Microdosing Cannabis for Lung Cancer

Can cannabis help treat lung cancer? While it may seem surprising, the evidence says yes. Small, controlled doses of THC and CBD may have potential benefits for lung cancer patients.

According to Preet, et. al., “THC was able to inhibit tumor growth and lung metastases in a murine model of lung cancer.” 

This is where microdosing fits in perfectly. While unable to cure cancer, low doses of THC and CBD might disrupt cancer cell growth, trigger cell death, and even impede the formation of blood vessels that nourish tumors.

Let’s dig deep into the anticancer properties of Delta 9 and cannabidiol and explore the potent mechanisms behind their potential role in battling lung cancer. 

What Is Lung Cancer?

Lung cancer is a type of cancer that develops in the cells of the lungs, more specifically in the airways (bronchi) or small air sacs (alveoli). Due to its aggressive nature and late-stage diagnosis, lung cancer can spread quickly to other parts of the body. 

A lung cancer prognosis depends on how advanced the tumor is at the time of diagnosis and the type of cancer.

Stages of Lung Cancer

Cancer is typically referred to in stages, based on the size of the cancer and whether it’s spread to lymph nodes or other organs. 

1. Stage 0 (in-situ). In this stage, the cancer cells form in the top lining of the lung, or bronchus. They haven’t spread to other parts of the lung or body.
2. In Stage 1, the cancer cells haven’t spread to the lymph nodes yet.
3. Stage 2 is when the cancer cells have grown and spread to lymph nodes inside the lung. 
4. Stage 3. In this stage, cancer is larger, has spread to nearby lymph nodes, or there’s more than one tumor in a different lobe of the same lung.
5. Stage 4. Cancer has spread to the other lung, the fluid around the lung, the fluid around the heart, or other organs.

What Are the Symptoms of Lung Cancer?

Lung cancer symptoms typically depend on the type, stage, and individual factors. Early-stage lung cancer often has no noticeable symptoms. 

Here are some common symptoms.

• Fatigue
• Persistent cough
• Coughing up blood
• Recurrent respiratory infections
• Chest pain
• Shortness of breath
• Loss of appetite and weight loss
• Swelling in the face, neck, arms, or upper chest 

What are the Types of Lung Cancer?

There are two main types of lung cancer. 

1. Non-small cell lung cancer (NSCLC) is a more common form of lung carcinoma, and it includes subtypes like adenocarcinoma, squamous cell carcinoma, and large cell carcinoma. 
2. Small cell lung cancer (SCLC) is less common but also more aggressive and grows more rapidly, often leading to early metastasis. SCLC typically starts in the bronchi and quickly spreads to other parts of the body, including the lymph nodes and distant organs. Smokers are believed to be in greater danger of developing small cell lung cancer than non-smokers. 

Who Is at Risk of Developing Lung Cancer?

There are many things that can make you more likely to get lung cancer. Experts say that smoking causes about 80% of lung cancer deaths. 

Other risk factors include:

• Exposure to secondhand cigarette smoke.
• Exposure to hazardous substances such as air pollution, radon, asbestos, uranium, diesel exhaust, silica, coal products, and others.
• Having received radiation treatments to the chest.
• Having lung cancer in one’s family history.

Lung Cancer Treatment Options

Lung cancer treatment is different depending on the type of cancer, the patient's overall health, and individual preferences. Here are some common treatment approaches:

1. Surgery is an option if the cancer is detected early and is confined to a specific area of the lung. They remove the tumor and, in some cases, nearby lymph nodes. Surgical options include wedge resection (removal of a small part of the lung), lobectomy (removal of a lobe of the lung), or pneumonectomy (removal of an entire lung).
2. Radiation therapy uses high-energy rays to target and destroy cancer cells. It can be used before surgery to shrink tumors, after surgery to eliminate remaining cancer cells, or as the primary treatment for those who are unable to undergo surgery.
3. Chemotherapy involves the use of powerful drugs to kill cancer cells or slow their growth. It is often used for advanced lung cancer or when the cancer has spread to other parts of the body.
4. Targeted therapies involve drugs that specifically target certain genetic mutations or proteins that are involved in the growth and spread of cancer cells. They are often used for non-small cell lung cancers that have specific mutations.
5. Immunotherapy helps the immune system recognize and attack cancer cells. It can be particularly effective for some types of lung cancer. 
6. Palliative care is an important aspect of lung cancer treatment that focuses on managing symptoms, improving quality of life, and providing emotional support.

