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IACM-Bulletin of 05 June 2022

Science/Human: Cannabis may be helpful in the treatment of nausea according to an app based study

Using an app, where Herr patients can enter their symptom changes, by 886 people cannabis was helpful in the treatment of nausea. The research was conducted by investigators of the College of pharmacy at the University of New Mexico in Albuquerque, USA. Participants completed 2220 cannabis self-administration sessions intended to treat nausea between 2016 and 2019.

By 1 hour post consumption, 96.4% of people had experienced symptom relief with an average symptom intensity reduction of -3.85 points on a 0 to 10 visual analogue scale. Among product characteristics, flower and concentrates yielded the strongest, yet similar results; products labelled as Cannabis indica underperformed those labelled as Cannabis sativa or hybrid; and joints were associated with greater symptom relief than pipes or vaporizers. In sessions using flowers, higher tetrahydrocannabinol and lower cannabidiol were generally associated with greater symptom relief.

Stith SS, Li X, Orozco J, Lopez V, Brockelman F, Keeling K, Hall B, Vigil JM. The Effectiveness of Common Cannabis Products for Treatment of Nausea. J Clin Gastroenterol. 2022 Apr 1;56(4):331-338.

Science/Human: Topical CBD effective in the treatment of thump basal joint arthritis according to a controlled study

In a controlled study at the Department of Plastic Surgery of the University of Virginia in Charlottesville, USA, with 18 patients suffering from thumb basal joint arthritis a CBD cream was superior to a placebo in pain reduction. They were randomized to 2 weeks of twice-daily treatment with CBD (6.2 mg/mL CBD with shea butter) or shea butter alone, followed by a 1-week washout period and then crossover for 2 weeks with the other treatment.

Cannabidiol treatment resulted in improvements from baseline among patient-reported outcome measures, including Visual Analog Scale pain disabilities of the arm, shoulder, and hand. Authors concluded that “in this single-center, randomized controlled trial, topical CBD treatment demonstrated significant improvements in thumb basal joint arthritis-related pain and disability without adverse events.”

Heineman JT, Forster GL, Stephens KL, Cottler PS, Timko MP, DeGeorge BR Jr. A Randomized Controlled Trial of Topical Cannabidiol for the Treatment of Thumb Basal Joint Arthritis. J Hand Surg Am. 2022 May 27:S0363-5023(22)00133-2.

Science/Human: Cannabis may alleviate symptoms associated with cancer

According to an open longitudinally study with cancer patients, who were followed for 6 months, the use of medical cannabis had positive effects on multiple symptoms. The study was conducted by scientist from several research institutions in Israel, including the Cancer Centre in Afula, centres in Haifa, Nahariya and Zafed. MC treatment was initiated by 324 patients and 212, 158 and 126 reported at follow-ups.

Most outcome measures improved significantly during MC treatment for most patients. Specifically, at 6 months, total cancer symptoms burden declined from baseline by a median of 18%, from 122 (82–157) at baseline to 89 (45–138) at endpoint. Authors concluded that “the results of this study suggest that MC treatment is generally safe for oncology patients and can potentially reduce the burden of associated symptoms with no serious MC-related adverse effects.”

Aviram J, Lewitus GM, Vysotski Y, Amna MA, Ouryvaev A, Procaccia S, Cohen I, Leibovici A, Akria L, Goncharov D, Mativ N, Kauffman A, Shai A, Bar-Sela G, Meiri D. The Effectiveness and Safety of Medical Cannabis for Treating Cancer Related Symptoms in Oncology Patients. Front. Pain Res., 20 May 2022.

Science/Human: CBD may show some efficacy in children with autism spectrum disorder according to a controlled study

In a placebo-controlled study with 60 children, aged between 5 and 11 years, CBD was able to improve 1 of the diagnostic criteria of autism spectrum disorder (ASD). The study was conducted at the Department of Psychology of the Federal University of Paraíba João Pessoa, Brazil. Participants were divided into 2 groups, the treatment group, which received the CBD-rich cannabis extract, and the control group, which received the placebo, both used the product for a period of 12 weeks.

Significant results were found for social interaction, anxiety, psychomotor agitation, concentration and number of meals. Authors concluded that “CBD-rich cannabis extract was found to improve one of the diagnostic criteria for ASD (social interaction), as well as often co-existing features, and to have few serious adverse effects.”

