Use Of Cannabidiol Research Articles

Efficacy of cannabidiol in convulsive and nonconvulsive seizure types associated with treatment-resistant epilepsies in the Expanded Access Program.

The cannabidiol (CBD) Expanded Access Program (EAP), initiated in 2014, provided CBD (Epidiolex) to patients with treatment-resistant epilepsy (TRE). In the final pooled analysis of 892 patients treated through January 2019 (median exposure = 694 days), CBD treatment was associated with a 46%-66% reduction in median monthly total (convulsive plus nonconvulsive) seizure frequency. CBD was well tolerated, and adverse events were consistent with previous findings. We used pooled EAP data to investigate the effectiveness of add-on CBD therapy for individual convulsive seizure types (clonic, tonic, tonic-clonic, atonic, focal to bilateral tonic-clonic), nonconvulsive seizure types (focal with and without impaired consciousness, absence [typical and atypical], myoclonic, myoclonic absence), and epileptic spasms. CBD treatment was associated with a reduction in the frequency of convulsive seizure types (median percentage reduction = 47%-100%), and nonconvulsive seizure types and epileptic spasms (median percentage reduction = 50%-100%) across visit intervals through 144 weeks of treatment. Approximately 50% of patients had ≥50% reduction in convulsive and nonconvulsive seizure types and epileptic spasms at nearly all intervals. These results show a favorable effect of long-term CBD use in patients with TRE, who may experience various convulsive and nonconvulsive seizure types. Future controlled trials are needed to confirm these findings.

Current state of knowledge on the use of cannabidiol (CBD) in various medical conditions

INTRODUCTION AND PURPOSECannabis sativa contains hundreds of compounds, referred to as cannabinoids. Two most prevalent are delta-9-tetrahydrocannabinol and cannabidiol (CBD). CBD is non-psychoactive substance that has recently gained attention in lay press and in medical research. Aim of this study is to review evidence-based data on safety, effectiveness and applicability of CBD in various medical conditions in order to provide healthcare professionals with information that may be useful in their practice.MATERIALS AND METHODSIn April 2023, PubMed and Google Scholar databases were searched for studies that included phrases “CBD” or “cannabidiol”, and related phrases. In the review, only studies that used well-established research methods were included.RESULTSCBD is an effective novel treatment option in Lennox–Gastaut syndrome, tuberous sclerosis complex and Dravet syndrome. Data supporting CBD’s applicability in anxiety, Parkinson’s Disease, schizophrenia, insomnia, pain, autoimmune diseases, osteoporosis and as an anti-aging agent is promising, but more research on bigger groups of patients is needed to establish its role in modern medicine.CONCLUSIONSThe use of CBD is associated with risks of variable dosage, contamination and adulteration. At present, there is a need of more research to establish effective and safe doses of CBD. Clinicians need to monitor new data from ongoing CBD trials, but at present there is no hard evidence supporting effectiveness of CBD in various medical conditions, apart from epilepsy.

Genotoxicity evaluation of cannabidiol

Consumer use of cannabidiol (CBD) for personal wellness purposes has garnered much public interest. However, safety-related data on CBD in the public domain are limited, including a lack of quality studies evaluating its genotoxic potential. The quality of available studies is limited due to the test material used (e.g., low CBD purity) and/or study design, leading some global regulatory agencies to highlight genotoxicity as an important data gap for CBD. To address this gap, the genotoxic potential of a pure CBD isolate was investigated in a battery of three genotoxicity assays conducted according to OECD testing guidelines. In an in vitro microbial reverse mutation assay, CBD up to 5000 μg/plate was negative in Salmonella typhimurium strains TA98, TA100, TA1535, and TA1537, and Escherichia coli strain WP2 uvrA, with and without metabolic activation. Testing in an in vitro micronucleus assay was negative in human TK6 cells up to 10–11 μg/mL, with and without metabolic activation. Finally, an in vivo micronucleus assay conducted in male and female rats was negative for genotoxicity up to 1000 mg/kg-bw/d. Bioanalysis of CBD and its primary metabolite, 7-carboxy CBD, confirmed a dose-related increase in plasma exposure. Together, these assays indicate that CBD is unlikely to pose a genotoxic hazard.