Treatment plans are often personalized and may involve a combination of these approaches. Some intriguing research suggests that giving small, precise doses of cannabis compounds like THC and CBD could be a promising and natural supplement to traditional cancer treatments. 

What’s even better is that low doses of Delta 9 THC and CBD can even alleviate many of the nasty chemotherapy-related side effects. 

You may have heard of the great therapeutic potential of THC, but what about CBD? Cannabidiol is another major compound found in the cannabis plant with extraordinary therapeutic and medicinal properties. 

Many of our hemp-derived edibles contain a combination of THC and CBD for even greater health benefits. The best way to reap the benefits of this cannabis synergy is with full spectrum CBD products. 

Order our full spectrum CBD gummies with low amounts of THC and a balanced dose of CBD to elevate your wellness game and protect yourself from the harmful effects of tumors. 

Anticancer Properties of Cannabis

A 2022 systemic review published in the British Journal of Cancer gave us a detailed look at the anti-cancer properties of cannabis. Hinz and Ramer explained cannabis's potential in cancer treatment and concluded that:

…cannabinoid compounds exert tumour growth inhibitory and antimetastatic effects, cannabinoid compounds may represent a useful additional therapeutic option to currently used cytostatic drugs. This view is also supported by studies indicating a synergistic effect of cannabinoids in combination with currently used chemotherapeutic agents and other therapeutic options. Furthermore, data increasingly suggest that cannabinoids may additionally function as antimetastatic and anti-angiogenic tumour therapy and support the immune system in its defence against tumours.

Here are some of the most important points Hinz and Ramer provided us with in their extensive review:

1. Cannabinoid compounds like THC and CBD have demonstrated promise in inhibiting tumor growth and metastasis in laboratory studies.
2. THC and CBD might work as anti-metastatic and anti-angiogenic agents, support the immune system, overcome drug resistance, and sensitize cancer cells to other treatments.
3. Cannabinoids could enhance the effects of traditional cancer drugs, potentially acting synergistically with chemotherapeutic agents and offering relief from adverse effects induced by chemotherapy. 

An older study conducted by Hinz and Ramer revealed that cannabis can block cancer cell invasion and migration, which significantly lowers the risk of metastasis. It seems that cannabis can also directly inhibit angiogenesis, a process in which new blood vessels form that tumors feed on.

Among the diverse mediators of cannabinoids' antitumorigenic action, the tissue inhibitor of matrix metalloproteinases-1, which is released from cancer cells upon cannabinoid treatment, has been implicated as a pivotal factor conferring both anti-invasive properties of cancer cells as well as antiangiogenic capacities of endothelial cells. In addition, cannabinoids have been shown to inhibit angiogenic capacities of endothelial cells directly via suppressing their proliferation, tube formation, and migration. 

This all sounds very promising. These potent anti-tumor properties of CBD and THC may offer relief to cancer patients, but how effective are they against lung cancer?

Can Microdosing Cannabis Help Treat Lung Cancer?

Lung cancer cells express cannabinoid receptors, which are known targets for THC. THC binds to the cannabinoid receptors in our endocannabinoid system (ECS) to modulate their effects and produce its therapeutic benefits.

For example, when THC binds to the CB1 cannabinoid receptor—primarily found in the brain and central nervous system—it activates a signaling pathway that influences neurotransmitter release. This impacts our bodily functions and processes like memory, mood, coordination, pain perception, and appetite. 

The result is a wide range of effects, such as:

• Euphoria
• Relaxation 
• Pain relief
• Increased appetite, often referred to as the munchies

THC’s interaction with CB1 receptors produces its well-known psychoactive effects when consumed in sufficient amounts. When you take small amounts of THC, the results are wonderful pain and anxiety relief and a mild euphoric experience, which is why microdosing cannabis is always a better choice. 

CB2 cannabinoid receptors are located mainly in the immune cells involved in the body’s defense and inflammatory responses. By binding to CB2 receptors, THC can modulate our immune responses and lower inflammation. That’s why taking small amounts of Delta 9 THC can reduce inflammation in the body and help fight many chronic inflammatory conditions. 

