Endocannabinoids: a unique opportunity to develop multitarget analgesics.

“After 4 millennia of more or less documented history of cannabis use, the identification of cannabinoids, and of Δ(9)-tetrahydrocannabinol in particular, occurred only during the early 1960s, and the cloning of cannabinoid CB1 and CB2 receptors, as well as the discovery of endocannabinoids and their metabolic enzymes, in the 1990s.

Despite this initial relatively slow progress of cannabinoid research, the turn of the century marked an incredible acceleration in discoveries on the “endocannabinoid signaling system,” its role in physiological and pathological conditions, and pain in particular, its pharmacological targeting with selective agonists, antagonists, and inhibitors of metabolism, and its previously unsuspected complexity.

The way researchers look at this system has thus rapidly evolved towards the idea of the “endocannabinoidome,” that is, a complex system including also several endocannabinoid-like mediators and their often redundant metabolic enzymes and “promiscuous” molecular targets.

These peculiar complications of endocannabinoid signaling have not discouraged efforts aiming at its pharmacological manipulation, which, nevertheless, now seems to require the development of multitarget drugs, or the re-visitation of naturally occurring compounds with more than one mechanism of action.

In fact, these molecules, as compared to “magic bullets,” seem to offer the advantage of modulating the “endocannabinoidome” in a safer and more therapeutically efficacious way.

This approach has provided so far promising preclinical results potentially useful for the future efficacious and safe treatment of chronic pain and inflammation.”

http://www.ncbi.nlm.nih.gov/pubmed/23623250

Fibromyalgia.

“Fibromyalgia is a chronic pain condition present in 2-4% of the population. Fibromyalgia consists of widespread pain with similarities to neuropathic pain in clinical findings, pathophysiology, and neuropharmacology. Pain is the predominant symptom and allodynia and hyperalgesia are common signs. Extreme fatigue, impaired cognition and nonrestorative sleep difficulties coexist in addition to other somatic symptoms.

Research including neuroimaging investigations shows abnormalities in neurotransmitters and an abnormal response to pain. Altered pain processing peripherally and centrally contribute to central sensitization and a dampened effect of the diffuse noxious inhibitory control (DNIC).

Successful management incorporates education of the patient in self-management skills, cognitive behavioral therapy (CBT), exercise, and drug therapy.

Tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors (SNRIs) (duloxetine and milnacipran), α2-δ ligands (gabapentin and pregabalin) are effective in reducing pain by≥30%. Some success has been shown with dopamine agonists (pramipexole), tramadol, other opioids and cannabinoids(nabilone).

Further evidence-based trials using complementary treatments are needed. Fibromyalgia is complex and requires a multidisciplinary approach to treatment. Patient self-management is key.”

http://www.ncbi.nlm.nih.gov/pubmed/24365316

Chronic administration during early adulthood does not alter the hormonally-dependent disruptive effects of delta-9-tetrahydrocannabinol (Δ9-THC) on complex behavior in female rats.

“This study examined whether chronic Δ9-THC during early adulthood would produce the same hormonally-dependent deficits in learning that are produced by chronic Δ9-THC during adolescence…

no significant effects of chronic treatment and no significant interaction between the chronic treatment and cannabinoid signaling. Thus, acute Δ9-THC produced hormonally-dependent effects on learning and performance behavior, but a period of chronic administration during early adulthood did not alter these effects significantly, which is contrary to what we and others have shown for chronic administration during adolescence.”

http://www.ncbi.nlm.nih.gov/pubmed/24361784

Marijuana treatments for autoimmune disorders

“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 sclerosisarthritis and type 1 diabetes.”

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

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

“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

Marijuana Might Kill Cancer – Newsweek

“A new study suggests that several components of the cannabis plant slow or kill malignant cells.”
Pot

 “Recent research gives new hope and meaning to the phrase “medical marijuana.”

In a paper published in October’s Anticancer Research, Wai Liu, a senior research fellow at St. George’s University of London, reports that he found six cannabinoids – active components of the cannabis plant – that can slow or outright kill cancer cells.

Though THC is the main cannabinoid associated with marijuana and has been recognized to have a “really strong anti-cancer effect,” Liu says, “it’s not a good candidate for therapeutic use because of its psychoactive properties.”

He examined whether several lesser-known cannabinoids would impact the growth of leukemia cells both individually and in combination.

The result?

“They’re good at killing cancer cells,” he says. And “because they’re not psychoactive, you can actually have the benefits associated with anti-cancer technology but not have the feelings of high, which are associated with THC.””

More: http://www.newsweek.com/marijuana-might-kill-cancer-1289

Non-Hallucinogenic Cannabinoids Are Effective Anti-Cancer Drugs – ScienceDaily

“New research has shown that the non-hallucinogenic components of cannabis could act as effective anti-cancer agents.

