News in Cannabinoid Research Franjo Grotenhermen nova-Institut, Hürth IACM, Cologne (Colonia) 1 Topics I II Tourette‘s syndrome Antineoplastic properties (anti-cancer effects) III IACM International Association for Cannabis as Medicine 2 I. Tourette‘s syndrome Gilles de la Tourette‘s Syndrome Complex neurological-psychiatric disorder Permanently changing motor tics At least one vocal tic Disturbed behaviour (autoaggression, disturbed attention) No satisfactory therapy 3 Course of a TS attack Photos taken from: Hartung S. "... sonst bin ich ganz normal" - Leben mit dem Tourette-Syndrom. Rasch und Röhring Verlag, 1995. 4 Study on TS Placebo-controlled study (Medical School of Hannover) 24 patients Duration: 6 weeks Dose: 7.5 – 10.0 mg 9-THC Müller-Vahl KR, et al. Tetrahydrocannabinol (THC) is effective in the treatment of tics in Tourette-Syndrome: a 6-week randomized trial. (zur Veröffentlichung eingereicht) 5 Yale Global Tic Severity Scale (THC-Dosis =/> 7,5mg) ° = p<0,10 10 ° 0 p = 0.077 -10 THC Placebo -20 9 20-22 Studientag 30-31 +1 Tag +5 Wo 6 Global Clinical Impression Scale (THC-Dosis =/> 7,5mg) * = p < 0,05 ,1 * 0,0 ** -,1 p = 0,079 -,2 -,3 -,4 -,5 THC -,6 -,7 Placebo 9 20-22 Studientag 30-31 +1 Tag +5 Wo 7 II. Antineoplastic properties Long-term survival of rats (Chan et al. 1996) Treatment of glioma (malignant brain tumour) in rats with THC and a synthetic cannabinoid (Galve-Roperph 2000) Clinical study with THC in malignant glioma in Spain (since 2002) 8 Long-term survival of rats Groups of 60 to 70 rats and mice Dose for rats: no THC, 5 mg, 15 mg or 50 mg per kg body weight Dose for mice: no THC, 125 mg, 250 mg or 500 mg per kg body weight 5 x per week for 2 years Chan PC, et al. Toxicity and carcinogenicity of delta 9-tetrahydrocannabinol in Fischer rats and B6C3F1 mice. Fundam Appl Toxicol 1996;30(1):109-117. 9 Survival rates for rats after 2 years (Chan et al. 1996) 50 mg 66 15 mg 68 5 mg 74 no THC 46 0 10 20 30 40 50 60 70 80 10 Tumour rates after 2 years (Chan et al. 1996) 7 Uterus (female rats) with THC without THC 16 22 Breast (female rats) 31 27 Pineal gland (male rats) 40 1 Pancreas (male rats) 15 77 Testes (male rats) 88 0 20 40 60 80 100 11 Glioma therapy in rats 45 rats with malignant glioma 15 treated with THC, 15 with WIN55,212-2, 15 without treatment Cannabinoids cured 1/3 of the rats and prolonged survival in another 1/3 Galve-Roperh I, et al. Anti-tumoral action of cannabinoids: involvement of sustained ceramide accumulation and extracellular signal-regulated kinase activation. Nat Med 2000;6(3):313-319. 12 Treatment results – cannabinoids in glioma of rats No treatment Early death (< 18 days) Prolonged survival (19-43 days) Cure WIN-55,212-2 THC 0 2 4 6 8 10 12 14 16 13 Clinical study in glioma Hospital of La Laguna (Tenerife) 5 patients with glioblastoma multiforme; later more patients Phase-I/II study to find out the best dose THC for 2-8 weeks Direct application at the tumour (operation) Aim: Prolonged survival 14 III. IACM Founded in March 2000 Mainly members of the German ACM Two regional sections, German ACM and Austrian CAM Regular members and associate members 15 Aims of the IACM The IACM is a scientific society advocating the improvement of the legal situation for the use of the hemp plant (Cannabis sativa L.) and its pharmacologically most important active compounds, the cannabinoids, for therapeutic applications through promotion of research and dissemination of information. 16 Regional sections Members of one or several nations may found a regional section to deal with regional affairs. The sections may elect their own representatives and choose their own regulations. In regional sections all members may have equal rights and decide on the guidelines of the work, analogous to the ACM in the German language region. Existing national organisations may become a member of the IACM, if goals and principles are congruent. 17 www.cannabis-med.org 18