The way THC binds to both cannabinoid receptors is particularly significant for lung cancer treatment. According to Hart, et. al., the interaction between CB1 and CB2 receptors and “low levels of THC induced lung cancer cell proliferation.” 

…pharmacologically active concentrations of THC are capable of promoting the cell proliferation of human carcinoma cells and identify [epidermal growth factor receptor] signal transactivation as the underlying molecular mechanism.

Inflammation plays a major role in cancer progression. Controlling the inflammatory and immune responses through CB2 receptors can potentially impact the tumor microenvironment, while THC’s effects on CB1 receptors are needed to alleviate chronic pain, lower stress and anxiety, and even improve appetite.

THC and CBD Inhibit Lung Cancer Growth

A 2020 study showed that THC and CBD act as CB1 and CB2 cannabinoid receptor agonists. They bind to them and influence their signaling pathways, leading to a range of physiological and psychological effects in the body. The study revealed that patients with higher levels of these receptors had better survival rates, mainly due to the potent anti-cancer action THC and CBD together exert.

Together, THC and CBD slowed down the non-small cell lung cancer cells' growth, changed their morphology (shape and size), and reduced their ability to move and spread. They decreased lung cancer cell proliferation, making them less likely to spread and infect healthy cells. 

In an animal study, THC showed similar results, inhibiting lung cancer growth. 

…there was significant inhibition of the subcutaneous tumor growth and lung metastasis of A549 cells in THC-treated animals as compared to vehicle-treated controls. Tumor samples from THC-treated animals revealed antiproliferative and antiangiogenic effects of THC. 

In this study, researchers focused on a specific type of lung cancer characterized by an overactive epidermal growth factor receptor (EGFR). EGFR-overexpressing lung cancers are often aggressive and resistant to chemotherapy. When THC was present in the system, the cancer cells' response to EGFR was hindered, leading to decreased growth, movement, and invasion. 

The study suggested that THC's effects are likely connected to its interference with specific cell signaling pathways involved in cancer growth, like ERK1/2, JNK1/2, and AKT. THC was also shown to slow cell division and reduce blood vessel formation (angiogenesis). In tests on mice, THC also showed promise for reducing tumor growth and the spread of cancer to the lungs. 

Can Cannabis Cause Cancer Cell Apoptosis?

Apoptosis is the programmed death of cells, a natural process that occurs in healthy cells as a means of maintaining tissue homeostasis. However, in cancer cells, this programmed cell death mechanism becomes disrupted, leading to uncontrolled cell growth and tumor development. THC and CBD have been shown to have potential anti-cancer properties by inducing apoptosis in cancer cells. 

Hinz and Ramer have discovered that certain compounds called PPARγ-activating prostaglandins (PGs) play an important role in the effects of CBD on lung cancer cells. When CBD activates the cannabinoid receptor in lung cancer cells, it can trigger cell death through a process that does not involve the TRPV1 receptor.

A functional role of the aforementioned PPARγ-activating PGs could also be proven for the CBD-triggered cannabinoid receptor and TRPV1-independent apoptotic death of lung cancer cells. CBD also led to an upregulation of COX-2 and PPARγ in tumour tissue in A549-xenografted nude mice and to tumour regression, which was reversed by a PPARγ antagonist. (Hinz and Ramer)

Experiments with mice also showed that CBD caused an increase in the levels of COX-2 and PPARγ in tumor tissue. This increase in COX-2 and PPARγ was linked to the regression of tumors in these mice. However, when a substance that blocks PPARγ was applied, the tumor regression caused by CBD was reversed.

Essentially, these findings suggest that CBD affects lung cancer cells through multiple mechanisms. It activates PPARγ, which leads to cell death and tumor regression. It also increases the levels of COX-2 enzymes, which may have a role in these effects. However, when PPARγ is blocked, the tumor regression caused by CBD is reversed.

By promoting apoptosis, cannabis can help cancer patients by targeting and eliminating cancer cells. This can help slow down tumor growth, prevent metastasis, and potentially enhance the effectiveness of conventional cancer treatments like chemotherapy and radiation therapy.

A 2020 study confirmed these proapoptotic properties of cannabis, showing how “CBD has direct antineoplastic effects on lung cancer cells through various mechanisms mediated by cannabinoid receptors or independent of these receptors.”

