Evaluation of the antimicrobial effect of cannabidiol (CBD) in a multispecies subgingival biofilm model

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“Background: This study evaluated the antimicrobial effect of cannabidiol (CBD) on a multi-species subgingival biofilm model.

Materials and methods: Biofilms were formed using 33 bacterial species on a Calgary device. Two protocols were tested: (A) biofilm in contact with CBD (125, 250 and 500 µg/mL) and chlorhexidine 0.12% (CHX) for the entire period; (B) treatments with CBD (500 and 1000 µg/mL) and CHX started on day 3, twice a day, for 1 minute. The total biofilm counts, the proportion of complexes, and the counts of each species were evaluated by DNA-DNA hybridization (Checkerboard).

Results: In Experiment A, CBD at concentrations of 250 and 500 µg/mL, as well as CHX, significantly reduced the total biofilm count. At 500 µg/mL, CBD also decreased the proportion of the red complex and reduced the counts of 10 bacterial species, whereas CHX affected 20 species. In Protocol B, both CBD at 1000 µg/mL and CHX reduced the total biofilm count and the proportion of the red complex, while increasing the proportion of the green complex. Both protocols led to a reduction in Porphyromonas gingivalis and Tannerella forsythia.

Conclusion: CBD reduced the total bacterial count and the red complex, inhibiting known periodontal pathogens. Within the limitations, the results provide exploratory evidence that CBD may reduce the total bacterial count in the proposed polymicrobial biofilm model, including the red complex bacteria, and may thus be postulated as an inhibitor of known periodontal pathogens. However, future in vivo studies with robust sample sizes and standardized CFU-based quantification are required to confirm these findings.”

https://pubmed.ncbi.nlm.nih.gov/41509036

“These exploratory observations demonstrated a notable antimicrobial activity of CBD by reducing red complex bacteria and key periodontopathogens, including Porphyromonas gingivalis and Tannerella forsythia, in a multispecies subgingival biofilm model, comparable to CHX.”

https://www.tandfonline.com/doi/full/10.1080/20002297.2025.2603706

Intravesical Cannabidiol for Inflammation and Pain in Interstitial Cystitis/Bladder Pain Syndrome via TLR4/NF-κB and TRPV1 Modulation

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“Purpose: This study explored the anti-inflammatory and analgesic mechanisms of intravesical cannabidiol (CBD) in cyclophosphamide (CYP)-induced interstitial cystitis/bladder pain syndrome (IC/BPS) rats.

Materials and methods: Female Sprague-Dawley rats were divided into four groups of control, IC/BPS, IC/BPS+10 mg/kg CBD, and IC/BPS+100 mg/kg CBD (n=5/group). IC/BPS was induced by CYP injections, followed by intravesical CBD administration. Pain sensitivity and bladder function were assessed via Von Frey tests and cystometrograms. Histological, Western blot, and immunofluorescence analyses were performed on bladder tissues. SV-HUC1 cells were analyzed using western blot and scratch assays.

Results: CBD improved bladder function, reducing instability, prolonging intercontractile intervals, and enhancing detrusor contraction pressure. The CBD 100 mg/kg group showed greater pain relief in Von Frey tests compared with other groups. Histology revealed reduced inflammation, mast cell infiltration, and fibrosis in bladder tissues. CBD decreased TNF-α, COX2, IL-6, and TRPV1 levels and inhibited the TLR4/MyD88/pNF-κB pathway. In SV-HUC1 cells, CBD suppressed epithelial injury and downregulated TRPV1, TLR4, MyD88, p-NF-κB, and Bax/Bcl-xL, demonstrating anti-inflammatory and anti-apoptotic effects.

