Anxiety Modulation by Cannabinoids-The Role of Stress Responses and Coping

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“Endocannabinoids were implicated in a variety of pathological conditions including anxiety and are considered promising new targets for anxiolytic drug development. The optimism concerning the potentials of this system for anxiolysis is probably justified. However, the complexity of the mechanisms affected by endocannabinoids, and discrepant findings obtained with various experimental approaches makes the interpretation of research results difficult. Here, we review the anxiety-related effects of the three main interventions used to study the endocannabinoid system: pharmacological agents active at endocannabinoid-binding sites present on both the cell membrane and in the cytoplasm, genetic manipulations targeting cannabinoid receptors, and function-enhancers represented by inhibitors of endocannabinoid degradation and transport. Binding-site ligands provide inconsistent findings probably because they activate a multitude of mechanisms concomitantly. More robust findings were obtained with genetic manipulations and particularly with function enhancers, which heighten ongoing endocannabinoid activation rather than affecting all mechanisms indiscriminately. The enhancement of ongoing activity appears to ameliorate stress-induced anxiety without consistent effects on anxiety in general. Limited evidence suggests that this effect is achieved by promoting active coping styles in critical situations. These findings suggest that the functional enhancement of endocannabinoid signaling is a promising drug development target for stress-related anxiety disorders.”

https://pubmed.ncbi.nlm.nih.gov/37958761/

“Three hypotheses have been put forward so far on the role of endocannabinoids in emotional and behavioral control.

  • The endocannabinoid system controls behavior by its interactions with the stress system (HPA-axis) and ensures normal functioning by eliminating excessive stress responses at all three levels: the hormonal, neural, and behavioral.
  • The endocannabinoid system contributes to the integration of perception and execution, by allowing this adaptation to the environment. It buffers maladaptive responses and protects against psychiatric symptoms.
  • The endocannabinoid system promotes an active coping with challenges, which confers the organism advantages in critical situations. This may be the common denominator of its anxiolytic- and antidepression-like effects.

These three hypotheses appear complementary rather than contradictory. All three suggest that the endocannabinoid system is a valid target for the treatment of psychiatric conditions associated with dysregulated affect. The task is to find the agent that achieves the goal with minimal risks.”

https://www.mdpi.com/1422-0067/24/21/15777


An In Silico Study for Expanding the Utility of Cannabidiol in Alzheimer’s Disease Therapeutic Development

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“Cannabidiol (CBD), a major non-psychoactive component of the cannabis plant, has shown therapeutic potential in Alzheimer’s disease (AD). In this study, we identified potential CBD targets associated with AD using a drug-target binding affinity prediction model and generated CBD analogs using a genetic algorithm combined with a molecular docking system. As a result, we identified six targets associated with AD: Endothelial NOS (ENOS), Myeloperoxidase (MPO), Apolipoprotein E (APOE), Amyloid-beta precursor protein (APP), Disintegrin and metalloproteinase domain-containing protein 10 (ADAM10), and Presenilin-1 (PSEN1). Furthermore, we generated CBD analogs for each target that optimize for all desired drug-likeness properties and physicochemical property filters, resulting in improved pIC50 values and docking scores compared to CBD. Molecular dynamics (MD) simulations were applied to analyze each target’s CBD and highest-scoring CBD analogs. The MD simulations revealed that the complexes of ENOS, MPO, and ADAM10 with CBD exhibited high conformational stability, and the APP and PSEN1 complexes with CBD analogs demonstrated even higher conformational stability and lower interaction energy compared to APP and PSEN1 complexes with CBD. These findings demonstrated the capable binding of the six identified targets with CBD and the enhanced binding stability achieved with the developed CBD analogs for each target.”

https://pubmed.ncbi.nlm.nih.gov/37959001/

https://www.mdpi.com/1422-0067/24/21/16013

Effectiveness of Cannabidiol to Manage Chronic Pain: A Systematic Review

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“Objectives: Cannabidiol (CBD), a component in Cannabis, is used to treat seizures, anxiety, and pain. Little is known about how effectively CBD works in managing chronic pain, a condition characterized by discomfort that persists beyond 3-6 months or beyond expected normal healing. Therefore, this systematic review aimed to synthesize evidence on the effectiveness of CBD in chronic pain management.

