Cannabis and the oral microbiome: Exploring their impacts on the brain
Inspiration strikes when you least expect it. For Wei Jiang, M.D., a professor of Microbiology and Immunology at the Medical University of South Carolina (MUSC), inspiration came in 2018 on a smoke-filled boat tour around Amsterdam during an international conference.
“Everyone was smoking cannabis except me,” said Jiang. “I was studying the microbiome at the time, so after talking to them, I figured out their oral health was affected by smoking and wanted to understand this further.”
In the years since, Jiang has focused her research on how smoking cannabis alters the oral microbiome, or the community of bacteria that live in the mouth. The South Carolina Clinical and Translational Research Institute provided pilot funding for Jiang’s research.
Now, with $3.7 million in recent funding from the National Institute on Drug Abuse (NIDA), Jiang and her collaborator Sylvia Fitting, Ph.D., from the University of North Carolina at Chapel Hill, will dive deeper into the effects of cannabis-caused changes to the oral microbiome and their impacts on neurological disease.
“This will be the first study to investigate the cannabis-altered oral microbiome and its effects on the brain,” said Jiang.
Cannabis is the most widely used drug in the U.S. and can have positive mental effects, such as reducing anxiety. However, long-term use can lead to impaired memory, learning and motor skills, said Jiang. Smoke also contains harmful compounds from combustion that affect oral health.
Changes in oral bacteria have been linked to cardiovascular diseases, preterm birth and even Alzheimer’s disease. Unnatural changes in the oral microbiome, known as dysbiosis, can allow harmful bacteria to thrive in the mouth and even enter the bloodstream, damaging other organs, such as the brain.
Jiang and her collaborators showed in a December 2021 EBioMedicine study that frequent cannabis use alters the oral microbiome. They found unusually high levels of the bacterium Actinomyces meyeri, A. meyeri, in frequent cannabis users but not in tobacco or cocaine users.
“In general, the amount of A. meyeri should be very low in a healthy oral microbiome,” said Jiang.
Mice orally exposed to A. meyeri for six months showed increased inflammation and more amyloid-beta proteins in their brains. These proteins are thought to be linked to long-term memory loss and Alzheimer’s disease.
“After we saw these changes in mice given this bacterium, we became very intrigued by what was happening in their brains,” said Jiang.
The new grant funding will enable the team to explore the mechanisms underlying the link between high levels of A. meyeri in the oral microbiome of frequent cannabis users and neurological disease.
“Psychological dependency on a drug can have harmful neurological effects, but we don’t know what is driving these effects in heavy cannabis users,” said Jiang. “We know that oral health affects your mental health. However, we don’t know exactly what role the microbiome plays.”
Although Jiang’s earlier work showed that the cannabis-altered oral microbiome played a role in neurological changes, it did not specifically look at what component of cannabis caused those changes. Cannabis contains both psychoactive (THC) and non-psychoactive (CBD) components, which interact with the brain and nervous system in different ways.
“Now, we want to identify the specific effects of THC and CBD on oral microbiome dysbiosis and mental health,” said Jiang.
Jiang plans to expose mice to different levels of THC and CBD to determine their effects on levels of A. meyeri in the oral microbiome.
“We think that long-term exposure to THC, but not CBD, will increase levels of A. meyeri in saliva and lead to harmful neurological effects in mice,” said Jiang.
In the new study, Jiang will also move beyond mouse models to humans with cannabis use disorder to see how changes in their oral microbiomes affect memory.
“We expect memory-related deficits to be associated with greater levels of A. meyeri in frequent cannabis users compared with nonusers,” said Jiang.
Jiang’s research highlights the importance of oral health and its complex relationship with other diseases.
“Anyone using cannabis frequently should pay particular attention to their oral hygiene,” said Jiang.
With support from the NIDA grant, Jiang plans to lay a foundation for developing therapeutics that target the oral microbiome in frequent cannabis users with neurological disorders.
“If our hypothesis is correct, a therapeutic strategy targeting A. meyeri could reduce irregularities in brain function in frequent cannabis users,” said Jiang. “In the future, it may also be useful to screen for certain bacteria as biomarkers of different diseases that affect the brain, such as Alzheimer’s disease.”
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About MUSC
Founded in 1824 in Charleston, MUSC is the state’s only comprehensive academic health system, with a unique mission to preserve and optimize human life in South Carolina through education, research and patient care. Each year, MUSC educates more than 3,000 students in six colleges – Dental Medicine, Graduate Studies, Health Professions, Medicine, Nursing and Pharmacy – and trains more than 850 residents and fellows in its health system. MUSC brought in more than $297.8 million in research funds in fiscal year 2022, leading the state overall in research funding. For information on academic programs, visit musc.edu.
As the health care system of the Medical University of South Carolina, MUSC Health is dedicated to delivering the highest quality and safest patient care while educating and training generations of outstanding health care providers and leaders to serve the people of South Carolina and beyond. Patient care is provided at 14 hospitals with approximately 2,500 beds and five additional hospital locations in development, more than 350 telehealth sites and connectivity to patients’ homes, and nearly 750 care locations situated in all regions of South Carolina. In 2022, for the eighth consecutive year, U.S. News & World Report named MUSC Health the No. 1 hospital in South Carolina. To learn more about clinical patient services, visit muschealth.org.
MUSC and its affiliates have collective annual budgets of $5.1 billion. The nearly 25,000 MUSC team members include world-class faculty, physicians, specialty providers, scientists, students, affiliates and care team members who deliver groundbreaking education, research and patient care.
