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IACM-Bulletin of 17 November 2013

Science/Human: Many patients with inflammatory bowel disease use cannabis to treat their symptoms

Many patients with inflammatory bowel syndrome find cannabis very helpful for symptom control, including patients with ulcerative colitis, a survey conducted by scientists of the Department of Medicine at Brigham and Women's Hospital in Boston, USA, revealed. A total of 292 patients completed a survey, of whom 12.3% were active cannabis users, 39.0% were past users, and 48.6% were never users.

Among current and past users, 16.4% of patients used cannabis for disease symptoms, the majority of whom felt that cannabis was "very helpful" for relief of abdominal pain, nausea, and diarrhea. Half of the never users expressed an interest in using cannabis, were it legally available. Authors concluded that “a significant number of patients with IBD currently use marijuana (…). Clinical trials are needed to determine marijuana's potential as an IBD therapy and to guide prescribing decisions.”

Ravikoff Allegretti J, Courtwright A, Lucci M, Korzenik JR, Levine J. Marijuana Use Patterns Among Patients with Inflammatory Bowel Disease. Inflamm Bowel Dis. 2013 Oct 31. [in press]

USA: Patients and their families migrate to Colorado to get a legal treatment with cannabis

The Salt Lake Tribune reported of families, who move to Colorado to profit from the medical cannabis laws. More than medical tourists, they are medical refugees, forced to flee states where cannabis is illegal. "This is just the first wave," said Margaret Gedde, a Colorado Springs physician with a doctorate from Stanford who prescribes cannabis and has compiled case studies of children using cannabis-infused oil. "These families are going to keep coming as awareness spreads because the results are real."

Medical cannabis is currently legal in 20 US states, plus Washington D.C. But Colorado has become the go-to place for an extract from a plant that’s high in cannabidiol (CBD) but low in tetrahydrocannabinol (THC), the psychoactive component of cannabis that creates a high in users. CBD is effective in the treatment of epilepsy and some other medical conditions.

A similar observation of refugees can be made in EURope, where patients move to the Netherlands or Spain to get a treatment with cannabis without fear of prosecution.

Salt Lake Tribune of 10 November 2013.

News in brief

Czech Republic: Police raids 100 stores, which are suspected of selling material for cannabis growing
Czech police say they have opened investigations against 45 people after nationwide raids on dozens of stores suspected of selling materials that help people illegally grow cannabis. In a statement on 12 November, police said they have raided about 100 places since the beginning of their unusually large sweep.
Associated Press of 12 November 2013.

Science/Human: GW Pharmaceuticals starts a clinical study with Sativex in brain cancer
In a study with 20 patients the British company GW Pharmaceuticals wants to test the effects of Sativex, which contains THC and CBD, in combination with temozolomide, a chemotherapeutic agent, in glioblastoma multiforme. This is a particularly aggressive brain tumor.
Press release by GW Pharmaceuticals of 11 November 2013.

World: Kofi Annan calls for an end of the war on drugs
Kofi Annan, former secretary general of the United Nations, and Fernando Henrique Cardoso, former president of Brazil, call for an end of the war on drugs, which indeed is a war on drug users. On CNN they said: “We called on governments to adopt more humane and effective ways of controlling and regulating drugs. We recommended that the criminalization of drug use should be replaced by a public health approach. We also appealed for countries to carefully test models of legal regulation as a means to undermine the power of organized crime, which thrives on illicit drug trafficking.”
CNN of 5 November 2013.

USA: Colorado voters approve 25 percent taxes on recreational cannabis
A Colorado measure to impose sales and excise taxes of 25 percent on newly legalized recreational cannabis and earmark the first 40 million dollars in revenue for public schools was approved by voters on 5 November, Governor John Hickenlooper said. Colorado and Washington last year became the first U.S. states to legalize cannabis for recreational purposes.
Reuters of 6 November 2013.