Design: A systematic review of literature utilizing PRISMA 2020 guidelines.

Data sources: PubMed/MEDLINE, Web of Science, CINAHL, Academic Search Complete, PsycArticles, PsycINFO, SocINDEX, and CENTRAL. The gray literature search was performed through the World Health Organization, the Centers for Disease Control and Prevention, and the European Centre for Disease Prevention and Control.

Review/analysis methods: We searched eight databases and gray literature for relevant studies until August 30, 2022. We gathered original research articles with various study designs published in English that looked at patients who used CBD to manage their chronic pain. Two authors assessed the risk of bias and certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach. We used narrative synthesis to analyze the results.

Results: We included 15 studies among 1,516 identified articles. The majority of the studies indicated pain reduction ranging from 42% – 66% with CBD alone and CBD with Tetrahydrocannabinol. Three studies showed no significant improvement in reducing pain, and one had mixed findings in pain control. The included studies had various methods of measuring pain reduction, mostly through self-reporting and scales such as visual analog scales and verbal numerical scales, among others.

Conclusion: CBD may be useful in treating chronic pain. Findings should be interpreted with caution due to the small number of included studies and heterogeneity brought about by different study designs and outcome measures. More studies with robust study designs are warranted to evaluate CBD’s effectiveness in treating chronic pain.”

https://pubmed.ncbi.nlm.nih.gov/37953193/

https://www.painmanagementnursing.org/article/S1524-9042(23)00193-5/fulltext

Cannabis Use Linked to Enhanced Empathy

“Summary: A new study suggests regular cannabis users may have a heightened ability to understand others’ emotions. Psychological assessments coupled with brain imaging revealed that users show stronger connectivity in brain regions associated with empathy. The research, involving 136 participants, could have implications for treating social interaction deficits.

Key Facts:

  1. Regular cannabis users may have a greater empathetic understanding of others compared to non-users.
  2. Brain imaging indicates enhanced connectivity in the anterior cingulate cortex, a region related to empathy, among cannabis users.
  3. The study’s findings may inform potential treatments for social interaction deficits in various psychological conditions.”

https://neurosciencenews.com/empathy-cannabis-use-25173/

Synergistic inhibition of glioblastoma multiforme through an in-silico analysis of luteolin and ferulic acid derived from Angelica sinensis and Cannabis sativa: Advancements in computational therapeutics

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“The primary objective of this study is to uncover novel therapeutic agents for the treatment of Glioblastoma Multiforme (GBM), a highly aggressive form of brain cancer, and Alzheimer’s Disease (AD). Given the complexity and resistance associated with both conditions, the study underscores the imperative need for therapeutic alternatives that can traverse the biological intricacies inherent in both neuro-oncological and neurodegenerative disorders. To achieve this, a meticulous, target-based virtual screening was employed on an ensemble of 50 flavonoids and polyphenol derivatives primarily derived from plant sources. The screening focused predominantly on molecular targets pertinent to GBM but also evaluated the potential overlap with neural pathways involved in AD. The study utilized molecular docking and Molecular Dynamic (MD) simulation techniques to analyze the interaction of these compounds with a key biological target, protein tyrosine phosphatase receptor-type Z (PTPRZ). Out of the 50 compounds examined, 10 met our stringent criteria for binding affinity and specificity. Subsequently, the highest value of binding energy was observed for the synergistic binding of luteolin and ferulic acid with the value of -10.5 kcal/mol. Both compounds exhibited inherent neuroprotective properties and demonstrated significant potential as pathway inhibitors in GBM as well as molecular modulators in AD. Drawing upon advanced in-silico cytotoxicity predictions and sophisticated molecular modeling techniques, this study casts a spotlight on the therapeutic capabilities of polyphenols against GBM. Furthermore, our findings suggest that leveraging these compounds could catalyze a much-needed paradigm shift towards more integrative therapeutic approaches that span the breadth of both neuro-oncology and neurodegenerative diseases. The identification of cross-therapeutic potential in flavonoids and polyphenols could drastically broaden the scope of treatment modalities against both fatal diseases.”

https://pubmed.ncbi.nlm.nih.gov/37943817/

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0293666

The holistic effects of medical cannabis compared to opioids on pain experience in Finnish patients with chronic pain

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“Background: Medical cannabis (MC) is increasingly used for chronic pain, but it is unclear how it aids in pain management. Previous literature suggests that MC could holistically alter the pain experience instead of only targeting pain intensity. However, this hypothesis has not been previously systematically tested.

