Effects of Cannabis on Stress Response: A Double-Blind Randomized Placebo-Controlled Crossover Trial (NCT05261321)

Approximately 50% of Canadians have used cannabis at least once in their lifetime. The vast majority of cannabis users report using cannabis to reduce stress. While there is some evidence to suggest that cannabis may impact the body’s stress regulation systems via the endocannabinoid system, there remains limited experimental evidence that cannabis does indeed reduce acute stress and the effects of cannabis on the brain during acute stress are not well understood. The current randomized control trial aims to examine the effects of oral cannabis (THC and THC+CBD vs placebo) on acute stress response in humans using a combination of functional Magnetic Resonance Imaging, psychoneuroimmunological assays, and subjective assessments. With stress dysregulation being a major risk factor for a range of physical and mental health disorders, and with stress reduction being a primary reason for cannabis use, the effects of cannabis on stress regulation may have significant public health implications.  

This study is occurring at the University of British Columbia. The study team includes Karina Thiessen (awardee), study qualified investigator Dr. Christian Schütz and co-investigators Dr. Alasdair Barr, Dr. Clare Beasley, and Reza Rafizadeh. Funding support includes research grant and student stipend funding from the Canadian Centre on Substance Use and Addiction, BC Mental Health and Substance Use Services, Brain Canada, and the Michael Smith Health Research BC-CIHR CANTRAIN Clinical Trials Training Platform Doctoral Studentship. 

Canadian Primary Care Research Network – Phase 2

Health Research BC is providing match funds for the BC Primary Health Care Research Network (BC-PHCRN) Phase 2, the BC node of the Canadian Primary Care Research Network (CPCRN), which is funded by the Canadian Institutes of Health Research’s (CIHR) Strategy for Patient-Oriented Research (SPOR) Primary Care Network

 

The goal of the BC-PHCRN is to encourage, facilitate, and support collaborations between government, health authorities, health professionals, patients and researchers. The CPCRN and BC-PHCRN objectives include:

  • Expand PBRLNs by recruiting new primary care practices and providers  to include more electronic medical record data for research purposes,
  • Participate in CPCRN research and quality improvement projects and other projects as well,
  • Support development of a pan-Canadian primary health care information system that integrates electronic medical records with Patient Reported Experience Measures (PREMs) and Patient Reported Outcome Measures (PROMs),
  • build a network of primary care researchers, patient partners, clinicians, decision-makers and trainees to facilitate communications and knowledge mobilization, and
  • build capacity in patient-oriented primary care research in BC and beyond.

In British Columbia, the network is participating in both funded and non-funded research projects. Funded projects include:

  • OECD PaRIS to measure the outcomes and experiences of health care that matter most to people,
  • SPIDER to deprescribe potentially inappropriate prescriptions among elderly living with chronic conditions, and
  • Choosing Wisely antibiotic prescribing to provide CPCSSN providers with portrait detailing their antibiotic prescribing for respiratory tract infections.

Non-funded projects include:

  • Evaluation of ICD-11 and ICPC-3 codes to build evidence for updating Canada’s Disease Classification Systems in primary care, and
  • Team-based care to understand functioning of teams in primary care.

The Nominated Principal Investigator of BC-PHCRN is Dr. Rubee Dev. Dr. Dev is an Assistant Professor in the UBC School of Nursing & Associate Faculty in the Centre for Health Services and Policy Research, University of British Columbia, with research foci in global health and primary health care nursing. Dr. Dev leads the BC PHCRN along with Dr. Nathaniel Hawkins who is also Director of Research and Associate Professor at the UBC Division of Cardiology.

Maresin 1 as a novel therapy for vitiligo

Patients with vitiligo experience social stigmatization due to white patches on their face and hands. The existing therapies have limited effectiveness. Our lab recently discovered that an omega-3 essential fatty-acid derivative, maresin 1, has the ability to prevent development of vitiligo patches. In this proposal, I plan to test its effectiveness and long-term safety using a mouse model of vitiligo. We will induce vitiligo in B6 mice, and then treat them with maresin 1 injections three times a week for 80 weeks, which is equivalent to 60 years of human life, and observe the mice for changes in white patches and development of side effects. We expect maresin 1 treatment to shrink the white patches without causing cancers or other side effects. The experiments will be performed by an experienced research associate, Dr. Mingwan Su, and a graduate student. My lab is located in Vancouver Coastal Health Research Institute, which has a licensed animal care facility. The results will be vital for planning of maresin 1 clinical trials in the future. Despite using mice for our research, we will collaborate with vitiligo patient partners who will help ensure our findings will eventually be useful to vitiligo patients.

