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IACM-Bulletin of 28 August 2022

Science/Human: Cannabis improves abdominal pain in gastroparesis

In a study at Westchester Medical Center in Valhalla, USA, with 24 patients suffering from gastroparesis both isolated THC and cannabis improved symptoms. Gastroparesis is characterised by delayed gastric emptying due to weak muscle constructions of the stomach. Six patients were prescribed pure THC, ten cannabis and eight pure oral THC followed by cannabis.

Medical cannabis was prescribed as needed at varying THC:CBD ratios and was taken via vaporized inhalation or sublingual drops. Dosage of pure THC ranged from 2—10mg twice daily to four times daily. Statistically significant improvement in abdominal pain score was seen in patients who received either cannabinoid treatment. When analysed individually, both cannabis and pure oral THC showed statistically significant improvement in abdominal pain scores.

Barbash B, Chawla L, Siddiqui T, Dworkin B, FACG, FACN1. Cannabinoids Lead to Significant Improvement in Gastroparesis—Related Abdominal Pain. Am J Gastroenterology:2018;688:689.

Science/Human: CBD may be effective in the treatment of joint pain according to a survey

In a survey by the Core Institute/Banner University Medical Center in Phoenix, USA, with 428 patients suffering from arthritis the use of CBD (cannabidiol) was associated with improved pain, sleep and physical function. Participants were recruited through social media and newsletters by the Arthritis Foundation and Savvy Cooperative

CBD use was associated with improvements in pain (83%), physical function (66%), and sleep quality (66%). Subgroup analysis by diagnosis type (osteoarthritis, rheumatoid, or other autoimmune arthritis) found improvements among groups for physical function (P=0.013), favouring the osteoarthritis group. The overall cohort reported a 44% reduction in pain after CBD use

Frane N, Stapleton E, Iturriaga C, Ganz M, Rasquinha V, Duarte R. Cannabidiol as a treatment for arthritis and joint pain: an exploratory cross-sectional study. J Cannabis Res. 2022;4(1):47.

Science/Human: Cannabis use was protective against overweight in HIV-hepatitis C virus co-infected people

People living with HIV co-infected with hepatitis C virus have a higher risk of metabolic disorders than their mono-infected counterparts. Investigators of Aix Marseille University and IBSERM, France, tested whether cannabis use is associated with body mass index (BMI), overweight, and underweight in 992 people infected by both viruses.

Cannabis use was associated with a lower risk of overweight and lower risk of underweight, respectively. Authors concluded that “cannabis use should be assessed and taken into account in the clinical management of the HIV-HCV co-infected population.”

Barré T, Sogni P, Zaegel-Faucher O, Wittkop L, Marcellin F, Carrieri P, Gervais A, Levier A, Rosenthal E, Salmon-Céron D, Protopopescu C; ANRS CO13 HEPAVIH Study Group. Cannabis Use as a Protective Factor Against Overweight in HIV-Hepatitis C Virus Co-Infected People (ANRS CO13 HEPAVIH Cohort). AIDS Educ Prev. 2022;34(4):272-290.

Science/Human: Cannabis was associated with a lower risk of mortality in hospital in patients with gastroparesis

According to a review of about 1.5 million patients with gastroparesis admitted to hospitals in the USA between 2008 in 2014 cannabis use was associated with improved outcomes. 2.3% were diagnosed with cannabis use disorder. This research was conducted by investigators at Brigham and Women's Hospital of Harvard Medical School in Boston, USA.

Controlling for confounders, length of stay, and mortality were significantly decreased for patients with gastroparesis and cannabis use. Authors noted that “while patients with gastroparesis and cannabis use disorder were younger, with a lower socioeconomic status, and disproportionately affected by psychiatric diagnoses, these patients had better hospitalization outcomes.”

McCarty TR, Chouairi F, Hathorn KE, Chan WW, Thompson CC. Trends and Socioeconomic Health Outcomes of Cannabis Use Among Patients With Gastroparesis: A United States Nationwide Inpatient Sample Analysis. J Clin Gastroenterol. 2022;56(4):324-330.

Science/Human: CBD may prevent from chemotherapy-induced neuropathy in an open study

In a study with 54 patients, who underwent chemotherapy, concomitant administration of CBD attenuated early symptoms of peripheral neuropathy. At the Department of Clinical Oncology and Palliative Care of Zealand University Hospital in Roskilde, Denmark all patients with cancer scheduled to undergo treatment with carboplatin and paclitaxel or capecitabine and oxaliplatin received 150 mg CBD oil twice daily (300 mg/daily) for 8 days beginning 1 day before initiation of chemotherapy. Controls were obtained from a similar patient cohort that did not receive CBD.

Authors found that “CBD attenuated early symptoms of CIPN (chemotherapy induced peripheral neuropathy) with no major safety concerns. Long-term follow-up is ongoing.”

Nielsen SW, Hasselsteen SD, Dominiak HSH, Labudovic D, Reiter L, Dalton SO, Herrstedt J. Oral cannabidiol for prevention of acute and transient chemotherapy-induced peripheral neuropathy. Support Care Cancer. 2022 Aug 6. [in press].

