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IACM-Bulletin of 06 June 2021

Science/Human: Cannabis may be effective in reducing behavioural symptoms associated with dementia

A series of 3 patients suffering from frontotemporal dementia shows that these patients may show reduced anxiety and improved mood following treatment with cannabis. These patients from the Department of Psychiatry of the University of Arizona College of Medicine, USA, had disability due to behaviour despite typical pharmacologic management. They were prescribed cannabis for comorbidities (anxiety, insomnia and pain).

A 69-year-old patient showed improved mood and reduced impulsivity with cannabis. A 63-year-old patient exhibited reduced irritability and anxiety with a CBD treatment and improved sleep with THC. A 65-year-old patient exhibited reduced anxiety and better chronic pain management with cannabis.

Gopalakrishna G, Srivathsal Y, Kaur G. Cannabinoids in the management of frontotemporal dementia: a case series. Neurodegener Dis Manag. 2021;11(1):61-64.

Science/Human: More than two thirds of medical doctors in the USA believe that cannabis has medical value

According to a survey with about 1500 participants 69% of family practice doctors, internists, nurse practitioners, and oncologists believe that cannabis has medical value. They responded to a web-based survey of clinicians analysed by investigators of the Centres for Disease Control and Prevention in Atlanta, USA. Questions assessed medicinal uses for and practices related to cannabis and assessed clinicians' knowledge of cannabis legality in their state.

Among survey participants a quarter (27%) had ever recommended cannabis to a patient. Authors wrote that “beliefs about conditions for medical cannabis use did not necessarily align with the current scientific evidence.” However, physicians’ knowledge about medical uses of cannabis is often more advanced than medical science for many potential indications.

Schauer GL, Njai R, Grant AM. Clinician Beliefs and Practices Related to Cannabis. Cannabis Cannabinoid Res. 2021 April 26. [in press].

Science: Update on the knowledge of cannabis compounds, including 125 cannabinoids

Up-to-date 125 cannabinoids, including 25 of the delta-9-THC -type, 10 of CBD type (cannabidiol) and 16 of the CBG type (cannabigerol) have been detected in at least one cannabis plant. An overview is presented by researchers of the National Center for Natural Products Research at the University of Mississippi in Oxford, USA. More than 500 compounds have now been reported in cannabis.

The non-cannabinoid constituents include: non-cannabinoid phenols (42), flavonoids (34), terpenes (120), amino acids, fatty acids and others, most of which are also present in other organisms. The review discusses the chemistry of the cannabinoids and major non-cannabinoid constituents (terpenes, non-cannabinoid phenols, and alkaloids).

Radwan MM, Chandra S, Gul S, ElSohly MA. Cannabinoids, Phenolics, Terpenes and Alkaloids of Cannabis. Molecules. 2021;26(9):2774.

Science/Human: Cannabis use may not severely influence the course of schizophrenia, but may increase the risk for relapses

According to a longitudinal study 98 patients with first episode schizophrenia spectrum disorders, who were followed for 24 months cannabis use had no influence on remission rates, but was associated with a higher risk of relapse. These results were presented by investigators of the Stellenbosch University in Cape Town, South Africa, and King’s College in London, UK. The group was divided into 45 recent or current cannabis users and 53 non-users.

Health outcomes were similar in both groups including remission rates. Authors concluded that their “results suggest that cannabis users do not have poorer treatment response than non-users in terms of symptom reduction over the 24 months of treatment. However, dose-related risk of relapse remains with ongoing cannabis use, possibly by directly reducing the threshold for psychotic breakthrough.”

Scheffler F, Phahladira L, Luckhoff H, du Plessis S, Asmal L, Kilian S, Forti MD, Murray R, Emsley R. Cannabis use and clinical outcome in people with first-episode schizophrenia spectrum disorders over 24 months of treatment. Psychiatry Res. 2021;302:114022.

News in brief

Science/Human: CBD is effective long-term in the treatment of epilepsy
According to an analysis of data of 54 people with refractory epilepsy, who received CBD, the cannabinoid was effective over a period of at least 60 months.
Massachusetts General Hospital, USA.
Patel S, et al. Epilepsia. 2021 May 29. [in press].

Greece: Parliament vote in favour of the legalisation of cannabis for medical use
On 21 May the Greek Parliament voted in favour of a bill to legalise the cultivation and sale of cannabis for medical use in Greece. The bill, which was proposed by the main opposition party Syriza, got 158 votes for and 33 against.
Greek Reporter of 23 May 2021

Morocco: Parliament adopts a bill legalising the medical use of cannabis
On 26 May the House of Representatives adopted a bill legalizing the use of cannabis for medical purposes. The text on “the legal uses of cannabis, medical, cosmetic and industrial” was adopted by the House of Representatives with 119 votes for and 48 against. The draft law provides for the setting up of a national agency in charge of buying the plant from farmers and selling it to pharmaceutical firms.
North Africa Post of 27 May 2021

China: Patent for a CBD preparation for a CBD
Deyi Pharmaceuticals has been granted a patent for "the application of cannabidiol in the preparation and treatment of pulmonary arterial hypertension drugs" by the State Intellectual Property Office of China.
Securities Times and Company News of 18 May 2021

The Netherlands: Institute Medicinal Cannabis Netherlands
Dutch pharmacists, doctors, companies and researchers have joined forces and set up a new partnership: the Institute Medicinal Cannabis Netherlands (IMC).
Bedrocan of 18 May 2021

France: The government wants to allow oral CBD products and prohibit flowers
France wants to allow CBD products, but hemp flowers rich in CBD will remain illegal. This decision allows French farmers to cultivate CBD for the manufacture of derived products and clarifies the activity of specialised shops which until now have been operating in a vacuum and risked legal proceeding.
Le Figaro of 25 May 2021