Evaluation of a manualized telehealth-based psychoeducation group for individuals at high risk for bipolar disorder

Bipolar Disorder (BD) is a psychiatric condition that affects about 2 percent of people in BC. Individuals with BD experience extreme changes in their mood, as well as their energy and ability to function. These changes, however, are frequently underreported and unrecognized — especially in youth — which can delay the diagnosis and treatment of BD by several years. Dr. Kamyar Keramatian is a psychiatrist at Vancouver Coastal Health and UBC. His research team, including people living with BD, have developed a virtual group-based educational program for youth at high risk for BD. This program aims to increase knowledge of BD, reduce self-stigma, improve help-seeking and enhance resilience in adolescents and young adults who are at high risk of developing BD. His research will explore the feasibility of implementing this new program throughout BC and how it can help young people with BD to be identified earlier and receive more timely care. By facilitating early identification and treatment of BD, his research can potentially reduce health-care costs and lead to more efficient access to care and service delivery for youth with BD across BC.

Tumour tissue biomarkers to guide personalized lung cancer treatment in British Columbia

Non-small cell lung cancer (NSCLC) is the most common cause of cancer death in BC and worldwide. In 2020, 29,300 Canadians were diagnosed with lung cancer and 21,000 died from it — more than colon, breast, and prostate cancers combined. Patients amenable to surgery have the best prospect of cure, but often cancer returns and is lethal. Only 5 percent of patients benefit from chemotherapy after surgery. Return of cancer is caused by changes in the tumour genes and immune system. It is possible to predict these changes to identify patients who would benefit from targeted gene and immune therapies, but testing for tumour genes and immune biomarkers is not done in Stage I-III NSCLC in BC. We will use novel tests to understand how the immune system and tumour genes predict cancer recurrence after surgery. This will be led by thoracic surgeon Dr. Anna McGuire. Tumour gene analysis will be done at the BC Cancer Genomic Lab and immune system analysis will be led by Drs. MacAulay and Guillaud at the BCCRC. Our results will reveal which features predict cancer recurrence so patients who can benefit from targeted gene or immune therapies can be identified. This is first step to implementing this testing for NSCLC patient in BC to improve survival.

Re-purposing the ordering of ‘routine’ laboratory tests in hospitalized medical patients (RePORT)

Blood tests can help diagnose diseases and monitor health status. However, overuse of blood testing, particularly in hospitals, leads to patient discomfort, loss of sleep, contributes to blood loss leading to blood transfusions, and wastes health care dollars. We previously developed and tested a multi-part healthcare provider (HCP) engagement strategy to safely reduce overuse of six target laboratory tests that make up 40 percent of costs on laboratory testing in hospitalized medical patients. In collaboration with a Patient and Family Advisory Council (PFAC), we have co-designed a patient engagement strategy that includes an infographic, video and website. Our team, made up of clinicians, researchers, patient partners and policy makers, proposes to launch the HCP and patient engagement strategies across 16 hospitals in British Columbia and 14 hospitals in Alberta in a cluster randomized stepped-wedge design. We will evaluate the impact of this strategy on number of laboratory tests done, patient experience, patient safety, costs and HCP experience, using administrative data systems and patient and HCP interviews. We will work with the PFAC to design implementation evaluation, particularly of the patient engagement strategy.

FIRE-Diet: food as an intervention to reduce effects of woodsmoke exposure on respiratory health

Many people in BC are exposed to woodsmoke from woodburning stoves in their homes, controlled burning for farming purposes, and increasingly from wildfires. Exposure to woodsmoke can lead to difficulty breathing, lung disease, hospitalizations, and in some people who have underlying health conditions, even death. Children, whose lungs are actively developing, may be at heightened risk. We don’t yet fully understand how woodsmoke causes health effects nor how to reduce or prevent these effects in people who can’t avoid exposure. We want to find these answers, first by examining symptoms and changes in function and immune activity in the lung with exposure to woodsmoke. We will also study whether and how the impact of woodsmoke may differ by (1) age of exposure, including developmental windows in childhood, (2) female or male sex, and (3) genetic factors, so that we can design strategies to protect and help those with the greatest and most urgent need. Lastly, because of growing evidence that a healthier diet may help the body to protect itself from pollution, we will study whether a person’s diet changes the effects of woodsmoke on the lung. This work will be performed at UBC with partners across BC and Canada.