CBD may be directly toxic to tumor cells, and it induces apoptosis through caspase activation. This process may be mediated by PPAR-γ and COX-2 upregulation, independent of cannabinoid receptors.

We love all our gummies equally, so here’s our collection of the best CBD gummies. Some of them contain both CBD and THC for that sweet cannabis synergy we like to call the entourage effect. With our entourage effect gummies, you’ll experience a harmonious blend of CBD and THC that work together to provide a heightened sense of relaxation, relief, and some good old anti-tumor action. 

The mouthwatering kick of sour berries in our Euphoria gummies is not only skillfully crafted to please your palate but also to deliver a wide range of health benefits. Each gummy boasts an uplifting dose of 10 mg of THC and 10 mg of CBD that elevates your mood and helps you alleviate the nasty nausea and chronic pain from chemotherapy. 

Cannabis Against the Formation of Tumor Blood Vessels

Angiogenesis is the process by which new blood vessels are created. Tumors need blood in order to grow, so they latch on to these newly-created blood vessels to receive oxygen and nutrients. THC and CBD have shown the ability to inhibit angiogenesis. This disruption of the blood vessel network can starve the tumor and hinder its growth.

A 2015 study on the anti-angiogenic properties of cannabis found that cannabinoids may inhibit the attraction of vessel cells, thereby suppressing angiogenesis in tumors. 

Among the diverse mediators of cannabinoids' antitumorigenic action, the tissue inhibitor of matrix metalloproteinases-1, which is released from cancer cells upon cannabinoid treatment, has been implicated as a pivotal factor conferring both anti-invasive properties of cancer cells as well as antiangiogenic capacities of endothelial cells.

The endothelial cells are important because they regulate exchanges between the bloodstream and the surrounding tissues. The study suggests that cannabinoids can directly hinder the angiogenic capacities of endothelial cells by inhibiting their growth, tube formation, and migration. 

“Other in vivo studies demonstrated that treatment with CBD reduced colon cancer cell proliferation, induced apoptosis, and also had anti-metastatic and anti-angiogenesis effects.” (Honarmand, et. al.)

Can Cannabis Alleviate Chemotherapy-Related Side Effects?

Chemotherapy and other cancer treatments are frequently associated with distressing side effects that can have a substantial negative impact on a patient's quality of life. Cannabis has been known to help alleviate chemo-related side effects. 

A 2021 study revealed that advanced cancer patients regularly use cannabis to treat both cancer- and therapy-specific symptoms, such as:

• Chronic pain
• Nausea and vomiting
• Fatigue
• Poor appetite
• Anxiety and depression
• Sleep problems
• Digestive problems

A 2022 review study of cannabis in palliative care suggested that “positive treatment effects have been reported for some medical cannabis products in the palliative care setting.” 

Positive treatment effects (statistical significance with P < 0.05) were seen for some [cannabis] products in pain, nausea and vomiting, appetite, sleep, fatigue, chemosensory perception and paraneoplastic night sweats in patients with cancer…

Here are all the ways our low-dose edibles with THC, CBD, and other cannabinoids can help lung cancer patients find much needed relief from cancer treatment.

• THC and CBD can help with nausea and vomiting. It’s no secret cannabis has antiemetic properties: it can help reduce nausea and vomiting commonly experienced as side effects of chemotherapy. A 2020 clinical trial found that “the addition of oral THC:CBD to standard antiemetics was associated with less nausea and vomiting…” and that “no serious adverse events were attributed to THC:CBD.”
• Cannabis helps with pain management associated with chemotherapy. Low doses of cannabis can actually deal with a long list of chronic pain. A 2015 study on the use of cannabis and cannabinoids for treating chronic pain conditions found that cannabis might be an effective way to relieve neuropathic pain, arthritis pain, and cancer pain. The results of a 2010 study showed that “the THC:CBD extract had a significant analgesic effect and helped manage cancer-related pain better than the THC extract or placebo.”
• Cancer and chemotherapy treatments often lead to loss of appetite and weight loss. THC has been found to stimulate appetite, which can help cancer patients maintain a healthy caloric intake and prevent muscle wasting. By interacting with the CB1 receptors in the brain's hypothalamus, THC stimulates the release of the hormone ghrelin, which triggers hunger. 
• Another thing cancer patients—especially those undergoing chemotherapy—experience on a daily basis is sleep disturbance. Certain cannabis strains, particularly those higher in CBD, have calming effects that can promote relaxation and improve sleep quality.
• Did you know cannabis is terrific at lowering stress, reducing anxiety, and battling depression? Chemotherapy can be harsh on patients and have a multitude of adverse effects. One of those is mental health deterioration: chronic stress, anxiety, and depression can seriously impact patients’ lives. A 2019 study indicated that 80% of participants treated with CBD for anxiety experienced improvement within the first month. According to Crippa, et. al., “CBD reduces anxiety in [generalized social anxiety disorder] and this is related to its effects on activity in limbic and paralimbic brain areas.”

