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IACM-Bulletin of 06 January 2019

Science/Human: Cannabis rich in THC may be useful in the treatment of fibromyalgia

In an experimental placebo -controlled study with 3 different strains of cannabis provided by the company Bedrocan THC-rich cannabis reduced pain. Study results by researchers at Leiden University Medical Center, The Netherlands, and Bedrocan International were published in the journal Pain. On 4 different occasions 20 patients with fibromyalgia received either the variety Bedrocan with 22 mg THC, the variety Bediol with 13 mg THC and 18 mg CBD, Bedrolite with 18 mg CBD or a placebo.

The two cannabis varieties containing THC caused a significant increase in pressure pain threshold relative to placebo. CBD inhalation increased THC plasma concentrations but diminished THC-induced analgesic effects, indicative of synergistic pharmacokinetic but antagonistic pharmacodynamic interactions of THC and CBD. Authors wrote that this “experimental trial shows the complex behavior of inhaled cannabinoids in chronic pain patients with just small analgesic responses after a single inhalation.” Tjalling Erkelens, founder and CEO of Bedrocan, is especially delighted for patients: “The outcome is very important for patients who suffer from fibromyalgia. Now we have the serious clinical evidence that medical doctors are asking for when prescribing our products and that health insurance companies want to have, to legitimise reimbursement.”

van de Donk T, Niesters M, Kowal MA, Olofsen E, Dahan A, van Velzen M. An experimental randomized study on the analgesic effects of pharmaceutical-grade cannabis in chronic pain patients with fibromyalgia. Pain. 2018 Dec 20. [in press]
Press release by Bedorcan of 24 December 2018

Thailand: Cannabis may be used for therapeutic and scientific purposes

Thailand approved cannabis for medical use and research on 25 December, the first legalization of the drug in a region with some of the world’s strictest drug laws. The junta-appointed parliament in Thailand voted to amend the Narcotic Act of 1979 in an extra parliamentary session.

The main controversy with legalization involved patent requests by foreign firms that could allow them to dominate the market, making it harder for Thai patients to access medicines and for Thai researchers to access cannabis extracts. “We’re going to demand that the government revoke all these requests before the law takes effect,” said Panthep Puapongpan, Dean of the Rangsit Institute of Integrative Medicine and Anti-Aging.

Reuters of 25 December 2018

Science/Human: Cannabis use is associated with lower risk for factors associated with diseases of heart and blood vessels

In a study with 253 men greater cannabis use was associated with lower body mass index and other risk factors for cardiovascular disease. Scientists of the Department of Psychology of Arizona State University in Tempe published their research in the recent issue of Psychosomatic Medicine. Participants were followed from age 7 to age 32.

Cannabis use was associated with lower body mass index (BMI), better waist-to-hip-ratio (WHR), better HDL and LDL cholesterol, lower triglycerides, lower fasting glucose, and lower blood pressure (both systolic and diastolic). A theoretical explanation for this long-term effect of cannabis despite the well-known appetite-enhancing effects of the drug is provided by scientists at Indiana University in South Bend, USA, in the journal Cannabis and Cannabinoid Research.

Meier MH, Pardini D, Beardslee J, Matthews KA. Associations between cannabis use and cardiometabolic risk factors: A longitudinal study of men.
Psychosom Med. 2018 Dec 27. [in press]
Clark TM, et al. Cannabis Cannabinoid Res. 2018 Dec 21. [available online]

News in brief

Europe: Increase of THC content in cannabis flowers (marijuana) and resin (hashish) in the past 10 years
Between 2006 and 2016 there was a considerable increase of average THC content in cannabis resin (from 8% to 17%) and in cannabis flowers ( from 5% to 10%). Prices increased on average from 8 to 12 EURos for hashish and 7 to 12 EURos for marijuana.
Department of Psychology, University of Bath, UK.
Freeman TP, et al. Addiction. 2018 Dec 29.[in press]

USA: Medicines agency considers new cannabis policy
The US medicines agency FDA (Food and Drug Administration) said on 21 December it will consider creating new policy regarding the marketing and sale of cannabis after President Donald Trump signed the Farm Bill, which legalized commercial production of hemp in the United States. The FDA said in a statement that it hopes to make more efficient “pathways” for companies to introduce and market cannabis and cannabis-derived products, including cannabidiol (CBD) into interstate commerce.
Reuters of 21 December 2018

Science/Human: CBD may be effective in refractory status epilepticus according to a case report
CBD was effective in a child with long-standing, super-refractory status epilepticus. There was complete resolution of the attack upon treatment with the cannabinoid.
David Geffen School of Medicine and UCLA Mattel Children's Hospital, Los Angeles, USA.
Rajaraman RR, et al. Epilepsy Behav Case Rep. 2018;10:141-144.

