The anti-nausea/anti-emetic effects of CBD may be mediated by indirect activation of .. CBD reduces nausea by a non-cannabinoid mechanism of action . Jan 5, Cannabis has long been known to limit or prevent nausea and it was not until the early s that the mechanism of action of cannabis was .. There are no reports of any specific evaluation of CBD alone to reduce nausea. In this section we will describe the mechanisms of action and the effects that occur .. Pain relief by both THC and CBD significantly superior to placebo. . they are prescribed only when other medications for nausea and vomiting do not work.
non-cannabinoid CBD action reduces by mechanism nausea a of
Randomised, double-blind, placebo-controlled, three period crossover study. Significant improvement on pain severity and on sleep disturbances. Generally well tolerated, majority of adverse events being mild to moderate in severity and resolving spontaneously.
Studies of longer duration in neuropathic pain are required to confirm a clinically relevant, improvement in the treatment of this condition. Acute Pain Opioids are powerful analgesics widely utilised in clinical pain management, but they yield a poor analgesic response in conditions of certain pathologic pain, such as neuropathy. Postoperative Pain One potential indication of cannabinoids would be as analgesic for postoperative pain. Chronic Pain Multiple Sclerosis Multiple sclerosis MS is a life-long chronic disease in which nerve cells are attacked by the immune system, originating painful muscle spasms and many other problems, including neuropathic pain.
Neuropathic Pain Neuropathic pain, which is frequently chronic, arises when neurons in the brain or peripheral nervous system become hypersensitised and generate abnormal or prolonged impulses. Cancer Pain Pain is one of the most frequent symptoms in patients with cancer and the World Health Organisation recommends that they receive adequate pain relief.
References Treatment Results and Remarks Noyes et al. Each patients all treatments Double blind placebo-controlled trial preliminary. Analgesic effect of THC at high doses 15 and 20 mg , significantly superior than placebo. At these doses, substantial sedation and mental clouding. No nausea or emesis. Increased appetite in some patients. Mild analgesic effect of THC.
At 20 mg THC similar to mg codeine induced side effects that would prohibit its therapeutic use, including somnolence, dizziness, ataxia, and blurred vision; and even some alarming adverse reactions. At 10 mg THC similar to 60 mg codeine: Double-blind, 5-way crossover designed study. Significant analgesic relief with mg of codeine, but no differences between placebo and benzopyranopyridine analogue of THC.
Pain perception even appeared to be augmented by both doses of benzopyranopyridine. Evaluation of mild, moderate, and severe pain. NIB superior to placebo and equivalent to 50 mg of codeine. NIB superior to placebo and to 50 mg secobarbital a short-acting barbiturate. However, NIB is not useful clinically because of the frequency of side effects. Fibromyalgia This disease is characterised by the presence of generalised pain throughout the body, confirmed by the presence of tender and painful points on digital palpation in at least 11 of the 18 points established for diagnosis.
Migraine Migraine is defined as vasomotor headache characterised by its pulsatile nature, the presentation of crises, and its periodic occurrence. Spasticity Spasticity entails increased resistance to passive movement. Phantom Limb Syndrome Patients who suffer amputation of an extremity can experience a type of referred neuropathic pain in the amputated zone.
Cannabinoid 1 receptors are expressed in nociceptive primary sensory neurons. Comparative epidemiology of dependence on tobacco, alcohol, controlled substance and inhalants: Intrathecally applied flurbiprofen produces an endocan-nabinoid-dependent antinociception in the rat formalin test.
How cannabinoids work in the brain. Functional characteristics of the midbrain periaqueductal gray. Efficacy of two cannabis based medicinal extracts for relief of central neuropathic pain from brachial plexus avulsion: Discovery of a potent, selective, and efficacious class of reversible alpha-ketoheterocycle inhibitors of fatty acid amide hydrolase effective as analgesics. Evidence for a new G-protein-coupled cannabinoid receptor in mouse brain.
Int J Clin Pharmacol Ther. The synthetic cannabi-noid WIN 55, attenuates hyperalgesia and allodynia in a rat model of neuropathic pain. Localisation of cannabinoid receptor 1 in rat dorsal root ganglion using in situ hybridisation and immunohisto-chemistry. Harwood Academic Publishers; Therapeutic Uses of Cannabis. Immunomodulation by cannabinoids is absent in mice deficient for the cannabinoid CB 2 receptor. Lack of analgesic efficacy of oral deltatetrahydrocannabinol in postoperative pain.
Occurrence and biosynthesis of endogenous cannabinoid precursor, N-arachidonoyl phosphatidylethanolamine, in rat brain. The capsaicin receptor, a heat-activated ion channel in the pain pathway. The cannabinoid CB1 receptor antagonist, SRA, selectively facilitates nociceptive responses of dorsal horn neurones in the rat.
Chieng B, Christie MJ. Inhibition by opioids acting on mu-receptors of GABAergic and glutamatergic postsynaptic potentials in single rat periaqueductal gray neurones in vitro. Effects of moderate and high doses of marihuana on thermal pain: A sensory decision theory analysis. Patterns of cannabis use among patients with multiple sclerosis. In vivo characterization of a specific cannabinoid receptor antagonist SRA , inhibition of delta 9-tetrahydocannabinol-induced responses and apparent agonist activity.
J Pharmacol Exp Ther. The perceived effects of smoked cannabis on patients with multiple sclerosis. Evaluation of cAMP involvement in cannabinoid-induced antino-ciception. Delta 9-tetrahydrocannabinol increases prodynorphin and proenkephalin gene expression in the spinal cord of the rat. Supersensitivity to anandamide and enhanced endogenous cannabinoid signaling in mice lacking fatty acid amide hydrolase. Fatty acid sulfonyl fluorides inhibit anandamide metabolism and bind to the cannabi-noid receptor.
Biochem Biophys Res Commun. Determination and characterization of a can-nabinoid receptor in rat brain. Isolation and structure of a brain constituent that binds to the cannabinoid receptor. Levels, metabolism, and pharmacological activity of anandamide in CB1 can-nabinoid receptor knockout mice, evidence for non-CB1, non-CB2 receptor-mediated actions of anandamide in mouse brain.
Formation and inactivation of endogenous cannabinoid anandamide in central neurons. Antisense oligodeoxynucleotide treatment to the brain cannabinoid receptor inhibits antinociception. Elphick MR, Egertova M. The neurobiology and evolution of cannabinoid signalling. Cannabinoid CB 1 receptor expression in rat spinal cord. Opiate, cannabinoid, and eicosanoid signaling converges on common intracellular pathways nitric oxide coupling. Prostaglandins Other Lipid Mediat.
Possible involvement of the endocannabinoid system in the actions of three clinically used drugs. The role of central and peripheral Cannabinoid 1 receptors in the antihyperalgesic activity of cannabinoids in a model of neuropathic pain. Role of endogenous cannabinoids in synaptic signaling. Cannabinoids as potential new analgesics.
Gaoni Y, Mechoulam R. Isolation, structure and partial synthesis of an active constituent of hashish. J Am Chem Soc. Molecular characterization of human and mouse fatty acid amide hydrolases. Mechanisms of endocannabinoid inactivation, biochemistry and pharmacology.
Functional outcomes, provides neu-roprotection, and reduces inflammation in a rat model of traumatic brain injury. Antinociceptive, subjective and behavioral effects of smoked marijuana in humans.
Grinspoon L, Bakalar JB. Marihuana the forbidden medicine. Yale University Press; Grudt TJ, Henderson G. A role for endocannabinoids in indo-methacin-induced spinal antinociception. Novel cannabinoid-sensitive receptor mediates inhibition of glutamatergic synaptic transmission in the hippocampus. Proc Natl Acad Sci. Characterization and localization of cannabinoid receptors in rat brain, a quantitative in vitro autoradiographic study.
