Raphael Mechoulam

2022
Lihi Bar-Lev Schleider, Raphael Mechoulam, , Sikorin, Inbal , Naftali, Timna , and Novack, Victor . 2022. Adherence, Safety, And Effectiveness Of Medical Cannabis And Epidemiological Characteristics Of The Patient Population: A Prospective Study.. Frontiers In Medicine, 9, Pp. 827849. doi:10.3389/fmed.2022.827849.
BACKGROUND: Despite the absence of rigorous prospective studies, there has been an increase in the use of cannabis-based medicinal products. During the study period, the use of medical cannabis in Israel was tightly regulated by national policy. Through a prospective study of approximately 10,000 patients, we aimed to characterize the medical cannabis patient population as well as to identify treatment adherence, safety, and effectiveness. METHODS AND FINDINGS: In this study of prescribed medical cannabis patients, adherence, safety, and effectiveness were assessed at 6 months. Treatment adherence was assessed by the proportion of patients purchasing the medication out of the total number of patients (excluding deceased cases and patients transferred to another cannabis clinic). Safety was assessed by the frequency of the side-effects, while effectiveness was defined as at least moderate improvement in the patient condition without treatment cessation or serious side-effects. The most frequent primary indications requiring therapy were cancer (49.1%), followed by non-specific pain (29.3%). The average age was 54.6 ± 20.9 years, 51.1% males; 30.2% of the patients reported prior experience with cannabis. During the study follow-up, 1,938 patients died (19.4%) and 1,735 stopped treatment (17.3%). Common side-effects, reported by 1,675 patients (34.2%), were: dizziness (8.2%), dry mouth (6.7%), increased appetite (4.7%), sleepiness (4.4%), and psychoactive effect (4.3%). Overall, 70.6% patients had treatment success at 6 months. Multivariable logistic regression analysis revealed that the following factors were associated with treatment success: cigarette smoking, prior experience with cannabis, active driving, working, and a young age. The main limitation of this study was the lack of data on safety and effectiveness of the treatment for patients who refused to undergo medical assessment even at baseline or died within the first 6 months. CONCLUSIONS: We observed that supervised medical-cannabis treatment is associated with high adherence, improvement in quality of life, and a decrease in pain level with a low incidence of serious adverse events.
Hana Golan, Raphael Mechoulam, , Reem Smoum, , Cohen-Zada, Efrat , Pri-Chen, Sara , Wiener, Sapir , Grinberg, Igor , Bar-Lev, Dekel D, Haj, Christeeneh G, Fisher, Tamar , and Toren, Amos . 2022. Anti-Tumorigenic Effect Of A Novel Derivative Of 2-Hydroxyoleic Acid And The Endocannabinoid Anandamide On Neuroblastoma Cells.. Biomedicines, 10, 7. doi:10.3390/biomedicines10071552.
Modulation of the endogenous cannabinoid system has been suggested as a potential anticancer strategy. In the search for novel and less toxic therapeutic options, structural modifications of the endocannabinoid anandamide and the synthetic derivative of oleic acid, Minerval (HU-600), were done to obtain 2-hydroxy oleic acid ethanolamide (HU-585), which is an HU-600 derivative with the anandamide side chain. We showed that treatment of SK-N-SH neuroblastoma cells with HU-585 induced a better anti-tumorigenic effect in comparison to HU-600 as evidenced by 3-[4,5-dimethylthiazole-2-yl]-2,5-diphenyltetrazolium bromide assay, colony-forming assay, and migration assay. Moreover, HU-585 demonstrated pro-apoptotic properties shown by increased levels of activated caspase-3 following treatment and a better senescence induction effect in comparison to HU-600, as demonstrated by increased activity of lysosomal $\beta$-galactosidase. Finally, we observed that combined treatment of HU-585 with the senolytic drugs ABT-263 in vitro, and ABT-737 in vivo resulted in enhanced anti-proliferative effects and reduced neuroblastoma xenograft growth in comparison to treatment with HU-585 alone. Based on these results, we suggest that HU-585 is a pro-apoptotic and senescence-inducing compound, better than HU-600. Hence, it may be a beneficial option for the treatment of resistant neuroblastoma especially when combined with senolytic drugs that enhance its anti-tumorigenic effects.
Nicole Rodrigues Silva, Gomes, Francisco Isaac Fernandes , Lopes, Alexandre Hashimoto Pereira , Cortez, Isadora Lopes , dos Santos, Jéssica Cristina , Silva, Conceição Elidianne Aníbal , Raphael Mechoulam, , Gomes, Felipe Villela , Cunha, Thiago Mattar , and Guimarães, Francisco Silveira . 2022. The Cannabidiol Analog Pecs-101 Prevents Chemotherapy-Induced Neuropathic Pain Via Ppar$\Gamma$ Receptors.. Neurotherapeutics : The Journal Of The American Society For Experimental Neurotherapeutics, 19, 1, Pp. 434–449. doi:10.1007/s13311-021-01164-w.