Many cancer patients take small amounts of THC and CBD to alleviate depression. People undergoing cancer treatment tend to be low in “happy hormones” like dopamine and serotonin. These neurotransmitters are directly responsible for regulating our mood, keeping us happy and cheerful when their levels are optimal or making us sad and miserable when their levels are too low.

Microdoses of cannabis raise serotonin levels, directly impacting mental health, boosting mood, and reducing depressive thoughts. Relax Plus gummies are our favorite cannabis product to boost serotonin and promote relaxation. With 25 mg of premium CBD and a touch of Delta 9,  these delicious gummies offer you a moment of respite from the challenges of cancer treatment. 

Why Are Microdosing Edibles Better Than Smoking Cannabis?

Microdosing with gummies and THC drinks offers a plethora of advantages over regular smoking or vaping, especially when it comes to lung cancer.

Here are some reasons why our edibles and drinks are way better than smoking cannabis:

1. Longer lasting effects: edibles typically provide a longer duration of effects compared to smoking. When you eat cannabis, it goes through your digestive system, leading to a slower onset of effects that can last for up to eight hours for some people. This is so much better for maintaining a consistent level of relief throughout the day. We’re talking about sustained relief for conditions that require continuous symptom management, such as chronic pain, anxiety, or insomnia—all of which we’ve listed as nasty adverse effects of chemotherapy.
2. Precise dosage: edibles allow for more accurate dosing. Each edible product comes with a predetermined amount of THC, making it easier to control and monitor the dosage. This is particularly important when your goal is to achieve subtle effects without feeling overwhelmed.
3. Gentler high: speaking of not feeling overwhelmed, microdosing edibles can offer a milder and more gradual high compared to smoking larger amounts of cannabis. Delta 9 THC is the main psychoactive compound from the cannabis sativa plant, but that doesn’t mean you have to experience its intense effects every time you need its therapeutic benefits. The last thing cancer patients need are these overpowering psychoactive effects that typically come with smoking. 
4. Smoke-free consumption: this is an obvious one. Edibles provide a smoke-free alternative to dangerous and cancerous smoking or vaping. Smoking can have potential negative impacts on lung health, increasing the risk of lung cancer and other respiratory issues. For those concerned about the respiratory effects of smoking weed, edibles offer a way to consume cannabis without inhaling harmful substances.
5. Discreetness: edibles are often more discreet than smoking. They don't produce a strong odor or visible smoke, making them suitable for situations where you'd like to munch on some weed gummies without drawing attention.

Our delicious gummies are the stars of our collections. However, not everyone enjoys the sweet variety of flavors packed in one bite-sized treat. Some people prefer drinking their cannabis and that’s okay because we have just the thing for them.

Add a drop or two of our liquid cannabis product and spice up your favorite non-alcoholic drink. With only 2.2 mg of THC and 2.9 mg of CBD, this delightful drinkable will be the life of every party.

Is Microdosing Cannabis Legal?

Microdosing Delta 9 THC is federally legal in the US under specific 2018 Farm Bill stipulations that say that Delta 9 THC edibles are legal if:

• The THC is derived from hemp, not marijuana
• The THC content does not exceed 0.3% by dry weight. 

The Farm Bill removed hemp from the list of controlled substances, legally separating hemp from marijuana. This means that all of our THC edibles and CBD gummies are 100% legal at the federal level because they’re made from organic hemp. 

However, each state chooses independently whether cannabis products containing Delta 9 THC will be legal in that state. For example, you can’t buy our Delta 9 edibles in Idaho and Kansas. Check out our detailed guide to state-by-state THC legality for additional information. 