Cannabinoid suppression of noxious heat-evoked activity in wide dynamic range neurons in the lumbar dorsal horn of the rat. Hohmann AG, Herkenham M. Regulation of cannabinoid and mu opioid receptors in rat lumbar spinal cord following neonatal capsaicin. Cannabinoid receptors undergo axonal flow in sensory nerves. Localization of central cannabinoid CB1 receptor messenger RNA in neuronal subpopula-tions of rat dorsal root ganglia, a double-label in situ hybridization study.
Cannabinoid modulation of wide dynamic range neurons in the lumbar dorsal horn of the rat by spinally administered WIN55, Holt S, Fowler CJ. Anandamide metabolism by fatty acidamide hydrolase in intact C6 glioma cells.
Increased sensitivity to inhibition by ibuprofen and flurbiprofen upon reduction of extra- but not intracellular pH. Naunyn Schmiedebergs Arch Pharmacol. Efficacy in CB1 receptor-mediated signal transduction. Nonclassical cannabinoid analgetics inhibit adenylate cyclase: An endogenous capsaicin-like substance with high potency at recombinant and native vanilloid VR1 receptors. Cannabis and the brain. Iversen LL, Chapman V. Cannabinoids, a real prospect for pain relief?
Evaluation of intramuscular levonantradol and placebo in acute postoperative pain. Cannabinoid-induced mesenteric vasodilation through an endothelial site distinct fromCB1or CB2 receptors. Cannabinoid actions on rat superficial medullary dorsal horn neurons in vitro. Drug of abuse profile: Kamibayashi T, Maze M.
Clinical uses of alpha2-adrenergic agonists. Analgesic effect of the synthetic cannabinoid CT-3 on the chronic neuropathic pain. GABAergic interneurons are the targets of cannabinoid actions in the human hippocampus. Alpha-2 and imi-dazoline receptor agonists. Their pharmacology and therapeutic role. Actions of opioids on excitatory and inhibitory transmission in substantia gelatinosa of adult rat spinal cord. Amino acid determinants in cyclooxy-genase-2 oxygenation of the endocannabinoid anandamide.
Oxygenation of the endocannabinoid, 2-arachidonylglycerol, to glyceryl prosta-glandins by cyclooxygenase Cerebellar depolarization-induced suppression of inhibition is mediated by endogenous can-nabinoids. Retrograde inhibition of pre-synaptic calcium influx by endogenous cannabinoids at excitatory synapses onto Purkinje cells. Unresponsiveness to cannabi-noids and reduced addictive effects of opiates in CB1 receptor knockout mice.
Investigation of brain sites mediating cannabinoid-induced antinociception in rats, evidence supporting periaqueductal gray involvement. Cannabinoid-induced antino-ciception is mediated by a spinal a2-noradrenergic mechanism. Spinal and supraspinal components of cannabinoid-induced antinociception. Upregulation of spinal cannabinoidreceptors following nerve injury enhances the effects of Win 55, on neuropathic pain behaviors in rats. Design, synthesis and biological evaluation of novel arachidonic acid derivatives as highly potent and selective endocannabinoid transporter inhibitors.
Anandamide inhibits excitatory transmission to rat substantia ge-latinosa neurones in a manner different from that of capsaicin. The rodent amygdala contributes to the production of cannabinoid-induced an-tinociception. Pharmacological and biochemical interactions between opioids and cannabinoids. Two distinctive antinociceptive systems in rats with pathological pain.
Structural requirements for cannabinoid-induced antinociceptive activity in mice. Cannabinoid transmission and pain perception. Anatomical basis for cannabinoid-induced an-tinociception as revealed by intracerebral microinjections. Suppression of noxious stimulus-evoked activity in the ventral posterolateral nucleus of the thalamus by a cannabinoid agonist, correlation between electrophysiological and antinociceptive effects. Structure of a cannabinoid receptor and functional expression of the cloned cDNA.
Deltatetrahydrocannabinol shows antispastic and analgesic effects in a single case double-blind trial. Eur Arch Psychiatry Clin Neurosci. Looking back at Cannabis research. Identification of an endogenous 2-monoglyceride, present in canine gut, that binds to cannabinoid receptors. An analgesia circuit activated by cannabinoids. Marijuana-produced changes in pain tolerance. Experienced and non-experienced subjects. Morisset V, Urban L. Cannabinoid-induced presynaptic inhibition of glutamatergic EPSCs in substancia gelatinosa neurons of the spinal cord.
Anan-damide-induced vasorelaxation in rabbit aortic rings has two components, G protein dependent and independent. Molecular characterization of a peripheral receptor for cannabinoids. The analgesic effect of oral deltatetrahydrocannabinol THC , morphine, and a THC-morphine combination in healthy subjects under experimental pain conditions. Clinical experience with nabilone for chronic pain. Initial experiences with medicinal extracts of cannabis for chronic pain: The analgesic properties of deltatetrahydrocannabinol and codeine.
Analgesic effect of delta-9 tetrahydrocannabinol. Endogenous cannabinoids mediate retrograde signals from depolarized postsyn-aptic neurons to presynaptic terminals.
Cannabinoid receptors and pain. Cannabinoids and multiple sclerosis. Structural determinants for recognition and translocation by the anandamide transporter. The endocannabinoid nervous system, unique opportunities for therapeutic intervention. Characterization of a novel endocan-nabinoid, virodhamine, with antagonist activity at the CB1 receptor.
The neuronal distribution of cannabinoid receptor type 1 in the trigeminal ganglion of the rat. Cannabinoids inhibit neu-rodegeneration in models of multiple sclerosis. Przewlocki R, Przewlocka B. Opioids in chronic pain. The role of endogenous opioids in enhancing the antinociception produced by the combination of delta 9-tetrahydrocannabinol and morphine in the spinal cord.
Antisense oligode-oxynucleotides to the k-1 receptor block the antinociceptive effects of D9-THC in the spinal cord. Radbruch L, Elsner F. Emerging analgesics in cancer pain management. Expert Opin Emerg Drugs. Differential cholera-toxin sensitivity of supraspinal antinociception induced by the can-nabinoid agonists D9-THC, WIN 55, and anandamide in mice. Effects of intravenous tetrahydrocannabinol on experimental and surgical pain. Psychological correlates of the analgesic response. Deltatetrahydro-cannabinol increases arachidonic acid levels in guinea pig cerebral cortex slices.
Prostaglandins Leukot Essent Fatty Acids. SR A, a cannabinoid receptor antagonist, produces hyperalge-sia in untreated mice. Anti-hyperalgesic effects of spinal cannabinoids. Cannabinoids reduces hyperalgesia and inflammation via interaction with peripheral CB1 receptors.
Therapeutic aspects of cannabis and cannabi-noids. Early clinical manifestations of cannabis dependence in a community sample. Cannabis for migraine treatment: An historical and scientific review. Clinical endocannabinoid deficiency CECD: Activational role of cannabinoids on movement. CB1 receptor localization in rat spinal cord and roots, dorsal root ganglion, and peripheral nerve. Zhongguo Yao Li Xue Bao. Schlicker E, Kathmann M. Modulation of transmitter release via presynaptic cannabinoid receptors.
Evidence that CB-1 and CB-2 cannabinoid receptors mediate antinociception in neuropathic pain in the rat. Cannabi-noid receptor agonists inhibit glutamatergic synaptic transmission in rat hippocampal cultures. An amino-terminal variant of the central cannabinoid receptor resulting from alternative splicing.
