Malignant melanoma is a complex malignancy with significant morbidity and mortality. The incidence continues to rise, and despite advances in treatment, the prognosis is poor. Thus, it is necessary ...to develop novel strategies to treat this aggressive cancer. Synthetic cannabinoids have been implicated in inhibiting cancer cell proliferation, reducing tumor growth, and reducing metastasis. We developed a unique study focusing on the effects of treatment with a cannabinoid derivative on malignant melanoma tumors in a murine model.
Murine B16F10 melanoma tumors were established subcutaneously in C57BL/6 mice. Mice were then treated with intraperitoneal injections of vehicle twice per week (control—group 1, n = 6), Cisplatin 5 mg/kg/wk (group 2; n = 6), and Cannabidiol (CBD) 5 mg/kg twice per week (group 3; n = 6). Tumors were measured and volume calculated as (4π/3) × (width/2)2 × (length/2). Tumor size and survival curves were measured. Results were compared using a one-way ANOVA with multiple comparison test.
A significant decrease in tumor size was detected in mice treated with CBD when compared with the control group (P = 0.01). The survival curve of melanoma tumors treated with CBD increased when compared with the control group and was statistically significant (P = 0.04). The growth curve and survival curve of melanoma tumors treated with Cisplatin were significantly decreased and increased, respectively, when compared with the control and CBD-treated groups. Mice treated with Cisplatin demonstrated the longest survival time, but the quality of life and movement of CBD-treated mice were observed to be better.
We demonstrate a potential beneficial therapeutic effect of cannabinoids, which could influence the course of melanoma in a murine model. Increased survival and less tumorgenicity are novel findings that should guide research to better understand the mechanisms by which cannabinoids could be utilized as adjunctive treatment of cancer, specifically melanoma. Further studies are necessary to evaluate this potentially new and novel treatment of malignant melanoma.
Some researchers are prepared to accept weak evidence that increased access to medical cannabis in the US has reduced opioid overdose deaths in that country. The evidence for this hypothesis is very ...weak: ecological studies showing a correlation over time between the passage of medical cannabis laws and decreasing opioid overdose death rates in US states. There would no doubt have been a much more critical response to these studies if they had found that opioid overdose deaths increased at a faster rate in states with medical cannabis laws.
: Opioid therapy is critical for pain relief for most hospice patients but may be limited by adverse side effects. Combining medical cannabis with opioids may help mitigate adverse effects while ...maintaining effective pain relief.
: This single-arm study investigated the impact of combined medical cannabis/opioid therapy on pain relief, opioid dose, appetite, respiratory function, well-being, nausea, and adverse events in hospice inpatients.
: Adult hospice inpatients using scheduled oral, parenteral, or transdermal opioids for pain were administered standardized oral medical cannabis, 40 mg CBD/1.5 mg THC or 80 mg CBD/3 mg THC. Descriptive statistics detailed demographic and clinical baseline characteristics, the Mann-Whitney test compared outcomes, and the longitudinal mixed effects regression model analyzed longitudinal effects of combined therapy.
: Sixty-six inpatients at The Connecticut Hospital, Inc. were assessed over 996 treatment days; average age was 68.2 ± 12.9 years, 90.9% were white. Cancer was the most common diagnosis.
: The medical cannabis/opioid combination showed a significant longitudinal reduction in pain intensity (
= .0029) and a non-significant trend toward lower opioid doses. Well-being, appetite, nausea, and respiratory function showed non-statistically significant changes. Three patients (4.5%) experienced minor, reversible adverse events potentially related to medical cannabis. No serious or life-threatening adverse events were seen.
: Combination medical cannabis/opioid therapy showed statistically significant pain relief and may have the potential for reducing opioid dose and mitigating opioid toxicity, offering a safe pain management alternative to opioids alone for patients in end-of-life care settings, and warrants further investigation in larger controlled trials.
With the current COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), there is an urgent need for new therapies and prevention strategies that can help ...curtail disease spread and reduce mortality. The inhibition of viral entry and thus spread is a plausible therapeutic avenue.
SARS-CoV-2 uses receptor-mediated entry into a human host via the angiotensin-converting enzyme 2 (ACE2), which is expressed in lung tissue as well as the oral and nasal mucosa, kidney, testes and gastrointestinal tract. The modulation of ACE2 levels in these gateway tissues may be an effective strategy for decreasing disease susceptibility.
