finalfullthesisdjpotter

Abstract
In response to known pharmacology, and an increasing weight of anecdotal evidence of
efficacy, clinical trials have been performed to support the licensing of cannabis-based
botanical medicines. The initial applications envisaged were the treatment of cancer
pain, neuropathic pain and various symptoms associated with multiple sclerosis. With
effective alternatives often unavailable, otherwise law-abiding UK patients have regularly
turned to illicit cannabis for medical relief. The main active ingredients in this are the
cannabinoids THC and CBD, but other pharmacologically active cannabinoids are also
present. One study reported here quantifies these cannabinoids and assesses the likely
implications for efficacy. Using light microscopy, studies are performed to expand current
knowledge of the form and function of trichomes in Cannabis sativa L. Supporting
chemical analyses ascertain what secondary metabolites are biosynthesised within
these trichomes, and determines where and when this occurs. To comply with the
demands of the pharmaceutical industry, and in marked contrast to illicit cannabis, a
phytopharmaceutical feedstock must meet high expectations regarding the minimum
and maximum content of a range of compounds. Specific studies are performed to
ascertain how growing methods affect the secondary metabolite content. They also aim
to find out how a tight specification can be met while satisfying commercial and
environmental expectations. This involves studying plant development and secondary
metabolite biosynthesis in both indoor and outdoor conditions. The first approved
cannabis-based botanical medicine supported by this research is Sativex®. This
became available in Canada in 2005 for the treatment of central neuropathic pain in
multiple sclerosis and in 2007 for intractable cancer pain. The medicine is also available
in the UK and many other countries on a ‘named patient basis’. This thesis has also
supported the production of a range of other cannabinoids which are undergoing in-vitro
and in-vivo testing. This could lead to the commercial production of an increasing range
of phytopharmaceuticals.
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