Cannabinoid CB 1 receptor upregulation in a rat model of chronic neuropathic pain. Characterization of D9-tetrahydrocannabinol and anandamide antinoci-ception in non-arthritic and arthritic rats.
Spinal mechanisms of delta 9-tetrahydrocannabinol-induced analgesia. Medicinal cannabis extracts for the treatment of multiple sclerosis. Curr Opin Investig Drugs. Effect of a nitrogen analog of tetrahydrocannabinol on cancer pain. A second endogenous cannabinoid that modulates long-term potentiation. The cannabinoid WIN 55, inhibits the activity-dependent facilitation of spinal noci-ceptive responses. Cannabis use and dependence among Australian adults: Cannabinoids inhibit excitatory neurotransmission in the substantia nigra pars reticulata.
Takano Y, Yaksh TL. Characterization of the pharmacology of intrathecally administered alpha-2 agonists and antagonists in rats. Tjolsen A, Hole K. Animal models of analgesia In: The Pharmacology of Pain. Dick-enson L, Bessing J, editors. The localization of classical transmitters and neuropeptides within neurons in laminae I-III of the mammalian spinal dorsal horn. Cannabinoids for control of chemotherapy induced nausea and vomiting: Immunohistochemical distrubution of cannabinoid CB1 receptors in the rat central nervous system.
Pharmacological and pharmacokinetic characterization of the can-nabinoid receptor 2 agonist, GW, utilizing rodent models of acute and chronic pain, anxiety, ataxia and catalepsy. Efficacy, safety and tolerability of an orally administered cannabis extract in the treatment of spasticity in patients with multiple sclerosis: Actions of cannabinoids on membrane properties and synaptic transmission in rat periaqueductal gray neurons in vitro.
Cannabinoid receptor activation inhibits GABAergic neurotransmission in rostral ventromedial medulla neurons in vitro. Do cannabis-based medicinal extracts have general or specific effects on symptoms in multiple sclerosis? A double-blind, randomized, placebo-controlled study on patients. A preliminary controlled study to determine whether whole-plant cannabis extracts can improve intractable neurogenic symptoms. The neurobiology of cannabinoid analgesia. Pain modulation by release of the endogenous cannabinoid anandamide.
Experimental Approach The ability of acute CBD pretreatment to prevent PAC-induced mechanical sensitivity was assessed, as was the effect of CBD on place conditioning and on an operant-conditioned learning and memory task. The neuroprotective actions of cannabidiol and other cannabinoids were examined in rat cortical neuron cultures exposed to toxic levels of the excitatory neurotransmitter glutamate. Cannabinoids protected equally well against neurotoxicity mediated by N-methyl-d-aspartate receptors , 2-amino 4-butylhydroxyisoxazolyl propionic acid receptors , or kainate receptors.
The neuroprotection observed with cannabidiol and THC was unaffected by cannabinoid receptor antagonist, indicating it to be cannabinoid receptor independent. Previous studies have shown that glutamate toxicity may be prevented by antioxidants. Cannabidiol , THC and several synthetic cannabinoids all were demonstrated to be antioxidants by cyclic voltametry.
Cannabidiol and THC also were shown to prevent hydroperoxide-induced oxidative damage as well as or better than other antioxidants in a chemical Fenton reaction system and neuronal cultures. These data also suggest that the naturally occurring, nonpsychotropic cannabinoid, cannabidiol , may be a potentially useful therapeutic agent for the treatment of oxidative neurological disorders such as cerebral ischemia.
Epilepsy is the most common neurological disorder, with over 50 million people worldwide affected. Recent evidence suggests that the transient receptor potential cation channel subfamily V member 1 TRPV1 may contribute to the onset and progression of some forms of epilepsy. Since the two nonpsychotropic cannabinoids cannabidivarin CBDV and cannabidiol CBD exert anticonvulsant activity in vivo and produce TRPV1-mediated intracellular calcium elevation in vitro, we evaluated the effects of these two compounds on TRPV1 channel activation and desensitization and in an in vitro model of epileptiform activity.
The prototypical TRPV1 agonist, capsaicin, produced similar, although not identical effects. Molecular targets for cannabidiol and its synthetic analogues: Little is known on the possible molecular targets of this compound.
We investigated whether CBD and some of its derivatives interact with vanilloid receptor type 1 VR1 , the receptor for capsaicin, or with proteins that inactivate the endogenous cannabinoid, anandamide AEA. The effects of maximal doses of the two compounds were not additive. These findings suggest that VR1 receptors , or increased levels of endogenous AEA, might mediate some of the pharmacological effects of CBD and its analogues.
In view of the facile high yield. The aim of this review is to present some of the recent publications on cannabidiol CBD; 2 , a major non-psychoactive constituent of Cannabis, and to give a general overview. Special emphasis is laid on biochemical and pharmacological advances, and on novel mechanisms recently put forward, to shed light on some of the pharmacological effects that can possibly be rationalized through these mechanisms.
The plethora of positive pharmacological effects observed with CBD make this compound a highly attractive therapeutic entity. Cannabidiol , extracted from Cannabis sativa, selectively inhibits inflammatory hypermotility in mice. Cannabidiol is a Cannabis-derived non-psychotropic compound that exerts a plethora of pharmacological actions, including anti-inflammatory, neuroprotective and antitumour effects, with potential therapeutic interest.
However, the actions of cannabidiol in the digestive tract are largely unexplored. In the present study, we investigated the effect of cannabidiol on intestinal motility in normal control mice and in mice with intestinal inflammation.
Motility in vivo was measured by evaluating the distribution of an orally administered fluorescent marker along the small intestine; intestinal inflammation was induced by the irritant croton oil; contractility in vitro was evaluated by stimulating the isolated ileum, in an organ bath, with ACh. In vivo, cannabidiol did not affect motility in control mice, but normalized croton oil-induced hypermotility. The inhibitory effect of cannabidiol was counteracted by the cannabinoid CB1 receptor antagonist rimonabant, but not by the cannabinoid CB2 receptor antagonist SR N-[-1S-endo-1,3,3-trimethyl bicyclo [2.
Cannabidiol did not reduce motility in animals treated with the fatty acid amide hydrolase FAAH inhibitor N-arachidonoylhydroxytryptamine, whereas loperamide was still effective. In vitro, cannabidiol inhibited ACh-induced contractions in the isolated ileum from both control and croton oil-treated mice. Cannabidiol selectively reduces croton oil-induced hypermotility in mice in vivo and this effect involves cannabinoid CB1 receptors and FAAH.
In view of its low toxicity in humans, cannabidiol may represent a good candidate to normalize motility in patients with inflammatory bowel disease. Over the past few years, considerable attention has focused on cannabidiol CBD , a major nonpsychotropic constituent of cannabis. The authors present a review on the chemistry of CBD and discuss the anticonvulsive, antianxiety, antipsychotic, antinausea, and antirheumatoid arthritic properties of CBD. CBD does not bind to the known cannabinoid receptors , and its mechanism of action is yet unknown.
It is possible that, in part at least, its effects are due to its recently discovered inhibition of anandamide uptake and hydrolysis and to its antioxidative effect.
Over the past few years, increasing public and political pressure has supported legalization of medical marijuana. One of the main thrusts in this effort has related to the treatment of refractory epilepsy-especially in children with Dravet syndrome-using cannabidiol CBD.
Despite initiatives in numerous states to at least legalize possession of CBD oil for treating epilepsy, little published evidence is available to prove or disprove the efficacy and safety of CBD in patients with epilepsy. This review highlights some of the basic science theory behind the use of CBD, summarizes published data on clinical use of CBD for epilepsy, and highlights issues related to the use of currently available CBD products.