Science/Human: Cannabis is effective in nausea and vomiting during pregnancy according to a survey

According to a survey with 550 women, who experienced extreme nausea and vomiting during pregnancy (hyperemesis gravidarum) cannabis was more effective than standard medication. The study was conducted by the Hyperemesis Education and Research Foundation in Clackamas, USA.

84% experienced weight loss during pregnancy; 96% reported using prescription antiemetics and 14% reported cannabis use for hyperemesis gravidarum . Most respondents reported using cannabis and cannabinoids because their prescribed antiemetics were self-reported to be ineffective. Eighty-two percent of cannabis users reported symptom relief, compared to 60% of prescription antiemetic users.

First OK, MacGibbon KW, Cahill CM, Cooper ZD, Gelberg L, Cortessis VK, Mullin PM, Fejzo MS. Patterns of Use and Self-reported Effectiveness of Cannabis for Hyperemesis Gravidarum. Geburtshilfe Frauenheilkd. 2022;82(5):517-527.

Science/Human: THC may be helpful in the treatment of post-traumatic stress disorder according to a controlled study

In a placebo-controlled study with 51 people THC was superior to a placebo in supporting a well-established emotion regulation task for people with post-traumatic stress disorder. Researchers at the Department of Pharmacy Practice of Wayne State University, in Detroit, USA, investigated the effect of THC on negative affect and brain activation in a priori regions of interest during cognitive reappraisal among trauma-exposed individuals with and without post-traumatic stress disorder. They used functional magnetic resonance imaging (fMRI).

THC but not placebo reduced negative affect during reappraisal, and THC increased dorsomedial prefrontal cortex activation in response to neutral images. Individuals with post-traumatic stress disorder displayed less activation in the angular gyrus, overall, compared to the trauma-exposed control (TEC) group, however THC increased angular gyrus activation in the post-traumatic stress disorder group so that there was no significant difference in angular gyrus activation between both groups.

Pacitto R, Peters C, Iadipaolo A, Rabinak CA. Cannabinoid modulation of brain activation during volitional regulation of negative affect in trauma-exposed adults. Neuropharmacology. 2022;218:109222.

Science/Human: THC facilitates fear extinction learning

Thread memory extinction and fear extinction is essential in overcoming symptoms of post-traumatic stress disorder. In a study at the School of Psychological and Behavioral Sciences of Southern Illinois University Carbondale, USA, THC-deprived participants were conditioned to fear visual stimuli in a delay conditioning and extinction paradigm. Following conditioning, individuals, in a randomized smoked either an active THC cannabis cigarette (26 mg THC) or a placebo cannabis cigarette (0.002% THC) on 1 day and the opposite cigarette on the second day.

Relative to placebo, THC facilitated extinction of the conditioned response, as reflected by reductions in late positive potential amplitude during extinction learning. Authors concluded that the “results indicate that acute THC administration may facilitate extinction of the conditioned fear response in humans.”

Diggs HA, Rabinovich NE, Gilbert DG. Facilitated extinction of conditioned fear responses by delta 9-tetrahyrdrocannabidol in humans: a pilot study. Hum Psychopharmacol. 2022:e2853.

Science/Human: Cannabis use is not associated with amotivation

Scientists of the Department of Psychiatry at the University of Cambridge, UK, investigated the association between non-acute cannabis use and apathy and anhedonia. Participants were 274 young adults aged 26 to 29 years and adolescents aged 16 to 17 years, who used cannabis for 1 2 7 days a week in the past 3 months and a-matched controls without cannabis use.

Controls had higher levels of anhedonia than cannabis users. There were no other significant effects of cannabis use. Authors concluded that their “results suggest that cannabis use at a frequency of three to four days per week is not associated with apathy, effort-based decision-making for reward, reward wanting, or reward liking in adults or adolescents. Cannabis users had lower anhedonia than controls, albeit at a small effect size. These findings are not consistent with the hypothesis that non-acute cannabis use is associated with amotivation.”

Skumlien M, Mokrysz C, Freeman TP, Valton V, Wall MB, Bloomfield M, Lees R, Borissova A, Petrilli K, Giugliano M, Clisu D, Langley C, Sahakian BJ, Curran HV, Lawn W. Anhedonia, apathy, pleasure, and effort-based decision-making in adult and adolescent cannabis users and controls. Int J Neuropsychopharmacol. 2022:pyac056.

News in brief

USA: DEA awards seventh cannabis cultivation license for research purposes
The US’s Drug Enforcement Administration (DEA) and the Department of Justice have licensed the company Maridose to produce cannabis for research purposes. The Maine-based company is the seventh to receive such a license “for the bulk manufacture of cannabis to supply marijuana, cannabis extracts and THC to researchers.” For decades, the sole source of cannabis for scientific research in the United States was a single cultivation facility operated at the University of Mississippi.
analyticalcannabis.com of 22 August 2022

Science/Human: Cannabis use may be associated with a reduced risk of bladder and prostate cancer
According to data from the UK “previous use of cannabis was associated with a lower risk of bladder cancer, renal cell carcinoma, and prostate cancer. The inverse association between cannabis and both renal cell carcinoma and bladder cancer was only found in females but not in males.”
Department of Urology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Huang J, et al. Cancer Med. 2022 Aug 17. [in press].