Association of pediatric cannabis poisonings with legal edible product sales in Canada
JAMA Health Forum
Peer-Reviewed PublicationAbout The Study: Following cannabis legalization in Canada, provinces that permitted edible cannabis sales experienced much larger increases in hospitalizations for unintentional pediatric poisonings than the province that prohibited cannabis edibles in this analysis including Canada’s four most populous provinces. In provinces with legal edibles, approximately one-third of pediatric hospitalizations for poisonings were due to cannabis. These findings suggest that restricting the sale of legal commercial edibles may be key to preventing pediatric poisonings after recreational cannabis legalization.
Authors: Daniel T. Myran, M.D., M.P.H., of the Ottawa Hospital Research Institute in Ottawa, Ontario, Canada, is the corresponding author.
To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/
(doi:10.1001/jamahealthforum.2022.5041)
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About JAMA Health Forum: JAMA Health Forum is an international, peer-reviewed, online, open access journal that addresses health policy and strategies affecting medicine, health and health care. The journal publishes original research, evidence-based reports and opinion about national and global health policy; innovative approaches to health care delivery; and health care economics, access, quality, safety, equity and reform. Its distribution will be solely digital and all content will be freely available for anyone to read.
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JAMA Health Forum
ASTHMA IS CAUSED BY AIR POLLUTUION
Asthma is on the rise among teens in states where cannabis is recreationally legal
Increases in asthma also observed among children in some minority racial and ethnic groups in states with recreational legalization
Peer-Reviewed PublicationJanuary 11, 2023-- Increases in asthma prevalence were found among teens in states that have legalized cannabis for recreational use, as well as among children in some minority racial and ethnic groups in states with recreational legalization, relative to states that remain fully illegal, according to a new study at Columbia University Mailman School of Public Health and The City University of New York. The results provide early evidence that legalizing and commercializing adult cannabis use may be related to a potential rise in asthma prevalence. The study is the first to examine the relationship between changes in cannabis policy for adult use and asthma prevalence among children and adolescents. The results are published online in the journal Preventive Medicine.
“Our findings suggest that state-level cannabis policy could have downstream impacts on children’s respiratory health,” said Renee D. Goodwin, PhD, adjunct associate professor in the Department of Epidemiology at Columbia Mailman School of Public Health and professor at The City University of New York. “Cannabis use is increasing among adults with children in the home, particularly in states which have legalized for medical or recreational use. Exposure to secondhand smoke is a key risk factor for asthma among children. This study offers a critical first step in identifying a key children’s health concern emerging in the context of rapid, ongoing changes in cannabis policy that are unaccompanied by clinical or public health guidelines for parents.”
Asthma affects approximately 5 million children and is the most common chronic condition affecting children in the nation. The researchers used data from the 2011-2019 National Survey on Children’s Health, a representative sample of the physical and mental health of non-institutionalized children in the U.S. ages 0-17 years old.
Nationally, a statistically significant decrease in the prevalence of pediatric asthma was reported from 2011-2012 to 2016-2017, with no decline thereafter. Relative to states where cannabis was fully illegal, the prevalence of asthma increased slightly among adolescents 12-17 years old and among children identifying with non-Hispanic minoritized race and ethnic groups in states where cannabis was legal for adult recreational use.
Cannabis use has been increasing among adults with minor children in the home and is more common among those who live in states where cannabis is legal for recreational use. An earlier study by Goodwin found that, among parents with minor children, cannabis use was observed in 12 percent of parents in states with legal cannabis for recreational purposes, followed by parents residing in states with legalized cannabis for medical purposes (9.5 percent), with the lowest prevalence seen in parents in states with no cannabis laws (6 percent).
“Increased adult cannabis use across the U.S. may inadvertently impact asthma among youth. In the context of rapidly increasing legalization of adult (21 and older) use and commercialization in the U.S., an evidence base is urgently needed to inform legislators, policy makers, clinicians and the public on the potential heath impact of increasing secondhand cannabis smoke (SCS) exposure among children. Yet, no clinical nor public education regarding child exposure to SCS is available or routinely offered to parents,” noted Goodwin.
“While tremendous progress has been made in asthma management in concert with tobacco control over the past several decades, the possibility that increased adult cannabis use may pose new risks, requires more in-depth study and, in particular, to learn whether SCS is associated with increases in asthma morbidity, including symptom frequency, use of rescue medicines, impairment—including missed school days -- and emergency medical services.
“We believe that more research is urgently needed to estimate the potential consequences of increased adult use of cannabis in the community for children’s respiratory health and that this work should come before, or at least be done contemporaneously with, the widespread commercialization of cannabis for adult use in U.S. states,” observed Goodwin.”
Co-authors are Katarzyna Wyka, The City University of New York; Man Luo, UC, San Diego; Andrea H. Weinberger, Yeshiva University and Albert Einstein College of Medicine; and Meyer Kattan, Columbia University Irving Medical Center/New York-Presbyterian/Morgan Stanley Children’s Hospital.
The study was supported by the National Institutes of Health/National Heart, Lung and Blood Institute (grant 1R21HL149773-01).
Columbia University Mailman School of Public Health
Founded in 1922, the Columbia University Mailman School of Public Health pursues an agenda of research, education, and service to address the critical and complex public health issues affecting New Yorkers, the nation and the world. The Columbia Mailman School is the fourth largest recipient of NIH grants among schools of public health. Its nearly 300 multi-disciplinary faculty members work in more than 100 countries around the world, addressing such issues as preventing infectious and chronic diseases, environmental health, maternal and child health, health policy, climate change and health, and public health preparedness. It is a leader in public health education with more than 1,300 graduate students from 55 nations pursuing a variety of master’s and doctoral degree programs. The Columbia Mailman School is also home to numerous world-renowned research centers, including ICAP and the Center for Infection and Immunity. For more information, please visit www.mailman.columbia.edu.
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Preventive Medicine
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