Cannabidiol is the major nonpsychoactive component of Cannabis sativa. Over the centuries, a number of medicinal preparations derived from C. These preparations were widely employed as analgesics by Western medical practitioners in the 19 th century 1. More recently, there is clinical evidence suggesting efficacy in HIV-associated neuropathic pain, as well as spasms associated with multiple sclerosis 1.
Cannabidiol -induced apoptosis in human leukemia cells: A novel role of cannabidiol in the regulation of p22phox and Nox4 expression. In the current study, we examined the effects of the nonpsychoactive cannabinoid, cannabidiol , on the induction of apoptosis in leukemia cells. Exposure of leukemia cells to cannabidiol led to cannabinoid receptor 2 CB2 -mediated reduction in cell viability and induction in apoptosis. Furthermore, cannabidiol treatment led to a significant decrease in tumor burden and an increase in apoptotic tumors in vivo.
From a mechanistic standpoint, cannabidiol exposure resulted in activation of caspase-8, caspase-9, and caspase-3, cleavage of poly ADP-ribose polymerase, and a decrease in full-length Bid, suggesting possible cross-talk between the intrinsic and extrinsic apoptotic pathways. The role of the mitochondria was further suggested as exposure to cannabidiol led to loss of mitochondrial membrane potential and release of cytochrome c.
It is noteworthy that cannabidiol exposure led to an increase in reactive oxygen species ROS production as well as an increase in the expression of the NAD P H oxidases Nox4 and p22 phox.
Finally, cannabidiol exposure led to a decrease in the levels of p-p38 mitogen-activated protein kinase, which could be blocked by treatment with a CB2-selective antagonist or ROS scavenger. Together, the results from this study reveal that cannabidiol , acting through CB2 and regulation of Nox4 and p22 phox expression, may be a novel and highly selective treatment for leukemia.
Cannabidiol CBD is a non-psychoactive constituent of Cannabis sativa with potential to treat neurodegenerative diseases. Its neuroprotection has been mainly associated with anti-inflammatory and antioxidant events; however, other mechanisms might be involved. CBD increased cell viability, differentiation, and the expression of axonal GAP and synaptic synaptophysin and synapsin I proteins.
Its neuritogenic effect was not dependent or additive to NGF, but it was inhibited by Ka trkA inhibitor. CBD did not induce neuritogenesis in this cellular model, which supports the involvement of trkA receptors.
This is the first study to report the involvement of neuronal proteins and trkA in the neuroprotection of CBD. Cannabidiol CBD is a natural non-psychotropic cannabinoid from marijuana Cannabis sativa with anti-epileptic and anti-inflammatory properties. CBD being a major component of Cannabis, our study indicates that marijuana may modulate or dysregulate the immune system by mobilizing MDSC.
The Dravet syndrome is a complex childhood epilepsy disorder that is associated with drug-resistant seizures and a high mortality rate. We studied cannabidiol for the treatment of drug-resistant seizures in the Dravet syndrome.
In this double-blind, placebo-controlled trial, we randomly assigned children and young adults with the Dravet syndrome and drug-resistant seizures to receive either cannabidiol oral solution at a dose of 20 mg per kilogram of body weight per day or placebo, in addition to standard antiepileptic treatment.
The primary end point was the change in convulsive-seizure frequency over a week treatment period, as compared with a 4-week baseline period. The median frequency of convulsive seizures per month decreased from Adverse events that occurred more frequently in the cannabidiol group than in the placebo group included diarrhea, vomiting, fatigue, pyrexia, somnolence, and abnormal results on liver-function tests. There were more withdrawals from the trial in the cannabidiol group.
The effects of leptin in combination with a cannabinoid receptor 1 antagonist, AM , or cannabidiol on food intake and body weight in rats fed a high-fat or a free-choice high sugar diet.
High intake of fats and sugars has prompted a rapid growth in the number of obese individuals worldwide. The hormone had no significant effects, however, on either caloric intake, body weight or food preferences in rats fed an FC diet. This drug combination, however, had no effect on the consumption of high-sucrose chow. None of the drug combinations affected water consumption. It is concluded that the concomitant treatment with leptin and AM attenuated markedly body weight gain in rats maintained on high-calorie diets rich in fat and carbohydrates but did not affect preferences for sweet food.
We describe the varied clinical features and mutations in nine patients examined at the National Institutes of Health who were compound heterozygotes for XPD mutations but had different clinical phenotypes: The vitamin D stimulation ratio of CYP24 and osteopontin was associated with specific pairs of mutations reduced in 5, elevated in 1 but not correlated with distinct clinical phenotypes.
Thyroid receptor stimulation ratio for KLF9 was not significantly different from normal. Potential protective effects of cannabidiol on neuroanatomical alterations in cannabis users and psychosis: Cannabis use and the development of schizophrenic psychoses share a variety of similarities.
Both start during late adolescence; go along with neuropsychological deficits, reduced activity, motivation deficits, and hallucinations suggesting impairment of similar brain structures. In cannabis heavy users diminished regional gray and white matter volume was reported.
Similar alterations were observed in the large literature addressing structural abnormalities in schizophrenia. Furthermore, in cannabis using schizophrenic patients, these brain alterations were especially pronounced. Close relatives of schizophrenic patients showed greater cannabis-associated brain tissue loss than non-relatives indicating a genetically mediated particular sensitivity to brain tissue loss. Possible mechanisms for the induction of structural brain alterations are here discussed including impairments of neurogenesis, disturbance of endocannabinoids and diminished neuroplasticity.
Especially direct THC effects or via endocannabinoids may mediate diminished glutamatergic neurotransmission usually driving neuroplasticity. Correspondingly, alterations of the kynurenic acid blocking NMDA receptors may contribute to brain structure alterations.
However, different cannabis compounds may exert opposite effects on the neuroanatomical changes underlying psychosis. This finding is further supported by several animal experiments supporting neuroprotective properties of CBD mainly via anti-oxidative effects, CB2 receptors or adenosine receptors.
We will discuss here the mechanisms by which CBD may reduce brain volume loss, including antagonism of THC, interactions with endocannabinoids, and mechanisms that specifically underlie antipsychotic properties of CBD. Prenatal exposure to phencyclidine produces abnormal behaviour and NMDA receptor expression in postpubertal mice. Several studies have shown the disruptive effects of non-competitive N-methyl-d-aspartate NMDA receptor antagonists on neurobehavioural development.
Based on the neurodevelopment hypothesis of schizophrenia, there is growing interest in animal models treated with NMDA antagonists at developing stages to investigate the pathogenesis of psychological disturbances in humans. Previous studies have reported that perinatal treatment with phencyclidine PCP impairs the development of neuronal systems and induces schizophrenia-like behaviour. This study investigated the long-term effects of prenatal exposure to PCP in mice.
The prenatal PCP-treated mice showed hypersensitivity to a low dose of PCP in locomotor activity and impairment of recognition memory in the novel object recognition test at age 7 wk. Meanwhile, the prenatal exposure reduced the phosphorylation of NR1, although it increased the expression of NR1 itself.
Furthermore, these behavioural changes were attenuated by atypical antipsychotic treatment. Taken together, prenatal exposure to PCP produced long-lasting behavioural deficits, accompanied by the abnormal expression and dysfunction of NMDA receptors in postpubertal mice. It is worth investigating the influences of disrupted NMDA receptors during the prenatal period on behaviour in later life. The novel endocannabinoid receptor GPR55 is activated by atypical cannabinoids but does not mediate their vasodilator effects.
