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IACM-Bulletin of 23 May 2010

Science: Call for clinical trials on cannabinoids in amyotrophic lateral sclerosis

According to a review by scientists of the University of Washington School of Medicine, USA, there is now enough scientific data available to support clinical trials on cannabis in amyotrophic lateral sclerosis (ALS). They note that "preclinical data indicate that cannabis has powerful antioxidative, anti-inflammatory, and neuroprotective effects" which are effects that may be of use to combat disease progression. In recent years several animal studies have been conducted showing that cannabinoids may have a positive effect on disease onset and/or life span. For example, a synthetic cannabinoid which selectively binds to the CB2 receptor was shown to prolong survival in a 2007 study. Daily injections of the selective CB2 agonist AM-1241 to the mice increased the survival interval after disease onset by 56 per cent. In a 2006 study the application of a synthetic cannabinoid (WIN55,212-2) and the inhibition of endocannabinoid degradation delayed disease onset in the animals without affecting life span.

In addition, cannabis has many properties that may be applicable to the management of ALS. These include analgesia, muscle relaxation, bronchodilation, saliva reduction, appetite stimulation, and sleep induction, already used by many ALS patients. Researchers stated that "from both a disease modifying and symptom management viewpoint, clinical trials with cannabis are the next logical step. Based on the currently available scientific data, it is reasonable to think that cannabis might significantly slow the progression of ALS, potentially extending life expectancy and substantially reducing the overall burden of the disease."

(Source: Carter GT, Abood ME, Aggarwal SK, Weiss MD. Cannabis and Amyotrophic Lateral Sclerosis: Hypothetical and Practical Applications, and a Call for Clinical Trials. Am J Hosp Palliat Care. 2010 May 3. [in press])

News in brief

Holland: Cannabis pharmacy
There is now a second pharmacy in the Netherlands which is selling cannabis from the company Bedrocan at a lower prize than usual pharmacies in the Netherlands since they buy large amounts of the drug and than package it into smaller packaging units themselves. It is the "Apotheek Maasbracht" in Maasbracht (www.apotheekmaasbracht.nl/) not far away from Maastricht. The first Dutch cannabis pharmacy was Hanzeplein in Groningen (www.hanzeplein.nl).

Science: Psychosis
Scientists at the Albert Einstein College of Medicine in New York, USA, investigated the question whether cannabis use disorders (CUD) are associated with an earlier age at onset of psychosis, comparing 49 first-episode schizophrenia subjects with CUD and 51 first-episode schizophrenia subjects with no substance use disorders. They found out that "although cannabis use precedes the onset of illness in most patients, there was no significant association between onset of illness and CUD that was not accounted for by demographic and clinical variables. Previous studies implicating CUD in the onset of schizophrenia may need to more comprehensively assess the relationship between CUD and schizophrenia, and take into account additional variables that we found associated with CUD." (Source: Sevy S, et al. Schizophr Res. 2010 May 12. [in press])

Science: Stroke
According to a group of Italian researchers, who investigated the blood of 10 patients with stroke within six hours since symptoms started and compared it with 8 control subjects, levels of the endocannabinoid anandamide were significantly higher in stroke patients. There was a positive correlation between anandamide blood levels and stroke volume. (Source: Naccarato M, et al. Lipids Health Dis 2010;9(1):47.)

Science: Fat metabolism
According to cell experiments at the University of Porto, Portugal, THC influences the biology of fat cells. Their observations on the effects of cannabinoids point toward increased deposition of fat tissue in cells and an improved insulin sensitivity of cells. (Source: Teixeira D, et al. Obesity (Silver Spring). 2010 May 13. [in press])

Science: Passive smoking
Scientists at the University of Mainz, Germany, investigated urine and blood samples of 8 healthy subjects after passive exposure to cannabis smoke for three hours in a Dutch coffee shop. "THC could be detected in trace amounts close to the detection limit of the used method in the first two blood samples after initial exposure (1.5 and 3.5 h). In the 6 h blood samples, THC was not detectable anymore." (Source: Röhrich J, et al. J Anal Toxicol 2010;34(4):196-203.)

Science: Parkinson's disease
According to research at the University of Rome Tor Vergata, Italy, anandamide levels in cerebrospinal fluid of patients with Parkinson's disease were more than doubled as compared to controls. After chronic treatment with Levodopa these levels normalized. Scientists noted that "abnormal anandamide increase might reflect a compensatory mechanism occurring in course of PD, aimed at normalizing dopamine depletion." (Source: Pisani V, et al. Mov Disord 2010;25(7):920-4.)

Science: Panic attacks
According to animal research with rats at the University of Rio Grande do Norte, Brazil, cannabidiol (CBD) which was injected into a certain brain region (dorsal periaqueductal gray) caused an anxiolytic-like effect, and inhibited escape response, a panicolytic-like effect by the activation of 5-HT1A receptors. (Source: Soares VD, et al. Behav Brain Res 2010 May 8. [in press])

Science: Pregnancy
According to a Dutch study the use of cannabis during pregnancy had a specific effect on the uterine blood flow. Researchers compared pregnant woman with continued cannabis use (9 women), cannabis use only in early pregnancy (14), continued tobacco use (85), tobacco use only in early pregnancy (92), and no tobacco or cannabis use during pregnancy (85 women). (Source: El Marroun H, et al. Early Hum Dev. 2010 May 5. [in press])

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