Cannabis sativa
, especially those high in the anti-inflammatory cannabinoid cannabidiol (CBD), has been found to alter gene expression and inflammation and harbour anti-cancer and anti-inflammatory properties. However, its effects on ACE2 expression remain unknown.
Working under a Health Canada research license, we developed over 800 new
C. sativa
cultivars and hypothesized that high-CBD
C. sativa
extracts may be used to down-regulate ACE2 expression in target COVID-19 tissues. Using artificial 3D human models of oral, airway and intestinal tissues, we identified 13 high-CBD
C. sativa
extracts that decrease ACE2 protein levels. Some
C. sativa
extracts down-regulate serine protease TMPRSS2, another critical protein required for SARS-CoV-2 entry into host cells.
While our most effective extracts require further large-scale validation, our study is important for future analyses of the effects of medical cannabis on COVID-19. The extracts of our most successful novel high-CBD
C. sativa
lines, pending further investigation, may become a useful and safe addition to the prevention/treatment of COVID-19 as an adjunct therapy.
Cannabis has been cultivated for millennia for medicinal, industrial and recreational uses. Our long-term goal is to compare the transcriptomes of cultivars with different cannabinoid profiles for ...therapeutic purposes. Here we describe the de novo assembly, annotation and initial analysis of two cultivars of Cannabis, a high THC variety and a CBD plus THC variety. Cultivars were grown under different lighting conditions; flower buds were sampled over 71 days. Cannabinoid profiles were determined by ESI-LC/MS. RNA samples were sequenced using the HiSeq4000 platform. Transcriptomes were assembled using the DRAP pipeline and annotated using the BLAST2GO pipeline and other tools. Each transcriptome contained over twenty thousand protein encoding transcripts with ORFs and flanking sequence. Identification of transcripts for cannabinoid pathway and related enzymes showed full-length ORFs that align with the draft genomes of the Purple Kush and Finola cultivars. Two transcripts were found for olivetolic acid cyclase (OAC) that mapped to distinct locations on the Purple Kush genome suggesting multiple genes for OAC are expressed in some cultivars. The ability to make high quality annotated reference transcriptomes in Cannabis or other plants can promote rapid comparative analysis between cultivars and growth conditions in Cannabis and other organisms without annotated genome assemblies.
IMPORTANCE: Opioid analgesic overdose mortality continues to rise in the United States, driven by increases in prescribing for chronic pain. Because chronic pain is a major indication for medical ...cannabis, laws that establish access to medical cannabis may change overdose mortality related to opioid analgesics in states that have enacted them. OBJECTIVE: To determine the association between the presence of state medical cannabis laws and opioid analgesic overdose mortality. DESIGN, SETTING, AND PARTICIPANTS: A time-series analysis was conducted of medical cannabis laws and state-level death certificate data in the United States from 1999 to 2010; all 50 states were included. EXPOSURES: Presence of a law establishing a medical cannabis program in the state. MAIN OUTCOMES AND MEASURES: Age-adjusted opioid analgesic overdose death rate per 100 000 population in each state. Regression models were developed including state and year fixed effects, the presence of 3 different policies regarding opioid analgesics, and the state-specific unemployment rate. RESULTS: Three states (California, Oregon, and Washington) had medical cannabis laws effective prior to 1999. Ten states (Alaska, Colorado, Hawaii, Maine, Michigan, Montana, Nevada, New Mexico, Rhode Island, and Vermont) enacted medical cannabis laws between 1999 and 2010. States with medical cannabis laws had a 24.8% lower mean annual opioid overdose mortality rate (95% CI, −37.5% to −9.5%; P = .003) compared with states without medical cannabis laws. Examination of the association between medical cannabis laws and opioid analgesic overdose mortality in each year after implementation of the law showed that such laws were associated with a lower rate of overdose mortality that generally strengthened over time: year 1 (−19.9%; 95% CI, −30.6% to −7.7%; P = .002), year 2 (−25.2%; 95% CI, −40.6% to −5.9%; P = .01), year 3 (−23.6%; 95% CI, −41.1% to −1.0%; P = .04), year 4 (−20.2%; 95% CI, −33.6% to −4.0%; P = .02), year 5 (−33.7%; 95% CI, −50.9% to −10.4%; P = .008), and year 6 (−33.3%; 95% CI, −44.7% to −19.6%; P < .001). In secondary analyses, the findings remained similar. CONCLUSIONS AND RELEVANCE: Medical cannabis laws are associated with significantly lower state-level opioid overdose mortality rates. Further investigation is required to determine how medical cannabis laws may interact with policies aimed at preventing opioid analgesic overdose.