Conclusions: Intravesical CBD alleviates inflammation by inhibiting the TLR4/MyD88/pNF-κB pathway, reduces neuropathic pain via TRPV1 channels, and improves cell apoptosis and migration in CYP-induced IC/BPS model animals.”

https://pubmed.ncbi.nlm.nih.gov/41508393

“Cannabidiol (CBD) is a non-psychoactive cannabinoid with a variety of biological activities and a wide range of benefits such as antioxidant, anti-inflammatory, and immunomodulatory effects. Research has demonstrated the therapeutic significance of CBD in neurological disorders, cardiomyopathy, diabetes, and other diseases.”

“In the present study, we investigated the potential therapeutic effects of CBD in IC/BPS. We conducted intravesical instillation of CBD in a rat model of IC/BPS and evaluated the effects on inflammation and bladder function and pain. We further analyzed its mechanism of action. Our study provides evidence of the potential effectiveness of CBD in the treatment of IC/BPS.”

https://wjmh.org/DOIx.php?id=10.5534/wjmh.250152

CBD-Rich Cannabis Therapy in Children with Autism Spectrum Disorder May Improve Symptoms of Hyperactivity and Attention Deficit: An Open-Label Study

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“Introduction: Medical cannabis has gained growing attention as a potential treatment for children with Autism Spectrum Disorder (ASD), particularly in cases where conventional pharmacological approaches have proven ineffective. Emerging evidence suggests that cannabinoid-based therapies may alleviate Attention Deficit Hyperactivity Disorder (ADHD) related symptoms in children with ASD. The objective of this study is to evaluate changes in ADHD symptoms over six months of treatment with a CBD-rich cannabis oil, using the Conners’ Teacher Rating Scale as the assessment tool.

Methods: This was a prospective, single-arm, open-label study conducted at a single center. A total of 109 children and young adults diagnosed with ASD and ADHD symptoms were recruited between November 2019 and April 2021. Of these, 53 participants were assessed by their schoolteachers using the Conners’ Teacher Rating Scale (CTRS) questionnaire, both before and after a three- to sixmonth treatment period with a CBD-rich, cannabis oil-based product. Blood samples were collected before and after treatment to measure cannabinoid levels, including CBD, 6-OH-CBD, 7-COOHCBD, and 7-OH-CBD.

Results: Significant improvements were observed in the following categories: anxious-shyness, perfectionism, ADHD index, emotional lability, and hyperactivity-impulsivity (p < 0.001). Additional trends toward improvement were identified in oppositional behavior (p = 0.009), cognitive inattention (p = 0.009), hyperactivity (p = 0.006), the Conners’ Global Index (p = 0.007), and DSM-IV inattention scores (p = 0.003). No significant correlations were found between cannabinoid dosage or blood levels and changes in CTRS scores, except for emotional lability, where higher CBD concentrations were predictive of greater symptom improvement.

Discussion: This is the first prospective study to evaluate the effects of CBD-rich cannabis on ADHD symptoms in children with ASD using standardized teacher-based Assessments (CTRS). The findings indicate improvements in core behavioral domains. While previous studies have focused primarily on parent-reported outcomes or small-scale trials, our results support emerging evidence on the role of cannabinoids in modulating attention and emotional regulation. The main limitations of the study were its open-label design.

Conclusion: CBD-rich cannabis oil may reduce ADHD symptoms in children with ASD. These findings support the need for future clinical trials to validate efficacy and determine optimal dosing.”

https://pubmed.ncbi.nlm.nih.gov/41503912

https://www.eurekaselect.com/article/152283

UK medical Cannabis registry: A two-year case series of clinical outcomes in depression

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“Background: Whilst preclinical evidence details the effects of cannabinoids on mood regulation, there is a paucity of clinical evidence on the use of cannabis-based medicinal products (CBMPs) in individuals with depression. This study aims to evaluate longitudinal changes in patient-reported outcome measures (PROMs) and the incidence of adverse events over 24 months in patients treated with CBMPs for depression.

Methods: Patient data from the UK Medical Cannabis Registry were used for analysis. PROMs, including the Patient Health Questionnaire-9 (PHQ-9), Generalised Anxiety Disorder-7 (GAD-7), Single-Item Sleep Quality Scale (SQS), EuroQol 5-Dimension 5-Level (EQ-5D-5L), and Patient Global Impression of Change (PGIC), were measured at baseline, 1, 3, 6, 12, 18, and 24 months. Adverse events (AEs) were also recorded. P < 0.050 was considered statistically significant.

