Drugs targeting the endocannabinoid system hold promise as a novel painkiller, say researchers.
Researchers in the US are exploring treatments that could reduce pain amongst chemotherapy patients, without producing the psychoactive effects associated with THC.
The endocannabinoid system was discovered in the 1990s by researchers in Israel who were looking at the effects of cannabis on the brain. Named after the plant, the system is thought to act as a regulator, keeping the body’s internal functions in equilibrium.
The system consists primarily of endocannabinoids (cannabinoids produced by the body), receptors and enzymes. The two main receptors which endocannabinoids bind to are known as CB1 and CB2.
The stimulation of CB1 receptors is responsible for the medical effects of cannabis as well as its intoxicating effects caused by THC. Meanwhile, CB2 receptors are expressed on cells in the immune system meaning they can produce anti-inflammatory effects without the psychoactive effects associated with CB1 stimulation.
The therapeutic uses of cannabis are not a new discovery.
Ancient texts from China, Iran and India have been found to include information about the medicinal properties of the plant. In 19th century Europe, William O’Shaughnessy introduced cannabis to western countries, leading to the use of cannabis extracts for treating pain and seizure disorders.
Speaking at a New York Academy of Sciences webinar in January, Dr Aron Lichtman, of Virginia Commonwealth University said: “Everything that we think cannabinoids do for the treatment of pain and other disease states, much of this has already been thought through thousands of years ago.
“Much of the research today and what is thought to be its clinical uses, has really long been known from ancient research on botanicals.”
Lichtman believes there is a “great need” for the development of non-opioid medications to treat pain associated with various diseases and injuries.
According to the scientist, a potential solution could be drugs targeting the endocannabinoid system.
The endogenous cannabinoid system is known to moderate neuronal and immune cell function; two key factors associated with pain.
Chemotherapeutic agents such as Taxanes can have severe dose-limiting side effects, preventing an increase in the level of the treatment.
Sensory neuropathy is a common side effect that can in occur in half of patients. The condition, caused by the damage of the body’s sensory nerves, can be experienced for as long as three years after treatment particularly affecting the hands, fingers, feet and toes.
The condition, known as chemo-induced peripheral neuropathy (CIPN), is resistant to traditional analgesics making treatment difficult.
There have been a number of preclinical studies looking at potential CIPN treatments which have found that CB1 and CB2 agonists can be effective in treating the condition in rodent models.
Much of the current research involves flooding the endocannabinoid system with THC, stimulating the receptors in an effort to reduce pain. Although initial findings have been positive, Lichtman’s research takes a different approach.
He and his team focused on the endocannabinoid regulating enzymes, or inhibitors, which he says also show analgesic effects in rodent models. Specifically, Lichtman’s research looks at the enzyme, monoacylglycerol lipase (MAG lipase) which is expressed widely thoughout the nervous system.
Its inhibition leads to elevated levels of 2-Arachidonoylglycerol (2-AG), an endocannabinoid that binds to the CB1 receptor. According to a number of animal models, this produces both antinociceptive effects (blocking the detection of pain) and anti-inflammatory effects.
“[This] means that when you inhibit MAG lipase, you’re going to get some stimulation of CB1 and CB2 receptors. This is quite different from what we heard previously about THC where you stimulate receptors everywhere,” Lichtman said.
“In the case of these endocannabinoid regulating enzymes, it’s a lot more localised. These endocannabinoids are believed to be produced and released on demand. So when you block an enzyme such as MAG lipase and raise 2-AG levels, you don’t get the widespread psychotropic effects that you see with cannabis or THC.”
Lichtman’s research involved giving mice an injection of the chemotherapy agent, Pacitaxel. Hypersensitive to heat, the mice were exposed to a filament to create a scenario similar to patients who are treated with chemo agents.
The mice who had been administered Paclitaxel experienced pain, whereas the others did not. When the mice were given a drug that inhibited MAG lipase, the mice appeared to experience less pain.
