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IACM-Bulletin of 10 May 2020

Science/Human: A high number of patients suffering from inflammatory bowel disease benefit from self-medication with cannabis

New research conducted by the Lambert Initiative for Cannabinoid Therapeutics at the University of Sydney reveals a quarter of Australians with inflammatory bowel disease have used cannabis, predominantly from illicit sources, to manage their condition. Of 838 respondents 25.3% were using or had previously used cannabis to manage their symptoms. Only 3 (1.4%) of cannabis users got their medication from legal pathways provided by the government.

More than 90% of patients reported that cannabis use improved their symptom management—with greatest benefits reported for abdominal pain, stress, sleep, cramping and anxiety symptoms. There were, however, fewer benefits to symptoms associated with disease pathology, such as rectal bleeding, obstructive symptoms and stool frequency/consistency/urgency. Patients with ulcerative colitis who use cannabis scored higher on measures of "quality of life" than non-users.

MedicalXpress of 22 April 2020

News in brief

Science/Animal: CBD reduced arthritic pain in dogs in a placebo-controlled study
In a placebo-controlled 4-week study with dogs suffering from arthritis CBD significantly decreased pain and improved mobility. CBD was either nested as pure CBD (50 mg per day) and encapsulated in liposomes (20 mg per day) in an additional study with mice CBD reduced the production of pro-inflammatory cytokines (interleukin-6, tumour necrosis factor alpha). Authors wrote that this “study supports the safety and therapeutic potential of hemp-derived CBD for relieving arthritic pain and suggests follow-up investigations in humans is warranted.”
Center for Cell and Gene Therapy, Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, USA.
Verrico CD, et al. Pain. 2020 Apr 24 [in press]

Australia: Gov ernment proposes CBD be made available for retail sale
On 24 April 2020 the Therapeutic Goods Administration released the Department of Health-initiated proposal to make low-dose CBD available for sale in pharmacies as a Schedule 3 drug. The proposed changes would allow the sale of pure CBD (with 2% or less other cannabinoids) to adults in packets containing up to 1,800 mg of CBD. This is a 30 days’ supply of the recommended maximum daily dose of 60 mg. Pharmacists would still need to consult with consumers to ensure they are aware of potential drug-drug interactions as CBD can affect the way certain other medications are metabolised. Only registered preparations will be available for sale.
FreshLeaf Analytics of 24 April 2020
Review on the safety of low dose cannabidiol by the Australian government

New Zealand: Government published wording for the referendum on cannabis legalisation
The New Zealand cannabis referendum will be a non-binding referendum, on the question of whether to legalise the sale, use, possession and production of cannabis. The cannabis referendum will be held at the same time as the 2020 general election and an euthanasia referendum on 19 September. Now the concrete wording had been published.
New Zealand's referendum on cannabis in Wikipedia

USA: Florida researchers want to study whether hemp plants may battle toxic algae blooms
Florida researchers have started to study how hemp plants could battle toxic algae blooms by cleaning polluted waterways. If research results appear promising, they intend to grow large mats of hemp in key Florida waterways, potentially providing a source of industrial hemp fibre while also benefiting water quality.
UPI of 6 May 2020

USA: Majority of citizens say that the legalisation of cannabis for recreational use was a success
In a survey conducted by YouGov 27328 US adults were asked whether “In the states that have decided to allow recreational marijuana use, do you think legalisation has been a success or failure?” 19% answered that it was a success only and 36% that it was “more of a success than a failure”. Altogether 17% answered that it was a failure only (6%) or more a failure than a success (13%). 26% said that they “don’t know.” YouGov is an international research data and analytics group headquartered in London.
YouGov of 20 April 2020

Science/Animal: CBD modulates DNA methylation in certain brain regions, which may be relevant for antidepressant effects
Researchers found, that one of the reasons, why CBD has antidepressant effects may be based on its ability to influence DNA methylation in certain brain regions (prefrontal cortex and hippocampus). This has been demonstrated in mice, which received 10 mg of CBD per kilogram bodyweight.
Department of Pharmacology, School of Medicine of Ribeirão Preto, University of São Paulo, Brazil.
Sales AJ, et al. Behav Brain Res. 2020:112627

Science/Animal: The pharmacokinetics of THC depend on age
Studies with mice, which received THC in a dose of 5 mg/kg, show that in the liver of adolescent mice THC is converted to its metabolite THC-COOH twice as fast as the liver of adult mice. In adolescent mice THC resulted in 50% higher blood concentrations compared to elder mice. Conversely, 40% lower brain concentrations for THC were measured in adolescent relative to adult animals. Researchers observed further differences.
University of California, Irvine, USA.
Torrens A, et al. J Pharmacol Exp Ther. 2020 Apr 28 [in press]

Science/Israel: Investigation on the use of CBD on inflammation associated with COVID-19
A new study at Ichilov Medical Center (Israel) is investigating whether cannabidiol can slow down the inflammatory storm that accompanies the deterioration of patients with severe symptoms following infection with the new corona virus and alleviate the symptoms. The study is conducted in collaboration with several departments in the hospital.
Channel 7 of 19 April 2020