If you’re looking to buy the best THC edibles in the country, nama is the obvious choice. We care about what goes into our gummies, so we make sure we use only the highest quality ingredients and natural flavors. 

Resources

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Hinz, B., & Ramer, R. (2022, March 11). Cannabinoids as anticancer drugs: current status of preclinical research - British Journal of Cancer. Nature. https://doi.org/10.1038/s41416-022-01727-4

New Insights into Antimetastatic and Antiangiogenic Effects of Cannabinoids. (2014, December 18). ScienceDirect. https://doi.org/10.1016/bs.ircmb.2014.10.005

Cannabidiol enhances the inhibitory effects of delta9-tetrahydrocannabinol on human glioblastoma cell proliferation and survival - PubMed. (2010, January 1). PubMed. https://doi.org/10.1158/1535-7163.MCT-09-0407

Cannabinoid receptor expression in non-small cell lung cancer. Effectiveness of tetrahydrocannabinol and cannabidiol inhibiting cell proliferation and epithelial-mesenchymal transition in vitro - PubMed. (2020, February 12). PubMed. https://doi.org/10.1371/journal.pone.0228909

Delta9-Tetrahydrocannabinol inhibits epithelial growth factor-induced lung cancer cell migration in vitro as well as its growth and metastasis in vivo - PubMed. (2008, January 10). PubMed. https://doi.org/10.1038/sj.onc.1210641

Vasileios, I., Milas, G. P., & Zareifopoulos, N. (2022, October 8). Antitumorigenic Effect of Cannabidiol in Lung Cancer: What Do We Know So Far?–A Mini Review. PubMed Central (PMC). https://doi.org/10.52547/ibj.3732

New Insights into Antimetastatic and Antiangiogenic Effects of Cannabinoids. (2014, December 18). New Insights Into Antimetastatic and Antiangiogenic Effects of Cannabinoids - ScienceDirect. https://doi.org/10.1016/bs.ircmb.2014.10.005

Honarmand, M., Namazi, F., Mohammadi, A., & Nazifi, S. (2018, August 27). Can cannabidiol inhibit angiogenesis in colon cancer? - Comparative Clinical Pathology. SpringerLink. https://doi.org/10.1007/s00580-018-2810-6

The Management of Cancer Symptoms and Treatment-Induced Side Effects With Cannabis or Cannabinoids - PubMed. (2021, November 28). PubMed. https://doi.org/10.1093/jncimonographs/lgab011

Oral THC:CBD cannabis extract for refractory chemotherapy-induced nausea and vomiting: a randomised, placebo-controlled, phase II crossover trial. (2020, August 13). Oral THC:CBD ScienceDirect. https://doi.org/10.1016/j.annonc.2020.07.020

Medical Marijuana for Treatment of Chronic Pain and Other Medical and Psychiatric Problems: A Clinical Review - PubMed. (2015, June 1). PubMed. https://doi.org/10.1001/jama.2015.6199

Multicenter, Double-Blind, Randomized, Placebo-Controlled, Parallel-Group Study of the Efficacy, Safety, and Tolerability of THC:CBD Extract and THC Extract in Patients with Intractable Cancer-Related Pain. (2009, November 5). ScienceDirect. https://doi.org/10.1016/j.jpainsymman.2009.06.008

Shannon, S., Lewis, N., Lee, H., & Hughes, S. (2019, January 7). Cannabidiol in Anxiety and Sleep: A Large Case Series. PubMed Central (PMC). https://doi.org/10.7812/TPP/18-041

Crippa JA. Neural basis of anxiolytic effects of cannabidiol (CBD) in generalized social anxiety disorder: a preliminary report - PubMed. (2011, January 1). PubMed. https://doi.org/10.1177/0269881110379283

Cannabis in Palliative Care: A Systemic Review of Current Evidence - PubMed. (2022, November 1). PubMed. https://doi.org/10.1016/j.jpainsymman.2022.06.002

Chen, S., Deng, C., Zheng, W., Li, S., Liu, Y., Zhang, T., Zhang, C., Fu, Y., Miao, H., Ren, F., & Ma, X. (2021, September 7). Cannabidiol Effectively Promoted Cell Death in Bladder Cancer and the Improved Intravesical Adhesion Drugs Delivery Strategy Could Be Better Used for Treatment. PubMed Central (PMC). https://doi.org/10.3390/pharmaceutics13091415

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