Cannabinoids and Pain: New Insights From Old Molecules

Frontiers in Pharmacology, Год журнала: 2018, Номер 9

Опубликована: Ноя. 13, 2018

Cannabis has been used for medicinal purposes thousands of years. The prohibition cannabis in the middle 20th century arrested research. In recent years there is a growing debate about use medical purposes. term 'medical cannabis' refers to physician-recommended herb and its components, called cannabinoids, treat disease or improve symptoms. Chronic pain most commonly cited reason using cannabis. Cannabinoids act via cannabinoid receptors, but they also affect activities many other ion channels enzymes. Preclinical studies animals both pharmacological genetic approaches have increased our understanding mechanisms cannabinoid-induced analgesia provided therapeutical strategies treating humans. analgesic effect cannabinoids include inhibition release neurotransmitters neuropeptides from presynaptic nerve endings, modulation postsynaptic neuron excitability, activation descending inhibitory pathways, reduction neural inflammation. Recent meta-analyses clinical trials that examined chronic present moderate amount evidence cannabis/cannabinoids exhibit activity, especially neuropathic pain. main limitations these are short treatment duration, small numbers patients, heterogeneous patient populations, examination different doses, efficacy endpoints, as well modest observable effects. Adverse effects short-term generally mild moderate, tolerated transient. Considering serious health problems arise recreational cannabis, it necessary collect more information on safety long-term Larger well-designed longer duration mandatory determine provide definitive answers physicians patients regarding risk benefits Due limited adverse events, should be reserved refractory cases with monitoring

Язык: Английский

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Cannabis use among patients at a comprehensive cancer center in a state with legalized medicinal and recreational use

Cancer, Год журнала: 2017, Номер 123(22), С. 4488 - 4497

Опубликована: Сен. 25, 2017

BACKGROUND Cannabis is purported to alleviate symptoms related cancer treatment, although the patterns of use among patients are not well known. This study was designed determine prevalence and methods patients, perceived benefits, sources information in a state with legalized cannabis. METHODS A cross‐sectional, anonymous survey adult performed at National Cancer Institute–designated center Washington State. Random urine samples for tetrahydrocannabinol provided validation. RESULTS Nine hundred twenty‐six 2737 eligible (34%) completed survey, median age 58 years (interquartile range [IQR], 46‐66 years). Most had strong interest learning about cannabis during treatment (6 on 1‐10 scale; IQR, 3‐10) wanted from providers (677 911 [74%]). Previous common (607 926 [66%]); 24% (222 926) used last year, 21% (192 month. found similar percentages users who reported weekly (27 193 [14%] vs 164 [18%]). Active inhaled (153 220 [70%]) or consumed edibles (154 [70%]); 89 (40%) both modalities. primarily physical (165 219 [75%]) neuropsychiatric (139 [63%]). Legalization significantly increased likelihood more than half respondents. CONCLUSIONS high rates active across broad subgroups, legalization be important patients' decision use. desire but receiving their oncology providers. 2017;123:4488‐97 . © 2017 The Authors. published by Wiley Periodicals, Inc. behalf American Society an open access article under terms Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits distribution any medium, original work properly cited, non‐commercial no modifications adaptations made.

Язык: Английский

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Targeting the endocannabinoid system: future therapeutic strategies

Drug Discovery Today, Год журнала: 2016, Номер 22(1), С. 105 - 110

Опубликована: Авг. 23, 2016

Язык: Английский

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The current use and evolving landscape of nutraceuticals

Pharmacological Research, Год журнала: 2021, Номер 175, С. 106001 - 106001

Опубликована: Ноя. 24, 2021

Язык: Английский

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Goods and Bads of the Endocannabinoid System as a Therapeutic Target: Lessons Learned after 30 Years

Pharmacological Reviews, Год журнала: 2023, Номер 75(5), С. 885 - 958

Опубликована: Май 10, 2023

The cannabis derivative marijuana is the most widely used recreational drug in Western world and consumed by an estimated 83 million individuals (∼3% of population). In recent years, there has been a marked transformation society regarding risk perception cannabis, driven its legalization medical use many states United States worldwide. Compelling research evidence Food Drug Administration cannabis-derived cannabidiol approval for severe childhood epilepsy have confirmed large therapeutic potential itself, Δ

Язык: Английский

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A review of oral cannabinoids and medical marijuana for the treatment of chemotherapy-induced nausea and vomiting: a focus on pharmacokinetic variability and pharmacodynamics

Cancer Chemotherapy and Pharmacology, Год журнала: 2017, Номер 80(3), С. 441 - 449

Опубликована: Авг. 5, 2017

Oral cannabinoids (i.e., dronabinol, nabilone) containing the active component of marijuana, delta(Δ)9-tetrahydrocannabinol (THC), are available for treatment chemotherapy-induced nausea and vomiting (CINV) in patients with cancer who have failed to adequately respond conventional antiemetic therapy. The aim this article is provide an overview efficacy, pharmacokinetics (PK), pharmacodynamics (PD), safety oral CINV. A PubMed search English-language literature through 4 January 2017 was conducted identify relevant articles inclusion review. been shown similar or improved efficacy compared antiemetics resolution and/or cancer. However, THC has high PK variability, variability dronabinol peak plasma concentrations (C max) estimated between 150 200%. new solution decreased intraindividual (area under curve) vs capsules. Further, a slower time C max administered intravenously (IV) by smoking, lower systemic availability than IV smoked THC. PD profile (e.g., "high") differs from that healthy individuals. associated greater incidence adverse effects therapy placebo dizziness, hypotension, dysphoria depression). formulation solution) minimized PK/PD currently observed capsule formulations.