Chemotherapy-induced peripheral neuropathy (CIPN) is the main dose-limiting adverse effect of chemotherapy drugs such as paclitaxel (PTX). PTX causes marked molecular and cellular damage, mainly in the peripheral nervous system, including sensory neurons in the dorsal root ganglia (DRG). Several studies have shown the therapeutic potential of cannabinoids, including cannabidiol (CBD), the major non-psychotomimetic compound found in the Cannabis plant, to treat peripheral neuropathies. Here, we investigated the efficacy of PECS-101 (former HUF-101), a CBD fluorinated analog, on PTX-induced neuropathic pain in mice. PECS-101, administered after the end of treatment with PTX, did not reverse mechanical allodynia. However, PECS-101 (1 mg/kg) administered along with PTX treatment caused a long-lasting relief of the mechanical and cold allodynia. These effects were blocked by a PPAR$\gamma$, but not CB1 and CB2 receptor antagonists. Notably, the effects of PECS-101 on the relief of PTX-induced mechanical and cold allodynia were not found in macrophage-specific PPAR$\gamma$-deficient mice. PECS-101 also decreased PTX-induced increase in Tnf, Il6, and Aif1 (Iba-1) gene expression in the DRGs and the loss of intra-epidermal nerve fibers. PECS-101 did not alter motor coordination, produce tolerance, or show abuse potential. In addition, PECS-101 did not interfere with the chemotherapeutic effects of PTX. Thus, PECS-101, a new fluorinated CBD analog, could represent a novel therapeutic alternative to prevent mechanical and cold allodynia induced by PTX potentially through the activation of PPAR$\gamma$ in macrophages.
José Alexandre S Crippa, Pacheco, Julia Cozar , Zuardi, Antonio W, Guimarães, Francisco S, Campos, Alline Cristina , de Osório, Flávia Lima , Loureiro, Sonia Regina , Dos Santos, Rafael G, Souza, José Diogo S, Ushirohira, Juliana Mayumi , Ferreira, Rafael Rinaldi , Mancini Costa, Karla Cristinne , Scomparin, Davi Silveira , Scarante, Franciele Franco , Pires-Dos-Santos, Isabela , Raphael Mechoulam, , Kapczinski, Flávio , Fonseca, Benedito AL, Esposito, Danillo LA, Passos, Afonso Dinis Costa , Fabbro, Amaury Lelis Dal , Bellissimo-Rodrigues, Fernando , Arruda, Eurico , Scarpelini, Sandro , Andraus, Maristela Haddad , Junior, Julio Cesar Nather , Wada, Danilo Tadao , Koenigkam-Santos, Marcel , Santos, Antonio Carlos , Filho, Geraldo Busatto , and Hallak, Jaime EC. 2022. Cannabidiol For Covid-19 Patients With Mild To Moderate Symptoms (Candidate Study): A Randomized, Double-Blind, Placebo-Controlled Clinical Trial.. Cannabis And Cannabinoid Research, 7, 5, Pp. 658–669. doi:10.1089/can.2021.0093.
{Importance: Owing to its anti-inflammatory properties and antiviral "in vitro" effect against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), cannabidiol (CBD) has been proposed as a potential treatment for coronavirus disease 2019 (COVID-19). Objective: To investigate the safety and efficacy of CBD for treating patients with mild to moderate COVID-19. Design: Randomized, parallel-group, double-blind, placebo-controlled clinical trial conducted between July 7 and October 16, 2020, in two sites in Brazil. Setting: Patients were recruited in an emergency room. Participants: Block randomized patients (1:1 allocation ratio-by a researcher not directly involved in data collection) with mild and moderate COVID-19 living in Ribeirão Preto, Brazil, seeking medical consultation, and those who voluntarily agreed to participate in the study. Interventions: Patients received 300 mg of CBD or placebo added to standard symptomatic care during 14 days. Main Outcome and Measure: The primary outcome was reduction or prevention of the deterioration in clinical status from mild/moderate to severe/critical measured with the COVID-19 Scale or the natural course of the resolution of typical clinical symptoms. Primary study outcome was assessed on days 14, 21, and 28 after enrollment. Results: A total of 321 patients were recruited and assessed for eligibility, and 105 were randomly allocated either in CBD (n=49) or in placebo (n=42) group. Ninety-one participants were included in the analysis of efficacy. There were no baseline between-group differences regarding disease severity ($\chi$(2)=0.025
Raphael Mechoulam. 2022. A Delightful Trip Along The Pathway Of Cannabinoid And Endocannabinoid Chemistry And Pharmacology.. Annual Review Of Pharmacology And Toxicology. doi:10.1146/annurev-pharmtox-051921-083709.
