Category Archives: Multiple Sclerosis (MS)

THC:CBD Spray and MS Spasticity Symptoms: Data from Latest Studies.

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“New clinical experience with 9-delta-tetrahydocannabinol (THC) and cannabidiol (CBD) oromucosal spray (Sativex®)…

A randomized, placebo controlled long-term follow-up clinical trial with THC:CBD spray versus placebo demonstrated that it was not associated with cognitive decline, depression or significant mood changes…

THC:CBD oromucosal spray did not adversely influence standard driving ability in patients with moderate to severe MS spasticity…

Findings to date reinforce the efficacy and safety observed in Phase III clinical trials…

Importantly, no additional safety concerns were identified…

Thus, these new data support a positive benefit-risk relationship for THC:CBD oromucosal spray during longer-term use.”

http://www.ncbi.nlm.nih.gov/pubmed/24457846

Pre- and postsynaptic type-1 cannabinoid receptors control the alterations of glutamate transmission in experimental autoimmune encephalomyelitis.

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“Type-1 cannabinoid receptors (CB1R) are important regulators of the neurodegenerative damage in multiple sclerosis (MS) and in experimental autoimmune encephalomyelitis (EAE). In GABAergic striatal neurons, CB1R stimulation exerts protective effects by limiting inflammation…

Our results provide further evidence that CB1R are involved in EAE pathophysiology, and suggest that both pre- and postsynaptic alterations of glutamate transmission are important to drive excitotoxic neurodegeneration typical of this disorder.”

http://www.ncbi.nlm.nih.gov/pubmed/24440366

Clinical experience with THC:CBD oromucosal spray in patients with multiple sclerosis-related spasticity.

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“This detailed medical charts’ data collection study conducted at an MS clinic in Germany evaluated the effectiveness of tetrahydrocannabinol (THC) / cannabidiol (CBD) oromucosal spray in patients with resistant multiple sclerosis (MS) spasticity…

In this routine clinical practice setting at an MS clinic in Germany, THC:CBD spray was effective and well tolerated as add-on therapy or as monotherapy in a relevant proportion of patients with resistant MS spasticity.”

http://www.ncbi.nlm.nih.gov/pubmed/24392812

Association between a Genetic Variant of Type-1 Cannabinoid Receptor and Inflammatory Neurodegeneration in Multiple Sclerosis

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“Genetic ablation of type-1 cannabinoid receptors (CB1Rs) exacerbates the neurodegenerative damage of experimental autoimmune encephalomyelitis, the rodent model of multiple sclerosis (MS)…

Our results demonstrate the biological relevance of the (AAT)n CNR1 repeats in the inflammatory neurodegenerative damage of MS…

In conclusion, our study points to CB1R as an interesting molecular target for preventing neuronal loss and cognitive impairment in MS as well as in other CNS disorders in which inflammation-driven neurodegeneration process play a role.”

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0082848

Sativex(®) (tetrahydrocannabinol + cannabidiol), an endocannabinoid system modulator: basic features and main clinical data.

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“Sativex(®) (nabiximols, USAN name) oromucosal spray contains the two main active constituents of Cannabis sativa, tetrahydrocannabinol and cannabidiol in a 1:1 molecular ratio, and acts as an endocannabinoid system modulator. Randomized, controlled clinical trials of Sativex as add-on therapy provide conclusive evidence of its efficacy in the treatment of more than 1500 patients with multiple sclerosis (MS)-related resistant spasticity…

Sativex oromucosal spray appears to be a useful and welcomed option for the management of resistant spasticity in MS patients. Although the management of MS has been improved by the availability of disease-modifying agents that target the underlying pathophysiological processes of the disease, a clear need remains for more effective symptomatic treatments, especially as regards MS-related spasticity and pain.”

http://www.ncbi.nlm.nih.gov/pubmed/21449855

Endocannabinoid pathways and their role in multiple sclerosis-related muscular dysfunction.

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“Modulation of the endocannabinoid system has been shown to have therapeutic potential in a number of disease states.

Sativex(®) (nabiximols, USAN name) contains the two main phytocannabinoids from Cannabis sativa, tetrahydrocannabinol and cannabidiol in a 1:1 ratio, and it acts as an endocannabinoid system modulator.

In an experimental mouse model of MS-related spasticity, Sativex dose-dependently improved hind limb flexion/stiffness and a dosage of 10 mg/kg was shown to be as effective as the most widely established anti-spasticity treatment baclofen (5 mg/kg).

These findings with Sativex are very promising and offer encouragement for MS patients, the majority of whom will develop spasticity-related disabling and recalcitrant symptoms. Furthermore, research into the endocannabinoid system may offer potential in other neurodegenerative, inflammatory and pain disorders.”

http://www.ncbi.nlm.nih.gov/pubmed/21449854

Marijuana treatments for autoimmune disorders

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“Researchers from the University of South Carolina say that tetrahydrocannabinol, the principal constituent of marijuana, may have another medical use – treating those with autoimmune disorders.