Legislative changes in the last years have made possible the prescription of medical cannabis in several countries, often following a growing public demand. However, the medical indications for use ...and the access to prescribed cannabis are still limited. Prescribers face several challenges in the form of barriers and dilemmas, often related to stigma, and deficient information and training. As a result, many people keep on using illicit cannabis for medical problems. In this session we will outline the most common controversies of cannabis prescription, particularly in psychiatry. We will discuss the ethical considerations regarding prescription practices, the benefit-risk assessment, the limitations of the current knowledge, and some potential solutions to respond to the strong demand from patients and families.
Disclosure
No significant relationships.
This review considers the potential influences of the use of cannabis for therapeutic purposes (CTP) on areas of interest to mental health professionals, with foci on adult psychopathology and ...assessment. We identified 31 articles relating to the use of CTP and mental health, and 29 review articles on cannabis use and mental health that did not focus on use for therapeutic purposes. Results reflect the prominence of mental health conditions among the reasons for CTP use, and the relative dearth of high-quality evidence related to CTP in this context, thereby highlighting the need for further research into the harms and benefits of medical cannabis relative to other therapeutic options. Preliminary evidence suggests that CTP may have potential for the treatment of PTSD, and as a substitute for problematic use of other substances. Extrapolation from reviews of non-therapeutic cannabis use suggests that the use of CTP may be problematic among individuals with psychotic disorders. The clinical implications of CTP use among individuals with mood disorders are unclear. With regard to assessment, evidence suggests that CTP use does not increase risk of harm to self or others. Acute cannabis intoxication and recent CTP use may result in reversible deficits with the potential to influence cognitive assessment, particularly on tests of short-term memory.
•Mental health conditions are prominent among the reasons for medical cannabis use.•Cannabis has potential for the treatment of PTSD and substance use disorders.•Cannabis use may influence cognitive assessment, particularly with regard to memory.•Cannabis use does not appear to increase risk of harm to self or others.•More research is needed to characterize the mental health impact of medical cannabis.
The year 2019 was a breakthrough in the availability of cannabis herb for Polish patients. Three months after being registered, the first dried hemp preparation hit the market. This fact has created ...new therapeutic options for patients. It also set new challenges for pharmacists. The imminent interest in the therapeutic use of Cannabis sativa is evidenced by the huge number of papers on the pharmacological properties of cannabis compounds and very numerous clinical trials. The aim of this work was to present practical aspects of the presence of medical cannabis in Polish pharmacies. The year 2019 was a breakthrough in the availability of cannabis herb for Polish patients. Three months after being registered, the first dried hemp preparation hit the market. This fact has created new therapeutic options for patients. It also set new challenges for pharmacists. The imminent interest in the therapeutic use of Cannabis sativa is evidenced by the huge number of papers on the pharmacological properties of cannabis compounds and very numerous clinical trials. The aim of this work was to present practical aspects of the presence of medical cannabis in Polish pharmacies. The year 2019 was a breakthrough in the availability of cannabis herb for Polish patients. Three months after being registered, the first dried hemp preparation hit the market. This fact has created new therapeutic options for patients. It also set new challenges for pharmacists. The imminent interest in the therapeutic use of Cannabis sativa is evidenced by the huge number of papers on the pharmacological properties of cannabis compounds and very numerous clinical trials. The aim of this work was to present practical aspects of the presence of medical cannabis in Polish pharmacies. The year 2019 was a breakthrough in the availability of cannabis herb for Polish patients. Three months after being registered, the first dried hemp preparation hit the market. This fact has created new therapeutic options for patients. It also set new challenges for pharmacists. The imminent interest in the therapeutic use of Cannabis sativa is evidenced by the huge number of papers on the pharmacological properties of cannabis compounds and very numerous clinical trials. The aim of this work was to present practical aspects of the presence of medical cannabis in Polish pharmacies.
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