Understanding the potential of cannabinoids for Alzheimer’s disease, cannabinoids in the treatment of multiple sclerosis; and more
Research regarding cannabis use for treating Alzheimer’s disease, multiple sclerosis and inflammatory bowel disease for Wednesday, July 14, 2021 (1200 words, 8 minutes)
While not legal in many places, cannabis has been used for treating multiple chronic conditions in recent years, including MS, IBS, Alzheimer’s disease, and addiction. Research shows that in some cases, cannabis can help treat the disease itself and in others, it simply helps mitigate the symptoms or unpleasant side effects.
This edition of CJMC Fortnightly examines the potential and limitations of medical cannabis in Alzheimer’s disease therapy by reporting on a study conducted by the University of Brescia, Italy. This edition also explores recent research that reviews the effects of cannabinoids to treat bladder symptoms in multiple sclerosis. On a similar note, this issue summarizes a practical approach for clinicians analyzing how cannabis can impact inflammatory bowel disease. Today’s edition also examines data suggesting that CBD administration could produce behavioural changes in mice associated with decreased drug-seeking behaviours.
If you are new to our e-newsletter, welcome to our community. We are delighted to have you join us. Every two weeks, CJMC Fortnightly provides readers with an update on new findings regarding medical cannabis. Delivering your cannabis news this week is Cristela Tello Ruiz of the Canadian Journal of Medical Cannabis (CJMC), a publication for physicians produced in Toronto, Canada. Here is this week’s medical cannabis news:
Potential and limits of cannabinoids in Alzheimer’s disease therapy
A team of researchers from the University of Brescia in Italy has completed a review study to understand the potential and limitations of cannabinoids in Alzheimer’s disease.
According to the study, recent discoveries have shown how the modulation of cannabinoid receptors 1 (CB1) and 2 (CB2) can be neuroprotective without the psychoactive properties of cannabis. The review aims to explore the potential of cannabis as a therapeutic option for Alzheimer’s disease.
Data breakdown
The lack of CB1 receptors is associated with a faster decline of cognitive function and loss of neurons in mice.
THC shows a broad spectrum of effects that could be potentially beneficial in blocking or preventing Alzheimer’s disease.
Dronabinol, a synthetic form of THC, demonstrated positive effects on body weight and mitigated disturbing behaviour in patients with AD.
CBD has a low affinity to the CB1 and CB2 receptors.
THC inhibits the enzyme acetylcholinesterase (AChE) activity more effectively than some approved drugs for AD treatment.
CBD has neuroprotective, anti-inflammatory, anxiolytic, and anti-insomnia properties that could help treat Alzheimer’s disease symptoms.
Key takeaways
Molecular changes related to Alzheimer’s disease tend to begin several years before symptoms manifest.
The potential beneficial effects of cannabinoids should be administered before the disease intensifies.
Studies on the long-term effects of cannabinoids are not yet available.
Conclusion
According to the researchers, while cannabis could help treat AD symptoms, studies on the long-term cognitive effects of heavy cannabis use suggest that cannabis could negatively influence cognitive function. For this reason, further studies are needed to explore the general effects of cannabinoids in cognitively impaired people.
Insights from the world of medical cannabis research
“In rare diseases, large clinical trials [involving medical cannabis] are not possible and small studies involving real-world evidence are important.”
-- Dr. Colleen O’Connell, Assistant Professor at Dalhousie University (CJMC 2019; 3:15).
Cannabinoids and bladder symptoms in multiple sclerosis
According to researchers from the University of Calgary, some data supports the existence of a biological mechanism by which cannabinoids can impact various symptoms of MS. However, evidence of the effectiveness of cannabis as a treatment for bladder symptoms remains mostly unexplored.
As published in the journal Multiple Sclerosis and Related Disorders, researchers conducted an exploratory study to assess the relationship between cannabis use and the improvement of bladder function symptoms in patients with MS.
Study framework
It was a cross-sectional survey study.
More than 2,000 people with MS from the MS Clinic in Calgary were contacted by email.
Findings
Nineteen participants reported bladder symptoms as their main reason for cannabis use.
89.5% of the 19 participants who self-reported bladder symptoms also reported “better” bladder symptoms when using cannabis.
Cannabis consumption in the past three months was associated with increased odds of reporting improvement in urinary frequency and urgency.
Cannabis was associated with reduced bladder leakage and wetness, pad use and improved bladder emptying.
Bottom line
According to the survey, people with MS commonly use medical cannabis. Among respondents, 734 reported cannabis use in the past three months. There were 275 (37.5%) respondents who reported cannabis use in the prior three months, and 73.8% of these reported at least weekly use of cannabis. The authors write that while the sample is small and the results are limited, this pilot study provides initial glimpses into the therapeutic use of cannabinoids for bladder symptoms among people with MS.
Inflammatory bowel disease and cannabis: A practical approach for clinicians
In a review published by the journal Advancements in Therapy, researchers explore the relationship between cannabis and the treatment of inflammatory bowel disease to understand the substance’s potential to treat the disease and its symptoms.
Study framework
This paper summarizes the current research and studies involving cannabis and IBD. In addition, clinical vignettes outlined the more practical considerations surrounding cannabis use.
Findings:
Cannabis can alleviate symptoms associated with IBD, such as abdominal pain, joint pain, abdominal cramping, and diarrhea.
Cannabis may not significantly reduce inflammation or improve endoscopic healing in patients with IBD.
A survey revealed that patients with Crohn's disease and ulcerative colitis were more likely to use cannabis than healthy controls.
Bottom line
The review shows that, in multiple studies, patients with IBD had a significant improvement in symptoms and quality of life due to medical cannabis use. However, the current research also shows that while CBD may improve perceived symptoms, it does not reduce inflammation or address underlying disease activity. These findings suggest that patients with IBD would benefit more from maintenance therapy optimization than from the initiation of cannabis as the principal therapy for IBD. The researchers also suggest that additional studies are needed because the current research is limited.
Finally, the role of cannabis in the treatment of IBD is a decision that will have to be made on a case-to-case basis, considering the uniqueness of each patient and their experience.
Insights from the world of medical cannabis research
“When it comes to the study of cannabis and its derivatives, it would be difficult to run large-scale double-blind, randomized, placebo-controlled trials, so I believe that real-world studies can help us in understanding the medical benefits of these products.”
--Dr. Wayne Gulliver, Professor of Medicine at Memorial University and Medical Director at NewLab Clinical Research speaking at the Real World Medicannabis Symposium in December 2020
CBD administration mitigates cocaine dependency in mouse model
A team of Spanish researchers studied the potential of CBD to modify behaviours in mice co-administered cocaine. They write that their findings suggest that CBD can prevent the development of cocaine addiction. They also discovered that when administered during cocaine abstinence, CBD may be of help in avoiding relapse. In this paper, the authors note that human trials assessing the use of cannabis and cannabinoids in cocaine-dependent subjects have provided inconsistent results. Two clinical trials from Brazil and Canada reported that cannabis use was associated with a decreased use of crack cocaine in substance-dependent subjects. In contrast, a study published earlier this year in the journal Addiction reported that the daily administration of CBD failed to reduce cocaine cravings in subjects with moderate to severe cocaine addiction.
The next edition of CJMC Fortnightly will be distributed on Wednesday, July 28. Sign up for a free subscription by clicking the link below.