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IACM-Bulletin of 14 August 2022

Science/Human: Many women use cannabis for the treatment of menopause-related symptoms

In a study with 285 women with menopause-related symptoms many participants used cannabis. It was conducted by researchers of the Department of Psychiatry of Harvard Medical School in Boston, USA. Participants (perimenopausal, n = 131; postmenopausal, n = 127) completed assessments of menopause-related symptomatology and cannabis use

Most participants reported current cannabis use (86%) and endorsed using cannabis for menopause-related symptoms (79%). The most common modes of use were smoking (84%) and edibles (78%), and the top menopause-related symptoms for cannabis use were sleep disturbance (67%) and mood/anxiety (46%).

Dahlgren MK, El-Abboud C, Lambros AM, Sagar KA, Smith RT, Gruber SA. A survey of medical cannabis use during perimenopause and postmenopause. Menopause. 2022 Aug 2. [in press].

Science/Human: CBD may reduce symptoms of chemotherapy-induced peripheral neuropathy

In a study with 54 patients, who underwent cancer chemotherapy with carboplatin and paclitaxel or capecitabine and oxaliplatin, CBD attenuated symptoms of chemotherapy-induced peripheral neuropathy (CIPN). Participants received either 150 mg of CBD twice-daily or a placebo for 8 days starting one day before initiation of chemotherapy. Patients were treated at the Department of Clinical Oncology and Palliative Care of Zealand University Hospital in Roskilde, Denmark.

Patients receiving CBD together with chemotherapy showed significantly lower (better) change in Z-scores in high-frequency vibrometry. The difference between CBD and placebo group was most pronounced for patients receiving carboplatin and paclitaxel. Authors concluded that “CBD attenuated early symptoms of CIPN with no major safety concerns.”

Nielsen SW, Hasselsteen SD, Dominiak HSH, Labudovic D, Reiter L, Dalton SO, Herrstedt J. Oral cannabidiol for prevention of acute and transient chemotherapy-induced peripheral neuropathy. Support Care Cancer. 2022 Aug 6.[in press].

Science/Human: Cannabis may be helpful in palliative care

In a retrospective analysis of data from 184 patients receiving palliative care with a diagnosis of cancer those who received cannabis showed an improvement of several symptoms. Patients were treated at the Upstate University Hospital, Syracuse, USA. 51.5% had received at least one prescription of cannabis from a licensed marijuana dispensary in New York.

For patients who took at least one dose of medical marijuana, 48% experienced an improvement in pain, 45% used fewer opioids, and 85% had an improvement in at least one symptom. Authors concluded that “medical marijuana has an important role in the palliation of symptoms in advanced cancers with few adverse effects.”

Sura KT, Kohman L, Huang D, Pasniciuc SV. Experience With Medical Marijuana for Cancer Patients in the Palliative Setting. Cureus. 2022;14(6):e26406.

Science/Human: Cannabis use may be associated with a lower COVID-19 severity in hospitalised patients according to a retrospective analysis

In a retrospective analysis of 1831 patients admitted to two medical centres in California cannabis use was associated with less severe outcome, including reduced days in hospital. Researchers of the David Geffen School of Medicine at the University of California in Los Angeles, CA, USA, evaluated outcomes including the COVID-19 Severity Score, mechanical ventilation and length of hospitalisation.

69 patients reported active cannabis use (4% of the cohort). They had lower levels of inflammatory markers upon admission than non-users as measured by C-reactive protein (3.7 mg/L versus 7.6 mg/L), shorter hospitalization (4 days versus 6 days), lower intensive care admission rates (12% versus 31%), and less need for mechanical ventilation (6% versus 17%). However, cannabis users were younger than non-users. Authors concluded that this “retrospective cohort study suggests that active cannabis users hospitalized with COVID-19 had better clinical outcomes compared with non-users.”

Shover CM, Yan P, Jackson NJ, Buhr RG, Fulcher JA, Tashkin DP, Barjaktarevic I. Cannabis consumption is associated with lower COVID-19 severity among hospitalized patients: a retrospective cohort analysis. J Cannabis Res. 2022;4(1):46.