After a traumatic childhood in Europe during the Second World War, I found that scientific research in Israel was a pleasure beyond my expectations. Over the last 65 year, I have worked on the chemistry and pharmacology of natural products. During the last few decades, most of my research has been on plant cannabinoids, the endogenous cannabinoids arachidonoyl ethanolamide (anandamide) and 2-arachidonoyl glycerol, and endogenous anandamide-like compounds, all of which are involved in a wide spectrum of physiological reactions. Two plant cannabinoids, $Δ$(9)-tetrahydrocannabinol and cannabidiol, are approved drugs. However, the endogenous cannabinoids and the anandamide-like constituents have not yet been well investigated in humans. For me, intellectual freedom-the ability to do research based on my own scientific interests-has been the most satisfying part of my working life. Looking back over the 91 years of my long life, I conclude that I have been lucky, very lucky, both personally and scientifically. Expected final online publication date for the Annual Review of Pharmacology and Toxicology, Volume 63 is January 2023. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
Erin M Rock, Limebeer, Cheryl L, Reem Smoum, , Raphael Mechoulam, , and Parker, Linda A. 2022. Effect Of Oleoyl Glycine And Oleoyl Alanine On Lithium Chloride Induced Nausea In Rats And Vomiting In Shrews.. Psychopharmacology, 239, 2, Pp. 377–383. doi:10.1007/s00213-021-06005-4.
RATIONALE: The fatty acid amide oleoyl glycine (OlGly) and its more stable methylated form oleoyl alanine (OlAla) reduce naloxone-precipitated morphine withdrawal (MWD)-induced conditioned gaping (nausea) responses in rats. In addition, OlGly has been shown to reduce lithium chloride (LiCl)-induced conditioned gaping in rats and vomiting in Suncus murinus (house musk shrews). OBJECTIVES: Here, we compared the potential of these fatty acid amides to maintain their anti-nausea/anti-emetic effect over a delay. The following experiments examined the potential of a wider dose range of OlGly and OlAla to interfere with (1) LiCl-induced conditioned gaping in rats and (2) LiCl-induced vomiting in shrews, when administered 20 or 70 min prior to illness. RESULTS: OlAla (1, 5, 20 mg/kg) reduced LiCl-induced conditioned gaping, with OlGly only effective at the high dose (20 mg/kg), with no effect of pretreatment delay time. At the high dose of 20 mg/kg, OlGly increased passive drips during conditioning suggesting a sedative effect. In shrews, both OlGly and OlAla (1, 5 mg/kg) suppressed LiCl-induced vomiting, with no effect of pretreatment delay. OlAla more effectively suppressed vomiting, with OlAla (5 mg/kg) also increasing the latency to the first vomiting reaction. CONCLUSIONS: OlAla was more effective than OlGly in reducing both LiCl-induced gaping in rats and LiCl-induced vomiting in shrews. These findings provide further evidence that these fatty acid amides may be useful treatments for nausea and vomiting, with OlAla demonstrating superior efficacy.
Erin M Rock, Limebeer, Cheryl L, Reem Smoum, , Raphael Mechoulam, , and Parker, Linda A. 2022. Evaluation Of Sex Differences In The Potential Of $Δ$(9)-Tetrahydrocannabinol, Cannabidiol, Cannabidiolic Acid, And Oleoyl Alanine To Reduce Nausea-Induced Conditioned Gaping Reactions In Sprague-Dawley Rats.. Cannabis And Cannabinoid Research. doi:10.1089/can.2022.0158.
Introduction: Cancer patients report nausea as a side effect of their chemotherapy treatment. Using the pre-clinical rodent model of acute nausea-lithium chloride (LiCl)-induced conditioned gaping-our group has demonstrated that exogenous cannabinoids may have antinausea potential. Materials and Methods: With the goal of evaluating the role of sex as a factor in pre-clinical research, we first compared the conditioned gaping reactions produced by varying doses of LiCl in male and female rats using the taste reactivity test (Experiment 1). Results: LiCl produced dose-dependent conditioned gaping similarly in male and female rats with the highest dose (127.2 mg/kg) producing robust conditioned gaping, with this dose used in subsequent experiments. Next, we examined the antinausea potential of THC (Experiment 2), CBD (Experiment 3), cannabidiolic acid (CBDA; Experiment 4) and oleoyl alanine (OlAla; Experiment 5) in both male and female rats. THC, CBD, CBDA, and OlAla dose dependently reduced conditioned gaping in both male and female rats in a similar manner. Conclusions: These results suggest that cannabinoids may be equally effective in treating nausea in both males and females.
Idan Carmon, Zecharyahu, Lital , Elayyan, Jinan , Meka, Sai RK, Reich, Eli , Kandel, Leonid , Bilkei-Gorzo, Andras , Zimmer, Andreas , Raphael Mechoulam, , Kravchenko-Balasha, Nataly , and Dvir-Ginzberg, Mona . 2022. Hu308 Mitigates Osteoarthritis By Stimulating Sox9-Related Networks Of Carbohydrate Metabolism.. Journal Of Bone And Mineral Research : The Official Journal Of The American Society For Bone And Mineral Research. doi:10.1002/jbmr.4741.
