In the race to find viable treatments for the novel coronavirus, cannabis has firmly established a seat at the table.
Studies and trials are being conducted around the world in a bid to discover whether the incredible capabilities of the plant could potentially extend to treating patients with COVID-19, and even with warding the virus off altogether.
Below we've done a round up of some of the key research being carried out, on our own shores and abroad.
SOUTH AFRICA
With a significant part of the South African population relying on traditional medicines for their health, science minister Blade Nzimande said earlier this month that R15 million would be diverted from the country's existing indigenous knowledge systems programmes to fund traditional medicine evaluation for COVID-19.
In partnership with universities and traditional healers, the South African government is funding research into the potential of 6 herbs used in traditional African medicines to treat coronavirus - and one of them has been confirmed to be cannabis.
ISRAEL
3 trials are now underway in Israel to investigate whether cannabis might have a part to play in providing treatment for patients.
For the first trial, two companies have collaborated with Tel Aviv University to develop a treatment to fight this deadly respiratory disease using cannabidiol (CBD) loaded exosomes.
Patients given the treatment will be administered CBD via an inhalation technique using those exosomes, which the companies are saying could potentially have anti-inflammatory properties that help in the recovery of infected lung cells.
The second trial taking place over a few weeks is looking at the combination of CBD and steroids as a treatment supplement for coronavirus.
The test subjects are 10 COVID-19 patients currently receiving steroid treatments at Israel’s Rabin Medical Centre, and if proven successful it will be expanded to the 40 additional hospitalised coronavirus patients.
A third trial at the Tel Aviv Ichilov Medical Centre will examine whether cannabis can slow down the lung infections experienced by many sufferers of the coronavirus.
Researchers are looking to see whether cannabis could succeed as an anti-inflammatory to help minimise the “cytokine storm” occurring in the bodies of these COVID-19 patients.
A cytokine storm is an overproduction of immune cells and their activating compounds (cytokines). In a flu virus, this is often associated with a surge of activated immune cells into the lungs which can be extremely damaging and ultimately lethal to patients who are infected.
A study by two Israeli research and development companies, Eybna (specialising in terpene-based medicine) and CannaSoul Analytics, is also focused on cytokine-storms.
They are trying to determine whether the anti-inflammatory properties of terpenes - the compounds that provide the aroma and flavour in cannabis and other plants - might help reduce this dangerous symptom, and if so how these results compare to other viable treatment options.
Eybna came up with a special terpene formulation called NT-VRL™, and then ran tests to weigh up the efficacy of this formulation against CBD, CBD in combination with NT-VRL™, and dexamethasone - a corticosteroid which the WHO has added to its recommendations for treatment of severe cases of COVID-19.
Dexamethasone has been found to be a very effective treatment for COVID-19 cytokine storms, and a recent study in the UK found that it reduced mortality by one third in hospitalised COVID-19 patients using ventilators.
Even so, it is very encouraging that results of the Israeli study have thus far have indicated that the combination of CBD with the NT-VRL™ terpene formulation was three times more effective at inhibiting cytokine activity than dexamethasone.
"Not only was the terpene formulation able to inhibit the cytokine activity, (with better results using higher doses), but it also outperformed both CBD and dexamethasone. CBD alone inhibited around 75% of the cytokines on average, while the terpenes alone inhibited around 80%...
"Still, the best results came from the combination of CBD and the NT-VRL™ terpene formulation, which was able to inhibit around 90% of the tested cytokines. In comparison, dexamethasone was only able to inhibit around 30% of the cytokines, suggesting that the combination of CBD and terpenes may be 2 times more effective than the current recommended treatment. "
CANADA
Preliminary findings of researchers in Canada also indicate that some strains of cannabis sativa may provide increased resistance to the virus.
The study is one of many papers globally being shared by scientists on pre-publication websites like preprints.org, in a bid to disseminate their initial data and discoveries around potential COVID-19 treatments that have yet to undergo rigorous peer review.
The premise of the study is that coronavirus needs a "receptor" in order to enter a human host, and that receptor is known as an "angiotensin-converting enzyme II," or ACE2.
Researchers from the University of Lethbridge identified 13 strong strains of cannabis (all high in anti-inflammatory CBD, but low in THC) which interact with these same ACE2 receptors.
It is thought that by doing this, these strains may ultimately reduce the receptor's activity by up to 70-80% and thereby diminish the virus's ability to enter the lungs - where it takes hold, reproduces and spreads.
The study was carried out under a Health Canada licence by Pathway Rx, a cannabis therapy research company, in collaboration with Swysh Inc., a cannabinoid-based research company, and was conducted using artificial human 3-D tissue models.
It was lead by biological scientist Dr. Igor Kovalchuk, who emphasised that these findings wouldn’t lead to a vaccine for the disease, but could nonetheless decrease susceptibility to it.
If successfully peer reviewed, researchers believe their work could find practical medical use by serving as a safe adjunct therapy for coronavirus in the form of mouth wash, gargle, inhalants or gel caps.