Science: Cannabis seeds show antimicrobial activity against Staphylococcus aureus without affecting probiotic bacteria
Researchers found a selective antimicrobial activity of cannabis seed extract against pathogenic strains and no inhibitory effects on the growth of probiotic strains belonging to the Bifidobacterium and Lactobacillus genera. Authors wrote that “this selective inhibition is of outmost importance for the maintenance of healthy gut microbiota. The study showed that the C. sativa extract was capable of inhibiting the biofilm producer Staphylococcus aureus ATCC 35556 strain.” They concluded that “hemp seeds extracts represent a new exploitable and valuable antimicrobial and antibiofilm agent for the food and nutraceutical industry as a possible alternative to antibiotics/antibacterial compounds.”
National Research Council (NRC), Institute of Agricultural Biology and Biotechnology (IBBA), Pisa, Italy.
Frassinettia S, et al. Science Direct, April 2020

Science: Two methods for the production of cannabis extracts are presented, which ensure the preservation of terpenes
An innovative method that is based on the extraction of the oil by dynamic maceration at room temperature from cannabis flowers which were partially decarboxylated in a closed system at a moderate temperature and partially pre-extracted with ethanol, produced similar yields of cannabinoids and terpenes as that obtained by using a microwave-assisted distillation of the essential oil from the plant material, in combination with a maceration extraction of the oil from the residue. Authors wrote that “these new methods provided a higher efficiency over already existing extraction procedures of medical Cannabis oils.”
Farmacia Dr. Ternelli, Bibbiano, Italy.
Ternelli M, et al. J Pharm Biomed Anal. 2020;186:113296

Science/Animal: Modulation of the endocannabinoid system may prevent stroke by several mechanisms
Researchers reviewed the effects of the endocannabinoid system on hypertension, atherosclerosis, obstructive sleep apnoea, heart failure and other pathologic conditions that may be relevant for stroke prevention. They asked for further research to better understand its therapeutic potential in this context.
Department of Neurology, Mayo Clinic, Rochester, USA.
Scharf EL, et al. Cannabis Cannabinoid Res. 2020;5(1):6-11

Science/Animal: The CB2 receptor mediates the anxiolytic effects of 2-AG in rats
The increase of the level of the endocannabinoid 2-AG (2-arachidonoylglycerol) by inhibition of its degradation reduced anxiety -like effects in rats. And this effect was mediated by the CB2 receptor.
Department of Anatomy and Neurobiology, University of California, Irvine, USA.
Ivy D, et al. Neuropsychopharmacology. 2020 May 6 [in press]

Science/Cells: CBD’s anti-inflammatory effects are partially mediated by the P2X7 receptor in certain white blood cells
Researchers showed that the anti-inflammatory effects of CBD in monocytes, certain white blood cells, were associated with binding to the P2X7 receptor. Authors wrote that this effect “may contribute to the overall anti-inflammatory effects reported for this phytocannabinoid.”
University of Rhode Island, Kingston, USA.
Liu C, et al. J Nat Prod. 2020 May 6 [in press]

Science/Animal: Altered dopamine receptor gene expression in schizophrenia may be reversed by CBD
In a rat model of schizophrenia both dopamine D2 and D3 receptors gene expression were altered. CBD given before puberty normalised levels of D3 gene expression. Authors concluded that “this gene might not only contribute to the schizophrenia symptoms but also represent an unexplored target for the antipsychotic activity of cannabidiol.”
Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
Stark T, et al. Biochem Pharmacol. 2020:114004

Science/Animal: Exercise reduces inflammatory pain by activation of the endocannabinoid system
In a study with mice activation of the endocannabinoid system by high-intensity swimming reduced inflammatory pain. Inhibition of endocannabinoid degradation prolonged this effect.
University of Southern of Santa Catarina, at Palhoça, Santa Catarina, Brazil.
Ludtke DD, et al. Scand J Med Sci Sports. 2020 May 1 [in press]

Science/Human: Cannabis use has tripled for rheumatology patients after legalisation for recreational use in Canada
According to a survey with 1047 rheumatology patients 12.6% had used cannabis. Compared to nonusers users were younger, not working, and having recreational cannabis experience. Authors wrote that “concerning issues are the poor knowledge of the product being used, access via the nonmedical route, and nondisclosure to the physician.”
McGill University Health Centre, Montreal, Quebec, Canada.
Fitzcharles MA, et al. ACR Open Rheumatol. 2020 Apr 30 [in press]

Science/Human: CBD use in combination with stripentol in epilepsy may influence the concentration of the standard drug
In a placebo-controlled study with 35 epilepsy patients receiving stripentol (14 patients) or valproate (21 patients) researchers found that stripentol exposure may increase if given in combination with CBD, while CBD co-administration did not affect valproate. It is unclear whether the influence on stripentol is of clinical relevance.
Department of Clinical Neuroscience at Institute of Neuroscience and Physiology, University of Gothenburg, Sweden.
Ben-Menachem E, et al. CNS Drugs. 2020 Apr 30 [in press]

Science/Animal: Stress during early life may result in long-term dysregulation of the endocannabinoid system in the cerebellum
Early life stress in animals decreased the concentration of the endocannabinoid 2-AG in males and females in different parts of the cerebellum. Authors wrote that “the cerebellar endocannabinoid system exhibits robust sex-specific differences, malleable through early-life stress, suggesting the role of endocannabinoids and stress to sexual differentiation of the brain and cerebellar-related dysfunctions.”
Psychological and Brain Sciences, Indiana University, Bloomington, USA.
Moussa-Tooks AB, et al. Sci Rep. 2020;10(1):7236

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