Results: Of the 34,563 patients in the UK Medical Cannabis Registry on January 6th 2025, 698 (2.02 %) patients were included in the analysis. Improvements were observed across the PHQ-9. GAD-7, SQS, and EQ-5D-5L index value at all time points compared to baseline (p < 0.001). At baseline, half of the patients reported severe anxiety (GAD-7 ≥ 15: 50.86 %, n = 355), which was correlated with depression severity (PHQ-9; r = 0.67, p < 0.001). Sixty-three patients (9.03 %) reported at least one AE during treatment, of which 85 % (n = 411) were mild or moderate.

Discussion: Initiation of CBMPs was associated with statistically and clinically significant improvements in depression, anxiety, sleep quality, and health-related quality of life among patients. Improvements were most prominent in the first 3 months. Limitations of the study mean that no causal relationship can be ascertained.

Conclusion: The positive findings from this and other observational data support future evaluation of CBMPs for the treatment of depression to establish their efficacy.”

https://pubmed.ncbi.nlm.nih.gov/41506388

“This UK Medical Cannabis Registry study of patients with treatment-resistant depression prescribed CBMPs demonstrated sustained and clinically meaningful improvements in depression, anxiety, health-related quality of life, and sleep quality over 24 months. Improvements were most pronounced within the first three months and were sustained thereafter. Adverse events were infrequent and predominantly mild to moderate.”

https://www.sciencedirect.com/science/article/pii/S0165032725025728?via%3Dihub

Cannflavin B ameliorates behavioural and neuronal systems alterations in adolescent rats exposed to prenatal valproic acid

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“Currently, no pharmacological treatments ameliorate the core and comorbid symptoms of autism spectrum disorders, but solely target comorbid symptoms such as irritability, anxiety, and epilepsy.

There has been growing interest in using whole cannabis or cannabidiol as potential therapeutics in autism. However, there are concerns surrounding the use of whole cannabis in children, and reports examining the therapeutic efficacy of cannabidiol are inconsistent.

In this study, the potential therapeutic efficacy of cannflavin B, a non-psychoactive component of the Cannabis sativa plant, was evaluated. Using prenatal valproic acid (VPA) exposure in rats, a model widely used to study aspects of autism, sex differences in adolescent behaviour, neuronal oscillatory changes, and microglial activity in response to cannflavin B administration (0.2 mg/kg, i.p.) were assessed.

Cannflavin B was well tolerated and ameliorated most of the observed VPA-induced changes.

Cannflavin B had anxiolytic-like properties in female VPA rats, and normalized sociality in VPA animals of both sexes.

Within the prefrontal cortex, cingulate cortex, and hippocampus, most of the VPA-induced regional responses in neuronal oscillatory spectral power, coherence, and theta-gamma cross-frequency synchrony were ameliorated by cannflavin B. Cannflavin B also attenuated the sex- and brain region-specific VPA-induced elevations in the microglial marker Iba1. In vitro, cannflavin B normalized VPA-induced elevations in cortical and hippocampal neuronal activity and promoted more organized cortical firing.

These findings demonstrate cannflavin B ameliorates behavioural and neuronal systems function alterations induced by prenatal VPA in rats, and highlights the importance of researching alternative cannabis compounds in autism and other disorders.”

https://pubmed.ncbi.nlm.nih.gov/41496357

“Like THC and CBD, cannflavins are most likely highly lipophilic based on their prenylated structure, indicating that they should be able to readily cross the blood brain barrier.”

