Beneficial Effects of Cannabis on Blood-Brain Barrier and Inflammation in HIV

Below is an abstract from the most important AIDS conference in the US. It’s a bit scientific, but important reading. The whole paper was presented at the recent HIV conference in Seattle at the beginning of March. The Blood-Brain Barrier (BBB) is a difficult issue in medicine since drugs meant for the brain are almost impossible to get across the BBB. This could have implications for further cannabis research about the BBB and the role of cannabis on crossing the barrier. The abstract begins below with a listing of the authors of the paper. This is just an abstract that speaks to the findings and not the paper itself.


Author(s): Ronald J. Ellis, Jennifer Iudicello, Erin Morgan, Brook Henry, Rachel Schrier, Mariana Cherner, Martin Hoenigl, Scott L. Letendre

University of California San Diego, La Jolla, CA, USA,University of California San Diego, San Diego, CA, USA

Abstract Body:

HIV infection is associated with increased permeability of the blood-brain barrier (BBB), which may permit increased entry of toxins with consequent CNS injury. Cannabis, which is commonly used among people living with HIV (PLWH); has anti-inflammatory effects; and stabilizes the BBB in animal models. One potential mechanism of increased BBB permeability is upregulation of the urokinase plasminogen activator (uPA), a matrix-degrading proteolytic enzyme, and its receptor, uPAR, disrupting the basal lamina around cerebral capillaries. This study sought to determine the effects of recent cannabis use on cerebrospinal fluid (CSF) concentrations of uPAR, CSF-to-serum albumin ratio (CSAR, an indicator of BBB permeability), and neuroinflammation among PLWH.

Participants were 45 recent (i.e., within the past month) cannabis users with (HIV+) or without HIV (HIV-) who were comparable in age (mean age=39.3) and sex (93.3% male). CSF levels of soluble uPAR, soluble CD14 (sCD14) and CXCL-10 were measured by immunoassay. Albumin was measured in CSF by nephelometry and in serum by a clinical assay. Data were analyzed using standard statistical methods, including regression and t-tests.

A statistically significant interaction (p=0.025) was present between HIV and cannabis use frequency (total days over the past month): more frequent use of cannabis was associated with lower concentrations of uPAR in CSF in the HIV+ group (p=0.043) but not in the HIV- group. The CSAR showed similar but non-statistically significant effects. Within the HIV+ group, higher CSF uPAR levels correlated with higher CSAR values (rho=0.47; pThese preliminary findings suggest that cannabis may have a beneficial impact on HIV-associated BBB injury and neuroinflammation. Given the role of the BBB in HIV-associated CNS injury, these results support the potential therapeutic role of cannabis among PLWH, and may have important treatment implications for antiretroviral therapy effectiveness and toxicity.

The conference was CROI – Conference on Retroviruses and Opportunistic Infections

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