other treatments. Sativex is administered as an oral spray. The approval of Sativex in additional EU member states is expected in 2011.

It is estimated that there are around 40,000 people suffering from multiple sclerosis in Spain of whom around 75 per cent suffer from spasticity. Sativex was developed by the British company GW Pharmaceuticals and is marketed in Europe (except the UK) by Almirall. There is already an approval of Sativex in the UK, where it is marketed by the company Bayer.

(Source: Press release by Almirall of 16 February 2011)

Science — Effects of synthetic cannabinoids (JWH-018) in humans

A scientist from New Zealand investigated the psychological effects of JWH-018, a synthetic cannabinoid found in preparations such as "Spice". For this purpose 15 persons with serious mental illness were interviewed. All 15 subjects were familiar with a locally available JWH-018 containing product called "Aroma" and 86 per cent reported having used it.

They credited the product's potent psychoactivity, legality, ready availability and non-detection in drug testing as reasons for its popularity, with most reporting it had replaced cannabis as their drug of choice. Anxiety and psychotic symptoms were common after use. No one reported becoming physically unwell after using JWH-018 and no one reported withdrawal symptoms. (Source: Every-Palmer S. Drug Alcohol Depend. 2011 Feb 10. [in press])

(Source: Every-Palmer S. Synthetic cannabinoid JWH-018 and psychosis: An explorative study. Drug Alcohol Depend. 2011 Feb 10. [in press])

News in brief

USA — Support for legalisation

According to a poll by the Economist a majority of Americans support the legalisation and taxation of cannabis. Even without excluding subjects who were undecided a clear majority favours treating the drug equivalently to tobacco and alcohol. Young people are very strongly in favour, but older participants are also in favour of legalisation. Breaking the poll down by party, one finds that Republicans as well as Democrats are in favour, though the former much more narrowly so. (Source: The Economist of 10 February 2011)

USA — Cannabis and driving

Lawmakers in Colorado are considering setting a driving under the influence blood-content threshold for cannabis that would make Colorado one of three states with such a provision in statute. Under the proposal, drivers who test positive for 5 nanograms per millilitre (ng/ml) or more of THC would be considered too impaired to drive. (Source: Associated Press of 20 February 2011)

Science — Migraine

According to research at the University of Pavia, Italy, the endocannabinoid anandamide improved migraine in a rat model of the disease. Authors stated that "a dysfunction of the endocannabinoid system may contribute to the development of migraine attacks and that a pharmacological modulation of CB receptors can be useful for the treatment of migraine pain." (Source: Greco R, et al. J Headache Pain. 2011 Feb 18. [in press])

Science — Cannabis cultivation

Researchers at the National Institute for Health and Welfare in Helsinki, Finland, compared domestic cannabis cultivation in Denmark and Finland to describe national characteristics in small-scale cannabis growing. They conducted an internet survey with 401 participants from Denmark and 1,054 from Finland. Cannabis was cultivated primarily for own use, but sharing with friends and avoiding criminal circles also were significant motives for growing. Finnish growers prioritized indoor cultivation, whereas the Danes were more in favour of open-air plantations. Growing for medical purposes was twice as prevalent in Finland as in Denmark. (Source: Hakkarainen P, et al. Eur Addict Res 2011;17(3):119-128.)

Science — Anandamide and THC

Researchers of the Virginia Commonwealth University in Richmond, USA, investigated similarities in the effect of the endocannabinoid anandamide and the plant cannabinoid THC in mice. Their findings suggest that, in the absence of the enzyme responsible for the degradation of anandamide (fatty acid amide hydrolase, FAAH), the endocannabinoid "produces intoxication comparable to THC, and consequently to marijuana." (Source: Walentiny DM, et al. Eur J Pharmacol. 2011 Feb 11. [in press])

Science — Cancer of the stomach

According to researchers of the Catholic University of Korea in Seoul, Korea, the synthetic cannabinoid WIN 55,212-2 arrested cell cycle in gastric cancer cells in the so-called G1 phase and thus reduced cancer proliferation. (Source: Park JM, et al. J Cell Biochem. 2011 Feb 10. [in press])

Science — GPR55

The GPR55 receptor was originally identified as a putative third cannabinoid receptor. Researchers at Kyushu University in Fukuoka, Japan, tried to identify the natural ligand of this receptor. From their investigation they suggest that 2-arachidonoyl lysophosphatidylinositol is "the most likely natural ligand of GPR55." (Source: Okuno T, Yokomizo T. J Biochem. 2011 Feb 15. [in press])

Science — Parkinson's disease

Spanish and British researchers investigated the effects of Delta-9-tetrahydrocannabivarin (THCV) in an animal model of Parkinson's disease. They concluded that "given its antioxidant properties and its ability to activate CB2 but to block CB1 receptors, Delta-9-THCV has a promising pharmacological profile for delaying disease progression in PD and also for ameliorating parkinsonian symptoms." (Source: García C, et al. Br J Pharmacol. 2011 Feb 16. [in press])

Science — Pigmentation of the skin

According to research at the University of Porto, Portugal, activation of the CB1 receptor reduced pigmentation of the skin induced by ultraviolet B radiation. Scientists concluded that "the endocannabinoid system in the skin may be a possible target for future therapies in pigmentary disorders." (Source: Magina S, et al. Arch Dermatol Res. 2011 Feb 5. [in press])

Science — Inflammation

According to research at Thomas Jefferson University, Philadelphia, USA a selective CB2 receptor agonist (0-1966) showed neuroprotective effects in a mouse model of traumatic brain injury. (Source: Elliott MB, et al. J Neurotrauma. 2011 Feb 20. [in press])