The research found that repeated administration of the drug led to full tolerance, however, if used at low doses, Lichtman believes MAG lipase inhibitors could be a “promising strategy” to treat CIPN.
Despite these promising results, he stressed that more work is needed to clarify the research findings.
“Preclinical studies are used or completed to show that cannabinoids can be a good treatment for many different indications,” he added.
“We have to be very careful about that and interpret preclinical data appropriately with limitations and acknowledge the importance of clinical trials.”
Fair Trials and Last Prisoner Project seek to launch global cannabis justice project
Fair Trials’ Global CEO Norman L. Reimer to discuss the project at Cannabis Europa Conference in London on June 29.
A new initiative from Fair Trials and the Last Prisoner Project aims to redress the harm caused by cannabis prohibition and to secure relief for those in prison for cannabis-related convictions.
The criminal justice reform NGO, Fair Trials hopes that the industry will support its work in countries across the globe where cannabis laws are being liberalised. Through collaboration with local partners in appropriate jurisdictions, the Fair Trials project will identify people in need of legal assistance, and recruit, train and match volunteer lawyers to take on their cases.
Fair Trials has enlisted the help of the Last Prisoner Project, a coalition of cannabis industry leaders, executives and artists dedicated to bringing restorative justice to the cannabis sector.
More and more jurisdictions are allowing adults to use and distribute medical and recreational cannabis. But after decades of prohibition, countless people remain behind bars or continue to suffer the collateral consequences of a cannabis conviction.
“The injustice of cannabis prohibition has resulted in millions of people worldwide serving time in prison or being saddled with a cannabis conviction, which brings with it a lifetime of harmful consequences, ranging from education and employment opportunities to immigration status and parental rights,” said Fair Trials Global CEO, Norman L Reimer.
“Of course, these harmful effects of prohibition not only impact the individuals charged, but also their families and communities. And those effects have been borne disproportionately by minorities, communities of colour, and the socio-economically disadvantaged. Legalising cannabis alone does not equal justice. Together, we must address the ongoing harms of past prohibition and leave no cannabis prisoner behind.”
The project will be modelled on the US Cannabis Justice Initiative, a collaborative effort between the cannabis industry and volunteer lawyers in the United States. When Norman Reimer was the Executive Director of the National Association of Criminal Defense Lawyers (NACDL), he partnered with the Last Prisoner Project to establish the initiative.
“Key to the success of the initiative has been generous donations from legal cannabis companies and consumers nationwide,” said Last Prisoner Project Co-Founder Steve DeAngelo. “Fair Trials, with its global reach as the world’s criminal justice watchdog, is uniquely positioned to build and house the infrastructure that’s going to be needed.”
Tomorrow (29 June), Norman Reimer will address the Cannabis Europa Conference discussing the project. Mr Reimer will be part of a panel entitled ‘Leave No Cannabis Prisoner Behind,’ and will be joined on that panel by Mary Bailey, Managing Director at the Last Prisoner Project; Dr. Laura Garius, Policy Lead at Release; and Denzel Uba, an individual impacted by criminal cannabis prohibition.
TOWIE star Amy Childs launches CBD range in honour of Jorja Foundation
The product range sees a portion of the proceeds going to the Jorja Foundation.
TOWIE star Amy Childs launched her new CBD range this week, with a star-studded event that shone a spotlight on the story of six-year-old Jorja Emerson.
Amy Childs was joined by former Love Islanders, Amy Hart and Cara Delahoyde-Massey, alongside her co-stars, Frankie Essex, Tom Skinner, Carina Lepore, Saffron Lempriere and Mark Ferris, for a heart-warming event celebrating the launch of her new CBD Infused beauty range, Jorja Botanicals.
The signature collection sees a portion of the proceeds going to the Jorja Foundation, which was set up in honour of six-year-old medical cannabis patient, Jorja Emerson.
