Did you know that endothelial inflammation, the source of atherosclerosis (and the cause of heart disease, hypertension and stroke), is the underlying cause or contributor in 50% of all mortalities[ref]Lusis AJ Department of Medicine, Biology Institute, University of California, Los Angeles 90095, USA Atherosclerosis. Nature. 2000 Sep 14;407(6801):233-41[/ref], not just heart disease?
Chronic inflammation is closely associated with cardiovascular disease (CVD), as well as a broad spectrum of neurodegenerative diseases including Alzheimer’s disease (AD)[ref]Paula Grammas. Neurovascular dysfunction, inflammation and endothelial activation: Implications for the pathogenesis of Alzheimer’s disease Journal of Neuroinflammation. (http://www.jneuroinflammation.com/content/8/1/26) 12/12/2011[/ref].
In addition, there are inflammatory mechanisms in pain, stroke, diabetes, cancer, obesity, chronic autoimmune processes, and possibly even some psychiatric disorders like depression to name just a few.
That means that we are suffering from unprecedented amounts of inflammation brought about by our modern lifestyle here in the west. Right now, we do not have any medications that effectively suppress this type of inflammation.
In treating pain we reach for Aspirin, Motrin, Acetaminophen, or we obtain a prescription for an opiate. That’s it for our choices but they all have dangerous side effects. Wouldn’t it be great if we had a powerful, safe, anti-inflammatory medicine that could be used by anyone who needed it regardless of how ill they may be?
Well, look no further because exciting new research is providing compelling evidence that the use of cannabis, with its ability to suppress pain and cellular inflammation, may be the Holy Grail of anti-inflammatory medicines.
As you probably already know, marijuana acts on certain special receptors in the brain and the body, the CB1 and CB2 receptors respectively. We also have endogenous (within the body) cannabinoids just like our endogenous opiate system. Agonists stimulate these receptors while antagonists block them.
Investigational and currently marketed CB receptor agonists (stimulants), and antagonists are already in use that possess amazing properties including treating inflammation. Here’s just a few uses:
There is widespread potential for therapeutic applications of CB receptor ligands. CB1 receptor agonists, for example, relieve pain, nausea and vomiting, reduce hyperexcitability in epilepsy, and increase food intake of debilitated patients. On the other hand CB1 receptor antagonists may be useful for the modulation of behavior in addiction and for treating obesity. In fact, rimonabant… had been approved for that indication, but has meanwhile been withdrawn from the market due to serious side-effects resulting in an increased suicide rate. Antinociceptive effects, especially in neuropathic and chronic pain, indications of medical need, may be achieved by selective CB2 receptor agonism thus avoiding adverse CB1 effects. Further fields of application for CB2 receptor agonists are inflammatory diseases including multiple sclerosis and arthritis. A few CB receptor agonists have already been licensed for clinical use, including dronabinol (Δ9-THC), nabilon, a synthetic THC analog, and a combination of Δ9-THC with cannabidiol to reduce psychotropic effects.[ref]Alexander Fuchs, et al., The Natural Product Magnolol as a Lead Structure for the Development of Potent Cannabinoid Receptor Agonists. PLoS One. 2013; 8(10): e77739.[/ref]
So far compelling evidence exists for anandamide, THC, cannabidiol, and synthetic cannabinoids in effectively treating animal models of pain from chemical, mechanical, and thermal stimuli.
Recent animal studies indicate that anandamide and cannabinoid ligands (similar in structure) are also very effective against chronic pain of both neuropathic and inflammatory origin[ref](Herzberg et al., 1997; Bridges et al., 2001; Fox et al., 2001; Guindon and Beaulieu, 2006)(Tsou et al., 1996; Richardson et al., 1998a,b,c; Li et al., 1999; Martin et al., 1999b; Guindon et al., 2006)[/ref]. In fact, the endocannabinoid system has been recently implicated in the pain relieving actions of acetaminophen (Tylenol) and the anesthetic induction agent Propofol[ref]IBID p. 22[/ref].
In addition to the role of CB1 receptors, there is recent evidence implicating CB2 receptors in the antihyperalgesic activity of cannabinoids in models of acute and chronic, neuropathic pain, especially of inflammatory origin. Cannabinoid agonists may also release endogenous opioids, and a functional interplay between the endocannabinoid and opioid systems in modulating analgesic responses has been suggested by numerous studies[ref]IBID p. 22[/ref].
In human studies the data initially were not as clear-cut. Recently however, the role of cannabinoids in ameliorating pain and inflammation has been revealed. From The Endocannabinoid System as an Emerging Target of Pharmacotherapy the authors note:
To the extent that pain and inflammation accompany many of the disorders discussed in the rest of this review, cannabinoids would be expected to provide significant benefit due to their analgesic and anti-inflammatory properties[ref]IBID p. 24[/ref].
Meanwhile, before we discuss the Sativa plant in greater detail, how many readers can tell me what inflammation really is?
In the next article, we’ll discuss what chronic, cellular inflammation actually is, its many faces, and how marvellous chemicals contained in marijuana affect that system.