Monthly Archives: October 2018

Reduced Incidence and Better Liver Disease Outcomes among Chronic HCV Infected Patients Who Consume Cannabis.

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“The effect of cannabis use on chronic liver disease (CLD) from Hepatitis C Virus (HCV) infection, the most common cause of CLD, has been controversial. Here, we investigated the impact of cannabis use on the prevalence of CLD among HCV infected individuals.

Our study revealed that cannabis users (CUs) had decreased prevalence of liver cirrhosis, unfavorable discharge disposition, and lower total health care cost versus, compared to noncannabis users (NCUs).

Among CUs, dependent cannabis use was associated with lower prevalence of liver cirrhosis, compared to nondependent use.

CONCLUSIONS:

Our findings suggest that cannabis use is associated with decreased incidence of liver cirrhosis, but no change in mortality nor LOS among HCV patients. These novel observations warrant further molecular mechanistic studies.”

https://www.ncbi.nlm.nih.gov/pubmed/30345261

Combined THC and CBD to treat pain in epidermolysis bullosa: a report of three cases.

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“Epidermolysis bullosa (EB) is a genetic blistering disorder characterized by intense pain related to disease pathology and care-based interventions. Opioid-based therapies underpin pain-care in EB however are unable to provide adequate analgesia in a significant proportion of patients. Cannabinoid-based medicines (CBMs) have been increasingly studied for pain conditions of various etiologies and pose as a novel dimension for pain-care in EB. We present three cases of EB who were prescribed pharmaceutical-grade sublingually administered CBMs comprising tetrahydrocannabinol (THC) and cannabidiol (CBD). All three patients reported improved pain scores, reduced pruritus and reduction in overall analgesic drug intake. ”

https://www.ncbi.nlm.nih.gov/pubmed/30347109

https://onlinelibrary.wiley.com/doi/abs/10.1111/bjd.17341

Light-activatable cannabinoid prodrug for combined and target-specific photodynamic and cannabinoid therapy.

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“Cannabinoids are emerging as promising antitumor drugs. However, complete tumor eradication solely by cannabinoid therapy remains challenging. In this study, we developed a far-red light activatable cannabinoid prodrug, which allows for tumor-specific and combinatory cannabinoid and photodynamic therapy. This prodrug consists of a phthalocyanine photosensitizer (PS), reactive oxygen species (ROS)-sensitive linker, and cannabinoid. It targets the type-2 cannabinoid receptor (CB2R) overexpressed in various types of cancers. Upon the 690-nm light irradiation, the PS produces cytotoxic ROS, which simultaneously cleaves the ROS-sensitive linker and subsequently releases the cannabinoid drug. We found that this unique multifunctional prodrug design offered dramatically improved therapeutic efficacy, and therefore provided a new strategy for targeted, controlled, and effective antitumor cannabinoid therapy.”

 https://www.ncbi.nlm.nih.gov/pubmed/30334393
https://www.spiedigitallibrary.org/journals/Journal-of-Biomedical-Optics/volume-23/issue-10/108001/Light-activatable-cannabinoid-prodrug-for-combined-and-target-specific-photodynamic/10.1117/1.JBO.23.10.108001.short?SSO=1

Anandamide Effects in a Streptozotocin-Induced Alzheimer’s Disease-Like Sporadic Dementia in Rats.

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“Alzheimer’s disease (AD) is characterized by multiple cognitive deficits including memory and sensorimotor gating impairments as a result of neuronal and synaptic loss.

The endocannabinoid system plays an important role in these deficits but little is known about its influence on the molecular mechanism regarding phosphorylated tau (p-tau) protein accumulation – one of the hallmarks of AD -, and on the density of synaptic proteins.

Thus, the aim of this study was to investigate the preventive effects of anandamide (N-arachidonoylethanolamine, AEA) on multiple cognitive deficits and on the levels of synaptic proteins (syntaxin 1, synaptophysin and synaptosomal-associated protein, SNAP-25), cannabinoid receptor type 1 (CB1) and molecules related to p-tau degradation machinery (heat shock protein 70, HSP70), and Bcl2-associated athanogene (BAG2) in an AD-like sporadic dementia model in rats using intracerebroventricular (icv) injection of streptozotocin (STZ).

This study showed, for the first time, that the administration of an endocannabinoid can prevent AD-like effects induced by STZ, boosting further investigations about the modulation of endocannabinoid levels as a therapeutic approach for AD.”

 https://www.ncbi.nlm.nih.gov/pubmed/30333717
“Altogether, our results showed, for the first time, that the administration of an endocannabinoid can prevent cognitive, synaptic and histopatological AD-like alterations induced by STZ, thus prompting endocannabinoids as a candidate therapeutic target in AD.”  https://www.frontiersin.org/articles/10.3389/fnins.2018.00653/full

Translational potential of allosteric modulators targeting the cannabinoid CB1 receptor.

