Join us for our quarterly meeting, available to all SCC members. Dr. Michelle Sexton is the featured speaker who will discuss “Cannabis and Epigenetics in Pain and Immunocompetence”
The meeting is remote and available to all SCC members. Members can log in to the membership portal for instructions on how to register.
Formal abstract of the data that will be presented:
Background: Chronic pain affects 1 in 5 adults and current pharmacologic therapies are often falling short of adequate pain control. The transition from acute to chronic pain involves many complex physiologic interactions spanning the endocrine, central and peripheral nervous and immune systems. The endocannabinoid system is expressed across these systems and represents a unifying system that ties these components to one another. The neuroimmune reflex has been implicated in the generation of chronic pain, and to explore whether elements in this reflex arc are modulated in patients with chronic pain, we used a systems biology approach.
Methods: A network-based approach using whole peripheral blood gene expression was employed for mapping the expression of genes in the endocannabinoidome, inflammatory markers and neurotransmitters. Blood from patients with pain (PP) and healthy subjects (HS), stratified by cannabis and opioid use, was used to compare transcriptomes (the sum total of all the messenger RNA molecules expressed from all genes) between PP and HS. We analyzed gene expression for identification of genes differentially expressed in pain pathophysiology, and/or by pharmacologic intervention.
Results: Our analysis of this pilot data found no significant differentially expressed genes in the endocannabinoidome, immune markers associated with chronic pain or neurotransmitters that may be related to endocannabinoid system function. There were some interesting ‘trends’.
Conclusion: Total RNA from subjects with chronic pain, opioid use, cannabis use or non-response to opioids or cannabis for pain treatment may not serve as a proxy for tissue-specific changes. So these lack of transcriptomic data may not allow for global changes or differentially expressed genes in tissues of interest related to chronic neuropathic pain, such as the dorsal root ganglia, glia cells or brain. However given that the CNS communicates with the periphery by several means, the ability for the periphery to serve as a ‘mirror’ of the brain needs further investigation.
Bio for Dr. Michelle Sexton
Dr. Sexton is an Assistant Adjunct Professor at UCSD in the Department of Anesthesiology. She graduated from Bastyr University in 2008 and completed a postdoctoral fellowship at the University of Washington, where she formally studied the endocannabinoid system for 6 years. Her NIH-funded pre-doctoral and postdoctoral research on the topic of cannabinoids and their roles in neuroinflammation and neurodegeneration investigated cannabis use and impact on inflammatory markers. She has continued her research into health effects of cannabis at UCSD via survey data and clinical studies. Prior to medical school, Michelle was a midwife and herbalist for 15 years.
Dr. Sexton has presented her research internationally and published 18 papers in peer-reviewed journals. Dr. Sexton’s clinical practice, research and teaching focus on the endocannabinoid system and roles for integrative medicine, including cannabis, to treat a range of conditions, across the lifespan. She is a member of the International Cannabinoid Research Society, the International Association of Cannabinoid Medicine the American and California Associations of Naturopathic Doctors and the Society of Cannabis Clinicians. She maintains a private medical practice in the Pacific Beach neighborhood of San Diego, CA and at UCSD. When not caring for patients or pursuing research activities, you can find her in the garden, paying music, playing with grandchildren, swimming or riding her bike to the beach for a surf session!