The purpose of the present study was to test the hypothesis that human recombinant GPR55 is activated by atypical cannabinoids and mediates vasodilator responses to these agents. In GPRdeficient and wild-type littermate control mice, in vivo blood pressure measurement and isolated resistance artery myography were used to determine GPR55 dependence of atypical cannabinoid-induced haemodynamic and vasodilator responses.
The abnormal cannabidiol vasodilator response was antagonized equivalently by O in both strains. These results demonstrate that while GPR55 is activated by atypical cannabinoids, it does not appear to mediate the vasodilator effects of these agents. Cannabidiol improves brain and liver function in a fulminant hepatic failure-induced model of hepatic encephalopathy in mice. We investigated the effects of cannabidiol , a non-psychoactive constituent of Cannabis sativa with anti-inflammatory properties that activates the 5-hydroxytryptamine receptor 5-HT1A, on brain and liver functions in a model of hepatic encephalopathy associated with fulminant hepatic failure induced in mice by thioacetamide.
Neurological and motor functions were evaluated 2 and 3 days, respectively, after induction of hepatic failure, after which brains and livers were removed for histopathological analysis and blood was drawn for analysis of plasma liver enzymes.
In a separate group of animals, cognitive function was tested after 8 days and brain 5-HT levels were measured 12 days after induction of hepatic failure. Similarly, decreased motor activity in thioacetamide-treated mice was partially restored by cannabidiol.
Increased plasma levels of ammonia, bilirubin and liver enzymes, as well as enhanced 5-HT levels in thioacetamide-treated mice were normalized following cannabidiol administration. Likewise, astrogliosis in the brains of thioacetamide-treated mice was moderated after cannabidiol treatment. Therefore, the effects of cannabidiol may result from a combination of its actions in the liver and brain.
Hepatic encephalopathy is a neuropsychiatric disorder of complex pathogenesis caused by acute or chronic liver failure. We investigated the effects of cannabidiol , a non-psychoactive constituent of Cannabis sativa with anti-inflammatory properties that activates the 5-hydroxytryptamine receptor 5-HT 1A , on brain and liver functions in a model of hepatic encephalopathy associated with fulminant hepatic failure induced in mice by thioacetamide.
Female Sabra mice were injected with either saline or thioacetamide and were treated with either vehicle or cannabidiol. Neurological and cognitive functions were severely impaired in thioacetamide-treated mice and were restored by cannabidiol. Cannabidiol restores liver function, normalizes 5-HT levels and improves brain pathology in accordance with normalization of brain function. Cannabidiol as potential anticancer drug.
Indeed, cannabinoids possess anti-proliferative and pro-apoptotic effects and they are known to interfere with tumour neovascularization, cancer cell migration, adhesion, invasion and metastasization. Cannabidiol , neuroprotection and neuropsychiatric disorders. Cannabidiol CBD is a non-psychotomimetic phytocannabinoid derived from Cannabis sativa. It has possible therapeutic effects over a broad range of neuropsychiatric disorders.
It also has positive effects on attenuating psychotic-, anxiety- and depressive-like behaviors. Moreover, CBD affects synaptic plasticity and facilitates neurogenesis. The mechanisms of these effects are still not entirely clear but seem to involve multiple pharmacological targets. In the present review, we summarized the main biochemical and molecular mechanisms that have been associated with the therapeutic effects of CBD, focusing on their relevance to brain function, neuroprotection and neuropsychiatric disorders.
Published by Elsevier Ltd. Altered localization, abnormal modification and loss of function of Sigma receptor -1 in amyotrophic lateral sclerosis. Intracellular accumulations of mutant, misfolded proteins are major pathological hallmarks of amyotrophic lateral sclerosis ALS and related disorders. In the present study, we found that levels of the SigR1 protein were reduced in lumbar ALS patient spinal cord. SigR1 was abnormally accumulated in enlarged C-terminals and endoplasmic reticulum ER structures of alpha motor neurons.
These accumulations co-localized with the 20s proteasome subunit. Along with the accumulation of SigR1 and several other proteins involved in protein quality control, severe disturbances in the unfolded protein response and impairment of protein degradation pathways were detected in the above-mentioned cell culture systems.
Finally, pharmacological activation of SigR1 induced the clearance of mutant protein aggregates in these cells. Our results support the notion that SigR1 is abnormally modified and contributes to the pathogenesis of ALS. Abstract Cannabidiol CBD , a major cannabinoid of hemp, does not bind to CB1 receptors and is therefore devoid of psychotomimetic properties. It has been argued that this may occur also after oral administration in humans.
However, the experimental conversion of CBD to THC and delta8-THC in simulated gastric fluid SGF is a highly artificial approach that deviates significantly from physiological conditions in the stomach; therefore, SGF does not allow an extrapolation to in vivo conditions.
In addition, the typical spectrum of side effects of THC, or of the very similar synthetic cannabinoid nabilone, as listed in the official Summary of Product Characteristics e. Cannabidiol CBD , a major cannabinoid of hemp, does not bind to CB1 receptors and is therefore devoid of psychotomimetic properties.
Cannabidiol restores intestinal barrier dysfunction and inhibits the apoptotic process induced by Clostridium difficile toxin A in Caco-2 cells. Clostridium difficile toxin A is responsible for colonic damage observed in infected patients. Drugs able to restore Clostridium difficile toxin A-induced toxicity have the potential to improve the recovery of infected patients.
The purpose of this study was to evaluate a the anti-apoptotic effect and b the mechanisms by which cannabidiol protects mucosal integrity in Caco-2 cells exposed to Clostridium difficile toxin A. Cytotoxicity assay, transepithelial electrical resistence measurements, immunofluorescence analysis and immunoblot analysis were performed in the different experimental conditions.
Clostridium difficile toxin A significantly decreased Caco-2 cells' viability and reduced transepithelial electrical resistence values and RhoA guanosine triphosphate GTP , bax, zonula occludens-1 and occludin protein expression, respectively. All these effects were significantly and concentration-dependently inhibited by cannabidiol , whose effects were completely abolished in the presence of the cannabinoid receptor type 1 CB1 antagonist, AM Cannabidiol improved Clostridium difficile toxin A-induced damage in Caco-2 cells, by inhibiting the apoptotic process and restoring the intestinal barrier integrity, through the involvement of the CB1 receptor.
However, further elucidation of the channel properties and physiological role of TRPV2 have been hindered by the lack of selective pharmacological tools as well as by the species-dependent differences in the activation of this channel. In the present study, we have used cell-based calcium mobilization and electrophysiological assays to identify and characterize several novel cannabinoid TRPV2 agonists. We also demonstrated that cannabidiol evoked a concentration-dependent release of calcitonin gene-related peptide CGRP from cultured rat dorsal root ganglion neurons in a cannabinoid receptor - and TRPV1-independent manner.
Moreover, the cannabidiol -evoked CGRP release depended on extracellular calcium and was blocked by the nonselective TRP channel blocker, ruthenium red. We further provide evidence through the use of small interfering RNA knockdown and repetitive stimulation studies, to show that cannabidiol -evoked CGRP release is mediated, at least in part, by TRPV2. Together, these data suggest not only that TRPV2 may comprise a mechanism whereby cannabidiol exerts its clinically beneficial effects in vivo, but also that TRPV2 may constitute a viable, new drug target.
Neurological Aspects of Medical Use of Cannabidiol. Cannabidiol CBD is among the major secondary metabolites of Cannabis devoid of the deltatetra-hydrocannabinol psychoactive effects. It is a resorcinol-based compound with a broad spectrum of potential therapeutic properties, including neuroprotective effects in numerous pathological conditions.