Science/Human: The effect of cannabis on fibromyalgia may in part be explained by an improvement of mood

According to a study with 323 fibromyalgia patients reduction in pain by the use of cannabis was partly explained by improvement of sleep and mood. Researchers of McGill University in Montréal, Canada, conducted a 12-month prospective study. Cannabis use in all patients was initiated under the care of physicians.

Analyses indicated that reductions in patients’ levels of pain intensity were partly explained by concurrent reductions in sleep problems and negative affect. This remained significant even when accounting for patients' baseline characteristics or changes in medical cannabis directives over time.

Sotoodeh R, Waldman LE, Vigano A, Moride Y, Canac-Marquis M, Spilak T, Gamaoun R, Kalaba M, Hachem Y, Beaulieu P, Desroches J, Ware MA, Perez J, Shir Y, Fitzcharles MA, Martel MO. Predictors of pain reduction among fibromyalgia patients using medical cannabis: a long-term prospective cohort study. Arthritis Care Res (Hoboken). 2022 Jul 25. [in press].

Science/Human: CBD may be helpful in anxiety disorders

In a study with 31 young people aged 12 to 25 years, who suffered from treatment resistant anxiety disorders, CBD was shown to significantly reduce anxiety. Researchers at the Centre for Youth Mental Health of the University of Melbourne, Australia, treated them with add-on oral CBD for 12 weeks on a flexible schedule titrated up to 800 mg per day.

Mean scores of the Overall Anxiety Severity and Impairment Scale decreased from a mean of 10.8 at baseline to 6.3 at week 12, corresponding to a 43% reduction. Depressive symptoms and functioning also improved significantly. Adverse events were reported in 25 of 31 participants and included fatigue, low mood, and hot flushes or cold chills.

Berger M, Li E, Rice S, Davey CG, Ratheesh A, Adams S, Jackson H, Hetrick S, Parker A, Spelman T, Kevin R, McGregor IS, McGorry P, Amminger GP. Cannabidiol for Treatment-Resistant Anxiety Disorders in Young People: An Open-Label Trial. J Clin Psychiatry. 2022;83(5):21m14130.

Science/Human: Oral THC may be helpful in the treatment of chronic pain

An analysis of the German Pain e—Registry on adult patients with chronic pain showed that oral THC may be helpful in the management of treatment resistant chronic pain. Of 89,095 patients 1145 patients received oral THC. The analysis was conducted by the Center of Excellence in Health Care Research of the German Pain Association, Institute of Neurological Sciences in Nuernberg, Germany.

The average THC daily dose was 16 mg. Average 24-hour pain intensity decreased from 46 to 27 mm on a visual analogue scale. Among patients who completed follow-up, an improvement from baseline of at least 50% was documented for pain (46.5%), activities of daily living (39%), quality of life (31.4%), and sleep (35.3%).

Ueberall MA, Horlemann J, Schuermann N, Kalaba M, Ware MA. Effectiveness and Tolerability of Dronabinol Use in Patients with Chronic Pain: A Retrospective Analysis of 12-Week Open-Label Real-World Data Provided by the German Pain e-Registry. Pain Med. 2022 Aug 1;23(8):1409-1422.

Science/Human: CBD may reduce pain after surgery according to a placebo-controlled study

In a study with 100 patients, who underwent arthroscopic knee surgery, CBD caused significant pain reduction in the immediate perioperative period. In the study by investigators of NYU Langone Health in New York, USA, participants either received 25 to 50 mg of oral CBD 3 times daily or a placebo. CBD was administered as a buccally absorbed tablet.

On day 1, the pain score was significantly lower in the CBD group than in the placebo group (4.4 versus 5.7) and the difference was no longer significant on day 2. On both days 1 and 2, patient satisfaction with pain control was significantly higher in the CBD group than in the placebo group. Authors concluded that “buccally absorbed CBD demonstrated an acceptable safety profile and showed significant promise in the reduction of pain in the immediate perioperative period.”