Science/Animal: Cannabinoids prevent from degeneration of retinal structures and blindness
In a rat model of retinitis pigmentosa the administration of the synthetic cannabinoid HU210, which activates the CB1 receptor, prevented the degradation of retinal structure and function and caused an improvement of circadian rhythmicity.
Physiology, Genetics and Microbiology, University of Alicante, Spain.
Lax P, et al. Exp Eye Res. 2018 Dec 31. [in press]

Science/Cells: How CBD may be effective in the treatment of a type of a severe brain cancer
In a study with glioblastoma cells CBD modulated so-called extracellular vesicles and prohibitin. Extracellular vesicles are mediators of cell communication, which are used by cancer cells, and prohibitin may contribute to chemoresistance, that is resistance of cancer cells to chemotherapeutic agents. Authors concluded that CBD may “act as an adjunct to enhance treatment efficacy in GBM.”
School of Human Sciences, London Metropolitan University, UK.
Kosgodage US, et al. Transl Oncol. 2018;12(3):513-522.

Science/Animal: Binding of cannabinoids to the allosteric binding site of the CB1 receptor may help to treat cannabis dependence and inflammation of the stomach
Some substances, such as cannabidiol (CBD) do not bind to the so-called orthosteric binding site of the CB1 receptor, as does THC, but to the so-called allosteric binding site. A synthetic cannabinoid (ZCZ 011) binding to the allosteric site was shown to be useful in cannabis dependence and inflammation of the stomach.
Department of Psychology, West Virginia University, Morgantown, USA.
Trexler KR, et al. Pharmacol Biochem Behav. 2018 Dec 28. [in press]

Science/Animal: Anti-inflammatory effects of terpenes of the cannabis plant
According to research with mice “in contrast to CBD that exerts prolonged immunosuppression and might be used in chronic inflammation, the terpenoids showed only a transient immunosuppression and might thus be used to relieve acute inflammation.”
Hadassah Medical School, Hebrew University of Jerusalem, Israel.
Gallily R, et al. Cannabis Cannabinoid Res. 2018;3(1):282-290

Science: Interactions of cannabinoids with other medicinal drugs
In a review authors wrote that “cannabinoids are usually well tolerated, but bidirectional effects may be expected with concomitant administered agents via affected membrane transporters (Glycoprotein p, breast cancer resistance proteins, and multidrug resistance proteins) and metabolizing enzymes (Cytochrome P450 and UDP-glucuronosyltransferases).”
NICM Health Research Institute, Western Sydney University, Westmead, Australia.
Alsherbiny MA, et al. Medicines (Basel). 2018;6(1).

USA: Pennsylvania Supreme Court rules that drug use during pregnancy is not child abuse
The Pennsylvania Supreme Court ruled on 28 December that mothers who use illegal drugs during their pregnancies are not committing child abuse against their newly-born children.
Reuters of 28 December 2018

Science/Human: Weight loss through regular exercise may involve anandamide
In a study with 34 participants, who underwent a 12-week supervised moderate exercise program, there were significant decreases in blood anandamide concentration, anxiety and body weight. Authors concluded “that the weight loss and mood improvement through regular moderate exercise may involve changes in anandamide metabolism/signaling.”
Universidade Federal de São Paulo, Brazil.
de Oliveira Belitardo A, et al. Physiol Behav. 2018 Dec 19. [in press]

Science/Human: Cannabinoid receptors may be therapeutic targets in the treatment or prevention of endometrial cancer
An analysis of endometrial biopsies from women with endometrial cancer (EC) and women without this cancer showed that CB1 receptors in cancer patients were reduced by 90% and CB2 receptors by 80%. Authors wrote that these “data suggest that the loss of both types of CB receptors is potentially involved in the development of or progression of EC and that CB1 and CB2 receptor expression could serve as useful histological markers and therapeutic targets in the treatment of or prevention of EC.”
Department of Cancer Studies and Molecular Medicine , University of Leicester , UK.
Ayakannu T, et al. J Recept Signal Transduct Res. 2018:1-8.

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