CANNABINOIDS AND CANCER AGOSTO 2DO. 2018

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1. Front Neurosci. 2018 Aug

Self-Reported Effectiveness and Safety of Trokie® Lozenges: A Standardized
Formulation for the Buccal Delivery of Cannabis Extracts.

Crowley K(1), de Vries ST(2), Moreno-Sanz G(3)(4).

Author information: 
(1)Palliative Care Corporation, Huntington Beach, CA, United States.
(2)Department of Clinical Pharmacy and Pharmacology, University of Groningen,
University Medical Center Groningen, Groningen, Netherlands.
(3)Abagune Research, Vitoria-Gasteiz, Spain.
(4)Phytoplant Research S.L., Córdoba, Spain.

Therapeutic use of cannabinoids, the main active ingredients of Cannabissativa
L., is often hindered by their limited bioavailability and undesirable
psychoactivity. We conducted an observational study in December 2016 and another 
one in February 2018 to investigate respectively: (i) the effectiveness of
Trokie® lozenges, a standardized formulation containing cannabis extracts, to
deliver cannabinoids via buccal absorption and (ii) its long-term safety.
Participants were members of the Palliative Care Corporation health clinic,
registered California cannabis patients, and had a diagnosis of chronic
non-cancer pain. For the effectiveness study, 49 participants were asked to
self-report pain perception before and after 1-12 weeks of taking Trokie®
lozenges, using an 11-point pain intensity numeric rating scale (PI-NRS). A mean 
reduction in PI-NRS score of 4.9 ± 2.0 points was observed. Onset of analgesia
typically varied between 5 and 40 min, which seems consistent with, at least
partial, buccal absorption. In the safety study, 35 participants were asked to
complete a questionnaire about adverse events (AEs) associated with Trokie®
lozenges. AEs were reported by 16 subjects (46%), the most common being
dizziness/unsteadiness (N = 7), bad taste (N = 5), and throat irritation/dry
mouth (N = 4). None of the self-reported AEs resulted in a serious medical
situation and most of them had limited impact on daily functions. Despite the
AEs, 90% of participants reported being "satisfied" or "very satisfied" with the 
product. These observations suggest that buccal administration of standardized
extracts via Trokie® lozenges may represent an efficacious and safe approach to
cannabis administration.

2. Dermatol Online J. 2018 Jun

Cannabinoids in dermatology: a scoping review.

Eagleston LRM, Kalani NK, Patel RR, Flaten HK, Dunnick CA, Dellavalle RP(1).

Author information: 
(1)University of Colorado School of Medicine, Department of Dermatology, Aurora, 
Colorado Denver Veterans Affairs Medical Center (VAMC), Department of
Dermatology, Denver, Colorado. Esta dirección de correo electrónico está siendo protegida contra los robots de spam. Necesita tener JavaScript habilitado para poder verlo..

The therapeutic applications of cannabis and cannabinoids are an increasingly
conspicuous topic as de-criminalization and legalization of these products
continues to expand. A limited number of cannabinoid compounds have been approved
for a specific set of conditions. However, the current role of cannabinoids for
the treatment of dermatologic conditions remains to be defined. We conducted a
review of the current literature to determine the applications of cannabinoids
for the therapy of various skin diseases. After conducting our analysis, we found
that cannabinoid products have the potential to treat a variety of skin
conditions, including acne vulgaris, allergic contact dermatitis, asteatotic
dermatitis, atopic dermatitis, hidradenitis suppurativa, Kaposi sarcoma,
pruritus, psoriasis, skin cancer, and the cutaneous manifestations of systemic
sclerosis. However, the majority of available data on these compounds are
pre-clinical and there is a corresponding lack of high-quality randomized,
controlled trials that evaluate their effects. Cannabinoids have shown some
initial promise as therapy for a variety of skin diseases. However, there is a
requirement for thorough pre-clinical research and large-scale, randomized,
controlled trials before cannabinoids can be considered safe and effective
treatments for these conditions.