Therapeutic use of cannabidiol in endometriosis: literature review

Therapeutic use of cannabidiol in endometriosis: literature review

Patterns, perceptions, and experience with cannabidiol (CBD) after cancer diagnosis.

e18829 Background: CBD is derived from cannabis and has minimal psychoactive effect. We sought to evaluate factors associated with CBD use among patients who received cancer treatment and elucidate the reasons for use, and perceived benefits of CBD. Methods: An anonymous online or phone survey was administered to patients treated for cancer between 3/2021-8/2021 at a comprehensive cancer center; only patients residing in states where cannabis is legal were contacted. Surveys were completed 8/2021-4/2022. Patient-reported use of cannabis and CBD products was assessed, as well as beliefs and perceptions regarding CBD. Unadjusted and weighted multivariable logistic regression (MVA) was used to assess factors associated with CBD use after diagnosis. Results: Among 1258 patients (35% response rate), 41% knew either “a lot” or “some” about CBD, 44% knew “a little”, 15% knew nothing or were unsure. Of those who had heard about CBD, 69% felt there were no risks of taking CBD. 370 patients (29%) both knew of CBD and endorsed cannabis use after diagnosis; 61% of that group, 226 (18% of all surveyed) specifically reported CBD use. Those who reported CBD use were 54% women, 83% white, and 88% non-Hispanic, with a median age of 63 (IQR 52-71). 75% of CBD users had used any cannabis product at least once prior to diagnosis and 40% of CBD users had used cannabis in the year prior to diagnosis. Among the 150 patients who used CBD during treatment, 54% used it several times a week or more; 49% used CBD after treatment completion. Among CBD users, common reasons for CBD use were pain (56%, n = 125), sleep (48%, n = 107), mood (36%, n = 80), or neuropathy (18%, n = 40). Symptom benefit from CBD (improved “somewhat” or “quite a bit”) was reported for pain (71%), sleep (71%), mood (74%), and neuropathy (60%). Only 1% reported worsening of non-target symptoms or side effects with CBD; 3% felt it worsened neuropathy. Overall, 47% either stopped using CBD or used it less than they would prefer due to no benefit (30%), high cost (25%), or lack of insurance coverage (21%). On weighted MVA, patients who were ≤45 (OR 1.16, 95%CI 1.06-1.26, p < 0.01) or 46-64 (OR 1.10, 95%CI 1.04-1.27, p < 0.01) were more likely to use CBD after diagnosis than those ≥65. Prior cannabis use, compared to no prior cannabis use, was associated with CBD use after diagnosis (OR 1.13, 95%CI 1.08-1.19, p < 0.01). Compared to patients with lung cancer, patients with gastrointestinal cancer were more likely to use CBD after diagnosis (OR 1.11, 95%CI 1.00-1.22, p = 0.04). Conclusions: Fewer than half of surveyed patients treated for cancer had good knowledge of CBD, however most felt it was safe to use without any risks. Almost one in five surveyed had used CBD after diagnosis for a variety of symptoms. Patient-reported benefits were high and negative side effects were rare except for cost. Additional research is needed to help guide patient use of CBD given weak evidence of benefits.

Oral toxicity evaluation of cannabidiol.

Use of cannabidiol (CBD) in humans has increased considerably in recent years. While currently available studies suggest that CBD is relatively safe for human consumption, data from publicly available studies on CBD conducted according to modern testing guidelines are lacking. In the current study, the potential for toxicity following repeated oral exposure to hemp-derived CBD isolate was evaluated in male and female Sprague Dawley rats. No adverse treatment-related effects were observed following administration of CBD via oral gavage for 14 and 90 days at concentrations up to 150 and 140 mg/kg-bw/d, respectively. Microscopic liver and adrenal gland changes observed in the 90-day study were determined to be resolved after a 28-day recovery period. CBD was well tolerated at these dose levels, and the results of this study are comparable to findings reported in unpublished studies conducted with other CBD isolates. The current studies were conducted as part of a broader research program to examine the safety of CBD.