Osteoarthritis (OA) is characterized by progressive, irreversible erosion of articular cartilage accompanied by severe pain and immobility. This study aimed to assess the effect and mechanism of action of HU308, a selective cannabinoid receptor type 2 (CB2) agonist, in preventing OA-related joint damage. To test the assumption that HU308 could prevent OA-related joint damage, Cnr2 null mice and wild type (WT) mice were aged to reach 20 months and analyzed for joint structural features. OA was induced in WT mice via a post-traumatic procedure or aging, followed by HU308 local (intra-articular) or systemic (intraperitoneal) administration, respectively. Additional analyses of time and dose courses for HU308 were carried out in human primary chondrocytes, analyzed by RNA sequencing, RT-PCR, chromatin immunoprecipitation, and immunoblotting. Our results showed that Cnr2 null mice exhibited enhanced age-related OA severity and synovitis compared to age-matched WT mice. Systemic administration of HU308 to 16-month-old mice improved pain sensitivity and maintained joint integrity, which was consistent with the intra-articular administration of HU308 in post-traumatic OA mice. When assessing human chondrocytes treated with HU308, we uncovered a dose- and time-related increase in ACAN and COL2A1 expression, which was preceded by increased SOX9 expression due to pCREB transcriptional activity. Finally, transcriptomic analysis of patient-derived human chondrocytes identified patient subpopulations exhibiting HU308-responsive trends as judged by enhanced SOX9 expression, accompanied by enriched gene networks related to carbohydrate metabolism. Collectively, the results showed that HU308 reduced trauma and age-induced OA via CB2-pCREB dependent activation of SOX9, contributing to augmented gene networks related to carbohydrate metabolism. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
Isadora Lopes Cortez, Silva, Nicole R, Rodrigues, Naielly S, Pedrazzi, João Francisco C, Del Bel, Elaine A, Raphael Mechoulam, , Gomes, Felipe V, and Guimarães, Francisco S. 2022. Hu-910, A Cb2 Receptor Agonist, Reverses Behavioral Changes In Pharmacological Rodent Models For Schizophrenia.. Progress In Neuro-Psychopharmacology & Biological Psychiatry, 117, Pp. 110553. doi:10.1016/j.pnpbp.2022.110553.
Despite attenuating the positive symptoms, drugs currently used to treat schizophrenia frequently do not improve the negative symptoms and cognitive impairments. In addition, they show low tolerability, which has been associated with high rates of treatment discontinuation. Recent evidence suggests that the endocannabinoid system may be a target for schizophrenia treatment. The CB2 receptor modulates dopaminergic neurotransmission, which is abnormally enhanced in schizophrenia patients. Here, we aimed to evaluate whether HU-910, a selective CB2 receptor agonist, would reverse schizophrenia-related behavioral changes observed after the acute injections of amphetamine or the N-methyl-d-aspartate receptor (NMDAR) antagonist MK-801. We also investigated the effects of HU-910 in the memory impairment caused by repeated MK-801 administration. Finally, we tested whether HU-910 would produce the cannabinoid tetrad (catalepsy, hypolocomotion, hypothermia, and antinociception). In male C57BL/6 mice, the acute treatment with HU-910 (30 mg/kg) prevented the hyperlocomotion induced by acute MK-801. This effect was blocked by the CB2 receptor antagonist AM630 (1 mg/kg). On the contrary, HU-910 did not prevent the increased locomotor activity caused by acute amphetamine. The acute treatment with HU-910 (3, 10, and 30 mg/kg) also attenuated the impairments in the prepulse inhibition test induced by acute MK-801 and amphetamine. The repeated treatment with HU-910 attenuated the cognitive impairment caused by chronic administration of MK-801 in the novel object recognition test. Furthermore, HU-910 did not produce the cannabinoid tetrad. These results indicate that HU-910 produced antipsychotic-like effects and support further research on the potential therapeutic properties of this compound to treat schizophrenia.
José Diogo S Souza, Zuardi, Antonio W, Guimarães, Francisco S, de Osório, Flávia Lima , Loureiro, Sonia Regina , Campos, Alline Cristina , Hallak, Jaime EC, Dos Santos, Rafael G, Machado Silveira, Isabella Lara , Pereira-Lima, Karina , Pacheco, Julia Cozar , Ushirohira, Juliana Mayumi , Ferreira, Rafael Rinaldi , Mancini Costa, Karla Cristinne , Scomparin, Davi Silveira , Scarante, Franciele Franco , Pires-Dos-Santos, Isabela , Raphael Mechoulam, , Kapczinski, Flávio , Fonseca, Benedito AL, Esposito, Danillo LA, Andraus, Maristela Haddad , and Crippa, José Alexandre S. 2022. Maintained Anxiolytic Effects Of Cannabidiol After Treatment Discontinuation In Healthcare Workers During The Covid-19 Pandemic.. Frontiers In Pharmacology, 13, Pp. 856846. doi:10.3389/fphar.2022.856846.