Alaia MJ, Hurley ET, Vasavada K, Markus DH, Britton B, Gonzalez-Lomas G, Rokito AS, Jazrawi LM, Kaplan K. Buccally Absorbed Cannabidiol Shows Significantly Superior Pain Control and Improved Satisfaction Immediately After Arthroscopic Rotator Cuff Repair: A Placebo-Controlled, Double-Blinded, Randomized Trial. Am J Sports Med. 2022:3635465221109573.

News in brief

Science/Human: Nabilone may improve sleep in patients with Parkinson’s disease suffering from sleep problems
According to a retrospective analysis of data from a double-blind randomised study with 19 patients suffering from Parkinson’s disease nabilone was superior to placebo in reducing sleep problems. Authors found that this “post-hoc analysis (…) suggests that nabilone has beneficial effects on sleep outcomes in PD patients experiencing sleep problems at baseline.”
Department of Neurology of the Medical University of Innsbruck, Austria.
Peball, et al. Mov Disord Clin Pract. 2022;9(6):751-758.
Peball , et al. Ann Neurol. 2020;88(4):712-722.

USA: States Legalising cannabis saw big drop in poisoning with synthetic cannabinoids
A new study reports a 37% drop in poisoning reports for dangerous, illegal synthetic cannabinoids in states that have legalized cannabis, as compared to states with restrictive cannabis policies. "This study shows some potential public health benefits to the legalization and regulation of adult use of cannabis," the study's lead author Tracy Klein, associate professor of nursing at Washington State University, said in a news release.
UPI of 9 August 2022

Science/Human: Cannabis may reduce pruritus in patients with lymphoma of the skin
In an online survey with 119 patients suffering from lymphoma of the skin 55% reported ever having used cannabis, with 22% endorsing current cannabis use. 25% of current users reported using cannabis specifically to treat itch.
University of Washington School of Medicine, Seattle, USA.
Mahurin HM, et al. Complement Ther Med. 2022;67:102830.

Science/Human: Cannabis users have a lower frequency of symptoms of the nose and nasal sinuses
A study with 2269 adults “found that the prevalence of sinonasal symptoms was lower among regular cannabis users.”
Keck School of Medicine of the University of Southern California, Los Angeles, USA.
Orozco FR, et al. JAMA Otolaryngol Head Neck Surg. 2022 Jul 28. [in press].

Science: CBD may protect from heart injury due to exhausting exercise
“The protective mechanism of CBD on myocardial injury in exhaustive exercise training mice may (…) exert anti-inflammatory, anti-apoptosis [programmed cell death] and inhibition of oxidative stress.”
College of Physical Education, Yanshan University, Qinhuangdao, China.
Zhang J, et al. Chem Biol Interact. 2022:110079. [in press].

Science/Animal: CBD and THC may show anittumor effects against pancreas cancer
In a mouse model of pancreas cancer CBD and THC in a ratio of 6 to 1 “induce apoptosis and inhibit proliferation of tumour cells in a dose-dependent manner.”
Division of Research and Academic Support, National Cancer Institute, Bangkok, Thailand.
Sakarin S, et al. Front Vet Sci. 2022;9:867575.

Science: CBD exerts antibacterial effects
CBD exerts antibacterial effects against Salmonella typhimurium and Salmonella newington.
College of Science, Technology, Engineering, and Mathematics, Alabama State University, Montgomery, USA.
Gildea L, et al. Molecules. 2022;27(9):2669.

Science/Human: Cannabis legalization may not have any effect on cannabis use by young persons
According to a study with 819,543 US residents “legalized cannabis retail sales might be followed by the increased occurrence of cannabis onsets for older adults, but not for underage persons who cannot buy cannabis products in a retail outlet.”
Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, USA.
Montgomery BW, et al. PLoS One. 2022;17(7):e0271720.

Science/Human: Cannabis-related mental disorders are not frequent in patients who use cannabis
Results of a study with 23,091 medical cannabis patients “suggest that the incidence of cannabis poisoning or cannabis-related mental and behavioral disorders was low among patients who were authorized to use cannabis for medical care.”
Faculty of Pharmacy, Université Laval, Quebec, Canada.
Zongo A, et al. Subst Use Misuse. 2022;57(10):1633-1641.