“In conclusion, this was the first study to examine the in vivo effects of cannflavin B in a model widely used to study aspects of autism. It was demonstrated that cannflavin B administration, a non-psychoactive component of the Cannabis sativa plant, could normalize many of the sex-dependent and independent alterations in behaviour and neuronal activity, as well as microglial marker levels, in adolescent rats following prenatal exposure to VPA. Cannflavin B, at the dose used, appeared to be well tolerated with no adverse effects observed.”

https://www.sciencedirect.com/science/article/pii/S0753332225011436?via%3Dihub


Unlocking the potential: Cannabidiol (CBD) as a promising anti-tumor agent

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“Background: Cannabidiol (CBD), the primary non-psychoactive component of cannabis, is renowned for its antiepileptic, analgesic, and anti-inflammatory properties. Emerging evidence highlights its potential as an anti-tumor agent, yet significant heterogeneity in preclinical studies and an incomplete mechanistic understanding impede its clinical translation.

Purpose: This review aims to systematically evaluate the anti-tumor efficacy, underlying mechanisms, and safety profile of CBD, and to discuss the challenges and future directions for its application in oncology.

Study design: A systematic review.

Methods: We integrated recent high-quality research to assess CBD’s effects across various cancer types. The analysis encompassed its mechanisms in tumor cell biology and the tumor microenvironment (TME), a comparison of monotherapy versus combination therapy efficacy, its role in managing cancer-related symptoms, and its pharmacokinetic/pharmacodynamic properties. Advances in nano-based drug delivery systems were also reviewed.

Results: CBD demonstrates multi-target anti-tumor effects, including inhibiting proliferation, inducing apoptosis, suppressing metastasis, and remodeling the TME via immunomodulation. It exhibits broad-spectrum efficacy in vitro and in vivo, shows synergistic effects in combination therapy, and can alleviate cancer-related symptoms. Safety data indicate a favorable tolerability profile. However, current evidence relies predominantly on preclinical models.

Conclusion: CBD holds substantial promise as an anti-tumor agent. This review provides a theoretical foundation for its rational development. Future work should focus on validating these findings in clinical trials, optimizing targeted drug delivery systems, and establishing standardized treatment protocols.”

https://pubmed.ncbi.nlm.nih.gov/41494497

“CBD, a non-psychoactive phytocannabinoid, has demonstrated therapeutic potential for epilepsy, Alzheimer’s disease, Parkinson’s disease, and multiple sclerosis. Its anti-inflammatory, antioxidant, and anti-necrotic properties, combined with established safety and tolerability in humans, make it a promising therapeutic agent.”

“Recent research has highlighted CBD’s anti-tumor activity across various cancer types. Studies demonstrate that CBD can inhibit migration, induce apoptosis, and suppress proliferation, invasion, metastasis, and angiogenesis in breast, glioma, lung, and colorectal cancers.”

“Cannabidiol (CBD), an FDA-approved and well-tolerated compound, demonstrates promising antitumor effects by inhibiting cancer growth, metastasis, and angiogenesis, while also alleviating cancer-related symptoms such as pain and nausea.”

https://www.sciencedirect.com/science/article/pii/S0944711325013716?via%3Dihub

Ultrasound-Assisted Green Extraction of Antioxidant and Antimicrobial Resins from Cannabis sativa for Potential Pharmaceutical Applications

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“Objective: To develop a green and efficient ultrasound-assisted extraction (UAE) process to obtain bioactive resins from Cannabis sativa with potential pharmaceutical applications, optimizing extraction parameters to maximize antioxidant capacity and total polyphenol content.

Significance: UAE using ethanol under mild temperature and time conditions as a green technique was applied to reduce solvent consumption, energy demand, and extraction time while preserving thermolabile bioactive compounds. Optimizing UAE enables the recovery of cannabinoid- and terpene-rich extracts that may serve as natural active pharmaceutical ingredients or functional excipients for drug development. This study integrate a Doehlert-based optimization of UAE with a functional evaluation of antioxidant efficiency and antimicrobial activity, providing a comprehensive framework for the development of cannabis-derived pharmaceutical ingredients.

