Study Suggests Cannabis Alleviates Symptoms of Cystic Fibrosis
A study conducted in 2002 revealed that cannabinoids could significantly reduce the symptoms of Cystic Fibrosis.
The study, conducted by the late Esther Fride was the first and only ever report that had researched the link between cannabis as medicine and Cystic Fibrosis, an inherited condition in which the lungs and digestive system can become clogged with thick, sticky mucus.
The World Health Organization reports that 1 in 2000–3000 newborns is found to be affected by Cystic Fibrosis in the European Union. With no known cure for the disease and a life expectancy of between 42 and 50 in the developed world, the diagnosis of CF can greatly impact a patient and their families.
Fride’s study indicates that cannabis could potentially alleviate many of the symptoms of CF, some of which can be leading factors in mortality rates within the disease.
Malnutrition is now recognised as playing a primary role in the progression of Cystic Fibrosis, possibly even being linked to lung pathology and infections. One of the primary roles that THC (one of the most prevalent compounds within cannabis) holds medically, is the ability to increase appetite. THC is in fact clinically used for this purpose in AIDS patients.
Therefore, administration of cannabinoids may promote appetite, thus combating malnutrition and increasing chances for survival.
A 1998 study by Raphael Mechoulam, the pre-eminent professor of cannabis medicine, determined that THC is extremely beneficial in relieving chemotherapy induced nausea and vomiting in patients. Vomiting is one of the key factors in the loss of appetite in CF patients. Therefore, the antiemetic potential of cannabinoids would contribute to appetite enhancement in the disease.
This unwanted side effect of Cystic Fibrosis presents itself due to inadequate digestion through pancreatic insufficiency. Excessive diarrhoea can often lead to key nutrients leaving the body. Esther Fride references three studies (Colombo 1998, Tyler 2000, Hanus 1999) which suggest that cannabinoids inhibit intestinal motility via local CB1 and CB2 receptors. The ingestion of cannabis would activate these receptors, decreasing the prevalence of diarrhoea and in turn, the loss of key nutrients.
Most destruction of lung tissue in CF is now thought to be secondary to a very aggressive neutrophilic inflammatory response. This ultimately leads to respiratory failure. The anti-inflammatory potential of cannabinoids is well documented (Klein et al. 2000; Straus 2001) and is thought to occur by interference with the arachidonic acid-eicosanoid synthetic pathways (basically signalling molecules). In vitro studies have been conducted which demonstrates the efficacy of cannabinoids as anti inflammatory agents via CB receptors.
Since cannabinoid receptors are present in lungs (Calignano, 2000), THC may be of additional benefit for CF patients, by reducing inflammatory processes in the lungs.
The ingestion method of cannabis for patients with Cystic Fibrosis is a key discussion. Smoking cannabis, which has been known to be effective for disorders such as multiple sclerosis, simply will not work because of irritation of the lungs. Other options that were discussed in Fride’s study were vaping and suppositories, although the general text did not provide a definitive answer for the most effective method of ingestion.
CF patients suffer pain from a variety of sources including abdominal pain related to steatorrhea (excreting abnormal levels of fat in faeces) and small intestine malabsorption, chest pain due to impacted sputum, pleuritic involvement with lung inflammation and infection, or chest wall pain associated with developing kyphoscoliosis (curvature of the spine) and decreased chest wall mobility. Pain may also occur from gall bladder or kidney stones or from osteoporosis. Cannabinoids are analgesics, effective in a variety of conditions (Mechoulam 1998, Martin and Lichtman 1998), acting via cannabinoid receptors within as well as outside the brain and spinal cord and suppressing both acute and chronic pain (Pertwee 2001).
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