Objective: To assess whether the effects of oral administration of 300 mg of Cannabidiol (CBD) for 28 days on mental health are maintained for a period after the medication discontinuation. Methods: This is a 3-month follow-up observational and clinical trial study. The data were obtained from two studies performed simultaneously by the same team in the same period and region with Brazilian frontline healthcare workers during the COVID-19 pandemic. Scales to assess emotional symptoms were applied weekly, in the first month, and at weeks eight and 12. Results: The primary outcome was that, compared to the control group, a significant reduction in General Anxiety Disorder-7 Questionnaire (GAD-7) from baseline values was observed in the CBD group on weeks two, four, and eight (Within-Subjects Contrasts, time-group interactions: F(1-125) = 7.67; p = 0.006; $η$(p) (2) = 0.06; F(1-125) = 6.58; p = 0.01; $η$(p) (2) = 0.05; F(1-125) = 4.28; p = 0.04; $η$(p) (2) = 0.03, respectively) after the end of the treatment. Conclusions: The anxiolytic effects of CBD in frontline health care professionals during the COVID-19 pandemic were maintained up to 1 month after the treatment discontinuation, suggesting a persistent decrease in anxiety in this group in the real world. Future double-blind placebo-controlled clinical trials are needed to confirm the present findings and weigh the benefits of CBD therapy against potential undesired or adverse effects.
Samah Shahen-Zoabi, Reem Smoum, , Beiser, Tehila , Nemirovski, Alina , Raphael Mechoulam, , and Yaka, Rami . 2022. N-Oleoyl Glycine And Its Derivatives Attenuate The Acquisition And Expression Of Cocaine-Induced Behaviors.. Cannabis And Cannabinoid Research. doi:10.1089/can.2022.0005.
Introduction: The endocannabinoid system (ECS) plays a key modulatory role during synaptic plasticity and homeostatic processes in the brain and plays an important role in the neurobiological processes underlying drug addiction. Impaired endocannabinoid (eCB) signaling contributes to dysregulated synaptic plasticity, increased stress responsivity, and craving that propel addiction. Therefore, we hypothesized that boosting the ECS by exogenous administration of selective eCBs will attenuate cocaine-induced behaviors. Materials and Methods: The behavioral paradigms included psychomotor sensitization (PS) and conditioned place preference (CPP). Liquid chromatography-mass spectrometry analysis was used for quantitative profiling of eCBs in mouse brain. Results: We first measured the levels of eCBs in different brain areas of the reward system following chronic cocaine treatment. We found that following daily administration of cocaine, the levels of N-oleoyl glycine (OlGly) were significantly elevated in the nucleus accumbens (NAc) in a region-specific manner. We next tested whether administration of OlGly will attenuate cocaine-induced behaviors. We found that administration of OlGly during withdrawal, but not during acquisition of PS, attenuated the expression of cocaine sensitization. In addition, the administration of OlGly during the acquisition of cocaine CPP, but not during withdrawal, attenuated the expression of cocaine-conditioned reward. To enhance the stability of OlGly and its duration of action, two methylated derivatives of OlGly were synthesized, the monomethylated OlGly (HU-595) and dimethylated OlGly (HU-596). We found that the effect of administration of HU-595 or HU-596 during cocaine conditioning did not differ from the OlGly-induced decrease in the expression of CPP. Conclusion: Our findings suggest that the ECS is involved in the common neurobiological mechanisms underlying the development and expression of cocaine reward and drug-seeking. Boosting the ECS exogenously has beneficial effects against cocaine-induced behaviors.
Ronit Vogt Sionov, Banerjee, Shreya , Bogomolov, Sergei , Reem Smoum, , Raphael Mechoulam, , and Steinberg, Doron . 2022. Targeting The Achilles' Heel Of Multidrug-Resistant Staphylococcus Aureus By The Endocannabinoid Anandamide.. International Journal Of Molecular Sciences, 23, 14. doi:10.3390/ijms23147798.
Antibiotic-resistant Staphylococcus aureus is a major health issue that requires new therapeutic approaches. Accumulating data suggest that it is possible to sensitize these bacteria to antibiotics by combining them with inhibitors targeting efflux pumps, the low-affinity penicillin-binding protein PBP2a, cell wall teichoic acid, or the cell division protein FtsZ. We have previously shown that the endocannabinoid Anandamide (N-arachidonoylethanolamine; AEA) could sensitize drug-resistant S. aureus to a variety of antibiotics, among others, through growth arrest and inhibition of drug efflux. Here, we looked at biochemical alterations caused by AEA. We observed that AEA increased the intracellular drug concentration of a fluorescent penicillin and augmented its binding to membrane proteins with concomitant altered membrane distribution of these proteins. AEA also prevented the secretion of exopolysaccharides (EPS) and reduced the cell wall teichoic acid content, both processes known to require transporter proteins. Notably, AEA was found to inhibit membrane ATPase activity that is necessary for transmembrane transport. AEA did not affect the membrane GTPase activity, and the GTPase cell division protein FtsZ formed the Z-ring of the divisome normally in the presence of AEA. Rather, AEA caused a reduction in murein hydrolase activities involved in daughter cell separation. Altogether, this study shows that AEA affects several biochemical processes that culminate in the sensitization of the drug-resistant bacteria to antibiotics.