Язык: Английский

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Evaluation of cannabinoids concentration and stability in standardized preparations of cannabis tea and cannabis oil by ultra-high performance liquid chromatography tandem mass spectrometry

Clinical Chemistry and Laboratory Medicine (CCLM), Год журнала: 2017, Номер 55(10)

Опубликована: Янв. 1, 2017

Abstract Background: Cannabis has been used since ancient times to relieve neuropathic pain, lower intraocular pressure, increase appetite and finally decrease nausea vomiting. The combination of the psychoactive cannabis alkaloid Δ9-tetrahydrocannabinol (THC) with non-psychotropic alkaloids cannabidiol (CBD) cannabinol (CBN) demonstrated a higher activity than THC alone. Italian National Institute Health sought establish conditions indications on how correctly use nationally produced guarantee therapeutic continuity in individuals treated medical cannabis. Methods: evaluation cannabinoids concentration stability standardized preparations tea oil was conducted using an easy fast ultra-high performance liquid chromatography tandem mass spectrometry (UHPLC-MS/MS) assay. Results: Extraction efficiency significantly that water respect different cannabinoids. This especially observed case pharmacologically active THC, CBD their acidic precursors. Fifteen minutes boiling sufficient achieve highest concentrations solutions. At ambient temperature, significant 50% or less initial over 3 7 days, respectively. When refrigerated at 4 °C, similar decreasing profiles were for two compounds. profile obtained after pre-heating flowering tops 145 °C 30 min static oven resulted complete decarboxylation cannabinoid acids CBDA THCA-A. Nevertheless, it apparent heat not only decarboxylated compounds, but also increased final oil. samples maximum (72% concentration) coming from unheated temperature. In other cannabinoids, temperatures, 80%–85% measured up 14 days preparation. Conclusions: As first most important aim is individuals, strictly preparation protocol necessary assure availability homogeneous product defined stability.

Язык: Английский

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Integrating Cannabis into Clinical Cancer Care

Current Oncology, Год журнала: 2016, Номер 23(11), С. 8 - 14

Опубликована: Март 1, 2016

Cannabis species have been used as medicine for thousands of years; only since the 1940s has plant not widely available medical use. However, an increasing number jurisdictions are making it possible patients to obtain botanical medicinal For cancer patient, cannabis a potential benefits, especially in management symptoms. is useful combatting anorexia, chemotherapy-induced nausea and vomiting, pain, insomnia, depression. might be less potent than other antiemetics, but some patients, agent that works, antiemetic also increases appetite. Inhaled more effective placebo ameliorating peripheral neuropathy conditions, could prove neuropathy. A pharmacokinetic interaction study vaporized with chronic pain on stable doses sustained-release opioids demonstrated no clinically significant change plasma opiates, while suggesting possibility synergistic analgesia. Aside from symptom management, body vitro animal-model studies supports direct anticancer effect cannabinoids by way different mechanisms involving apoptosis, angiogenesis, inhibition metastasis. Despite absence clinical trials, abundant anecdotal reports describe having remarkable responses agent, when taken high-potency orally ingested concentrate, circulating. Human should conducted address critical questions related foregoing effects.

Язык: Английский

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Cannabis Consumption Used by Cancer Patients during Immunotherapy Correlates with Poor Clinical Outcome

Cancers, Год журнала: 2020, Номер 12(9), С. 2447 - 2447

Опубликована: Авг. 28, 2020

Cannabis or its derivatives are widely used by patients with cancer to help symptoms and treatment side effects. However, cannabis has potent immunomodulatory properties. To determine if consumption during immunotherapy affects therapy outcomes, we conducted a prospective observatory study including 102 (68 34 plus cannabis) consecutive advanced cancers who initiated immunotherapy. correlated significant decrease in time tumor progression overall survival. On the other hand, use of reduced therapy-related immune-related adverse events. We also tested possibility that may affect immune system microenvironment through alteration endocannabinoid system. analyzed panel serum endocannabinoids (eCBs) eCB-like lipids, measuring their levels before after both groups. Levels eCBs immunotherapy, showed no differences between users nonusers. Nevertheless, four eCB compounds were associated patients' survival time. Collectively, considerable effects, among needs be carefully considered due potential effects on system, especially

Язык: Английский

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Oral administration of cannabis with lipids leads to high levels of cannabinoids in the intestinal lymphatic system and prominent immunomodulation

Scientific Reports, Год журнала: 2017, Номер 7(1)

Опубликована: Окт. 31, 2017

Cannabidiol (CBD) and ∆9-tetrahydrocannabinol (THC) have well documented immunomodulatory effects in vitro, but not following oral administration humans. Here we show that co-administration of cannabinoids with lipids can substantially increase their intestinal lymphatic transport rats. CBD concentrations the lymph were 250-fold higher than plasma, while THC 100-fold plasma. Since are currently clinical use for treatment spasticity multiple sclerosis (MS) patients to alleviate nausea vomiting associated chemotherapy cancer patients, lymphocytes from those used assess cannabinoids. The levels recovered system, above threshold murine human lymphocytes. showed immunosuppressive THC. Moreover, immune cells MS more susceptible healthy volunteers or patients. Therefore, administering a high-fat meal lipid-based formulations has potential be therapeutic approach improve MS, indeed other autoimmune disorders. However, immunocompromised requires caution.

Язык: Английский

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