Methods: A Doehlert experimental design combined with response surface methodology was employed to optimize temperature and extraction time. The optimized extract was characterized for its phytochemical composition. Antimicrobial activity was evaluated against Gram-positive and Gram-negative bacterial strains to assess potential therapeutic relevance.

Results: Under optimal conditions (54.5 °C, 28 min 25 s), the extract showed a total phenolic content of approximately 0.11 mg gallic acid/mg resin and an IC50 value of about 0.24 mg resin/mL extract, indicating enhanced antioxidant performance compared to non-optimized conditions. Also, showed selective bactericidal activity against Staphylococcus aureus ATCC 25923 and Staphylococcus epidermidis ATCC 12228, while Gram-negative strains remained resistant.

Conclusions: UAE extraction efficiently recovered antioxidant and selectively antimicrobial compounds from Cannabis sativa resins under mild, eco-friendly conditions, supporting their potential use as bioactive ingredients in pharmaceuticals.”

https://pubmed.ncbi.nlm.nih.gov/41489477

https://www.tandfonline.com/doi/full/10.1080/03639045.2025.2612300

Cross-sectional comparison of cannabis use in adults with neuropathic versus non-neuropathic pain

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“Introduction: Cannabis has been decriminalized by many states and shows promise in treating both neuropathic and non-neuropathic pain through its interaction with the endocannabinoid system and anti-inflammatory effects. This study examines differences in cannabis use for adults whose most bothersome chronic pain condition is neuropathic vs. non-neuropathic.

Materials and methods: Survey data were collected from adults receiving care at a pain clinic. Participants completed demographic questions and standardized self-report measures (PROMIS Pain Intensity/Interference and the ID-Pain tool). Participants’ most bothersome pain condition(s) were categorized as neuropathic or non-neuropathic pain based on ID-Pain scores. Linear regression models assessed differences in frequency and duration of cannabis product use between groups, adjusting for age and sex.

Results: A total of 113 individuals were recruited; following exclusions and missing data, 104 participants (61.5% female) were included in the final analysis. Of these, 36.5% reported neuropathic pain as their most bothersome, and 63.5% reported non-neuropathic pain. Those with neuropathic pain reported significantly more days per month of Tetrahydrocannabinol/Cannabidiol (THC/CBD) combination (b = 5.96, p = 0.02), Cannabidiol-only (CBD-only) (b = 8.82, p = 0.03), and Tetrahydrocannabinol-only (THC-only) products (b = 7.04, p = 0.02). They also used THC-only (b = 0.97, p < 0.05) and THC/CBD (b = 1.09, p < 0.01) products more frequently per day. Neuropathic pain was positively associated with pain intensity (b = 4.10, p < 0.001) and interference (b = 4.95, p < 0.001).

Discussion: Adults whose most bothersome pain condition(s) were neuropathic used cannabis, especially THC and THC/CBD combination products, more frequently than those whose most bothersome pain was non-neuropathic. Participants with neuropathic pain also reported higher levels of pain intensity and interference. Further longitudinal research is needed to confirm whether increased use of THC-rich cannabis provides symptom relief for adults with neuropathic pain.”

https://pubmed.ncbi.nlm.nih.gov/41487383

“Cannabis interacts with the endocannabinoid system, making it a potential treatment for neuropathic pain.”

“Because previous studies found THC products to be more effective in managing neuropathic pain by interacting with the endocannabinoid system, it is possible that our participants also experienced benefit; this could explain their higher use of THC containing products.

https://www.frontiersin.org/journals/pain-research/articles/10.3389/fpain.2025.1677391/full

Pharmacological, Molecular Mechanisms, and Therapeutic Potential of β-Caryophyllene and β-Caryophyllene-Rich Plants in Liver Diseases

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“β-caryophyllene, a bicyclic sesquiterpene widely abundant in various plant essential oils, has garnered growing attention for its potential biological effects and therapeutic benefits in liver diseases. This review systematically evaluates preclinical evidence on the pharmacological properties of BCP with emphasis on its hepatoprotective effects primarily through its anti-inflammatory, antioxidant, antifibrotic, and immunomodulatory actions.