Science/Animal: The CB1 receptor regulates salivation
According to research with mice CB1 receptors in the submandibular gland regulates salivation and THC is reducing salivation.
Department of Psychological and Brain Sciences, Gill Center for Biomolecular Science, Program in Neuroscience, Indiana University, Bloomington, USA.
Andreis K, et al. Sci Rep. 2022;12(1):14182.

Science: cis-delta-9-THCA was found in CBD rich cannabis varieties
According to analysis of several cannabis varieties the highest concentrations of cis-delta-9-THCA were found in CBD-rich varieties, lower levels were observed in cannabigerol (CBG)-rich varieties.
Institute of Nanotechnology - CNR NANOTEC, Campus Ecotekne, Lecce, Italy.
Tolomeo F, et al. J Pharm Biomed Anal. 2022;219:114958.

Science/Animal: CBD-loaded nanomicelles may be useful in oral mucositis treatment
According to studies with mice that administration of CBD-loaded nanomicelles may be a promising agent for oral mucositis treatment in cancer chemotherapy.
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
Liu Y, et al. Drug Deliv. 2022 Dec;29(1):1272-1281.

Science/Human: Tobacco but not cannabis smoking is associated with hearing loss
According to the National Health and Nutrition Examination Survey, 2011 to 2012 and 2015 to 2016 tobacco, but neither cannabis smoking nor co-drug use was associated with hearing loss.
Department of Speech, Language, and Hearing Sciences, University of Colorado Boulder, USA.
Baiduc RR, et al. Ear Hear. 2022;43(5):1582-1592.

Science/Animal: Cannabis oil ameliorates pain in a fibromyalgia model in mice
In a mouse model of fibromyalgia oral administration of a broad spectrum cannabis oil inhibited hyperalgesia.
Laboratory of Autoimmunity and Immunopharmacology, Department of Health Sciences, Campus Araranguá, Universidade Federal de Santa Catarina, Brazil.
Ferrarini EG, et al. Biomed Pharmacother. 2022;154:113552.

Science/Animal: Activation of the CB1 receptor restores intestinal barrier function
“When exposed to a high fat diet, intestinal permeability is increased and activation of the CB1 receptor on the intestinal epithelium restores barrier function.” Researchers used mice in the study.
“This work further highlights the role of the endocannabinoid system in regulating intestinal homeostasis when it is perturbed. “
Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Canada.
Cuddihey H, et al. Am J Physiol Gastrointest Liver Physiol. 2022;323(3):G219-G238.

Science/Human: Long-term recreational cannabis use is associated with lower executive function in older adults
According to data from adults age 60 or older, who were recreational cannabis users, regular long-term use may be associated with lower executive function and processing speed.
Psychology Department, University of Colorado, Colorado Springs, USA.
Stypulkowski K, et al. J Geriatr Psychiatry Neurol. 2022;35(5):740-746.

Science/Cells: CBD may be useful in the treatment of acne
In a study with skin cells “results indicated that CBD could inhibit inflammation.” And this effect was mediated by the activation of the CB2 receptor.
Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China.
Jiang Z, et al. J Inflamm Res. 2022;15:4573-4583.

Science/Human: Blood endocannabinoid concentrations are altered in patients with gastroparesis
The study compared blood plasma concentrations of endocannabinoids in patients with diabetic gastroparesis and healthy controls. Investigators found that endocannabinoids and other fatty acid derivatives with cannabimimetic properties are reduced” in female patients.
in female DM-GP patients.”
Division of Gastroenterology, Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, USA.
Bashashati M, et al. Neurogastroenterol Motil. 2021;33(1):e13961.

Science/Human: Cannabis use during pregnancy does not influence ADHD risk in children
According to a study with 2408 children, of whom 3.6% were exposed to cannabis during pregnancy of their mothers in-utero exposure to cannabis seems not to be associated with the risk of ADHD.
Research Centre, CHU Sainte-Justine, Montreal, Canada.
Tchuente V, et al. BMJ Open. 2022;12(8):e052220.

Science: Heavy metals were found in a large number of commercially available CBD products
Levels of lead, cadmium, arsenic, mercury, four phthalates, and CBD labelling accuracy were quantified in a selection of commercially available CBD products in the US. “Low-level contamination of edible CBD products with heavy metals and phthalates is pervasive.”
University of Miami Miller School of Medicine, Miami, USA.
Gardener H, et al. Sci Total Environ. 2022;851(Pt 1):158110.

Science/Animal: CBG administration reduces blood pressure in mice
In a study with normal mice cannabigerol (CBG) lowered blood pressure likely by involving alpha 2-adrenoreceptors.
Department of Neural and Behavioral Sciences, Penn State College of Medicine, Hershey, USA.
Vernail VL, et al. Front Physiol. 2022;13:871962.

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