Reem Smoum, Haj, Christeene , Shira Hirsch, , Nemirovski, Alina , Yekhtin, Zhannah , Bogoslavsky, Benny , Bakshi, Gaganjyot Kaur , Chourasia, Mukesh , Gallily, Ruth , Tam, Joseph , and Raphael Mechoulam, . 2022. Fenchone Derivatives As A Novel Class Of Cb2 Selective Ligands: Design, Synthesis, X-Ray Structure And Therapeutic Potential.. Molecules (Basel, Switzerland), 27, 4. doi:10.3390/molecules27041382.
A series of novel cannabinoid-type derivatives were synthesized by the coupling of (1S,4R)-(+) and (1R,4S)-(-)-fenchones with various resorcinols/phenols. The fenchone-resorcinol derivatives were fluorinated using Selectfluor and demethylated using sodium ethanethiolate in dimethylformamide (DMF). The absolute configurations of four compounds were determined by X-ray single crystal diffraction. The fenchone-resorcinol analogs possessed high affinity and selectivity for the CB2 cannabinoid receptor. One of the analogues synthesized, 2-(2',6'-dimethoxy-4'-(2″-methyloctan-2″-yl)phenyl)-1,3,3-trimethylbicyclo[2.2.1]heptan-2-ol (1d), had a high affinity (K(i) = 3.51 nM) and selectivity for the human CB2 receptor (hCB2). In the [(35)S]GTP$\gamma$S binding assay, our lead compound was found to be a highly potent and efficacious hCB2 receptor agonist (EC(50) = 2.59 nM, E((max)) = 89.6%). Two of the fenchone derivatives were found to possess anti-inflammatory and analgesic properties. Molecular-modeling studies elucidated the binding interactions of 1d within the CB2 binding site.
2020
E.M. Rock, Ayoub, S.M. , Limebeer, C.L. , Gene, A. , Wills, K.L. , DeVuono, M.V. , Smoum, R. , Di Marzo, V. , Lichtman, A.H. , Mechoulam, R. , and Parker, L.A. . 2020. Acute Naloxone-Precipitated Morphine Withdrawal Elicits Nausea-Like Somatic Behaviors In Rats In A Manner Suppressed By N-Oleoylglycine. Psychopharmacology, 237, 2, Pp. 375-384. doi:10.1007/s00213-019-05373-2.
Rationale: Acute naloxone-precipitated morphine withdrawal (MWD) produces a conditioned place aversion (CPA) in rats even after one or two exposures to high-dose (20 mg/kg, sc) morphine followed 24-h later by naloxone (1 mg/kg, sc). However, the somatic withdrawal reactions produced by acute naloxone-precipitated MWD in rats have not been investigated. A recently discovered fatty acid amide, N-oleoylglycine (OlGly), which has been suggested to act as a fatty acid amide hydrolase (FAAH) inhibitor and as a peroxisome proliferator-activated receptor alpha (PPARα) agonist, was previously shown to interfere with a naloxone-precipitated MWD-induced CPA in rats. Objectives: The aims of these studies were to examine the somatic withdrawal responses produced by acute naloxone-precipitated MWD and determine whether OlGly can also interfere with these responses. Results: Here, we report that following two exposures to morphine (20 mg/kg, sc) each followed by naloxone (1 mg/kg, sc) 24 h later, rats display nausea-like somatic reactions of lying flattened on belly, abdominal contractions and diarrhea, and display increased mouthing movements and loss of body weight. OlGly (5 mg/kg, ip) interfered with naloxone-precipitated MWD-induced abdominal contractions, lying on belly, diarrhea and mouthing movements in male Sprague–Dawley rats, by both a cannabinoid 1 (CB1) and a PPARα mechanism of action. Since these withdrawal reactions are symptomatic of nausea, we evaluated the potential of OlGly to interfere with lithium chloride (LiCl)-induced and MWD-induced conditioned gaping in rats, a selective measure of nausea; the suppression of MWD-induced gaping reactions by OlGly was both CB1 and PPARα mediated. Conclusion: These results suggest that the aversive effects of acute naloxone-precipitated MWD reflect nausea, which is suppressed by OlGly. © 2019, Springer-Verlag GmbH Germany, part of Springer Nature.
T. Stark, Di Bartolomeo, M. , Di Marco, R. , Drazanova, E. , Platania, C.B.M. , Iannotti, F.A. , Ruda-Kucerova, J. , D'Addario, C. , Kratka, L. , Pekarik, V. , Piscitelli, F. , Babinska, Z. , Fedotova, J. , Giurdanella, G. , Salomone, S. , Sulcova, A. , Bucolo, C. , Wotjak, C.T. , Starcuk, Z., Jr , Drago, F. , Mechoulam, R. , Di Marzo, V. , and Micale, V. . 2020. Altered Dopamine D3 Receptor Gene Expression In Mam Model Of Schizophrenia Is Reversed By Peripubertal Cannabidiol Treatment. Biochemical Pharmacology, 177. doi:10.1016/j.bcp.2020.114004.
