Effects of Medicinal Cannabis on CD4 immunity in AIDS
INVESTIGATOR: Rachel Schrier, Ph.D.
STUDY LOCATION: University of California, San Diego
PROJECT TITLE: Effects of Medicinal Cannabis on CD4 immunity in AIDS
PROJECT TYPE: Pre-Clinical Study, Sub-Study
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.