Method: A retrospective internet survey was used in a sample of Finnish chronic pain patients (40 MC users and 161 opioid users). The patients evaluated statements describing positive and negative phenomenological effects of the medicine. The two groups were propensity score matched to control for possible confounding factors.

Results: Exploratory factor analysis revealed three experience factors: Negative Side Effects, Positive Holistic Effects, and Positive Emotional Effects. The MC group (matched n = 39) received higher scores than the opioid group (matched n = 39) in Positive Emotional Effects with large effect size (Rank-Biserial Correlation RBC = .71, p < .001), and in Holistic Positive Effects with medium effect size (RBC = .47, p < .001), with no difference in Negative Side Effects (p = .13). MC and opioids were perceived as equally efficacious in reducing pain intensity. Ratings of individual statements were exploratively examined in a post hoc analysis.

Conclusion: MC and opioids were perceived to be equally efficacious in reducing pain intensity, but MC additionally positively affected broader pain-related factors such as emotion, functionality, and overall sense of wellbeing. This supports the hypothesis that MC alleviates pain through holistically altering the pain experience.”

https://pubmed.ncbi.nlm.nih.gov/37941019/

“The results of the present study support the hypothesis that the effects of MC on pain experience are more holistic than those of opioids. MC may alleviate pain through affecting a broad range of pain-related experience experiental factors such as relaxation, improved sleep and mood, being able not to react to the pain, as well as a sense of control. These holistic effects of MC could explain the inconsistencies in clinical trials, where focus has mainly been on pain intensity instead of broader pain phenomenology. The results highlight the importance of taking these holistic effects into account in treating patients with MC, considering them as part of the therapeutic process.”

https://jcannabisresearch.biomedcentral.com/articles/10.1186/s42238-023-00207-7

The pharmacology and therapeutic role of cannabidiol in diabetes

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“In recent years, cannabidiol (CBD), a non-psychotropic cannabinoid, has garnered substantial interest in drug development due to its broad pharmacological activity and multi-target effects. Diabetes is a chronic metabolic disease that can damage multiple organs in the body, leading to the development of complications such as abnormal kidney function, vision loss, neuropathy, and cardiovascular disease. CBD has demonstrated significant therapeutic potential in treating diabetes mellitus and its complications owing to its various pharmacological effects. This work summarizes the role of CBD in diabetes and its impact on complications such as cardiovascular dysfunction, nephropathy, retinopathy, and neuropathy. Strategies for discovering molecular targets for CBD in the treatment of diabetes and its complications are also proposed. Moreover, ways to optimize the structure of CBD based on known targets to generate new CBD analogues are explored.”

https://pubmed.ncbi.nlm.nih.gov/37933286/

“CBD is a non-psychoactive cannabinoid, which has demonstrated great translational potential. According to the current experimental results, CBD is of great value in the treatment of diabetes and its complications. CBD can improve pancreatic islet function, reduce pancreatic inflammation and improve insulin resistance. For diabetic complications, CBD not only has a preventive effect but also has a therapeutic value for existing diabetic complications and improves the function of target organs.”

https://onlinelibrary.wiley.com/doi/10.1002/EXP.20230047

The potential of cannabinoids in the treatment of lung cancer

Publikacje pracowników AWF - kwiecień 2023 - Akademia Wychowania Fizycznego  we Wrocławiu

“Introduction: Lung cancer is the number-one cause of death due to neoplasms worldwide. The 5-year overall survival rate is only 22%. In advanced stages, the therapeutic options are limited to chemotherapy, radiotherapy, molecularly targeted therapy and immunotherapy. Phytocannabinoids, the components of Cannabis sativa, their synthetic derivatives and endogenous cannabinoids have demonstrated anticancer activity in various common cancers – breast, prostate, colorectal and lung cancers, among others. The aim of this review was to assess the potential value of cannabinoids in the treatment of lung cancer.