Cannabidiol as a Treatment for Schizophrenia

Schizophrenia is a complex neuropsychiatric disorder that has undergone significant advancements in its treatment. However, there are still many aspects of symptom management and prevention that could benefit from new developments in psychopharmacology. One potential avenue is the use of cannabidiol (CBD), a major phytocannabinoid found in the cannabis plant. Preliminary evidence suggests that CBD could effectively treat certain symptoms of the disorder with fewer side effects than conventional antipsychotics. This article provides the reader with an in-depth discussion of the current scientific evidence concerning the use of CBD in the treatment of schizophrenia. [ Psychiatr Ann . 2023;53(6):252–255.]

Cannabidiol in the Pediatric Population

Recently, there has been significant interest in using cannabidiol (CBD) in the pediatric population. Robust evidence exists for the anticonvulsant action of CBD in some childhood epileptic syndromes, and CBD can reduce anxiety symptoms, stereotyped behavior, hyperactivity, and sleep disorders. However, there are other diseases, such as fragile X syndrome and conditions resulting in intellectual disability, in which CBD use is developing. This article provides the reader with a discussion of the current scientific evidence regarding the use of CBD in the pediatric population. [ Psychiatr Ann . 2023;53(6):256–258.]

Therapeutic Profile of Cannabidiol in the Broad Symptomatology of Autism Spectrum Disorder: Evidence From Basic Science to Clinical Approaches

Autism spectrum disorder (ASD) is a group of neurodevelopmental disorders whose symptoms include impaired communication and social interaction, stereotypies, and varying levels of intellectual disability. Together with these symptoms are co-occurring psychiatric or neurological conditions, often with hyperactivity and attention disorders, anxiety, depression, and epilepsy. So far, no effective treatment for ASD is available, possibly because its neurobiological basis and heterogeneous nature are not clearly understood. Clinical and preclinical trials support the involvement of the endocannabinoid system in the patho-physiology of ASD. Cannabidiol (CBD), the main nonpsychotomimetic compound of the cannabis plant, interacts with the endocannabinoid system and has significant therapeutic potential in treating several psychiatric disorders and manifestations of ASD. After this article, readers are expected to have a broad understanding of current scientific evidence and perspectives on the use of CBD in cases of ASD. [ Psychiatr Ann . 2023;53(6):247–251.]

Disposition of a single oral dose of a cannabidiol medication in healthy cats.

The historical use of the marijuana plant for medicinal purposes is long. One of the historical uses has been for the treatment of epilepsy. Recently, the Food and Drug Administration has approved a highly purified cannabidiol medication for the add on therapy in people with certain forms of epilepsy. With the increase interest of the use of cannabidiol in the veterinary community, the aim of this study was to describe the disposition of a single dose of a cannabidiol medication in healthy cats in both the fed and fasted state. Pharmacokinetic analysis reveals that relative bioavailability of cannabidiol shows a near eleven-fold increase when administered in the fed state compared to the fasted state. Additionally, concentrations achieved at a dose of 5 mg/kg, may be sufficient to explore the therapeutic potential in cats with epilepsy.

Cannabidiol Use Patterns and Efficacy for Children Who Have Cerebral Palsy.

Cannabidiol (CBD)-containing supplements are used by children with cerebral palsy (CP), but the prevalence and efficacy of their use have not been studied. We sought to describe CBD use patterns and perceived efficacy in the pediatric population with CP, evaluating any association between CBD use and health-related quality of life. Patients with CP were prospectively enrolled, and caregivers were offered the Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD) Questionnaire and a survey assessing CBD use. Of 119 participants, 20 (16.8%) endorsed CBD use (CBD+) and 99 (83.2%) denied it (CBD-). Participants in the CBD+ group had worse functional status (85% Gross Motor Function Classification System level IV-V for CBD+ vs 37.4% for CBD-, P<.001) and lower health-related quality of life (mean CPCHILD score of 49.3 for CBD+ vs 62.2 for CBD-, P=.001). Spasticity was the rationale most cited for CBD use (29%), followed by pain and anxiety (both 22.6%). CBD was perceived to be most effective for improving emotional health, spasticity, and pain. Fifty percent of the patients in the CBD+ group underwent surgery in the previous 2 years and most endorsed a general benefit in the postoperative setting. The most common side effects noted were fatigue and increased appetite (both 12%). Most participants endorsed no side effects (60%). CBD may serve as a useful adjunct for some children with CP, especially those with worse disease severity. Caregivers perceive CBD as offering some benefits, particularly in the domains of emotional health, spasticity, and pain. We found no evidence of severe adverse events in our small cohort. [Orthopedics. 2024;47(1):52-56.].