Silva EAD Junior, Medeiros WMB, Santos JPMD, Sousa JMM, Costa FBD, Pontes KM, Borges TC, Espínola C Neto Segundo, Andrade E Silva AH(, Nunes ELG, Torro N, Rosa MDD, Albuquerque KLGD. Evaluation of the efficacy and safety of cannabidiol-rich cannabis extract in children with autism spectrum disorder: randomized, double-blind and controlled placebo clinical trial. Trends Psychiatry Psychother. 2022 May 26;44. [in press].

News in brief

Japan: The health minister is considering legalisation of cannabis preparations for medical use
Japan's health minister is considering legalizing cannabis for medical purposes. In addition, a new legal framework is also to be created to criminalize use without a medical purpose. A ministry panel has been discussing revisions to the 1948 Controlled Substances Act since 25 May.
Sumikai of 27 May 2022

Science/Human: Nabilone did not affect cognitive performance in patients with Parkinson’s disease
In a placebo controlled study with 47 patients suffering from Parkinson’s disease the THC derivative nabilone “did not significantly worsen cognitive performance and appears to be safe to use" in this group of patients.
Department of Neurology, Medical University Innsbruck, Austria.
Ellmerer P, et al. Brain Sci. 2022;12(5):661.

Science/Human: THC may cause an altered state of consciousness
In a study with 25 healthy infrequent users of cannabis oral THC in a dose of 7.5 and 15 mg dose dependently increased “Insightfulness, and increased ratings of mindfulness and mind-wandering. THC also increased language entropy as previously reported for LSD.”
Department of Psychiatry and Behavioral Neuroscience, University of Chicago, USA.
Murray CH L, et al. Conscious Cogn.2022;102:103357.

Science/Human: CBD has no effect on driving abilities
According to a study with 17 healthy humans, who underwent simulated driving and other tests “acute, oral CBD treatment does not appear to induce feelings of intoxication and is unlikely to impair cognitive function or driving performance.”
Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, Sydney, Australia.
McCartney D, et al. J Psychopharmacol. 2022 May 30 [in press]

Science/Human: Endocannabinoid levels in the blood are associated with specific gut bacteria
According to a study with 92 young adults blood plasma levels of anandamide and related endocannabinoid-like substances “are correlated to specific fecal bacterial genera involved in maintaining gut barrier integrity in young adults. This suggests that plasma levels of endocannabinoids and their analogues may play a role in the gut barrier integrity in young adults.”
Sport and Health University Research Institute (iMUDS), University of Granada, Spain.
Ortiz-Alvarez L, et al. Nutrients. 2022;14(10):2143.

Science/Animal: CBD may reduce inflammation in the lungs of rats with pulmonary hypertension
In a study with rats with pulmonary hypertension CBD in a dose of 10 mg per kilogram bodyweight for 21 days showed “antioxidant and anti-inflammatory effects.” Authors concluded that CBD may act as an adjuvant therapy for pulmonary hypertension.
Department of Experimental Physiology and Pathophysiology, Medical University of Bialystok, Poland.
Krzyżewska A, et al. Molecules. 2022;27(10):3327.

Science/Animal: A derivative of CBDA may cause weight loss in obesity
In a study with obese mice a synthetic derivative of CBDA (cannabidiolic acid) “ameliorated obesity and its metabolic abnormalities.” Authors wrote that “these results support the idea to further promote this synthetic CBDA derivative toward clinical evaluation in humans.”
The Institute for Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Israel.
Ben-Cnaan E, et al. Int J Mol Sci. 2022 ;23(10):5610.

Science/Animal: CBD may reduce inflammation in endometriosis
In an animal model of endometriosis CBD showed anti-inflammatory effects including a reduction in pro-inflammatory mediators such as tumour necrosis factor alpha (TNF-alpha) and interleukin-1 alpha (IL-1 alpha).
Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Italy.
Genovese T, et al. Int J Mol Sci. 2022;23(10):5427.

Science/Animal: CBD may enhance removal of amyloid beta peptide, relevant in Alzheimer’s disease
Alzheimer's disease (AD) is associated with the accumulation and aggregation of amyloid in the brain. A new study with mice shows that CBD may help immune cells to remove amyloid beta peptides and CBD “successfully attenuated neuroinflammation while simultaneously improving mitochondrial function.” Author’s concluded that CBD may be “a promising candidate” for the treatment of Alzheimer’s disease.
College of Life Sciences, Northwest Normal University, Lanzhou, China.
Yang S, et al. Int J Mol Sci. 2022;23(10):5367.