The event saw The Only Way Is Essex star Frankie Essex, break down in tears as she heard Jorja’s story. Frankie, who gave birth to twins four weeks ago, wiped her eyes when Robin Emerson, Jorja’s father, showed videos of the life-threatening seizures his daughter was suffering before they discovered medical cannabis.
Love Island star, Amy Hart has since taken to Instagram to spread the word about the latest political campaign that sees Childs and Emerson petitioning to make medical cannabis more widely available on the NHS.
The Jorja Botanicals range was inspired by Jorja, who was diagnosed with a rare chromosome abnormality called 1q43q44 deletion, which has a side effect of life-threatening seizures. Her illness resulted in her being admitted to intensive care on two separate occasions, where Robin was told that she may not make it.
To save his daughter’s life, Emerson knew that he had to dig deep and find a treatment that would not only help Jorja but ultimately go on to help others.
At the time it was still illegal to prescribe cannabis in the UK. Emerson joined the campaign to see medical cannabis legalised in the UK in November 2018, and Jorja’s was among the first children to be legally prescribed medicinal cannabis.
In 2021 he went on to create the Jorja Foundation – a charity set up to help other families and children going through the same battles that Robin had to face.
The Jorja Foundation’s core principles are to fund special needs equipment that is not funded through the health system, fund family counselling, private appointments and tests when a second opinion is needed, as well s cannabis-based treatment for children in the UK and to continue to campaign and educate for wider NHS access in the UK for cannabis-based medications.
Childs commented: “When I saw Robin & Jorja’s story on social media it broke my heart.
“As a mum, I couldn’t imagine the pain of being told to take my child home to say goodbye to them. I love that Robin has fought for Jorja & is now helping other families with the Jorja Foundation.
“I’m so happy that I can help the foundation by being the Creative Director of Jorja Botanicals. We have created some beautiful products for the whole family to enjoy. We will be donating a percentage of the proceeds to the foundation so that we can help as many families as possible. ”
Emerson added: “ This is the fruition of a lot of hard work over many months and I am extremely proud to launch what is the first family brand in this category. In the coming weeks, we will also be launching a ‘parent’ focused cosmetic range in partnership with our creative director Amy Childs and our premium line of tincture oils.”
South Africa launches first trial of cannabis for chronic pain
The study will test whether cannabis can replace opioids in the management of chronic pain.
South Africa’s first cannabis trial has launched after initial results “show promise” for the treatment as a replacement for opioids.
The study will involve 1,000 participants who have been taking opioids for pain management for at least three months and are prepared to switch to cannabis as an alternative.
Biodata is the brainchild of Dr Shiksha Gallow, a cannabis clinician and the principal investigator in the trial which took over 18 months to get official clearance.
Dr Gallow said the trial is set to be ground-breaking as South Africa’s first real-world study of medical cannabis. Researchers predict that it will provide much-needed insight into the link between cannabis genetics and patient outcomes.
Dr Gallow told Cannabiz Africa: “We are currently recruiting patients, and data-capturing all the questionnaires and feedback from the patients for the live Study. It has been fairly slow. However, more options have been introduced, as suggested by the patients in the pilot study.
“The pilot results of the study were very promising, as it showed 98 per cent of the patients have some sort of pain relief from the cannabis.
“We were able to wean these patients off their opioid treatment. In the pilot group of patients below the age of 55, it was shown this group preferred to smoke cannabis and patients older than 55 years preferred oil. The patients who smoked the cannabis had relief almost immediately, while the oil took some time to alleviate their pain.”
“Once we reach the sample size required and all of the relevant data has been collated, the results of the study will be published. We have currently renewed this study for another year, due to the initial slow uptake of research participants.”
Patients can apply to be research participants through the Biodata website.
Labat is expanding its footprint over the next few months with the introduction of CannAfrica kiosks in major shopping malls.
The company believes these will be the “ideal locations for physical sign-up points for the study”.
Labat said the kiosks will also serve as Biodata dispensaries and is engaging with a number of vape stores to do the same, although these would have to be subject to South African Health Products Regulatory Authority’s pharma-ethics requirements.
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