CBD neuroprotection is due to its antioxidant and antiinflammatory activities and the modulation of a large number of brain biological targets receptors , channels involved in the development and maintenance of neurodegenerative diseases. The aim of the present review was to describe the state of art about the pre-clinical research, the potential use and, when existing, the clinical evidence related to CBD in the neurological field. Collection of all the pre-clinical and clinical findings carried out investigating the effects of CBD alone, not in combination with other substances, in the neurological arena with the exclusion of studies on neuropsychiatric disorders.
Pre-clinical evidence largely shows that CBD can produce beneficial effects in AD, PD and MS patients, but its employment for these disorders needs further confirmation from well designed clinical studies. CBD pre-clinical demonstration of antiepileptic activity is supported by recent clinical studies in human epileptic subjects resistant to standard antiepileptic drugs showing its potential use in children and young adults affected by refractory epilepsy.
Evidence for use of CBD in PD is still not supported by sufficient data whereas only a few studies including a small number of patients are available. Amphetamine-induced augmentation of striatal dopamine and its blunted release in prefrontal cortex PFC is a hallmark of schizophrenia pathophysiology. Here, we report enhanced dopaminomimetic-induced locomotor activity in these mutants, along with bidirectional, site-specific changes in in vivo amphetamine-induced dopamine release: Interestingly, the magnitude and distribution of amphetamine-induced c-Fos expression in dopamine neurons was comparable between genotypes across dopaminergic input subregions in the ventral tegmental area VTA.
Published by Oxford University. Responding was maintained under a fixed ratio 5 schedule of stimulus-shock termination. Results Both training drugs dose-dependently increased the percentage of responses on the respective drug-associated levers. Cannabidiol up to Moreover, 8-OH-DPAT significantly attenuated the discriminative stimulus effects of rimonabant, whereas cannabidiol did not modify the rimonabant discriminative stimulus. Both training drugs dose-dependently increased the percentage of responses on the respective drug-associated levers.
In the past five years, an increasing number of publications have focused on the discovery of the anti-inflammatory, anti-oxidant, and neuroprotective effects of CBD. In particular, CBD exerts positive pharmacological effects in ischemic stroke and other chronic diseases, including Parkinson's disease, Alzheimer's disease, and rheumatoid arthritis.
Importantly, CBD use does not lead to tolerance. In this review, we will discuss the therapeutic possibility of CBD as a cerebroprotective agent, highlighting recent pharmacological advances, novel mechanisms, and therapeutic time window of CBD in ischemic stroke. Cannabis contains the psychoactive component delta9-tetrahydrocannabinol delta9-THC , and the non-psychoactive components cannabidiol CBD , cannabinol, and cannabigerol. It is well-known that delta9-THC and other cannabinoid CB1 receptor agonists are neuroprotective during global and focal ischemic injury.
Additionally, delta9-THC also mediates psychological effects through the activation of the CB1 receptor in the central nervous system. In addition to the CB1 receptor agonists, cannabis also contains therapeutically active components which are CB1 receptor independent. The cerebroprotective action of CBD is CB1 receptor -independent, long-lasting, and has potent anti-oxidant activity.
Abnormal function of NMDA receptors is believed to be a contributing factor to the pathophysiology of schizophrenia. NMDAR subunits and postsynaptic-interacting proteins of these channels are abnormally expressed in some patients with this illness. In mice, reduced NMDAR expression leads to behaviors analogous to symptoms of schizophrenia, but reports of animals with mutations in core postsynaptic density proteins having similar a phenotype have yet to be reported.
SynGAP mutant mice exhibited nonhabituating and persistent hyperactivity that was ameliorated by the antipsychotic clozapine. SynGAP mutants exhibited enhanced startle reactivity and impaired sensory-motor gating. These mice also displayed a complete lack of social memory and a propensity toward social isolation. Finally, SynGAP mutants had deficits in cued fear conditioning and working memory, indicating abnormal function of circuits that control emotion and choice.
Our results demonstrate that SynGAP mutant mice have gross neurological deficits similar to other mouse models of schizophrenia. Taken together, these data support the idea that schizophrenia may arise from abnormal signaling pathways that are mediated by NMDA receptors. Intact attentional processing but abnormal responding in M1 muscarinic receptor -deficient mice using an automated touchscreen method. However, to better target therapeutically the appropriate receptor subsystems, we need to understand more about the functions of those subsystems.
In addition, we tested these mice on several tasks featuring learning, memory and perceptual challenges. An advantage of the touchscreen method is that each test in the battery is carried out in the same task setting, using the same types of stimuli, responses and feedback, thus providing a high level of control and task comparability.
The surprising finding, given the predominance of the M1 receptor in cortex, was the complete lack of effect of M1 deletion on measures of attentional function per se. They did, however, show clear abnormalities on a variety of response measures: Cannabidiol exerts sebostatic and antiinflammatory effects on human sebocytes. The endocannabinoid system ECS regulates multiple physiological processes, including cutaneous cell growth and differentiation.
Here, we explored the effects of the major nonpsychotropic phytocannabinoid of Cannabis sativa, - - cannabidiol CBD , on human sebaceous gland function and determined that CBD behaves as a highly effective sebostatic agent. Administration of CBD to cultured human sebocytes and human skin organ culture inhibited the lipogenic actions of various compounds, including arachidonic acid and a combination of linoleic acid and testosterone, and suppressed sebocyte proliferation via the activation of transient receptor potential vanilloid-4 TRPV4 ion channels.
Collectively, our findings suggest that, due to the combined lipostatic, antiproliferative, and antiinflammatory effects, CBD has potential as a promising therapeutic agent for the treatment of acne vulgaris.
Molecular Targets of Cannabidiol in Neurological Disorders. Cannabis has a long history of anecdotal medicinal use and limited licensed medicinal use. Until recently, alleged clinical effects from anecdotal reports and the use of licensed cannabinoid medicines are most likely mediated by tetrahydrocannabinol by virtue of: However, there has recently been considerable interest in the therapeutic potential for the plant cannabinoid, cannabidiol CBD , in neurological disorders but the current evidence suggests that CBD does not directly interact with the endocannabinoid system except in vitro at supraphysiological concentrations.
Thus, as further evidence for CBD's beneficial effects in neurological disease emerges, there remains an urgent need to establish the molecular targets through which it exerts its therapeutic effects. Here, we conducted a systematic search of the extant literature for original articles describing the molecular pharmacology of CBD.
We critically appraised the results for the validity of the molecular targets proposed. Thereafter, we considered whether the molecular targets of CBD identified hold therapeutic potential in relevant neurological diseases. The molecular targets identified include numerous classical ion channels, receptors , transporters, and enzymes.
Some CBD effects at these targets in in vitro assays only manifest at high concentrations, which may be difficult to achieve in vivo, particularly given CBD's relatively poor bioavailability. Moreover, several targets were asserted through experimental designs that demonstrate only correlation with a given target rather than a causal proof.
When the molecular targets of CBD that were physiologically plausible were considered for their potential for exploitation in neurological therapeutics, the results were variable. Implications for a Role in Epidermal Differentiation.
Bermudez, Yira; Benavente, Claudia A. Russell; Jacobson, Myron K. Background Chronic UV skin exposure leads to epidermal differentiation defects in humans that can be largely restored by pharmacological doses of nicotinic acid. Results Nicotinic acid increases epidermal differentiation in photodamaged human skin as judged by the terminal differentiation markers caspase 14 and filaggrin.