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“The cannabinoid type-1 (CB1) receptor, a G-protein-coupled receptor, is an attractive target for drug discovery due to its involvement in many physiological processes. Historically, drug discovery efforts targeting the CB1 receptor have focused on the development of orthosteric ligands that interact with the active site to which endogenous cannabinoids bind. Research performed over the last several decades has revealed substantial difficulties in translating CB1 orthosteric ligands into druggable candidates. The difficulty is mainly due to the adverse effects associated with orthosteric CB1 ligands. Recent discoveries of allosteric CB1 modulators provide tremendous opportunities to develop CB1 ligands with novel mechanisms of action; these ligands may potentially improve the pharmacological effects and enhance drug safety in treating the disorders by regulating the functions of the CB1 receptor. In this paper, we review and summarize the complex pharmacological profiles of each class of CB1 allosteric modulators, the development of new classes of CB1 allosteric modulators and the results from in vivo assessments of their therapeutic value.”

 https://www.ncbi.nlm.nih.gov/pubmed/30333554
https://www.nature.com/articles/s41401-018-0164-x

Cannabis and epilepsy.

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BMJ Journals

“The one-third of people who do not gain seizure control through current treatment options need a revolution in epilepsy therapeutics.

The general population appears to be showing a fundamental and rapid shift in its opinion regarding cannabis and cannabis-related drugs. It is quite possible that cannabidiol, licensed in the USA for treating rare genetic epilepsies, may open the door for the widespread legalisation of recreational cannabis.

It is important that neurologists understand the difference between artisanal cannabidiol products available legally on the high street and the cannabidiol medications that have strong trial evidence.

In the UK in 2018 there are multiple high-profile reports of the response of children taking cannabis-derived medication, meaning that neurologists are commonly asked questions about these treatments in clinic. We address what an adult neurologist needs to know now, ahead of the likely licensing of Epidiolex in the UK in 2019.”

 https://www.ncbi.nlm.nih.gov/pubmed/30337476
https://pn.bmj.com/content/early/2018/10/18/practneurol-2018-002058

Medical Cannabis Use by Hodgkin Lymphoma Patients: Experience of a Single Center.

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“Hodgkin lymphoma (HL) is one of the most curable malignancies. Despite its effectiveness, chemotherapy is often associated with adverse events (AEs) such as nausea, anorexia, and impairment of general well-being.

Our objective was to assess the extent of medical cannabis use among HL patients and evaluate its efficacy in controlling chemotherapy-related AEs.

Cannabis users reported improvement in pain, general well-being, appetite, and nausea in 94, 87, 82, and 79% of cases, respectively. Importantly, 81.5% reported a high overall efficacy of cannabis in relieving symptoms. AEs related to cannabis use itself were mild.

Thus, medical cannabis use is prevalent in this HL cohort, and appears to be effective in ameliorating chemotherapy-related AEs.”

https://www.ncbi.nlm.nih.gov/pubmed/30343297

https://www.karger.com/Article/Abstract/493567

Joint Effects: A Pilot Investigation of the Impact of Bipolar Disorder and Marijuana Use on Cognitive Function and Mood

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“The current study aimed to determine the impact of marijuana on mood in bipolar patients and to examine whether marijuana confers an additional negative impact on cognitive function.

Findings suggest that for some bipolar patients, marijuana may result in partial alleviation of clinical symptoms. Moreover, this improvement is not at the expense of additional cognitive impairment.

The current study highlights preliminary evidence that patients with BPD who regularly smoked MJ reported at least short-term clinical symptom alleviation following MJ use, indicating potential mood-stabilizing properties of MJ in at least a subset of patients with BPD.”

https://www.ncbi.nlm.nih.gov/pubmed/27275781

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0157060

Marijuana Use and the Risk of Ischemic Stroke: The Stroke Prevention in Young Adults Study

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“The association between marijuana use and ischemic stroke (IS) risk remains controversial. The goal of this study was to determine the effect of marijuana use on the risk of young-onset IS among Caucasians and African-Americans.

Having a history of marijuana/hashish use was not associated with IS in the overall sample or any gender-/ethnic-specific subgroup. Our data does not demonstrate a risk of ischemic stroke as associated with marijuana use.”

http://n.neurology.org/content/82/10_Supplement/S55.003

“No Link Between Marijuana Use and Stroke Risk. There was no evidence that marijuana use was associated with an increased risk of ischemic stroke in adolescents and young adults.”  https://www.medpagetoday.com/meetingcoverage/aan/45577

Cannabidiol presents an inverted U-shaped dose-response curve in a simulated public speaking test.

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SciELO - Scientific Electronic Library Online

“Cannabidiol (CBD), one of the non-psychotomimetic compounds of Cannabis sativa, causes anxiolytic-like effects in animals, with typical bell-shaped dose-response curves. No study, however, has investigated whether increasing doses of this drug would also cause similar curves in humans.

The objective of this study was to compare the acute effects of different doses of CBD and placebo in healthy volunteers performing a simulated public speaking test (SPST), a well-tested anxiety-inducing method.

Our findings confirm the anxiolytic-like properties of CBD and are consonant with results of animal studies describing bell-shaped dose-response curves. Optimal therapeutic doses of CBD should be rigorously determined so that research findings can be adequately translated into clinical practice.”

https://www.europeanneuropsychopharmacology.com/article/S0924-977X(16)31702-3/abstract

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462018005007102&lng=en&tlng=en