A journey through cannabidiol in Parkinson’s disease

Posted on July 20, 2024 by David

“Parkinson’s disease is a chronic neurodegenerative disorder with no known cure characterized by motor symptoms such as tremors, rigidity, bradykinesia (slowness of movement), and postural instability. Non-motor symptoms like cognitive impairment, mood disturbances, and sleep disorders often accompany the disease. Pharmacological treatments for these symptoms are limited and frequently induce significant adverse reactions, underscoring the necessity for appropriate treatment options.

Cannabidiol is a phytocannabinoid devoid of the euphoric and cognitive effects of tetrahydrocannabinol. The study of cannabidiol’s pharmacological effects has increased exponentially in recent years.

Preclinical and preliminary clinical studies suggest that cannabidiol holds therapeutic potential for alleviating symptoms of Parkinson’s disease, offering neuroprotective, anti-inflammatory, and antioxidant properties. However, knowledge of cannabidiol neuromolecular mechanisms is limited, and its pharmacology, which appears complex, has not yet been fully elucidated.

By examining the evidence, this review aims to provide and synthesize scientifically proven evidence for the potential use of cannabidiol as a novel treatment option for Parkinson’s disease. We focus on studies that administrated cannabidiol alone.

The results of preclinical trials using cannabidiol in models of Parkinson’s disease are encouraging. Nevertheless, drawing firm conclusions on the therapeutic efficacy of cannabidiol for patients is challenging.

Cannabidiol doses, formulations, outcome measures, and methodologies vary considerably across studies. Though, cannabidiol holds promise as a novel therapeutic option for managing both motor and non-motor symptoms of Parkinson’s disease, offering hope for improved quality of life for affected individuals.”

https://pubmed.ncbi.nlm.nih.gov/39029991/

“Understanding the therapeutic potential of CBD in neurological disorders is of paramount importance, as it has the potential to provide patients with effective and well-tolerated treatment options. With significant research, CBD has the potential to meet the healthcare needs of different groups of neurological and psychiatric patients.”

https://www.sciencedirect.com/science/article/abs/pii/S0074774224000679?via%3Dihub

Cannabidiol in experimental cerebral ischemia

Posted on July 20, 2024 by David

“The absence of blood flow in cerebral ischemic conditions triggers a multitude of intricate pathophysiological mechanisms, including excitotoxicity, oxidative stress, neuroinflammation, disruption of the blood-brain barrier and white matter disarrangement. Despite numerous experimental studies conducted in preclinical settings, existing treatments for cerebral ischemia (CI), such as mechanical and pharmacological therapies, remain constrained and often entail significant side effects. Therefore, there is an imperative to explore innovative strategies for addressing CI outcomes.

Cannabidiol (CBD), the most abundant non-psychotomimetic compound derived from Cannabis sativa, is a pleiotropic substance that interacts with diverse molecular targets and has the potential to influence various pathophysiological processes, thereby contributing to enhanced outcomes in CI. This chapter provides a comprehensive overview of the primary effects of CBD in in vitro and diverse animal models of CI and delves into some of its plausible mechanisms of neuroprotection.”

https://pubmed.ncbi.nlm.nih.gov/39029992/

“CBD emerges as a promising therapeutic agent for the treatment and management of cerebral ischemic conditions. The intricate pathogenesis of CI, coupled with CBD’s multitarget effects, underscores its potential as a neuroprotective agent. “

https://www.sciencedirect.com/science/article/abs/pii/S0074774224000643?via%3Dihub

Beta-caryophyllene in psychiatric and neurological diseases: Role of blood-brain barrier

Posted on July 20, 2024 by David

“Beta-caryophyllene is an abundant terpene in cannabis, cinnamon, black pepper, cloves, and citrus fruit, delivering a striking, woody-spicy, like cloves and a sweet fruity aroma.

Beta-caryophyllene is a Food and Drug Administration-approved food additive with Generally Recognized as Safe status.

Interestingly, several biologic activities have been described for beta-caryophyllene, including anti-inflammatory and analgesic effects, neuroprotection against cerebral ischemia and neuronal injury, protection of neurovascular unit against oxidative damage, glial activation and neuroinflammation and anticonvulsant effects.