Both GPRA and GPRB genes are transcribed in human skin and in epidermal keratinocytes, but expression in dermal fibroblasts is below limits of detection. Receptor transcripts are greatly over-expressed in squamous cell cancers. Receptor protein in normal skin is prominent from the basal through granular layers of the epidermis, with cellular localization more dispersive in the basal layer but predominantly localized at the plasma membrane in more differentiated epidermal layers.
In normal human primary and immortalized keratinocytes, nicotinic acid receptors show plasma membrane localization and functional Gi-mediated signaling. In contrast, in a squamous cell carcinoma derived cell line, receptor protein shows a more diffuse cellular localization and the receptors are nearly non-functional.
Conclusions The results of these studies justify future genetic and pharmacological intervention studies to define possible specific role s of nicotinic acid receptors in human skin homeostasis.
The Developmental Origins of Health and Disease DOHaD Theory proposes that the environment encountered during fetal life and infancy permanently shapes tissue physiology and homeostasis such that damage resulting from maternal stress, poor nutrition or exposure to environmental agents may be at the heart of adult onset disease.
Interference with endogenous developmental functions of the aryl hydrocarbon receptor AHR , either by gene ablation or by exposure in utero to 2,3,7,8-tetrachlorodibenzo-p-dioxin TCDD , a potent AHR ligand, causes structural, molecular and functional cardiac abnormalities and altered heart physiology in mouse embryos.
To test if embryonic effects progress into an adult phenotype, we investigated whether Ahr ablation or TCDD exposure in utero resulted in cardiac abnormalities in adult mice long after removal of the agent.
Underlying these effects, genes in signaling networks related to cardiac hypertrophy and mitochondrial function were differentially expressed. The findings reported here underscore the conclusion that AHR signaling in the developing heart is one potential target of environmental factors associated with cardiovascular disease.
The anti-cancer effect of the plant-derived cannabinoid, cannabidiol , has been widely demonstrated both in vivo and in vitro. Darmani found that 2-AG 2.
An evaluation of changes in endocannabinoid levels elicited by cisplatin revealed that cisplatin increased levels of 2-AG in the brainstem, but decreased intestinal levels of both 2-AG and anandamide Darmani et al. On the other hand, Van Sickle et al. CB 2 receptors in the brainstem may play a role in the regulation of emesis by 2-AG, at least when CB 1 receptors are co-stimulated.
The anti-emetic effects of 2-AG 0. Although inhibition of FAAH elevates multiple endocannabinoid-like molecules that show activity at multiple target receptors, the anti-emetic effects of URB were reversed by pretreatment with rimonabant, indicating a CB 1 mechanism of action. In experiments with the S. A relative of the cannabinoid system, vanilloid TRPV1 receptors have recently been shown to regulate emesis in the ferret Sharkey et al.
The TRPV1 receptor is targeted by capsaicin the burning component of chili peppers as well as resiniferatoxin, which can produce pro-emetic and anti-emetic effects at similar doses in S. Recent findings indicate that the cannabinoid system interacts with the 5-hydroxytryptaminergic system in the control of emesis e. The first evidence of an interaction between cannabinoids and 5-HT 3 receptors was revealed by the finding that anandamide, WIN55 and CP inhibit 5-HT 3 receptor-mediated inward currents with IC 50 values in the nanomolar concentration range in rat nodose ganglion cells Fan, Since WIN 55,—2 did not displace a 5-HT 3 antagonist [ 3 H]-GR from the ligand binding site, the results suggest that cannabinoids inhibit 5-HT 3A receptors noncompetitively by binding to an allosteric modulatory site of the receptor Barann et al.
Additionally, cannabinoids have been shown to reduce the ability of 5-HT 3 agonists to produce emesis Darmani and Johnson, and this effect was prevented by pretreatment with rimonabant.
Cannabinoids may act at CB 1 presynaptic receptors to inhibit the release of newly synthesized 5-HT Schlicker and Kathmann, ; Howlett et al. Indeed, Darmani et al. Another major cannabinoid found in marijuana is CBD. As has been reported by others e. A wide range of doses was not effective in reducing motion-induced emesis in the S. The anti-emetic effect of CBD does not appear to be mediated by its action at CB 1 receptors, because it is not reversed by the CB 1 antagonist, rimonabant Kwiatkowska et al.
Indeed, Russo et al. Recently, our laboratory has investigated the mechanism of action for the anti-emetic effects of CBD. This activation of the 5-HT 1A receptors results in a reduction of the rate of firing of 5-HT neurones, ultimately reducing the release of forebrain 5-HT Blier and de Montigny, In addition, a recent finding suggests that CBD may also act as an allosteric modulator of the 5-HT 3 receptor Yang et al.
These findings suggest that allosteric inhibition of 5-HT 3 receptors by CBD may also contribute to its role in the modulation of emesis. Nausea is more resistant to effective treatment with new anti-emetic agents than is vomiting e. Andrews and Horn, and therefore remains a significant problem in chemotherapy treatment and as a side effect from other pharmacological therapies, such as anti-depressants. Even when the cisplatin-induced emetic response is blocked in the ferret by administration of a 5-HT 3 receptor antagonist, c-fos activation still occurs in the AP, suggesting that an action here may be responsible for some of the other effects of cytotoxic drugs, such as nausea or reduced food intake Reynolds et al.
In rats, the gastric afferents respond in the same manner to physical and chemical intragastric copper sulphate and cisplatin stimulation that precedes vomiting in ferrets, presumably resulting in nausea that precedes vomiting Hillsley and Grundy, ; Billig et al.
Furthermore, 5-HT 3 antagonists that block vomiting in ferrets also disrupt this preceding neural afferent reaction in rats. That is, in the rat the detection mechanism of nausea is present, but the vomiting response is absent.
Nauseogenic doses of cholecystokinin and LiCl induce specific patterns of brainstem and forebrain c-fos expression in ferrets that are similar to c-fos expression patterns in rats Reynolds et al.
In a classic review paper, Borrison and Wang suggest that the rats' inability to vomit can be explained as a species-adaptive neurological deficit and that, in response to emetic stimuli, the rat displays autonomic and behavioural signs corresponding to the presence of nausea, called the prodromata salivation, papillary dilation, tachypnoea and tachycardia. The typical measure used in the literature to evaluate the nauseating potential of a drug is conditioned taste avoidance.
However, taste avoidance is not only produced by nauseating doses of drugs, it is also produced by drugs that animals choose to self-administer or that establish a preference for a distinctive location e. Berger, ; Wise et al. In fact, when a taste is presented prior to a drug self-administration session, the strength of subsequent avoidance of the taste is a direct function of intake of the drug during the self-administration session Wise et al.
This paradoxical phenomenon was initially interpreted as another instance of taste aversion learning. Because Garcia et al. However, in an animal capable of vomiting, the S. Since rats are incapable of vomiting, it is likely that conditioned taste avoidance produced by rewarding drugs in this species is based upon a learned fear of anything that changes their hedonic state e. Gamzu, when that change is paired with food previously eaten.
Another approach to understanding the role that nausea plays in the establishment of taste avoidance in rats is to evaluate the potential of anti-nausea treatments to interfere with avoidance of a flavour paired with an emetic treatment.
Early work suggested that anti-nausea agents interfered with the expression of previously established taste avoidance produced by LiCl Coil et al.
Furthermore, there is considerable evidence that anti-nausea treatments either do not interfere with the establishment of conditioned taste avoidance learning Rabin and Hunt, ; Rudd et al. Two prominent anti-nausea treatments include drugs that reduce 5-HT availability and drugs that elevate the activity of the endocannabinoid system in rats see Parker et al. Over the past number of years, our laboratory has provided considerable evidence that conditioned nausea in rats may be displayed as conditioned disgust reactions Parker, ; ; ; ; Limebeer and Parker, ; ; Limebeer et al.
