Abstracts - CannX: The International Medical Cannabis Conference Lisbon, Portugal, February 12-13, 2020

Abstract

Cancer is the second leading cause of death globally and is responsible for an estimated 9.6 million deaths in 2018. Reported cases of cancer in both genders are 18.78 million in 2018 with ap-proximately 70% of deaths occurring in low- and middle-income countries, including Pakistan. Breast cancer is the highest reported cancer in Pakistan while prostate cancer constitutes 6.7% of the total cancer burden. Anti-cancer activity of selected plant-derived cannabinoids has been studied in different cancer cell lines showing positive results by some investigators but there is no such report available from Pakistan and the therapeutic potential of Pakistani varieties of Cannabis Sativa remains unexplored. We infer that the variant of C. sativa cultivated in Pakistan is efficacious against human breast cancer and prostate cancer cell lines. This study is planned to evaluate the anticancer properties of different extracts (Flowers, leaves, stem, root, seeds and whole plant extracts) of Cannabis Sativa cultivated in Pakistan against human breast cancer cell lines (MCF-7 and MDA-MB-231) and prostate cancer cell lines (PC3 and LNCaP). All plant material will be dry and powdered in pharmacology laboratory. Each plant material will be soaked in aqueous methanol (30:70) for three days at room temperature and 1st, 2nd, and 3rd filtrates will be obtained using a muslin cloth and Whatman filter paper. The filtrates will be com-bined together and solvent will be removed using a rotary-evapo-rator under reduced pressure, to yield/obtained respective Cannabis sativa thick extract. An intramural grant has been procured for this study. Results will be shared during the research presentation. Delta-9-tetrahydrocannabinol (THC) is the main phytocan-nabinoid in “Cannabis sativa”. Cannabis use by pregnant women to relieve morning sickness has been increasing, as reported by various epidemiological studies. Diverse processes are involved in the remodelling of trophoblast cells, such as proliferation, differentiation, apoptosis and invasion, which are crucial for placental development. The consumption of cannabis during pregnancy is of much concern since it may disrupt the endocannabinoid system (ECS) which modulates several biological functions, including re-production. Our group demonstrated that THC has an impact on trophoblast turnover, through induction of apoptosis, as well as on the ECS homeostasis. Considering the relevance of cannabinoid signalling in reproductive tissues, women of child-bearing age may be a particularly sensitive group to cannabinoids exposure. Thus, it is important to understand the consequences of this exposure on reproductive health. The aim of this work was to study the effects of THC on trophoblast cells, using BeWo and HTR-8 (ATCC, USA) cell lines, well-accepted models of cytotrophoblasts (“stem cells”) and extravillous/invasive trophoblasts, respectively. It was observed that THC induces a dose-dependent decrease in cell vi-ability although at lower concentrations in the case of HTR-8 cells. Results indicate that THC may affect trophoblast cells remodelling by apoptosis activation. Moreover, this cannabinoid affects the invasive properties of extravillous trophoblasts. build and strengthen C4T in preparation for the successful design and conduct of future randomized controlled trials to evaluate the effectiveness of cannabis in children, starting with childhood cancers. Updates from C4T will be provided by our Scientific Director on our parent-resource hub, surveillance studies, observational studies on cannabis pharmacodynamics and pharmacokinetics in children with cancer and our open-label dosing study on a cannabis health product for symptom management in children with cancer. This session will also discuss practical considerations for operating cannabis clinical trials with children including ethical considerations, funding models and academic part-nerships. (knowl-edge, find Methodology: After ethics review committee approval, anesthesiologists working in centers that provide management will through to fill an online KAP survey. This survey will contain questions relevant to the knowledge about; available preparations of Cannabis, legality of use in the country, indications and contraindications, side effects, Attitude; willingness to use if available, barriers to use, and Practice; their experience of using medical Cannabis. Survey will be administered through Google forms. Selected participants will be sent a reminder after 10 days of the first email, and a second reminder after 20 days. Data will be analyzed by Statistical packages for social science version 17 (SPSS Mean and standard deviation will be computed for age and experience of anesthesiologist. Frequency and percentage will be computed for gender, knowledge, attitude and perception of Pakistani anesthesiologists about medical of cannabis. Chi-square test or Fisher exact test