Differences in Cannabidiol-Related Attitudes and Practice Behaviors Between U.S. Primary Care Physicians Practicing in a Single Health Care System Across States With and Without Marijuana Legalization.

Introduction: Dramatic shifts in marijuana laws, along with federal deregulation of hemp with the 2018 Farm Bill, have resulted in increased availability and use of cannabidiol (CBD) supplements throughout the United States (US). Given the rapid increase in CBD use in the U.S. general population, in this study, we aim to characterize primary care physician (PCP) attitudes and practice behaviors and to assess whether differences in provider attitudes and behaviors vary as a function of marijuana legalization (ML) status in the state of practice. Materials and Methods: Data are from an online provider survey on CBD supplement-related attitudes, beliefs, and behaviors administered to 508 PCPs as part of a larger mixed methods study. Participating PCPs were recruited from the Mayo Clinic Healthcare Network and provided medical care in primary care settings across four U.S. states (Minnesota, Wisconsin, Florida, and Arizona). Results: The survey response rate was 45.4% (n=236/508). According to providers, CBD was frequently brought up in PCP settings, typically by patients. PCPs were generally hesitant to screen for or discuss CBD with their patients and identified multiple barriers to open patient-provider dialogue about CBD. PCPs practicing in states that had passed ML were more receptive to patients using CBD supplements, whereas PCPs practicing in states that had not passed ML were more concerned about CBD-related side effects. Regardless of state ML status, most PCPs did not feel that they should be recommending CBD supplements to their patients. Most PCPs reported believing that CBD was unhelpful for most conditions for which it is marketed, with chronic non-cancer pain and anxiety/stress being exceptions. PCP respondents generally felt that they had insufficient knowledge/training around CBD. Conclusions: Results from this mixed methods study show that PCPs practicing in the U.S. rarely screen for or discuss CBD use with their patients and report several barriers to engage in proactive CBD-focused practice behaviors. Furthermore, survey results show that some PCP attitudes, practice behaviors, and barriers vary as a function of state ML status. These findings may guide medical education efforts and inform primary care practice modifications aimed at enhancing screening and monitoring of patient CBD use by PCPs.

Assessment of cannabidiol use in pets according to a national survey in the USA.

Conduct an online questionnaire to understand the motivations and perceptions about cannabidiol use in companion animals in the USA. Data from a USA population sample who owned a pet were gathered using an online questionnaire. Perception of cannabidiol efficacy was analysed for independence against explanatory variables using the Pearson chi-square test, followed by a binary logistic regression. A total of 1238 participants completed the survey; 356 had administered cannabidiol to their pet before. Dogs were the most prevalent pet, followed by cats (75.8 and 22.2%, respectively). Treats/chews and oils were the most common forms of cannabidiol (44.6 and 42.9%, respectively). The most prevalent condition for treating with cannabidiol was anxiety and stress (67.4%), followed by joint pain and inflammation (23%). Doses and frequency of cannabidiol used by many pet owners were inconsistent, and yet many participants perceived an improvement of their pets' condition with supplementation, with mild to no side effects. Most respondents had not given cannabidiol to their pets before due to uncertainty about its efficacy and safety. The frequency of cannabidiol administration and length of time administered were both significant for whether participants found it efficacious in treating a given condition, and this was more evident when supplementing cannabidiol for a longer time. We found heterogeneity regarding cannabidiol dosage and dosing frequency. Cannabidiol was mostly perceived as safe and effective, but there is a need to conduct further research on cannabidiol long-term tolerability and therapeutic efficacy for treating various conditions.