Rats display a distinctive pattern of disgust reactions including gaping, chin rubbing and paw treading when they are intraorally infused with a bitter tasting quinine solution. Rats also display this disgust pattern when infused with a sweet tasting solution that normally elicits hedonic reactions of tongue protrusions that has previously been paired with a drug that produces vomiting such as LiCl or cyclophosphamide in species capable of vomiting.
Only drugs with emetic properties produce this conditioned disgust reaction when paired with a taste. The most reliable conditioned disgust reaction in the rat is that of gaping Breslin et al. If conditioned gaping reflects nausea in rats, then anti-nausea drugs should interfere with this reaction. Limebeer and Parker demonstrated that when administered prior to a saccharin-LiCl pairing, the 5-HT 3 antagonist, ondansetron, prevented the establishment of conditioned gaping in rats, presumably by interfering with LiCl-induced nausea.
Since ondansetron did not modify unconditioned gaping elicited by bitter quinine solution, the effect was specific to nausea-induced gaping. Subsequently, Limebeer and Parker demonstrated a very similar pattern following pretreatment with the 5-HT 1A autoreceptor antagonist, 8-OH-DPAT, that also reduces 5-HT availability and serves as an anti-emetic agent in animal models.
Most recently, Limebeer et al. The orofacial characteristics of the rat gape are very similar to those of the shrew retch just before it vomits Parker, Indeed, Travers and Norgren suggest that the muscular movements involved in the gaping response mimic those seen in species capable of vomiting. Using the conditioned gaping response as a measure of nausea in rats, we have demonstrated that a low dose 0. The potent agonist, HU 0.
When administered 30 min prior to the conditioning trial, rimonabant did not produce conditioned gaping on its own, but it did potentiate the ability of LiCl to produce conditioned gaping. This same pattern has been reported in the emesis literature Van Sickle et al. Van Sickle et al.
More compelling evidence that the endocannabinoid system may serve as a regulator of nausea is the recent finding that prolonging the duration of action of anandamide by pretreatment with URB, a drug that inhibits the enzyme FAAH, also disrupts the establishment of LiCl-induced conditioned gaping reactions in rats Cross-Mellor et al.
Rats pretreated with URB 0. Rats given the combination of URB 0. Although inhibition of FAAH produces an elevation of a variety of fatty acids that act at different receptors, the effect of URB on conditioned nausea was reversed by AM, indicating that it was mediated by CB 1 receptors.
On the other hand, the silent CB 1 antagonists, AM and AM, which do not have inverse agonist properties, do not produce conditioned gaping Sink et al.
In addition, the peripherally restricted silent CB 1 antagonist, AM, which also suppresses feeding at equivalent doses of AM Cluny et al. Finally, neither the silent antagonist, AM which crosses the blood—brain barrier nor AM with limited CNS penetration , potentiate LiCl-induced nausea, an effect evident with low doses 2.
AMinduced conditioned nausea is thus mediated by inverse agonism of the CB 1 receptor. Recent research Rock et al. Research aimed at determining the forebrain regions e. AN often develops over the course of repeated chemotherapy sessions Nesse et al. For instance, Nesse et al.
He experienced the same nausea when returning for routine follow-up visits, even though he knew he would not receive treatment. The nausea gradually disappeared over repeated follow-up visits. AN is best understood as a classically conditioned response CR Pavlov, Control over AN could be exerted at the time of conditioning or at the time of re-exposure to the conditioned stimulus CS.
If an anti-emetic drug is presented at the time of conditioning, then a reduction in AN would be the result of an attenuated unconditioned response UCR ; that is, reduced nausea produced by the toxin at the time of conditioning thereby attenuating the establishment of the CR. Indeed, when administered during the chemotherapy session, the 5-HT 3 antagonist, granisetron, has been reported to reduce the incidence of AN in repeat cycle chemotherapy treatment Aapro et al.
On the other hand, if a drug is delivered prior to re-exposure to cues previously paired with the toxin-induced nausea, then suppressed AN would be the result of attenuation of the expression of the CR conditioned nausea ; the 5-HT 3 antagonists are ineffective at this stage Nesse et al.
Although there has been considerable experimental investigation of unconditioned retching and vomiting in response to toxins, there have been relatively few reports of conditioned retching; that is, emetic reactions elicited by re-exposure to a toxin paired cue. Conditioned retching has been observed to occur in coyotes, wolves and hawks upon re-exposure to cues previously paired with lithium-induced toxicosis Garcia et al.
This effect was replicated more recently and extended to demonstrate that CBD also interferes with the expression of conditioned retching in the shrew, but the 5-HT 3 antagonist ondansetron was completely ineffective Parker et al. The doses employed were selected on the basis of their potential to interfere with toxin-induced vomiting in the S.
Rats also display conditioned gaping reactions when re-exposed to a context previously paired with LiCl-induced nausea Limebeer et al. Following four pairings of a distinctive, vanilla odour-laced chamber with LiCl-induced illness, rats were returned to the context for 30 min and received a 1 min intraoral infusion of novel saccharin solution every 5 min.
During the infusions, the rats displayed gaping reactions. Surprisingly, the rats also gaped during intervals when they were not being infused with saccharin while in the LiCl-paired context. The finding that rats express conditioned gaping responses when re-exposed to an odour-laced context previously paired with LiCl during inter-infusion intervals Limebeer et al.
Meachum and Bernstein had previously shown the re-exposure to a lithium-paired odour cue elicited gaping reactions in rats. Recently, Limebeer et al. Most recently, Rock et al. Indeed, inhibition of FAAH by URB also prevented the establishment of LiCl-induced conditioned gaping elicited by the contextual cues when administered 2 h prior to each conditioning trial.
These results suggest that cannabinoid compounds may be effective agents in the treatment of AN in chemotherapy patients. Since the discovery of the mechanism of action of cannabinoids, our understanding of the role of the endocannabinoid system in the control of nausea and vomiting has greatly increased.
In the ferret and shrew models, the site of action has been identified in the emetic area of the brainstem, the DVC. The shrew model, in particular, is cost effective for the evaluation of the anti-emetic properties of agents.
The conditioned gaping response in the rat has provided a glimpse into the anti-nausea mechanisms of action of cannabinoids, in the absence of a vomiting response. Since nausea is a more difficult symptom to control than vomiting, the gaping model may serve as a useful tool for the development of new anti-nausea treatments, as well as for the evaluation of the potential side effects of nausea in newly developed pharmacological treatments. Recent work has also supported anecdotal reports that cannabis may attenuate AN.
Although chemotherapy-induced vomiting is well controlled in most patients by conventionally available drugs, nausea acute, delayed and anticipatory continues to be a challenge. Nausea is often reported as more distressing than vomiting, because it is a continuous sensation e.
Both preclinical and human clinical e.
Information for Health Care Professionals: Cannabis (marihuana, marijuana) and the cannabinoids
Cannabidiol (CBD), a non-psychoactive component of the marijuana plant, has generated and adenosine) and by enhancing or inhibiting the binding action of certain stronger than either CBD or THC, which also have anti-nausea properties. Historically, the vanilla bean has been used as a folk cure for headaches. Apr 20, Cannabinoid compounds are effective in reducing acute nausea in . As well, by a noncannabinoid mechanism of action, both CBD and CBDA. Jan 17, The primary non-psychoactive compound in cannabis, cannabidiol (CBD), also . the fundamental mechanisms underlying the antiemetic efficacy of CB 1 R . the Cannabis sativa plant, have been shown to reduce nausea and vomiting in .. [33, 34] In summary, the action of cannabinoids on CB1 receptor.