3. Biochem Pharmacol. 2018 Aug
The endocannabinoid system of the skin. A potential approach for the treatment of skin disorders. Río CD(1), Millán E(2), García V(3), Appendino G(4), DeMesa J(5), Muñoz E(6). Author information: (1)Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain; Departamento de Biología Celular, Fisiología e Inmunología, Universidad de Córdoba, Córdoba, Spain; Hospital Universitario Reina Sofía, Córdoba, Spain. (2)Innohealth Group, Madrid, Spain. (3)Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain; Departamento de Biología Celular, Fisiología e Inmunología, Universidad de Córdoba, Córdoba, Spain; Hospital Universitario Reina Sofía, Córdoba, Spain; Innohealth Group, Madrid, Spain. (4)Dipartimento di Scienze del Farmaco, Università del Piemonte Orientale, Novara, Italy. (5)Emerald Health Pharmaceuticals, San Diego, USA. (6)Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain; Departamento de Biología Celular, Fisiología e Inmunología, Universidad de Córdoba, Córdoba, Spain; Hospital Universitario Reina Sofía, Córdoba, Spain. Electronic address: Esta dirección de correo electrónico está siendo protegida contra los robots de spam. Necesita tener JavaScript habilitado para poder verlo.. The skin is the largest organ of the body and has a complex and very active structure that contributes to homeostasis and provides the first line defense against injury and infection. In the past few years it has become evident that the endocannabinoid system (ECS) plays a relevant role in healthy and diseased skin. Specifically, we review how the dysregulation of ECS has been associated to dermatological disorders such as atopic dermatitis, psoriasis, scleroderma and skin cancer. Therefore, the druggability of the ECS could open new research avenues for the treatment of the pathologies mentioned. Numerous studies have reported that phytocannabinoids and their biological analogues modulate a complex network pharmacology involved in the modulation of ECS, focusing on classical cannabinoid receptors, transient receptor potential channels (TRPs), and peroxisome proliferator-activated receptors (PPARs). The combined targeting of several end-points seems critical to provide better chances of therapeutically success, in sharp contrast to the one-disease-one-target dogma that permeates current drug discovery campaigns. Copyright © 2018 Elsevier Inc. All rights reserved. 4. Cannabis and Cannabinoids (PDQ®): Health Professional Version. PDQ Integrative, Alternative, and Complementary Therapies Editorial Board. In: PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. 2018 Aug 16. This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about the use of Cannabis and cannabinoids in the treatment of people with cancer. It is intended as a resource to inform and assist clinicians who care for cancer patients. It does not provide formal guidelines or recommendations for making health care decisions. This summary is reviewed regularly and updated as necessary by the PDQ Integrative, Alternative, and Complementary Therapies Editorial Board, which is editorially independent of the National Cancer Institute (NCI). The summary reflects an independent review of the literature and does not represent a policy statement of NCI or the National Institutes of Health (NIH). 5. Chem Biol Interact. 2018 Aug Effects of Δ9-tetrahydrocannabinol on irinotecan-induced clinical effects in rats. Prester L(1), Mikolić A(1), Jurič A(1), Fuchs N(2), Neuberg M(3), Vrdoljak AL(1), Karačonji IB(4). Author information: (1)Institute for Medical Research and Occupational Health, Zagreb, Croatia. (2)University Hospital Centre Zagreb, Zagreb, Croatia. (3)University Centre Varaždin, University North, Varaždin, Croatia. (4)Institute for Medical Research and Occupational Health, Zagreb, Croatia. Electronic address: Esta dirección de correo electrónico está siendo protegida contra los robots de spam. Necesita tener JavaScript habilitado para poder verlo.. Because of the great interest for research on the potential use of cannabis preparations as co-medication for alleviation of toxic effects in cancer management, we investigated the influence of Δ9-tetrahydrocannabinol (Δ9-THC) to modulate irinotecan (CPT-11)-induced toxicity. Male Wistar rats were treated either with a single irinotecan intraperitoneal dose, 100 mg/kg body-weight (b.w.), or with irinotecan in combination with THC (7 mg/kg b. w., p. o., administered repeatedly for 1, 3 and 7 days). Serial blood samples were obtained up to seven days after dosing and were analyzed for complete blood count and biochemical parameters (liver enzymes, creatinine, inflammatory markers, and lipid status). Serial urine samples were collected in the first 24 h to monitor the time-course of THC metabolite 11-nor-9-carboxy-Δ9-THC (THC-COOH) excretion with concomitant irinotecan treatment or without. Both irinotecan and irinotecan + Δ9-THC administration caused moderate leukopenia but a greater decrease in leukocyte count was observed in the irinotecan + Δ9-THC treated compared to the single irinotecan suggesting higher cytotoxic effects in combined treatment. Irinotecan treatment induced elevation of aspartate aminotransferase (AST) in rats without diarrheal symptoms and without an increase in circulating pro-inflammatory mediators. Interestingly, the elevation of AST was not observed in the irinotecan + Δ9-THC group. The median creatinine-corrected urinary THC-COOH concentration was higher in the irinotecan + THC group compared to the THC-only group in a time-dependent manner, suggesting a possible early interaction between cannabinoids and irinotecan. Further studies are needed to investigate the role of cannabinoids particularly on hematological toxicity, irinotecan metabolism and their role as a possible modifiable factor among irinotecan-treated hosts. Copyright © 2018. Published by Elsevier B.V.