Science/Human: Two case reports of stroke after intake of synthetic cannabinoids in “spice”
Reseachers presented two case reports of stroke after intake of “spice” containing the synthetic cannabinoid JWH-018. They wrote “that our 2 patients who smoked the street drug spice had a temporal association with symptoms of acute cerebral infarction. This association may be confounded by contaminants in the product consumed (...). The imaging of both patients suggests an embolic etiology, which is consistent with reports of serious adverse cardiac events with spice use, including tachyarrhythmias and myocardial infarctions."
Department of Neurology, University of South Florida, Tampa.
Freeman MJ, et al. Neurology. 2013 Nov 8. [in press]

Science/Animal: Beta-caryophyllene, which binds to the CB2 receptor, reduces pain
In a study scientists observed analgesic effects of BCP (beta-caryophyllene) in mice suffering from inflammatory and neuropathic pain. BCP binds to the cannabinoid-2 receptor and is found in cannabis and spices including pepper and oregano. Reseachers wrote that “the natural plant product BCP may be highly effective in the treatment of long lasting, debilitating pain states. Our results have important implications for the role of dietary factors in the development and modulation of chronic pain conditions.”
Institute of Molecular Psychiatry, University of Bonn, Germany.
Klauke AL, et al. EUR Neuropsychopharmacol. 2013 Oct 22. [in press]

Science/Animal: Substances found in magnolia activate cannabinoid receptors
Magnolol, the main bioactive constituent of the medicinal plant Magnolia officinalis, and its main metabolite tetrahydromagnolol activate cannabinoid receptors. Reseachers developed synthetic derivatives of these natural compounds with high activity at both CB1 and CB2 receptors and others with antagonism at the GPR55 receptor. Reseachers wrote that “the scaffold is versatile and may be fine-tuned to obtain a broad range of receptor affinities, selectivities and efficacies.”
PharmaCenter Bonn, Pharmaceutical Institute, Bonn, Germany.
Fuchs A, et al. PLoS One, 2013;8(10):e77739.

Science/Animal: The endocannabinoid 2-AG was beneficial in inflammatory lung injury
An increase of the endocannbinoid 2-AG (2-arachidonoyl glycerol) produced anti-inflammatory effects in a mouse model of inflammatory acute lung injury, a finding that was considered a consequence of the activation of the CB1 and CB2 receptors.
Department of Pathology, School of Veterinary Medicine, University of São Paulo, Brazil.
Costola-de-Souza C, et al. PLoS One, 2013;8(10):e77706.

Science/Cells: CBD shows anti-cancer effects in brain cancer cells
By several mechanisms CBD (cannabidiol) inhibited anti-tumor effects in glioma cells. Scientists wrote: “As CBD is a non-psychoactive phytocannabinoid that appears to be devoid of side effects, our results support its exploitation as an effective anti-cancer drug in the management of gliomas.”
Department of Theoretical and Applied Sciences, Centre of Neuroscience, University of Insubria, Varese, Italy.
Solinas M, et al. PLoS One, 2013;8(10):e76918.

Science/Human: Altered cannabinoid receptors in burning mouth syndrome
Burning mouth syndrome (BMS) is an intra-oral burning sensation, for which presently no medical or dental causes have been found, and in which the oral mucosa appears normal. Reseachers found that “in BMS patients there was increased TRPV1, decreased CB1 and increased CB2 expression in tongue epithelial cells also associated with a change in their distribution. It would appear that these receptors are related to BMS.”
Division of Anatomy and Physiopathology, University of Brescia, Italy.
Borsani E, et al. Histol Histopathol. 2013 Nov 5. [in press]

Science/Animal: Activation of the CB2 receptor increased formation of new nerve cells
In mice with impaired neurogenesis (formation of new nerve cells) activation of the CB2 receptor, resulted in enhanced neurogenesis in a certain brain region, called the hippocampus. Scientists concluded that “CB2 agonists may act as neuroprotective agents for rescuing impaired neurogenesis in HAD [HIV-associated dementia] patients.”
Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, USA.
Avraham HK, et al. Br J Pharmacol. 2013 Oct 21. [in press]

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