The impact of medical cannabis on pain and inflammation in people living with HIV

医用大麻对艾滋病毒感染者疼痛和炎症的影响

基本信息

批准号：
10633152
负责人：
Deepika Slawek
金额：
$ 19.42万
依托单位：
ALBERT EINSTEIN COLLEGE OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-07-15 至 2025-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10633152
关键词：
Absence of pain sensation Adherence Adverse event Affect Alternative Therapies Anti-Inflammatory Agents Anti-Retroviral Agents Anxiety Blood specimen Cannabidiol Cannabis Caring Certification Complex Data Data Sources Disease Dose Etiology Failure Gel Goals Growth HIV HIV Infections Health Inflammation Inflammatory Interleukin-10 Interleukin-4 Interleukin-6 Investigation K-Series Research Career Programs Knowledge Legal Link Measurable Mediation Medical Medical Marijuana Mental Depression Mentors Mentorship Modality New York Oils Opioid Outcome Pain Pain management Participant Patient Self-Report Persons Pharmacy facility Placebos Policy Making Psychoses Qualifying Questionnaires Randomized Randomized, Controlled Trials Records Regulation Reporting Research Research Personnel Research Project Grants Risk Severities Telephone Testing Tetrahydrocannabinol Time Titrations Training United States Visit arm capsule chronic pain chronic pain management cytokine depressive symptoms design disability experience federal policy follow-up functional disability high risk improved innovation interest marijuana use medical examination multidisciplinary novel therapeutics pain reduction painful neuropathy patient oriented primary outcome psychological symptom psychotic symptoms public health relevance randomized trial secondary outcome skills systemic inflammatory response trial design

项目摘要

ABSTRACT Dr. Deepika Slawek’s overall goal is to improve health outcomes in people living with HIV (PLWH), with a focus on determining the impact of medical cannabis. PLWH have a high burden of pain, and most commonly experience neuropathic pain. It is associated with significant disability, including functional impairment, poor antiretroviral adherence, and virologic failure. Neuropathic pain in PLWH is related to persistent systemic inflammation despite virologic suppression and is deeply interrelated with psychological symptoms. It is frequently managed with opioids, despite a high risk of misuse and use disorder, prompting interest in alternative therapies for pain like medical cannabis. Medical cannabis use is explosively increasing in the United States, and pain and HIV are qualifying conditions in most states. Though medical cannabis successfully reduced pain in the few randomized control trials completed to date, there remain gaps in our understanding of how medical cannabis affects neuropathic pain in PLWH. No studies have evaluated how the main active components of medical cannabis, ?9-tetrahydrocannabinol (THC) and cannabidiol (CBD) impact neuropathic pain in PLWH; none have occurred with products comparable to those dispensed at medical cannabis dispensaries; none have examined the impact medical cannabis has on inflammation; and none have studied how medical cannabis impacts adverse events (e.g., psychological symptoms, antiretroviral adherence, and virologic failure). Federal policies make conducting a randomized trial of medical cannabis for the management of chronic pain in PLWH infeasible. Therefore, this study will employ two coupons that provide deep discounts to medical cannabis products that are legally dispensed in New York. This K23 mentored patient-oriented career development award will train Dr. Slawek in skills necessary to be successful in the fields of HIV and cannabis research. These are: 1) design and conduct of randomized trials, 2) translational cannabis research, 3) causal inference, and 4) mediation analysis. These skills will be applied to an innovative study to test how coupons that provide deep discounts for high THC medical cannabis products or high CBD medical cannabis products affect neuropathic pain, inflammation, and adverse events in PLWH. Through a multidisciplinary mentorship team, formal coursework, and the proposed research project, Dr. Slawek will achieve the professional growth needed to become an independent investigator contributing critical findings that will be integral to the care of PLWH.

抽象的 Deepika Slawek博士的总体目标是改善艾滋病毒（PLWH）患者的健康状况，重点 PLWH疼痛燃烧很高，最常见的是体验神经性疼痛。它与严重的残疾有关，包括功能障碍，差抗逆转录病毒依从性和病毒学衰竭。 PLWH中的神经性疼痛与持续的全身性有关炎症目的地的病毒学抑制，与心理症状有着密切相关的。这是经常用阿片类药物管理，对小姐和使用障碍有很高的风险，引起人们对诸如医用大麻等疼痛的替代疗法。医用大麻的使用正在爆炸性地增加在大多数州，美国，疼痛和艾滋病毒是合格条件。虽然医用大麻在迄今已完成的少数随机对照试验中，成功减轻了疼痛，我们了解医用大麻如何影响PLWH的神经性疼痛。没有研究评估医用大麻的主要活性成分，？9-四氢大麻酚（THC）和大麻二酚（CBD）撞击 PLWH中的神经性疼痛；与在医疗上分配的产品相当的产品没有发生大麻药房；没有人检查过医用大麻对炎症的影响。而且没有研究了医用大麻如何影响不良事件（例如心理症状，抗逆转录病毒依从性和病毒学衰竭）。联邦政策对医用大麻进行随机试验 PLWH中慢性疼痛的管理不可行。因此，本研究将采用两种优惠券为在纽约合法分配的医用大麻产品提供深切的折扣。这个K23 指导的以患者为导向的职业发展奖将培训Slawek博士的成功技能在艾滋病毒和大麻研究领域。这些是：1）随机试验的设计和执行，2）转化大麻研究，3）因果推断和4）调解分析。这些技能将应用于一项创新的研究，用于测试如何为高分钱大麻产品提供深折扣的优惠券或高CBD医用大麻产品会影响PLWH中神经性疼痛，感染和不良事件。通过一个多学科的心态团队，正式课程和拟议的研究项目，博士 Slawek将实现成为一名独立调查员所需的专业成长将是PLWH护理不可或缺的发现。