Concomitant cannabidiol does not impact safety and effectiveness of diazepam nasal spray for seizure clusters: Post hoc analysis of a phase 3 safety study

People with epilepsy may experience episodes of frequent seizure activity (seizure clusters, acute repetitive seizures), and benzodiazepines are the cornerstone of rescue treatment. Cannabidiol (CBD) can be used as an adjunctive treatment for epilepsy, and it may interact with other antiseizure drugs, such as benzodiazepines. Here, we examined the safety and effectiveness of intermittent use of diazepam nasal spray in patients with seizure clusters who also received CBD treatment. This analysis included data from patients aged 6 to 65 years enrolled in a phase 3, long-term safety study of diazepam nasal spray. Age- and weight-based dosing of diazepam nasal spray were administered during a 12-month treatment period. Concomitant CBD use was recorded, and treatment-emergent adverse events (TEAEs) were collected. Of 163 treated patients, 119 (73.0%) did not receive CBD, 23 (14.1%) received the US Food and Drug Administration–approved highly purified CBD and 21 (12.9%) received another form of CBD. On average, patients receiving highly purified CBD were younger and more likely to have epileptic encephalopathies, including Dravet syndrome or Lennox-Gastaut syndrome, than patients who received another CBD preparation or no CBD. Rates of TEAEs and serious TEAEs were greater in patients who received any form of CBD (90.9% and 45.5%, respectively) compared with no CBD (79.0% and 26.1%, respectively). However, the lowest rates of TEAEs attributed to diazepam nasal spray were reported in patients who received highly purified CBD (13.0%), and this result was maintained in those who received concomitant clobazam. Use of second doses of diazepam nasal spray, a proxy for effectiveness, was lowest in the highly purified-CBD group (8.2%) compared with the no-CBD (11.6%) and other-CBD groups (20.3%). These results suggest that CBD does not alter the safety and effectiveness of diazepam nasal spray and supports concomitant use in appropriate patients.

Cannabidiol in children with treatment-resistant epilepsy with myoclonic-atonic seizures

PurposeThis multicenter study aimed to evaluate the efficacy and tolerability of add-on cannabidiol (CBD) in treatment-resistant patients with epilepsy with myoclonic-atonic seizures (EMAtS) (n = 22) and Sturge Weber syndrome (SWS) with myoclonic-atonic seizures (n = 4). MethodsPatients who met the diagnostic criteria of treatment-resistant EMAtS or SWS with myoclonic-atonic seizures were included. Cannabidiol was added in doses ranging from 8 to 40 mg/kg/day. Efficacy was assessed by comparing seizure frequency before and after initiating CBD therapy.Neurologic examinations, brain magnetic resonance imaging, repeated prolonged electroencephalography (EEG) and/or video-EEG recordings, and neurometabolic studies were performed in all patients, and genetic investigations in 15. ResultsAfter a mean follow-up of 19 months, 15/26 patients (57.7%) who received add-on CBD had a >50% seizure decrease; three (11.5%) became seizure-free. The remaining 11 patients (42.3%) had a 25–50% seizure reduction. Drop attacks, including myoclonic-atonic seizures and generalized tonic-clonic seizures, as well as atypical absences and nonconvulsive status epilepticus responded well to CBD. In SWS patients, focal motor seizures without consciousness impairment and focal non-motor seizures with consciousness impairment were recognized in two each; in three a 30% reduction of focal seizures was observed. Side effects were mild and did not lead to CBD discontinuation. ConclusionThis study evaluating the use of add-on CBD in children with EMAtS or SWS with myoclonic-atonic seizures found that 15/26 (57.7%) had a >50% seizure reduction with good tolerability; three (11.5%) became seizure-free.