In this chapter, we intend to review the beneficial effects of beta-caryophyllene in the context of psychiatric and neurological diseases. Also, we will analyze the possibility that the blood-brain-barrier may be a central target underlying the beneficial actions of beta-caryophyllene.”

https://pubmed.ncbi.nlm.nih.gov/39029971/

“Compelling evidence support the therapeutic potential of beta-caryophyllene in a broad range of conditions. Moreover, this natural compound is already in use with food and cosmetic industries. Altogether, these features may enable its application as a therapeutic adjuvant to conventional drug therapy for often difficult to treat psychiatric and neurological diseases in the near future. “

https://www.sciencedirect.com/science/article/abs/pii/S0083672924000074?via%3Dihub

“Beta-caryophyllene is a dietary cannabinoid”

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2449371/

Cannabinoids for Inflammatory Bowel Disease: A Scoping Review

Posted on July 20, 2024 by David

“Purpose: Inflammatory bowel disease (IBD) has two main variants, ulcerative colitis (UC) and Crohn’s disease (CD), which are characterized by a cycle of remission and relapse. The aim of this scoping review is to understand the landscape of unprescribed and prescribed cannabis use among patients with IBD and investigate objective clinical benefits.

Methodology: A literature search was performed across Medline, Embase via Ovid, Scopus, and Cochrane Library databases. We included 40 studies (14 abstracts/letters, 7 randomized controlled trials [RCTs], 6 cohort studies [2 case-matched], 10 cross-sectional surveys, and 3 meta-analyses) in the review.

Results: Between 11% and 17.6% of surveyed patients used cannabis for symptom control with a lifetime prevalence of 39.8-78.2%. Patients reported reduced abdominal pain, emotional distress, stool frequency, and anorexia. There was a higher rate of depression, tobacco, and alcohol use among patients with IBD who used cannabis. Individual studies showed patients who were prescribed cannabis were more likely to have had surgery for IBD (14.5% vs. 4.7%, p = 0.0008), require future abdominal surgery (odds ratio = 5.03), report a lower quality of life (p = 0.0001), currently be on corticosteroids (18.1% vs. 10.4%, p = 0.04) and opioids (27.7% vs. 6.4%, p = 0.0001). RCTs of cannabinoids reported mild reductions in disease activity and variable endoscopic inflammation improvement.

Conclusions: Patients who use cannabis for IBD are a cohort with refractory disease and lower quality of life who report improvements in symptom management. However, the ability to reduce underlying disease activity appears very modest. Further trials using refined cannabinoid formulations may define a use in IBD.”

https://pubmed.ncbi.nlm.nih.gov/39029906/

https://www.liebertpub.com/doi/10.1089/can.2024.0061

Long-term stability and bactericidal properties of galenic formulations of Cannabis sativa oils

Posted on July 19, 2024 by David

“The long-term stability in real and accelerated time for galenic oils based on full-spectrum cannabis has been studied, using sesame oil as a dilutant. Sesame oil is one of the most used vehicles in the cannabis pharmaceutical industry due to the costs and increased oral bioavailability of cannabinoids. The real-time assays conducted at 25 °C over twelve months demonstrated high stability and showed no significant changes in the composition of cannabinoids, total polyphenols, flavonoids, or antioxidant capacity. In these studies, it was observed that there was no development of microorganisms compromising the stability of the oils over a year. The three oil varieties exhibited a high bactericidal capacity against E. coli, S. aureus, and P. larvae.”

https://pubmed.ncbi.nlm.nih.gov/39025316/

Topical Nanoencapsulated Cannabidiol Cream as an Innovative Strategy Combatting Ultraviolet A-Induced Nuclear and Mitochondrial DNA Injury: A Pilot Randomized Clinical Study

Posted on July 19, 2024 by David

“Background: Ultraviolet-A radiation (UVA) contributes to photoaging/photocarcinogenesis by generating inflammation and oxidative damage. Current photoprotective strategies are limited by availability/utilization of UVA filters, highlighting an unmet need. Cannabidiol (CBD), having anti-inflammatory/antioxidant properties via regulation of NFR-2, HMOX1, and PPAR-y, could potentially mitigate damage from UVA exposure.

