Effects of Medicinal Cannabis on CD4 immunity in AIDS

May 18, 2011

Mul­ti­ple sci­en­tific reviews have con­cluded that although some research reports immuno­sup­pres­sive con­se­quences of cannabis, addi­tional research which includes cost/benefit approach and effects of ther­a­peu­tic doses on spe­cific immune responses is needed to eval­u­ate cannabis as an agent to treat pain, reduce nau­sea and wast­ing in patients with severe dis­ease such as AIDS and can­cers. Anes­thetic reagents are gen­er­ally immuno­sup­pres­sive for CD4 T-cell activ­ity, which would impact patients whose immune sys­tem is frag­ile. How­ever, if cannabis allows HIV infected patients to bet­ter tol­er­ate anti-retroviral treat­ment (which increases CD4 num­ber), reverses wast­ing, and avoid use of opi­ates, then it could have an over­all ben­e­fi­cial effect. My lab­o­ra­tory has been exam­in­ing lym­pho­pro­lif­er­a­tive responses in HIV infected cohorts and has shown asso­ci­a­tion of pos­i­tive responses to CMV and mycobac­terium with resis­tance to dis­ease caused by these agents.

This is a pro­posal to exam­ine the effects of cannabis use on CD4 T-cell pro­lif­er­a­tion and cytokine expres­sion in HIV infected patients. To con­serve costs and rather than set­ting up a sep­a­rate study, this an added set of eval­u­a­tions in Dr. Ron Ellis’s clin­i­cal study to exam­ine the effec­tive­ness of cannabis in treat­ing neu­ro­pathic pain in AIDS patients. That pro­posal is a cross-over study with pre-and post treat­ment eval­u­a­tions. This pro­posal will involve tak­ing periph­eral blood sam­ples at each eval­u­a­tion point and mea­sur­ing lym­pho­pro­lif­er­a­tive and cytokine pro­duc­tion (inter­feron gamma) in response to HIV, CMV, mito­gen, Can­dida, Tox­o­plasma, and mycobac­terium anti­gens. All of these anti­gens are cur­rently in use in our lab and elicit responses in 30–95% of patients. The study struc­ture (N=30) will be a sin­gle group, double-blind, cross-over trial com­pris­ing five phases: (1) one week base­line; (2) one week smoked cannabis-active; (3) two weeks Washout A; (4) one week smoked cannabis-placebo; and (5) two weeks Washout B.

http://​www​.cmcr​.ucsd​.edu/​i​m​a​g​e​s​/​p​d​f​s​/​S​c​h​r​i​e​r​_​a​b​s​_​1​.​pdf

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