Clinical Trial for Montbretin A (MbA) in Diabetics

Health Research BC is providing match funds for this research project, which is funded by GlycoNet’s Translational Grant

 

This fully B.C.-based project will undertake a Phase 1 human clinical trial of a promising natural product from plants, Montbretin A (MbA), for control of blood glucose levels in diabetics. The team comprises a chemist (Stephen Withers), a clinician (Robert Petrella), a plant biochemist (Joerg Bohlmann) and a biochemist/coordinator (J.P. Heale). Earlier B.C. work identified MbA as a potent inhibitor of amylase, the principal human enzyme that degrades starch in our guts leading to glucose release into the bloodstream. Subsequent studies in diabetic rats confirmed that orally administered MbA lowers blood glucose levels and is safe, even at very high dosages. On this basis Health Canada approved a Phase 1 clinical trial to evaluate the safety of MbA in humans. This funding will allow us to carry out that trial in a side-by-side evaluation with the drug acarbose that is currently used but causes unpleasant side effects. Due to its different mode of action of MbA should be better tolerated yet highly active.

 

Key words: diabetes, obesity, blood glucose, amylase, inhibitor

Mind the gap: Hormonal contraceptives and the brain

Hormonal contraceptives (HC) are used by 850 million girls, women and people with uteri — all reflected in the term women+ — , and 16 percent of people (5-49Y) in Canada. In addition to being contraceptives, HCs are prescribed off-label to treat many other conditions. Few studies have examined effects of these hormones on the brain; however, recent work suggests they can increase risk for mood disorders during adolescence and alter brain activation patterns. Yet, how HC use may influence long-term brain health is not known. Understanding brain health, especially through an equity lens, is critical. Women+ experience different brain health symptoms as a result of their unique experience of stress, which is impacted by age, gender, and race/ethnicity. Stress outcomes affect disease risk, which is also influenced by HCs. Collaborations between academics and research users are vital to understanding the unique ways that women+’s lives impact their brain health. This conference will explore how HCs influence women+’s brain health by bringing together researchers, clinicians, community partners, trainees, and policymakers to exchange knowledge and identify new research priorities that fill knowledge gaps and address patient experiences.


Team members: Katherine Moore (Women’s Health Research Cluster); Jesse Lacasse (Concordia University); Bonnie Lee (UBC); Jennifer Williams (McMaster University); Maureen MacDonald (McMaster University); Nafissa Ismail (University of Ottawa); Elizabeth Hampson (University of Western Ontario); Gillian Einstein (University of Toronto); Frances Chen (UBC); Sofia Ahmed (University of Calgary).

Improving access to breastfeeding support in interior British Columbia: A collaborative planning project

While breastfeeding has many health benefits for both infant and mother, many women and birthing people experience breastfeeding challenges. Insufficient supply, poor latch, and pain, as well as stigma and lack of support can impact breastfeeding goals. These challenges can be heavily influenced by social inequities, parental leave, and societal pressures, particularly among disadvantaged populations in Canada. It is important for postpartum people to receive breastfeeding support from healthcare professionals, especially during public health emergencies like the COVID-19 pandemic, where in-person contact is limited. Therefore, this C2 project will establish key networks and resources around optimal breastfeeding support in interior BC. Specific objectives are to build partnerships, conduct a needs assessment, and co-create a research agenda to develop and evaluate a virtual breastfeeding intervention study in this region. We expect to identify key aspects of virtual support that will create a thorough and meaningfully designed breastfeeding intervention study, which will ultimately lead to higher rates of breastfeeding rates, as well as improved user satisfaction and self-efficacy among parents and families in BC.


Team members: Elizabeth Keys (UBC – Okanagan); Rishma Chooniedass (UBC – Okanagan); Michele Hopkins (The Bridge Youth & Family Services); Ellen Boelcke (KCR Community Resources); Olivia Andrews (UBC – Okanagan).