Objective/methods: Prospective, single-center, pilot clinical trial (NCT05279495). Nineteen participants applied nano-CBD (nCBD) or vehicle (VC) cream to randomized, blinded buttock sites twice-daily for 14-days, then treated sites were irradiated with ≤3x UVA minimal erythema dose. After 24-hours, punch biopsies were obtained for histology, immunohistochemistry, real-time PCR.

Results: At 24-hours, 21% of participants had less observed erythema on CBD-treated skin than VC skin. Histologically, nCBD-treated skin had reduced UVA-induced epidermal hyperplasia than VC (p=0.01). Immunohistochemistry detected reduced cytoplasmic/nuclear 8-oxo-guanine glycosylase 1 staining in nCBD-treated skin compared to VC (p<0.01). Quantitative mtDNA PCR demonstrated UVA-induced deletion of ND4 (proxy:4977bp deletion; p=0.003) and ND1 (proxy:3895bp deletion; p=0.002) were significantly reduced by in vivo nCBD treatment compared to VC.

Limitations: Sample size.

Conclusion: Topically applied nCBD cream reduced UVA-induced formation of a frequent mutagenic nuclear DNA base lesion and protected against mtDNA mutations associated with UVA-induced skin aging. This trial is the first to identify UV-protective capacity of CBD-containing topicals in humans.”

https://pubmed.ncbi.nlm.nih.gov/39025264/

Relief in Gastrointestinal Symptoms with Medical Marijuana Over 1 Year

Posted on July 19, 2024 by David

“Introduction: Subjective improvement in gastrointestinal (GI) symptoms was assessed among patients using medical marijuana (MMJ).

Methods: Participants completed surveys at 0 days, 30 days, 6 months, and 12 months with questions about the severity of their GI symptoms on a scale from 1 (mild) to 3 (severe).

Results: In each survey, participants reported a significant decrease in GI symptom severity when using MMJ versus when not using MMJ (p < 0.05). The most common self-reported side effects from using MMJ were increased appetite (12-21.4%), fatigue (6-16.7%), anxiety (4-11.9%), cough (4-11.9%), headache (6-7.9%), and dry mouth (4-7.1%).

Conclusion: In patients with chronic GI symptoms, MMJ may provide persistent symptom severity improvement. Limited product availability and mild to moderate side effects are factors to consider before trialing MMJ.”

https://pubmed.ncbi.nlm.nih.gov/39015606/

“Overall, this study suggests there may be a role for MMJ to treat GI symptoms.”

https://karger.com/mca/article/7/1/80/907598/Relief-in-Gastrointestinal-Symptoms-with-Medical

Characteristics for Medical Cannabis Treatment Adherence among Autistic Children and Their Families: A Mixed-Methods Analysis

Posted on July 19, 2024 by David

“Introduction: Medical cannabis treatment for autistic children has recently become popular, and studies have focused on examining the treatment’s effects on children’s symptom presentation, reported side effects, and dropout rates. However, no previous study has investigated the factors influencing adherence and dropout rates in cannabis treatment.

Method: This explanatory sequential mixed-methods study explored these factors by examining the characteristics of 87 autistic children and their families and deepening parents’ perspectives and experiences of the 6-month CBD-rich cannabis treatment’s benefits and barriers.

Results: We found this treatment to have a high (75%) adherence rate, relatively mild side effects, and substantial reported benefits for the children and families. However, this treatment was not free of barriers; the intake regime, some side effects, and in some cases, unrealistic parental expectations made adherence difficult for some families.

Conclusion: Our results highlight the importance of providing professional guidance and knowledge to parents of autistic children, enhancing their understanding of the impact of CBD-rich cannabis treatment on their children and expected related challenges, and coordinating realistic treatment expectations. We hope that addressing these important aspects will influence parents’ ability to adhere to and enjoy the benefits of cannabis treatment for their autistic children.”

https://pubmed.ncbi.nlm.nih.gov/39015610/

“Our results support the effectiveness of CBD-rich cannabis treatment alongside the importance of professional guidance to inform parents of the treatment’s expected benefits and barriers.”

https://karger.com/mca/article/7/1/68/906156/Characteristics-for-Medical-Cannabis-Treatment

The Relationship between Muscarinic and Cannabinoid Receptors in Neuronal Excitability and Epilepsy: A Review

Posted on July 19, 2024 by David

“Background: Of the seventy million people who suffer from epilepsy, 40 percent of them become resistant to more than one antiepileptic medication and have a higher chance of death. While the classical definition of epilepsy was due to the imbalance between excitatory glutamatergic and inhibitory γ-aminobutyric acid (GABA)-ergic signalling, substantial evidence implicates muscarinic receptors in the regulation of neural excitability.