Denmark: Nationwide trial on the medical use of cannabis will be extended by 4 years
Danish patients will be able to access medical cannabis for another four years after a broad majority in the parliament agreed to extend a nationwide trial. And, companies in the Scandinavian country producing cannabis for medical purposes are also to be allowed to operate permanently. Denmark’s medical cannabis pilot programme had been due to finish at the end of December 2021 following a four year trial period.
Business Cann of 27 May 2021

Science/Animal: Both CBD and CBG may reduce pulmonary inflammation
In a study with guinea pigs both CBD and CBG and a combination of both cannabinoids had anti-inflammatory effects on inflammation of the lungs. Authors wrote that these results “suggest that these non-psychoactive cannabinoids may have beneficial effects in treating diseases characterised by airway inflammation.”
Sackler Institute of Pulmonary Pharmacology, Institute of Pharmaceutical Science, King's College London, United Kingdom.
Robaina Cabrera CL, et al. Pulm Pharmacol Ther. 2021:102047.

Science/Animal: CBD protects from early life stress
CBD “showed a promising therapeutic response in terms of ameliorating affect in a rat model of early-life stress during adolescence and up to adulthood.”
IUNICS, University of the Balearic Islands, Palma, Spain.
Bis-Humbert C, et al. Pharmacol Rep. 2021 Jun 2. [in press].

Science/Human: CBD in oil resulted in fourfold increase of bioavailability compared to CBD powder
In a study with 45 healthy volunteers, who received either 150 mg of CBD powder, 150 mg of CBD dissolved in corn oil or a placebo the “oil-based CBD formulation resulted in more rapid achievement of peak plasma level, with an approximate fourfold increase in oral bioavailability.”
Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP), Brazil.
Crippa JA, et al. Braz J Psychiatry. 2021:S1516-44462021005017201.

Science: The chemical profile of cannabis is influenced by the harvesting stage
The chemical profile of the female inflorescence extracts from seven hemp cultivars (Carmagnola, Fibranova, Eletta Campana, Antal, Tiborszallasi, Kompolti, and Tisza) was influenced by the harvesting stage.
Department of Chemistry and Technology of Drugs, Sapienza University of Rome, Italy.
Spano M, et al. Molecules. 2021;26(10):2912.

Science/Cells: CBD shows antioxidant and anti-cancer effects
In a study with different normal and cancer cells CBD in hemp oil showed antioxidant effects and induced programmed cell death (apoptosis) in cancer cells but not in healthy cells.
Centre of Advanced Research in Bionanoconjugates and Biopolymers, "Petru Poni" Institute of Macromolecular Chemistry, Iasi, Romania.
Petrovici AR, et al. Antioxidants (Basel). 2021;10(5):738.

Science/Animal: CBD improved the ratio of essential fatty acids in muscles of obese rats
New research shows that CBD significantly improved the ratio of omega 6 and omega 3 fatty acids
and shifted the equilibrium towards anti-inflammatory omega 3 fatty acids in muscles of obese rats.
Department of Physiology, Medical University of Bialystok, Poland.
Bielawiec P, et al. Nutrients. 2021;13(5):1603.

Science/Human: Cannabis use disorder is associated with an increased risk of adverse effects in pregnancy
According to an analysis of about 3 million pregnancies a cannabis-related diagnosis in 29,000 of pregnancies was associated with the 40% increased risk of preterm birth and a 40% increased risk of small babies.
Department of Pediatrics, University of California San Diego, United States.
Bandoli G, et al. Drug Alcohol Depend. 2021;225:108757.

Science/Human: A review suggests that cannabis may be helpful in autism spectrum disorder
According to a systematic review on clinical data “cannabis and cannabinoids may have promising effects in the treatment of symptoms related to ASD” (autism spectrum disorder).
Departamento de Psicologia, Universidade Federal da Paraíba (UFPB), João Pessoa, Brazil.
Silva EAD Junior, et al. Trends Psychiatry Psychother. 2021 May 21. [in press].

Science/Human: No relevant effect of cannabis use on anaesthesia
In a comparison of patients, who use cannabis and do not use cannabis, the cannabis use had no effect on anaesthesia with propofol, fentanyl or ketamine.
Northeastern University in Boston, Medical Center in Brockton, Massachusetts.
King DD, et al. AANA J. 2021;89(3):205-212.

Science/Animal: Inhibition of endocannabinoid degradation reduces paw inflammation
In a mouse model of inflammatory arthritis inhibition of the degradation of the endocannabinoid 2-AG (2-arachidonolglycerol) by an MAGL inhibitor improved inflammation.
Department of Psychology, West Virginia University, USA.
Nass SR, et al. Cannabis Cannabinoid Res. 2021 Mar 25. [in press].

Science/Animal: Hemp oil improves experimental atherosclerosis by reducing inflammation
In a study with mice cannabis seed oil reduced experimental atherosclerosis in mice prone to atherosclerosis by ameliorating vascular inflammation. Authors wrote that the “results provide a promising preventive strategy for the early progression of AS.”
College of Food Science and Engineering, Wuhan Polytechnic University, Wuhan, People's Republic of China.
Huang W, et al J Agric Food Chem. 2021 May 26. [in press].

Science/Animal: CBD has a unique effect on global brain activity
In a study with mice researchers found a unique effect of cannabidiol on brain activity “suggesting that CBD reduces autonomic arousal under conditions of emotional and physical stress.”
Center for Translational NeuroImaging, Northeastern University, Boston, USA.
Sadaka AH, et al. J Transl Med. 2021;19(1):220.

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