BCP is classified as a dietary cannabinoid due to its ability to activate cannabinoid type 2 receptors in the endocannabinoid system and thereby influence key cellular signaling pathways involved in lipid metabolism and tissue remodeling. Emerging studies also highlight BCP interaction with PPAR nuclear receptor and AMPK signaling, further corroborating its role in regulating lipid homeostasis.

In the present review, we compile, summarize, and critically analyze findings from in vitro and in vivo studies on nonalcoholic fatty liver disease, recently termed as metabolic dysfunction-associated fatty liver disease (MAFLD), alcoholic liver disease, and liver fibrosis, highlighting the pharmacological and molecular mechanisms underlying therapeutic effects. These studies consistently demonstrate a reduction in hepatic steatosis, collagen deposition, and hepatocellular markers reflecting a broad spectrum of hepatoprotective effects.

Taken together, the pharmacological properties and mechanistic insights place BCP as a promising natural compound with nutraceutical, phytopharmaceutical, or dietary supplement applications for liver diseases. Despite the robust preclinical evidence, clinical validation remains scarce. Therefore, regulatory toxicology and efficacy studies are needed to establish the therapeutic potential of BCP in liver diseases and its integration as a nutraceutical or phytopharmaceutical in the clinical usage.”

https://pubmed.ncbi.nlm.nih.gov/41489519

“BCP is one of the important constituents in Cannabis with an abundance of 35%. In addition to its presence in Cannabis, BCP is largely present in numerous edible plants.”

“In conclusion, BCP represents a promising therapeutic avenue for managing liver diseases due to its ability to modulate multiple interrelated molecular and cellular pathways.”

“With continued research, BCP has the potential to evolve from a natural product with hepatoprotective properties to an effective adjunct or alternative in liver disease therapy, offering new hope for patients and advancing the field of liver health management.”

https://faseb.onlinelibrary.wiley.com/doi/10.1096/fj.202502436R


Effect of patient marijuana use on perioperative opioid requirements

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“The effect of chronic marijuana use on patients is unknown, including in the surgical setting. Marijuana produces many effects on the body, which should be considered when providing medical care.

Chronic marijuana use may affect surgical opioid requirements. To explore this possibility, an observational study was completed by conducting a retrospective chart review of patients who underwent surgery with general anesthesia.

Patients were identified in the electronic medical record via self-reporting as marijuana users (users) or nonmarijuana users (nonusers). Users and nonusers were case-matched based on age, gender, weight, and procedure. After case matching, 570 patients’ charts were analyzed, and intraoperative opioid, intraoperative propofol, and post-anesthesia care unit opioid requirements were compared.

Marijuana users required less intraoperative opioids (mean [standard deviation (SD)] 27.2 [20.5] morphine milligram equivalents [MMEs]) compared to those who were marijuana nonusers (31.3 [22.1] MME).

These results show a statistically significant difference in the intraoperative opioid requirement between case-matched users and nonusers (p = 0.02), with p = 0.013 after statistical adjustment for racial differences between the marijuana user and nonuser cohorts. Users and nonusers required similar amounts of intraoperative propofol (242.2 [220.2] and 257.8 [250.9], respectively) and post-operative opioids (7.3 [6.0] and 8.0 [9.0], respectively). The differences in intraoperative propofol and post-operative opioid requirements were not different statistically with p-values of 0.43 and 0.31, respectively.

Based on this study population, marijuana users required less intraoperative opioids when compared to case-matched marijuana nonusers, with no difference in intraoperative propofol or post-operative opioid requirements.

Perspective: Typical preoperative screening includes queries about patient substance use including marijuana, but details such as frequency and length of use are infrequently asked. The addition of these details to the assessment may provide improved understanding of a patient’s surgical opioid requirements.”

https://pubmed.ncbi.nlm.nih.gov/41123263

https://wmpllc.org/ojs/index.php/jom/article/view/3918