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Cannabinoids have generally accepted palliative effects on some symptoms related to cancer of all types; accumulating preclinical data suggest that cannabinoids may reduce tumor growth in animal cancer models. This is achieved by influencing the signaling of specific biochemical pathways, which are involved in controlling the proliferation of cancer cells as well as their survival. Besides, cannabinoids seem to inhibit neo-angiogenesis and reduce the invasiveness of tumors (in animal studies). Human studies of this sort are not available yet. We will here address specifically glioblastoma multiform (GBM), one of the deadliest and most treatment-resistant cancers in humans.


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ySARS-CoV-2 electromicrograph. Credit NIAID-RML

The agnostic’s half-truth busted — An Integrative approach

Disclosures:

No funding has been received and there is no conflict of interests

Outline

Abstract

Characteristics of COVID19: Know thy enemy

Clinical & Epidemiologic aspect

The virus-host interaction

Respiratory distress

ARDS pathogenesis

Gender difference

Prophylactic measures: A strategy for the reduction of risk

Establishing a strong primary care system

General prophylaxis

Specific prophylaxis

Overview of therapeutic measures

The prevailing treatment

Other treatment options

Immunostimulatory herbal medicines

Treatment considerations for the severely ill

1. Glucocorticoids (GCs)

2. Anti-sera

3. Measures to counter cell-free hemoglobin (CFH) effects

4. Chloroquine & Azithromycin

5. Colchicine

6…


It turns out that they are equal but different. Why is that?

The use and abuse of cannabis, for medical or other reasons, is undeniably on the rise. As the experience of the medical world with the plant and its products increases, we begin to see a difference that we had not realized before: Cannabis affects men differently from women in some respects. This difference extends to animals as well. It has a biological basis, and it is related to the different effects of hormones on the endocannabinoid system (ECS), a diffuse system consisting of endogenous lipid ligands (endocannabinoids, ECs), their receptors and the enzymes that produce, degrade and transport them. …


Caring for the demented
Caring for the demented
Caring for the demented. Credit: NY Times

Can we do better?

According to the WHO, there are nearly 10 million new cases of dementia every year, worldwide. It is estimated that the incidence in the general population aged 60 and over is 5–8%. The WHO recognizes dementia as a public health priority because its frequency is on the rise; it can be overwhelming for the families of affected people; it has significant social and economic implications: The direct and indirect cost of dementia to society is at the order of 1.1% of global GDP (0.2%-1.4% depending on how rich is the country).


A neglected multi-purpose hormone and a simple painkiller in action

What does the “fall-asleep-fast” pill have to do with infections? Well, have you ever heard of off-label uses of medicines? Regulators (the FDA in the US) approve substances for the treatment of specific morbid conditions, and this is what shows on the label. This does not mean that there are no other potential uses, but these unfortunately pass into oblivion until someone bring them back to attention. Similar is the case with acetaminophen (alias paracetamol), well known in the US as Tylenol, whose label reads “anti-pyretic, analgesic”.

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Credit: https://www.melatonin-research.net/index.php/MR/about

Melatonin is a highly conserved molecule during evolution; a hormone with multiple physiological effects, including its all-important cross-reactivity with the endocannabinoid system. …


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Credit: Trends in Endocrinology & Nutrition

Emphasis on immunoregulation: The ECS is a disease modifier

The Endo-Cannabinoid System (ECS) is a disperse system, extending throughout the body; it is in constant interplay with all other organ systems promoting homeostasis in almost every aspect. Despite that, the ECS is still neglected and not included in the curricula of medical schools. For this reason a few introductory notes are in order. The ECS is the regulator of cognition, mood, nociception, energy metabolism, oxidation, inflammatory processes and a disease modifier as well.

The ECS consists of receptors, ligands to these receptors and enzymes that synthesize and degrade these ligands. The number of known endocannabinoid receptors is still growing to more that 55; the two most outstanding receptors are CB1R, mainly distributed throughout the nervous system and responsible for the psychoactivity of cannabis, and CB2R, mainly distributed on immune cells, even those “disguised” as specialized cells within other organs. Other receptors include TRPVx, GPR55, PPaRs etc; all these receptors form dimers between them as well as heterodimers with other types of receptors, like opioid, dopamine, serotonin, adenosine, catecholamine receptors and many others, thereby promoting a universal regulatory interplay throughout the body. The ligands to these receptors are the endocannabinoids (ECs): lipids of the eicosanoid family, derivatives of arachidonic acid (AA); the latter abounds in cell membranes; five of these are well characterized to date, but two are well studied: Anandamide (AEA) and 2-Arachidonoyl-Glycerole (2AG). ECs in the nervous system act in negative feedback loops, more or less like neurotransmitters, but, unlike them, they are synthesized and degraded on demand, and not stored in micro-vesicles. Several formerly unrelated morbid conditions are now recognized as ECS deficiencies, including, among many, migraine, autism, fibromyalgia, irritable bowel syndrome etc. …


Is it ethical not to investigate the use of phytocannabinoids?

This scanning electron microscope image shows SARS-CoV-2, the virus that causes COVID-19 — isolated from a patient.
This scanning electron microscope image shows SARS-CoV-2, the virus that causes COVID-19 — isolated from a patient.
This scanning electron microscope image shows SARS-CoV-2 (yellow) , the virus that causes COVID-19 — isolated from a patient in the U.S., emerging from the surface of cells (blue/pink) cultured in the lab. Credit: NIAID-RML

I have been very curious to see what experts had to say about cannabis use in the COVID19 epidemic, and thus have been researching extensively. I have found only broad generalizations, along with the popular refrain “cannabidiol does not cure coronavirus”. I find it to be a very over-simplified statement (who is talking about treatment of the virus itself, anyway?) and so I decided to do my own research.

According to all the studies to date (Nichols & Kaplan, 2020), there is no doubt that CBD is immunomodulatory and anti-inflammatory. By “immunomodulatory” we mean basically immunosuppressive, since it generally suppresses the proliferation and activation of mitogen stimulated T-cells, as well as the production of pro-inflammatory cytokines (Chen et al., 2012); the point that should be made here is that the immuosuppressive action of CBD is in no way related to the immunosuppressive action in drugs such as methotrexate or cyclophosphamide. These drugs alter immunity as suppressors only, while CBD (and THC for that matter) modulates its response either by suppressing or by enhancing it, depending on the level of existing T-cell activation (Chen et al., 2012). These findings apply to HIV infections and it remains to be proven if they apply to other corona viruses as well; nevertheless, some data are available: In SARS-CoV infections (very similar to current SARS-CoV-2), a severe decrease in circulating T-cells was observed in the acute phase (Channappanavar et al, 2014). It is therefore possible and worth investigating whether the same applies to COVID19, which would mean that the two basic phytocannabinoids, namely CBD and THC, would be indicated for the treatment of the acute phase. …

About

Aias-Theodoros Papastavrou, MD, PhD

Medical director at Biomed Aid Ltd. Integrative Medicine (Nutrition, Epigenetics, Medicinal Cannabis, Hyperthermia). https://bit.ly/2yim2J9

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