{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T18:31:12Z","timestamp":1792607472028,"version":"4.5.0"},"reference-count":89,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T00:00:00Z","timestamp":1706745600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cannabis &amp; Cannabinoid Research"],"published-print":{"date-parts":[[2024,2,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Utilizing cannabis as a therapeutic option for chronic pain (CP) has increased significantly. However, data regarding the potential immunomodulatory effects of cannabis in CP patients remain scarce. We aimed at exploring the relationship between cannabis use and inflammatory cytokines and chemokines among a cohort of CP patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Adult patients with a CP diagnosis and medical authorization of cannabis were enrolled. Patients completed validated clinical questionnaires and self-reported the effectiveness of cannabis for symptom management. Patients' blood and cannabis samples were analyzed for the presence of four major cannabinoids, two major cannabinoid metabolites, 29 different cytokines\/chemokines, and cortisol. The multivariable linear regression model was used to identify cannabis and patient factors associated with immune markers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Fifty-six patients (48\u00b115 years; 64% females) were included, with dried cannabis (53%) being the most common type of cannabis consumed. Seventy percent of products were considered delta-9-tetrahydrocannabinol (\u0394\n                      <jats:sup>9<\/jats:sup>\n                      -THC)-dominant. The majority of patients (96%) self-reported effective pain management, and 76% reported a significant decrease in analgesic medication usage (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u22640.001). Compared with males, female patients had higher plasma levels of cannabidiol (CBD), cannabidiolic acid, \u0394\n                      <jats:sup>9<\/jats:sup>\n                      -THC, and 11-hydroxy-\u0394\n                      <jats:sup>9<\/jats:sup>\n                      -tetrahydrocannabinol but lower concentrations of delta-9-tetrahydrocannabinolic acid and 11-nor-9-carboxy-\u0394\n                      <jats:sup>9<\/jats:sup>\n                      -tetrahydrocannabinol (THC-COOH). Females had significantly lower eotaxin levels (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      =0.04) in comparison to male patients. The regression analysis indicated that high cannabis doses were related to increased levels of interleukin (IL)-12p40 (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      =0.02) and IL-6 (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      =0.01), whereas female sex was associated with decreased eotaxin (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u22640.01) concentrations. Blood CBD levels were associated with lower vascular endothelial growth factor (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      =0.04) concentrations, and THC-COOH was a factor related to decreased tumor necrosis factor alpha (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      =0.02) and IL-12p70 (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      =0.03).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This study provides further support for the patient-perceived effectiveness of cannabis in managing CP symptoms and reducing analgesic medication consumption. The results suggest a potential sex difference in metabolizing cannabinoids, and the varying immune marker concentrations may support a possible immunomodulatory effect associated with patient sex and cannabis product type. These preliminary findings provide grounds for further validation using larger, well-designed studies with longer follow-up periods.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/can.2022.0143","type":"journal-article","created":{"date-parts":[[2022,11,7]],"date-time":"2022-11-07T11:59:08Z","timestamp":1667822348000},"page":"267-281","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":15,"title":["Medical Cannabis Use and Inflammatory Cytokines and Chemokines Among Adult Chronic Pain Patients"],"prefix":"10.1177","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8819-1347","authenticated-orcid":false,"given":"Prabjit","family":"Ajrawat","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Management, University Health Network, University of Toronto, Toronto, Ontario, 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