Retrospective chart review study of use of cannabidiol (CBD) independent of concomitant clobazam use in patients with Lennox-Gastaut syndrome or Dravet syndrome

PurposeThis retrospective chart review study (GWEP20052) evaluated plant-derived highly purified cannabidiol (CBD; Epidyolex®; 100 mg/mL oral solution) use without clobazam as add-on therapy in patients aged ≥2 years with Lennox-Gastaut syndrome (LGS) or Dravet syndrome (DS) enrolled in a European Early Access Program. MethodsData were extracted from patient charts covering a period starting 3 months before CBD treatment and concluding after 12 months of CBD treatment, or sooner if a patient discontinued CBD or started clobazam. ResultsOf 114 enrolled patients, data were available for 107 (92 LGS, 15 DS) who received CBD without clobazam for ≥3 months. Mean age: 14.5 (LGS) and 10.5 (DS) years; female: 44% (LGS) and 67% (DS). Mean time-averaged CBD dose: 13.54 (LGS) and 11.56 (DS) mg/kg/day. Median change from baseline in seizure frequency per 28 days over 3-month intervals varied from −6.2% to −20.9% for LGS and 0% to −16.7% for DS. Achievement of ≥50% reduction in drop (LGS) or convulsive (DS) seizures at 3 and 12 months: LGS, 19% (n = 69) and 30% (n = 53); DS, 21% (n = 14) and 13% (n = 8). Retention on CBD without clobazam (enrolled set): 94%, 80%, 69%, and 63% at 3, 6, 9, and 12 months. Adverse event (AE) incidence was 31%, most commonly somnolence, seizure, diarrhea, and decreased appetite. Two patients discontinued CBD owing to AEs, and four patients with LGS experienced elevated liver enzymes. ConclusionResults support favorable effectiveness and retention of CBD without concomitant clobazam for up to 12 months in clinical practice.

173 Industry perceptions of cannabidiol use in horses

Cannabidiol (CBD) use in horses has become more popular due to availability and anecdotal reports of its ability to reduce inflammation and illicit a calming effect. However, research demonstrating its efficacy and long-term health effects are limited. Additionally, there is no regulatory body or labeling requirements for horse products. This coupled with restrictions from national associations makes it difficult to explore therapeutic benefits of CBD in horses while adhering to competition regulations. The objective of this study was to gain insight into the equine industry's perception of CBD use in horses. A convenience survey of 133 equine industry professionals assessed both attitudes and behaviors related to CBD use in horses. A Qualtrics survey link was distributed via an extension specialist email listserv and Facebook page. Data were analyzed using descriptive statistics including frequency, percentage, mean and standard deviation. Differences in attitudes between groups were compared using independent samples t-test. Data are presented as mean ± standard deviation. Most respondents were female (91%), reported riding competitively (65.4%), manage a range of 1–24 horses, and report utilizing equine supplements (75.2%), only 28.6% of respondents indicated they currently use equine CBD products. As expected, those who reported administering CBD products have a more positive attitude (4.3 ± 0.6)toward CBD usage than those who do not (3.4 ± 0.9) (t97.1 = −6.6). However there is no difference in attitude toward CBD usage between those who ride competitively and those who do not. The number of horses managed by each respondent did not affect their attitude toward CBD usage. Most respondents (87.7%) indicated they were willing to pay up to $100 per product per horse regardless if they are currently using CBD products. In regards to efficacy, respondents believe that CBD products provide benefits for horses (67.2%) such as calming (47.6%) and believe it is an effective alternative to NSAIDS (44.3%) to reduce inflammation. They also believe that products should be labeled clearly (91%), should be legal to use in competitive associations (58%), and would recommend its use to others (53.3%), however only 6.1% indicate a licensed veterinarian has recommended its use. As more information becomes available and regulatory bodies make recommendations, associations are likely to make allowances for CBD use. There is a need for additional research defining therapeutic dosages and long-term physiological effects. In conclusion, the equine industry appears to have a positive attitude toward CBD use in horses despite the lack of concrete evidence and veterinarian recommendation.