Summary: Cannabinoids have shown to reduce seizure activity and neuronal excitability in several epileptic models through the activation of muscarinic receptors with drugs which modulate their activity. Cannabinoids also have been effective in reducing antiepileptic activity in pharmaco-resistant individuals; however, the mechanism of its effects in temporal lobe epilepsy is not clear.

Key messages: This review seeks to elucidate the relationship between muscarinic and cannabinoid receptors in epilepsy and neural excitability.”

https://pubmed.ncbi.nlm.nih.gov/39015608/

“Cannabis has been used as a traditional treatment of epilepsy since the 1800s.”

https://karger.com/mca/article/7/1/91/907741/The-Relationship-between-Muscarinic-and

Use and perceptions of Cannabidiol among individuals in treatment for opioid use disorder

Posted on July 19, 2024 by David

“Background: Cannabidiol (CBD) is a widely available cannabis product with many claims as to potential health benefits including alleviating symptoms related to opioid use disorder (OUD). However, little is known as to how individuals with OUD perceive CBD, to what extent they may already be using CBD, and for what purposes.

Methods: A survey was conducted among individuals receiving treatment for OUD at the Addiction Institute of Mount Sinai in New York City from July 2021 to August 2023. The survey consisted of demographic questions, questions about opioid use, CBD use, and perceptions regarding CBD. Statistical analysis using ordinal logistic regression was employed to compare perceptions between CBD users and non-users while adjusting for age and race.

Results: Among 587 respondents, 550 completed the survey. Among all survey completers, 129 (23%) reported a history of using CBD for a variety of reasons including: anxiety (81, 62.8%), pain (65, 50.4%), sleep (63, 48.8%), depression (62, 48.1%), recreational purposes (32, 24.8%), or for other reasons (8, 6.2%). Of note, 22 (17.1%) respondents reported using CBD to control their addiction and 54 (41.9%) reported using CBD to ease opioid withdrawal symptoms. CBD users demonstrated more positive perceptions regarding its legality (β = 0.673, OR = 1.960, 95% CI [1.211, 3.176], p = .006), social acceptance (β = 0.718, OR = 2.051, 95% CI [1.257, 3.341], p = .004), and therapeutic potential compared to non-users. CBD users also had a more positive view of its potential future role in managing addiction (β = 0.613, OR = 1.846, 95% CI [1.181, 2.887], p = .007).

Conclusions: This study highlights a significant association between CBD usage and progressive views regarding CBD among individuals with OUD, suggesting a growing interest in CBD as a potential adjunctive therapy for individuals in substance use treatment. Some patients are already using CBD for anxiety, pain, sleep, depression, or as a harm reduction intervention to control their addiction or for opioid withdrawal symptoms. These findings underscore the importance of integrating patient perspectives into future research and treatment strategies involving CBD in the context of OUD.”

https://pubmed.ncbi.nlm.nih.gov/39020418/

“The current survey study provides valuable insights into the usage and perceptions of CBD among individuals in treatment for OUD. The findings reveal that some patients are already using CBD for a variety of reasons including anxiety, pain, sleep, depression, or as a harm reduction intervention to control their opioid use or minimize opioid withdrawal symptoms. This is often done without the knowledge of their healthcare providers. Respondents overall had a positive view of CBD suggesting a growing interest in its use as a potential adjunctive therapy for individuals with substance use disorders. The results also emphasize the importance of incorporating patient real-world experience and opinions into the development of future research and treatment approaches. By doing so, we can create more effective, patient-centered strategies that address the complexities of the opioid overdose crisis. Robust clinical research and clear medical guidelines are essential to harness the full potential of CBD as a harm reduction tool, ultimately improving outcomes for those struggling with OUD.”

https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-024-01051-5