Science: The degradation of cannabinoids at different temperatures
The effect of pH and temperature on cannabinoids transformation in cannabis solution was examined at pH 2, 4, 6, 8, 10, and 12 and at 40°C, 50°C, 60°C, and 70°C. THC, CBD and CBN “reacted more quickly at high temperature and in an acidic solution.”
Cosmetics and Natural Products Research Center, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.
Jaidee W, et al. Cannabis Cannabinoid Res. 2022;7(4):537-547.

Science/Animal: Endocannabinoids promote sleep
Increased endocannabinoid signalling “supports sleep behavior through multiple stages of development” in mice.
Department of Cell Biology and Physiology and the UNC Neuroscience Center, University of North Carolina at Chapel Hill, USA.
Martin SC, et al. Sleep. 2022;45(8):zsac083.

Science: Memory consolidation depends on brain levels of anandamide
An optimal, stable extracellular concentration of anandamide is “a necessary condition to ensure the consolidation of a stable memory trace” in the hippocampus, a certain brain region.
Psychobiology and Neurocomputation Lab, Biophysics Department, Biosciences Institute, Universidade Federal do Rio Grande do Sul, Brazil.
Scienza-Martin K, et al. Neuroscience. 2022;497:53-72.

Science/Cells: CBD may protect against sepsis induced inflammation of the heart
Sepsis, caused by a dysregulated host response to infections, can lead to cardiac arrhythmias. researchers showed that CBD protects against this complication.
Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, Canada.
Fouda MA, et al. Br J Pharmacol. 2022 Jul 29. [in press].

Science/Animal: Cannabigerol attenuates chemotherapy-induced peripheral neuropathy
In a study with mice cannabigerol (CBG) attenuated mechanical hypersensitivity elicited by chemotherapy-induced peripheral neuropathy.
Department of Pharmacology, Penn State University College of Medicine, Hershey, Pennsylvania, USA.
Sepulveda DE, et al. EUR J Pain. 2022 Jul 28. [in press].

Science/Human: Many women with endometriosis use cannabis for symptom control
In an online survey with 1634 women suffering from endometriosis from 46 different countries 51% reported using cannabis in the past three-month. Of these 55% reported use for symptom management only.
NICM Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia.
Armour M, et al. Cannabis Cannabinoid Res. 2022;7(4):473-481.

Science/Human: The association between cannabis use and schizophrenia may partially be explained by externalising behaviours
According to genetic analyses “externalizing behaviors partially explained the association between cannabis use and schizophrenia by up to 42%.” Authors concluded that this “partial explanation of the association by externalizing behaviors suggests that there may be other unidentified confounding factors, alongside a possible direct association between schizophrenia and cannabis use.”
QIMR Berghofer, Translational Neurogenomics Group, Herston, Australia.
Wormington B, et al. Schizophr Bull. 2022:sbac095.

Science/Cells: CBD may increase the potency of the antibiotic gramicidin
Using embryonic kidney cells researchers found that CBD increased currents of the antibiotic gramicidin. by altering membrane biophysical properties, including elasticity.
Department of Cellular and Molecular Biology, Xenon Pharmaceuticals, Burnaby, Canada.
Ghovanloo et al. PLoS One. 2022;17(8):e0271801.

Science/Animal: Inhibition of endocannabinoid degradation resulted in reduced intraocular pressure
In a study with rabbits inhibition of endocannabinoid degradation by a selective monoacylglycerol lipase (MAGL) inhibitor (MAGL17b) resulted in reduced intraocular pressure and its use may be promising for glaucoma treatment.
Department of Cellular and Molecular Biology, Xenon Pharmaceuticals, Burnaby, Canada.
Ghovanloo MR, et al. PLoS One. 2022;17(8):e0271801.

Science/Animal: Phycocyanin activates the CB2 receptor
In a study with mice phycocyanin stimulated ulcerative colitis healing via selective activation of cannabinoid receptor-2 (CB2 receptor). Phycocyanin is an accessory pigment to chlorophyll.
Pharmacology Department, Theodor Bilharz Research Institute, Warrak El-Hadar, Giza, Egypt.
El-Maadawy WH, et al. Life Sci. 2022 Sep 15;305:120741.

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