Gestational methylazoxymethanol acetate (MAM) treatment produces offspring with adult phenotype relevant to schizophrenia, including positive- and negative-like symptoms, cognitive deficits, dopaminergic dysfunction, structural and functional abnormalities. Here we show that adult rats prenatally treated with MAM at gestational day 17 display significant increase in dopamine D3 receptor (D3) mRNA expression in prefrontal cortex (PFC), hippocampus and nucleus accumbens, accompanied by increased expression of dopamine D2 receptor (D2) mRNA exclusively in the PFC. Furthermore, a significant change in the blood perfusion at the level of the circle of Willis and hippocampus, paralleled by the enlargement of lateral ventricles, was also detected by magnetic resonance imaging (MRI) techniques. Peripubertal treatment with the non-euphoric phytocannabinoid cannabidiol (30 mg/kg) from postnatal day (PND) 19 to PND 39 was able to reverse in MAM exposed rats: i) the up-regulation of the dopamine D3 receptor mRNA (only partially prevented by haloperidol 0.6 mg/kg/day); and ii) the regional blood flow changes in MAM exposed rats. Molecular modelling predicted that cannabidiol could bind preferentially to dopamine D3 receptor, where it may act as a partial agonist according to conformation of ionic-lock, which is highly conserved in GPCRs. In summary, our results demonstrate that the mRNA expression of both dopamine D2 and D3 receptors is altered in the MAM model; however only the transcript levels of D3 are affected by cannabidiol treatment, likely suggesting that this gene might not only contribute to the schizophrenia symptoms but also represent an unexplored target for the antipsychotic activity of cannabidiol. © 2020 Elsevier Inc.
P. Pacher, Kogan, N.M. , and Mechoulam, R. . 2020. Beyond Thc And Endocannabinoids. Annual Review Of Pharmacology And Toxicology, 60, Pp. 637-659. doi:10.1146/annurev-pharmtox-010818-021441.
Research in the cannabinoid field, namely on phytocannabinoids, the endogenous cannabinoids anandamide and 2-arachidonoyl glycerol and their metabolizing and synthetic enzymes, the cannabinoid receptors, and anandamide-like cannabinoid compounds, has expanded tremendously over the last few years. Numerous endocannabinoid-like compounds have been discovered. The Cannabis plant constituent cannabidiol (CBD) was found to exert beneficial effects in many preclinical disease models ranging from epilepsy, cardiovascular disease, inflammation, and autoimmunity to neurodegenerative and kidney diseases and cancer. CBD was recently approved in the United States for the treatment of rare forms of childhood epilepsy. This has triggered the development of many CBD-based products for human use, often with overstated claims regarding their therapeutic effects. In this article, the recently published research on the chemistry and biological effects of plant cannabinoids (specifically CBD), endocannabinoids, certain long-chain fatty acid amides, and the variety of relevant receptors is critically reviewed. Copyright © 2020 by Annual Reviews. All rights reserved.
E.M. Rock, Sullivan, M.T. , Collins, S.A. , Goodman, H. , Limebeer, C.L. , Mechoulam, R. , and Parker, L.A. . 2020. Evaluation Of Repeated Or Acute Treatment With Cannabidiol (Cbd), Cannabidiolic Acid (Cbda) Or Cbda Methyl Ester (Hu-580) On Nausea And/Or Vomiting In Rats And Shrews. Psychopharmacology, 237, 9, Pp. 2621-2631. doi:10.1007/s00213-020-05559-z.
Rationale: When acutely administered intraperitoneally, the non-psychoactive cannabinoid cannabidiol (CBD), its acidic precursor cannabidiolic acid (CBDA) and a stable methyl ester of CBDA (HU-580) reduce lithium chloride (LiCl)–induced conditioned gaping in male rats (a selective preclinical model of acute nausea) via activation of the serotonin 1A (5-HT1A) receptor. Objectives: To utilise these compounds to manage nausea in the clinic, we must determine if their effectiveness is maintained when injected subcutaneously (s.c) and when repeatedly administered. First, we compared the effectiveness of each of these compounds to reduce conditioned gaping following repeated (7-day) and acute (1-day) pretreatments and whether these anti-nausea effects were mediated by the 5-HT1A receptor. Next, we assessed whether the effectiveness of these compounds can be maintained when administered prior to each of 4 conditioning trials (once per week). We also evaluated the ability of repeated CBD (7 days) to reduce LiCl-induced vomiting in Suncus murinus. Finally, we examined whether acute CBD was equally effective in male and female rats. Results: Both acute and repeated (7 day) s.c. administrations of CBD (5 mg/kg), CBDA (1 μg/kg) and HU-580 (1 μg/kg) similarly reduced LiCl-induced conditioned gaping, and these effects were blocked by 5HT1A receptor antagonism. When administered over 4 weekly conditioning trials, the anti-nausea effectiveness of each of these compounds was also maintained. Repeated CBD (5 mg/kg, s.c.) maintained its anti-emetic efficacy in S. murinus. Acute CBD (5 and 20 mg/kg, s.c.) administration reduced LiCl-induced conditioned gaping similarly in male and female rats. Conclusion: When administered repeatedly (7 days), CBD, CBDA and HU-580 did not lose efficacy in reducing nausea and continued to act via agonism of the 5-HT1A receptor. When administered across 4 weekly conditioning trials, they maintained their effectiveness in reducing LiCl-induced nausea. Repeated CBD also reduced vomiting in shrews. Finally, CBD’s anti-nausea effects were similar in male and female rats. This suggests that these cannabinoids may be useful anti-nausea and anti-emetic treatments for chronic conditions, without the development of tolerance. © 2020, Springer-Verlag GmbH Germany, part of Springer Nature.