will be used at p ≤ 0.05 of The endocannabinoid system (ECS) is composed by the cannabinoid receptors CB1 and CB2, their main endogenous ligands N -arachidonoylethanolamine (AEA) and 2-arachidonoylglycerol (2-AG) as their main metabolic enzymes of synthesis and degradation: N -acylphosphatidylethanolamide-specific phospholipase D (NAPE-PLD) and fatty acid amide hydrolase (FAAH) for AEA and diacylglycerol lipase (DAGL) and monoacylglycerol lipase (MAGL) for 2-AG. Among the physiological functions modulat-ed by the ECS, the reproductive one has been a hot topic, given the importance of a tight regulation of the endocannabinoid levels on decidualization and placentation. Moreover, the increase in cannabis consumption by woman during gestation has led to pour pregnancy outcomes such as low birth weight, prematurity and intrauterine growth restriction. These effects may be due to the main psychoactive compound of cannabis, Tetrahydrocannabinol (THC), since, even though it is hard to prove its effect in cannabis consumers, given the plethora of compounds present in the plant, we recently presented evidence that THC impairs the AEA levels and its metabolic enzymes in placental explants. To provide a better understand of the biochemical mechanisms behind these pour outcomes, we studied the impact of THC in 2-AG metabolism by quantification of its levels and expression of its main metabolic enzymes DAGL and MAGL in placental explants. Our results showed that both DAGL and MAGL are present in the placental explants in the syncytiotrophoblast layer. THC caused an increase in both DAGL and MAGL after short periods, a decrease in MAGL expression was observed for longer periods of incubation. However, 2-AG levels remained unchanged in both periods of culture, the 2-AG levels may be controlled by other mechanisms that under evaluation. Autism Spectrum Disorders comprise conditions that may affect In this study the steam extracted pure essential oil of hemp ( Cannabis sativa L) as well as its different fractions, obtained by fractional distillation of oil, were analyzed using Raman spectroscopy coupled with the Principal Component Analysis (PCA), a multivariate data analysis technique. The most important features observed in the Raman spectra are used to identify the presence of different components in the pure hemp oil as well as in its different fractions. These Raman spectral features can be considered as markers to provide information about the chemical composition of the hemp essential oil. Principal Component analysis (PCA) is employed to identify the biochemical features responsible for the differentiation between different fractions of hemp essential oil. Hepatoprotective activity of Cannabis sativa (Hemp) essential oil and its different fractions was studied using a carbon tetrachloride induced liver fibrosis model in rats. The hepatotoxicity produced by chronic carbon tetrachloride administration was found to be inhibited by Cannabis sativa essential oil and its different fractions with the evidence of decreased levels of serum aspartate amino-transferase, alanine aminotransferase, alkaline phosphatase and bilirubin. The histopathological findings also suggest that Cannabis sativa essential oil prevents the development of chronic liver damage. The changes in the body weights in the rats assigned to the study groups supported these biochemical and histopathological findings. The results of this study clearly indicate that Cannabis sativa essential oil and its five different fractions have a potent hepatoprotective action against carbon tetrachloride-induced liver fibrosis in rats. The fraction-5 was found to have maximum per-centage/concentration of the active component of β-carophyllene Medical cannabis usage has spread over the last few years in jurisdictions were it has been permitted, despite the plant being defined as a schedule one drug. Due to a fairly large body of evidence demonstrating possible amelioration of neuropathy symptoms following cannabis usage, this indication is currently approved in our nation. Patients must undergo a minimum of 12 months treatment by other medications in a pain clinic. The current cohort is a sequential cohort of 89 diabetic patients who failed a minimal 12 months course of drug therapy. The patients were treated by at least three drugs prior to instigation of medical cannabis therapy. The cannabis therapy was a smoked preparation with a minimal THC content of 10 percent and minimal CBD content of 2 percent. The dose was increased as necessary after a minimum of 3 months of therapy. Prior to therapy the patients had performed the following blood tests: hsCRP, total cholesterol, non-HDL cholesterol, HDL and complete blood count. These tests were repeated after 12 months of therapy. The primary outcome measure was the NRS and it declined from 8.7 ± 1.1 to 4.1 ± 3.1 post 24 months cannabis therapy. The BPI score decreased from 7.8 ± 2 to 2.9 ± 1. The CRP averaged 1.4 ± 0.8 and decreased to 0.6 ± 0.3. Hemoglobin levels did not change. W