The anti-cancer properties of tetrahydrocannabinol (THC), the primary hallucinogenic component of cannabis, has been recognised for many years, but research into similar cannabis-derived compounds, known as cannabinoids, has been limited.

The study was carried out by a team at St George’s, University of London. It has been published in the journal Anticancer Research.

The team, led by Dr Wai Liu and colleagues carried out laboratory investigations using a number of cannabinoids, either alone or in combination with each other, to measure their anti-cancer actions in relation to leukemia.

Of six cannabinoids studied, each demonstrated anti-cancer properties as effective as those seen in THC. Importantly, they had an increased effect on cancer cells when combined with each other.”

More: http://www.sciencedaily.com/releases/2013/10/131014094105.htm

New research shows marijuana compounds do fight cancer

The bracts surrounding a cluster of Cannabis sativa flowers are coated with cannabinoid-laden trichomes. (Photo: Wikimedia Commons)

“Debate is just beginning in Washington over how medical marijuana will be grown and distributed now that the rules for the recreational market are established. Meanwhile, research into medical benefits of compounds within the cannabis plant continues to show effectiveness.

Effectiveness against pain in its many forms and other side effects of major diseases – or the palliative side of marijuana use – have been pretty well established, but can marijuana directly take on a disease as big, scary and deadly as cancer?

“What we’ve shown using just a few of these (cannabis) compounds is that the effects against cancer are really profound. They really are,” said Dr. Wai Liu, a senior research fellow at St George’s University of London.

Anticancer success

Quick note: Cannabinoids are the chemicals in marijuana that have effects in the body, some have psychoactive (or make you high) effects such as THC, and others such as CBD don’t have psychoactive effects but do interact with the body’s “cannabinoid receptors.” There are more than 85 “cannabinoids” in marijuana.

Liu’s most recent published research “explored the activity of six cannabinoids, used both alone and in combination in leukaemic cells.” The research was published in Anticancer Research: International Journal of Cancer Research and Treatment.

He said the anticancer activity of THC has been “known for sometime” but that THC’s psychoactive effect or tendency to get you high limits its use as a cancer-fighting agent. That’s partly due to the negative social stigma about getting high and, of course, not everyone wants to experience a high.

So, he set out to explore the cancer fighting ability of other cannabinoids that don’t get you high.

“We have shown that these six other agents that lack psychoactivity are also just as effective as an anti-cancer agent,” he said. Chief among the six was cannabidiol or CBD.”

More: http://blog.seattlepi.com/marijuana/2013/10/22/new-research-shows-marijuana-compounds-do-fight-cancer/

The endocannabinoid system, cannabinoids, and pain.

“The endocannabinoid system is involved in a host of homeostatic and physiologic functions, including modulation of pain and inflammation… Exogenous plant-based cannabinoids (phytocannabinoids) and chemically related compounds, like the terpenes, commonly found in many foods, have been found to exert significant analgesic effects in various chronic pain conditions.

Currently, the use of Δ9-tetrahydrocannabinol is limited by its psychoactive effects and predominant delivery route (smoking), as well as regulatory or legal constraints.

 However, other phytocannabinoids in combination, especially cannabidiol and β-caryophyllene, delivered by the oral route appear to be promising candidates for the treatment of chronic pain due to their high safety and low adverse effects profiles.

This review will provide the reader with the foundational basic and clinical science linking the endocannabinoid system and the phytocannabinoids with their potentially therapeutic role in the management of chronic pain.”

http://www.ncbi.nlm.nih.gov/pubmed/24228165

Study: Marijuana Compound Can Kill Some Cancer Cells – TIME

Marijuana leaf

“Compounds derived from marijuana can kill cancerous cells in patients with leukemia, according to a recent study.

The study, published in the Anticancer Research journal, was partially funded by GW Pharmaceuticals. which already produces a cannabis-derived drug to help people with multiple sclerosis. Dr. Wai Liu studied six different non-psychoactive cannabinoids (compounds derived from marijuana that don’t get the user high like its THC component does). He found that certain non-psychoactive cannabinoids “resulted in dramatic reductions in cell viability” and “caused a simultaneous arrest at all phases of the cell cycle,” according to the study summary posted online.

Leukemia will take the lives of an estimated 23,720 people this year.

This isn’t the first time marijuana has been linked to deterring cancer: In 2012, researchers at the California Pacific Medical Center in San Francisco found that CBD — a non-psychoactive chemical compound found in cannabis — can stop metastasis in some kinds of aggressive cancer. Liu told the Huffington Post that smoking cannabis is unlikely to have the same cancer-inhibiting effect.”

http://healthland.time.com/2013/10/28/study-marijuana-compounds-can-kill-some-cancer-cells/