Y.F. Zhu, Linher-Melville, K. , Niazmand, M.J. , Sharma, M. , Shahid, A. , Zhu, K.L. , Parzei, N. , Sidhu, J. , Haj, C. , Mechoulam, R. , and Singh, G. . 2020. An Evaluation Of The Anti-Hyperalgesic Effects Of Cannabidiolic Acid-Methyl Ester In A Preclinical Model Of Peripheral Neuropathic Pain. British Journal Of Pharmacology, 177, 12, Pp. 2712-2725. doi:10.1111/bph.14997.
Background and Purpose: Chronic neuropathic pain (NEP) is associated with growing therapeutic cannabis use. To promote quality of life without psychotropic effects, cannabinoids other than Δ9-tetrahydrocannabidiol, including cannabidiol and its precursor cannabidiolic acid (CBDA), are being evaluated. Due to its instability, CBDA has been understudied, particularly as an anti-nociceptive agent. Adding a methyl ester group (CBDA-ME) significantly enhances its stability, facilitating analyses of its analgesic effects in vivo. This study examines early treatment efficacy of CBDA-ME in a rat model of peripherally induced NEP and evaluates sex as a biological variable. Experimental Approach: After 14 consecutive days of intraperitoneal CBDA-ME administration at 0.01, 0.1 and 1 μg·kg−1, commencing 1 day after surgically implanting a sciatic nerve-constricting cuff to induce NEP, the anti-nociceptive efficacy of this cannabinoid was assessed in male and female Sprague–Dawley rats relative to vehicle-treated counterparts. In females, 2 and 4 μg·kg−1 daily doses of CBDA-ME were also evaluated. Behavioural tests were performed for hind paw mechanical and thermal withdrawal thresholds once a week for 8 weeks. At endpoint, in vivo electrophysiological recordings were obtained to characterize soma threshold changes in primary sensory neurons. Key Results: In males, CBDA-ME elicited a significant concentration-dependent chronic anti-hyperalgesic effect, also influencing both nociceptive and non-nociceptive mechanoreceptors, which were not observed in females at any of the concentrations tested. Conclusion and Implications: Initiating treatment of a peripheral nerve injury with CBDA-ME at an early stage post-surgery provides anti-nociception in males, warranting further investigation into potential sexual dimorphisms underlying this response. © 2020 The British Pharmacological Society
S.M. Ayoub, Smoum, R. , Farag, M. , Atwal, H. , Collins, S.A. , Rock, E.M. , Limebeer, C.L. , Piscitelli, F. , Iannotti, F.A. , Lichtman, A.H. , Leri, F. , Di Marzo, V. , Mechoulam, R. , and Parker, L.A. . 2020. Oleoyl Alanine (Hu595): A Stable Monomethylated Oleoyl Glycine Interferes With Acute Naloxone Precipitated Morphine Withdrawal In Male Rats. Psychopharmacology, 237, 9, Pp. 2753-2765. doi:10.1007/s00213-020-05570-4.
Rationale: Oleoyl glycine, a little studied fatty acid amide similar in structure to anandamide, interferes with nicotine addiction in mice and acute naloxone-precipitated morphine withdrawal (MWD) in rats. Because endogenous oleoyl glycine is subject to rapid enzymatic deactivation, we evaluated the potential of more stable analogs to interfere with opiate withdrawal. Objectives: The potential of monomethylated oleoyl glycine (oleoyl alanine, HU595) to interfere with somatic and aversive effects of acute naloxone-precipitated MWD, its duration, and mechanism of action was assessed in male Sprague Dawley rats. The potential of dimethylated oleoyl glycine (HU596) to interfere with the aversive effects of naloxone-precipitated MWD was also investigated. Results: Oleoyl alanine (HU595) interfered with somatic and aversive effects produced by naloxone-precipitated MWD at equivalent doses (1 and 5 mg/kg, i.p.) as we have reported for oleoyl glycine; however, oleoyl alanine produced a longer lasting (60 min) interference, yet did not produce rewarding or aversive effects on its own and did not modify locomotor activity. HU596 was not effective. The interference with aversive effects of naloxone-precipitated MWD by oleoyl alanine was prevented by both a PPARα antagonist and a CB1 receptor antagonist. Accordingly, the compound was found to inhibit FAAH and activate PPARα in vitro. Finally, oleoyl alanine also reduced acute naloxone-precipitated MWD anhedonia, as measured by decreased saccharin preference. Conclusions: Oleoyl alanine (also an endogenous fatty acid) may be a more stable and effective treatment for opiate withdrawal than oleoyl glycine. © 2020, Springer-Verlag GmbH Germany, part of Springer Nature.

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