136 The effects of cannabidiol on libido and heart rate in stallions

Changes in the Agriculture Improvement Act of 2018 increased popularity of Cannabidiol (CBD) as a supplement. Exogenous CBD, derived from Cannabis Sativa L., binds to cannabinoid receptors in the endocannabinoid system. These receptors are located throughout the body, CB1 being prominent in the central nervous system and CB2 in the immune system. Physiological effects of CBD have been well researched but the effects on libido have not. Lack of libido or sexual drive can be detrimental to stallion breeding productivity. The use of CBD as a calming supplement in animals is increasing due to marketing strategies. The study objective was to evaluate libido and heart rate (HR) in stallions given a daily oral CBD supplement for 90d. Two-year old stallions (n = 7) were assigned to either Control (CON; n = 3) or Cannabidiol (CBD; n = 4) treatment groups. CBD was administered at 0.6mg/kg of BW/d, while CON was administered an equal volume of olive oil, as a placebo of similar nature. Treatments were top-dressed over morning feed. Horses were weighed every Monday with dosages recalculated accordingly. Data collections occurred 2x/wk during semen collections with an artificial vagina. Behaviors were previously defined, calmly called out and logged as they occurred. Observations included time spent licking a tease mare, time to erection, time to first mount, and time to ejaculation. A Polar® heart rate monitoring system linked to the KER® ClockItapp was usedto measure HR. Variations of HR included resting HR, teasing HR, mounting HR, step-off HR, and walk-off HR. Data was analyzed using a repeated measures ANOVA within R Statistical Program®(R Core Team, 2022). Results were considered significant at P ≤ 0.05. Throughout the duration all stallions exhibited normal sexual behavior, regardless of treatment. A treatment affect was not seen for licking time between CBD and CON (11.92s ± 3.76 and 0.32s ± 0.20 respectively). There was no difference between CBD and CON for time to erection (27.64s ± 6.84 and 22.9s ± 4.76 respectively). Time to first mount CBD stallions averaged 330.6s ± 23.04, CON stallions averaged 359.5s ± 25.51, with no effect of treatment. Time to ejaculation in CBD stallions was 356s ± 23.78 and 374s ± 24.84 in CON stallions. There were no differences in behaviors over time. There was a time x day effect for walk-off HR(P = 0.04), though this was significant in both groups. No other differences in HR occurred. Long-term use of CBD for young stallions was seen to not affect libido. However, supplementation may lower HR over time. The immediate and lasting response to CBD use in mature stallions and older aggressive stallions is needed to understand the effects of using these products.

Effects of cannabidiol on the differentiation of human monocytes into macrophages

Abstract Background: Innate immune myeloid cells, such as macrophages, contribute to chronic inflammation when consistently activated. Recently, cannabidiol (CBD), an active non-psychoactive constituent of the Cannabis sativa plant (i.e., Marijuana), has sparked interest as a safe and effective anti-inflammatory and immunomodulatory agent. This study aimed to investigate the CBD’s effects on the differentiation of human macrophages and their cell surface receptors. Methods: Peripheral blood was collected from healthy human donors. Monocytes, isolated from peripheral blood mononuclear cells, were differentiated with macrophage colony stimulating factor into monocyte-derived macrophages (MDM) with and without CBD (5 μM). Differentiated MDMs were then stained for different cell surface markers and analyzed by multicolor flow-cytometry. Proportions of anti-inflammatory (M2: CD206, CD71, CD163) and pro-inflammatory (M1: CD86, CD163) MDMs, and expression of myeloid lineage markers (CD14, CD16), chemokine receptor 5 (CCR5) and endocannabinoid type 2 receptor (CB2) were determined. Results: CBD promoted a shift towards a greater proportion of M2-type vs. M1-type MDMs (p&amp;lt;0.05, Fisher’s exact test). Cells displayed a significantly reduced expression of CD14, CD163, CD86, CCR5 and CB2 (p&amp;lt;0.05, Student t-test). Conclusions: CBD appears to promote differentiation of MDMs into anti-inflammatory phenotypes. Further studies are ongoing to determine the mechanistic pathways implicated in these processes, as these findings may have implications for the use of CBD in various disease conditions.

Adjunctive Use of Cannabidiol: A Joint Action to Patch Up Drug-Resistant Epilepsy.

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