Science/Cells: THC may reduce inflammation in rheumatoid arthritis
In synovial fibroblasts from patients with rheumatoid arthritis THC decreased the production of pro-inflammatory cytokines including tumour necrosis factor alpha and interleukin-10.
Poliklinik, Funktionsbereich & Hiller Forschungszentrum für Rheumatologie, University Hospital Duesseldorf, Germany.
Lowin T, et al. Biomedicines. 2022;10(5):1118.

Science/Cells: A CBD rich cannabis extract may help in the treatment of oral inflammation
In a study with human mouth cells (gingival fibroblasts) a hemp extract and CBD decreased the release tumour necrosis factor alpha release and that of interleukin-1 beta. Authors wrote that the study shows “that short-term exposure to hemp extract and CBD promoted gingival fibroblast wound healing, demonstrating that hemp extract and CBD have potential benefits in the treatment of oral inflammation and ulcers.”
Faculty of Pharmaceutical Sciences and Center of Excellence for Innovation in Chemistry, Naresuan University, Phitsanulok, Thailand.
Kongkadee K, et al. Arch Oral Biol. 2022;140:105464.

Science/Human: Food alters the pharmacokinetics of CBD
In a placebo-controlled study researchers demonstrated that “consuming CBD with food alters the dynamics of CBD metabolism and increases systemic availability.”
Department of Health and Exercise Science, Colorado State University, Fort Collins, USA.
Abbotts KSS, et al. Nutrients. 2022;14(10):2152.

Science/Animal: The receptor GPR55 plays a role in pain control
According to animal studies the activity of the cannabinoid receptor GPR55, which is influenced by THC and CBD, in the PAG of the brain (periaqueductal gray) may be involved in the mitigation of inflammatory pain.
Department of Pharmacology and Neuroscience, Texas Tech University Health Sciences Center, School of Medicine, Lubbock, Texas, USA.
Blanton H, et al. Cannabis Cannabinoid Res. 2022 May 24. [in press]

Science/Human: The diet may have an influence of endocannabinoid levels during exercise
In a controlled study with 7 women, who were on the Mediterranean diet for 7 days and on the normal Canadian diet for another 7 days, endocannabinoid levels in the blood increased directly after intense exercise after the Mediterranean diet but not after the other diet.
Centre Nutrition, Santé et Société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Quebec, Canada.
Forteza F, et al. Sci Rep. 2022;12(1):8568.

Science/Animal: Activation of the GPR55 may have antidepressant effects
In a study with mice researchers show that “activation and upregulation of GPR55”, a cannabinoid receptor in the brain, may cause antidepressant effects, “which might be correlated with its anti-inflammatory and subsequent neuroprotective effects.”
Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, China.
Shen SY, et al. Neurobiol Dis. 2022;169:105743.

Science/Human: No clear effect of cannabis on suicide risk
A review shows that studies, which investigated the effects of cannabis use on suicide and suicidal ideation, did not come to definite conclusions.
Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil.
Carvalho JV, et al. Psychiatry Res. 2022;312:114555.

Science/Human: Conflicting evidence of an opioid sparing effect by cannabis
A review shows that in “summary, preclinical and observational studies demonstrate the potential opioid-sparing effects of cannabinoids in the context of analgesia, in contrast to higher-quality RCTs that did not provide evidence of opioid-sparing effects.”
Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Frankston, Australia.
Nielsen S, et al. Neuropsychopharmacology. 2022;47(7):1315-1330.

Science/Animal: Stress increases 2-AG levels in several brain regions, which is supported by green nut oil supplementation
In a study with mice stress increased the levels of the endocannabinoid 2-AG (2-arachidonoylglycerol) in several brain regions (hypothalamus, midbrain and hindbrain) and this was increased by the intake of green nut oil. Authors conclude that green nut oil May “improve brain 2AG levels which might be used to treat anxiety and depressive behaviors.
Department of Cellular and Molecular Anatomy, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.
Islam A, et al. Biochem Biophys Res Commun. 2022;609:9-14.

Science/Human: Adolescents are more sensitive than adults to acute cognitive effects of THC
In a study with 12 adolescents aged 18 to 20 years and 12 adults aged 30 to 40 years, who received THC capsules (7.5 mg, 15 mg) “doses that produce comparable ratings of intoxication, adolescents may exhibit greater cognitive impairment and alterations in brain function.”
hi Department of Psychiatry and Behavioral Neuroscience, University of Chicago, USA.
Murray CH, et al. Neuropsychopharmacology. 2022;47(7):1331-1338.

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