Tetrahydrocannabinol (THC) is known to have analgesic effects so can be used to treat pain. It also aids relaxation and can reduce feelings of nausea and stimulate appetite…

Now, a new study, published in the Journal of Biological Chemistry, explores how analgesicmicroRNAs are influenced by THC.

MicroRNAs (miRNAs) are small, single-stranded, non-coding RNAs that play a vital role in regulating gene expression. And the authors claim that the ability to alter miRNA expression may be the key to successful treatment for many autoimmune diseases, including multiple sclerosis, arthritis and type 1 diabetes.”

More: http://www.medicalnewstoday.com/articles/269432.php

Erythrocyte membrane Fatty acids in multiple sclerosis patients and hot-nature dietary intervention with co-supplemented hemp-seed and evening-primrose oils.

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“The risk of developing multiple sclerosis (MS) is associated with increased dietary intake of saturated fatty acids. For many years it has been suspected that this disease might be associated with an imbalance between unsaturated and saturated fatty acids.

We determined erythrocyte membrane fatty acids levels in Hot nature dietary intervention with co-supplemented hemp seed and evening primrose oils in multiple sclerosis patients…

We concluded that Hot-nature dietary intervention with co-supplemented hemp seed and evening primrose oils caused an increase PUFAs in MS patients and improvement in the erythrocyte membrane fatty acids composition. This could be an indication of restored plasma stores, and a reflection of disease severity reduction.”

http://www.ncbi.nlm.nih.gov/pubmed/24311880

Advances in the management of multiple sclerosis spasticity: experiences from recent studies and everyday clinical practice.

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“Herbal (smoked) cannabis has long been recognized as a possible option for relief of spasticity and neuropathic pain… An innovative method of benefiting from the mode of action of cannabinoids while limiting their drawbacks is to reduce peak plasma levels of 9-delta-tetrahydrocannabinol and counteract psychoactivity with higher than naturally occurring proportions of a second cannabinoid, cannabidiol.

Sativex® oromucosal spray (1:1 ratio of 9-delta-tetrahydrocannabinol/cannabidiol) has recently been approved in a number of EU countries and elsewhere for use in patients with MS-related spasticity who are resistant to treatment with other antispasticity medications.

In clinical trials, Sativex provided initial relief of spasticity symptoms within the first 4 weeks of treatment (trial period) in up to about half of patients resistant to other available oral antispasticity medications and demonstrated clinically significant improvement in spasticity (30% or higher reduction from baseline) in three-quarters of the initial responders. Adverse events were limited mainly to mild or moderate cases of somnolence and dizziness.

Under everyday clinical practice conditions, Sativex at a mean daily dose of <7 sprays/day, was shown to relieve spasticity in about 70% of patients previously resistant to treatment.

Clear improvements were also noted in associated symptoms such as sleep disturbances, bladder problems, loss of mobility and cramps…

Follow-up studies in Sativex responders support continued benefit without the need to increase doses for at least 1 year.

Sativex appears to be a promising solution for a meaningful proportion of patients with MS-related spasticity who have inadequate response to current antispasticity medications.”

http://www.ncbi.nlm.nih.gov/pubmed/24289844

The endocannabinoid system and multiple sclerosis.

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“Multiple sclerosis (MS) is a neurodegenerative disease that is characterised by repeated inflammatory/demyelinating events within the central nervous system (CNS). In addition to relapsing-remitting neurological insults, leading to loss of function, patients are often left with residual, troublesome symptoms such as spasticity and pain. These greatly diminish “quality of life” and have prompted some patients to self-medicate with and perceive benefit from cannabis.

Recent advances in cannabinoid biology are beginning to support these anecdotal observations, notably the demonstration that spasticity is tonically regulated by the endogenous cannabinoid system.

Recent clinical trials may indeed suggest that cannabis has some potential to relieve, pain, spasms and spasticity in MS. However, because the CB(1) cannabinoid receptor mediates both the positive and adverse effects of cannabis, therapy will invariably be associated with some unwanted, psychoactive effects.

In an experimental model of MS, and in MS tissue, there are local perturbations of the endocannabinoid system in lesional areas. Stimulation of endocannabinoid activity in these areas either through increase of synthesis or inhibition of endocannabinoid degradation offers the positive therapeutic potential of the cannabinoid system whilst limiting adverse events by locally targeting the lesion.

 In addition, CB(1) and CB(2) cannabinoid receptor stimulation may also have anti-inflammatory and neuroprotective potential as the endocannabinoid system controls the level of neurodegeneration that occurs as a result of the inflammatory insults.

Therefore cannabinoids may not only offer symptom control but may also slow the neurodegenerative disease progression that ultimately leads to the accumulation of disability.”

http://www.ncbi.nlm.nih.gov/pubmed/18781983