State of knowledge: The majority of preclinical studies demonstrates that cannabinoids inhibit lung cancer cell viability both in vitro and in vivo. The main mechanism of anticancer  activity is the induction of apoptosis, triggered by activation of CB1, CB2 and TRPV1 receptors or independently via other pathways. Cannabinoids influence the components of the tumour microenvironment – cancer associated fibroblasts, macrophages and lymphokine-activated-killer cells. Cannabinoids alter leukocyte infiltration into anti-cancer proportions, inhibit expression of EGFR and PAI-1 and increase the expression of TIMP-1. As a result they induce cytotoxicity, decrease proliferation, migration and invasive potential of lung cancer cells, suppress angiogenesis and metastasis forming. Patients with advanced lung cancer may also benefit from analgesic, antiemetic and appetite improving properties of cannabinoids.

Summary: Cannabinoids can be a supplementary agent in systemic anticancer therapeutic regimen in the future. The exact mechanisms of action, specific doses in anticancer treatment, routes of administration and interactions with other anticancer drugs has yet to be determined. Thus the clinical studies on cannabinoids in lung cancer should be performed in the future.”

https://apcz.umk.pl/JEHS/article/view/39529

Dysregulation of the endogenous cannabinoid system following opioid exposure

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“Rates of opioid-related deaths and overdoses in the United States are at record-high levels. Thus, novel neurobiological targets for the treatment of OUD are greatly needed. Given the close interaction between the endogenous opioid system and the endocannabinoid system (ECS), targeting the ECS may have therapeutic potential in OUD.

The various components of the ECS, including cannabinoid receptors, their lipid-derived endogenous ligands (endocannabinoids [eCBs]), and the related enzymes, present potential targets for developing new medications in OUD treatment.

The purpose of this paper is to review the clinical and preclinical literature on the dysregulation of the ECS after exposure to opioids. We review the evidence of ECS dysregulation across various study types, exposure protocols, and measurement protocols and summarize the evidence for dysregulation of ECS components at specific brain regions.

Preclinical research has shown that opioids disrupt various ECS components that are region-specific. However, the results in the literature are highly heterogenous and sometimes contradictory, possibly due to variety of different methods used. Further research is needed before a confident conclusion could be made on how exposure to opioids can affect ECS components in various brain regions.”

https://pubmed.ncbi.nlm.nih.gov/37931479/

https://www.sciencedirect.com/science/article/abs/pii/S016517812300536X?via%3Dihub

Involvement of cannabinoid receptors and adenosine A2B receptor in enhanced migration of lung cancer A549 cells induced by γ-ray irradiation

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“Residual cancer cells after radiation therapy may acquire malignant phenotypes such as enhanced motility and migration ability, and therefore it is important to identify targets for preventing radiation-induced malignancy in order to increase the effectiveness of radiotherapy. G-Protein-coupled receptors (GPCRs) such as adenosine A2B receptor and cannabinoid receptors (CB1, CB2 and GPR55) may be involved, as they are known to have roles in proliferation, invasion, migration and tumor growth. In this study, we investigated the involvement of A2B and cannabinoid receptors in γ-radiation-induced enhancement of cell migration and actin remodeling, as well as the involvement of cannabinoid receptors in cell migration enhancement via activation of A2B receptor in human lung cancer A549 cells. Antagonists or knockdown of A2B, CB1, CB2 or GPR55 receptor suppressed γ-radiation-induced cell migration and actin remodeling. Furthermore, BAY60-6583 (an A2B receptor-specific agonist) enhanced cell migration and actin remodeling in A549 cells, and this enhancement was suppressed by antagonists or knockdown of CB2 or GPR55, though not CB1 receptor. Our results indicate that A2B receptors and cannabinoid CB1, CB2 and GPR55 receptors all contribute to γ-radiation-induced acquisition of malignant phenotypes, and in particular that interactions of A2B receptor and cannabinoid CB2 and GPR55 receptors play a role in promoting cell migration and actin remodeling. A2B receptor-cannabinoid receptor pathways may be promising targets for blocking the appearance of malignant phenotypes during radiotherapy of lung cancer.”

https://pubmed.ncbi.nlm.nih.gov/37926527/

https://www.jstage.jst.go.jp/article/bpb/advpub/0/advpub_b23-00631/_article