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Off the Wall!

Cannabis for Inflammatory Bowel Disease

Naftali T.a, b · Mechulam R.d · Lev L.B.c · Konikoff F.M.a, b

Author affiliations

aInstitute of Gastroenterology and Hepatology, Meir Medical Center, Kfar Saba, bSackler School of Medicine, Tel Aviv University, and cTikunOlam NGO for Promotion of Medical Cannabis, Tel Aviv, and dInstitute for Drug Research, Medical Faculty, Hebrew University, Jerusalem, Israel

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Dig Dis 2014;32:468-474

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Article / Publication Details

First-Page Preview
Abstract of Off the Wall!

Published online: June 23, 2014
Issue release date: June 2014

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 1

ISSN: 0257-2753 (Print)
eISSN: 1421-9875 (Online)

For additional information: https://www.karger.com/DDI

Abstract

The marijuana plant Cannabis sativa has been used for centuries as a treatment for a variety of ailments. It contains over 60 different cannabinoid compounds. Studies have revealed that the endocannabinoid system is involved in almost all major immune events. Cannabinoids may, therefore, be beneficial in inflammatory disorders. In murine colitis, cannabinoids decrease histologic and microscopic inflammation. In humans, cannabis has been used to treat a plethora of gastrointestinal problems, including anorexia, emesis, abdominal pain, diarrhea, and diabetic gastroparesis. Despite anecdotal reports on medical cannabis in inflammatory bowel disease (IBD), there are few controlled studies. In an observational study in 30 patients with Crohn's disease (CD), we found that medical cannabis was associated with improvement in disease activity and reduction in the use of other medications. In a more recent placebo-controlled study in 21 chronic CD patients, we showed a decrease in the CD activity index >100 in 10 of 11 subjects on cannabis compared to 4 of 10 on placebo. Complete remission was achieved in 5 of 11 subjects in the cannabis group and 1 of 10 in the placebo group. Yet, in an additional study, low-dose cannabidiol did not have an effect on CD activity. In summary, evidence is gathering that manipulating the endocannabinoid system can have beneficial effects in IBD, but further research is required to declare cannabinoids a medicine. We need to establish the specific cannabinoids, as well as appropriate medical conditions, optimal dose, and mode of administration, to maximize the beneficial effects while avoiding any potential harmful effects of cannabinoid use.

© 2014 S. Karger AG, Basel


References

  1. Fonseca BM, Costa MA, Almada M, Correia-da-Silva G, Teixeira NA: Endogenous cannabinoids revisited: a biochemistry perspective. Prostaglandins Other Lipid Mediat 2013;102-103:13-30.
  2. Rodríguez de Fonseca F, Del Arco I, Bermudez-Silva FJ, Bilbao A, Cippitelli A, Navarro M: The endocannabinoid system: physiology and pharmacology. Alcohol Alcohol 2005;40:2-14.
  3. Schmid PC, Reddy PV, Natarajan V, Schmid HH: Metabolism on N-acylethanolamine phospholipids by a mammalian phosphodiesterase of the phospholipase D type. J Biol Chem 1983;258:9302-9306.
    External Resources
  4. Bisogno T, Ligresti A, Di Marzo V: The endocannabinoid signaling system: biochemical aspects. Pharmacol Biochem Behav 2005;81:224-238.
  5. Piomelli D, Giuffrida A, Calignano A, De Fonseca FR: The endocannabinoid system as a target for therapeutic drugs. Trends Pharmacol Sci 2000;21:218-224.
  6. Ramos JA, González S, Sagredo O, Gómez-Ruiz M, Fernández-Ruiz J: Therapeutic potential of the endocannabinoid system in the brain. Mini Rev Med Chem 2005;5:609-617.
  7. Battista N, Di Tommaso M, Bari M, Maccarrone M: The endocannabinoid system: an overview. Front Behav Neurosci 2012;6:9.
  8. Sugiura T, Kishimoto S, Oka S, Gokoh M: Biochemistry, pharmacology and physiology of 2-arachidonoylglycerol, an endogenous cannabinoid receptor ligand. Prog Lipid Res 2006;45:405-446.
  9. Aviello G, Romano B, Izzo AA: Cannabinoids and gastrointestinal motility: animal and human studies. Eur Rev Med Pharmacol Sci 2008;12(suppl 1):81-93.
    External Resources
  10. Percie du Sert N, Ho WS, Rudd JA, Andrews PL: Cannabinoid-induced reduction in antral pacemaker frequency: a telemetric study in the ferret. Neurogastroenterol Motil 2010;22:1257-1266.
  11. Storr MA, Keenan CM, Emmerdinger D, et al: Targeting endocannabinoid degradation protects against experimental colitis in mice: involvement of CB1 and CB2 receptors. J Mol Med 2008;86:925-936.
  12. Hillsley K, McCaul C, Aerssens J, et al: Activation of the cannabinoid 2 (CB2) receptor inhibits murine mesenteric afferent nerve activity. Neurogastroenterol Motil 2007;19:769-777.
  13. Govaerts SJ, Hermans E, Lambert DM: Comparison of cannabinoid ligands affinities and efficacies in murine tissues and in transfected cells expressing human recombinant cannabinoid receptors. Eur J Pharm Sci 2004;23:233-243.
  14. Pertwee RG: Receptors and channels targeted by synthetic cannabinoid receptor agonists and antagonists. Curr Med Chem 2010;17:1360-1381.
  15. Izzo AA, Borrelli F, Capasso R, Di Marzo V, Mechoulam R: Non-psychotropic plant cannabinoids: new therapeutic opportunities from an ancient herb. Trends Pharmacol Sci 2009;30:515-527.
  16. Zuardi AW, Shirakawa I, Finkelfarb E, et al: Action of cannabidiol on the anxiety and other effects produced by delta-9-THC in normal subjects. Psychopharmacology 1982;76:245-250.
  17. Bornhein LM, Reid M: Influence of cannabinoids on brain levels of other drugs. Symposium on the Cannabinoids; 1999 Jun 18-20: Acapulco. Burlington, International Cannabinoid Research Society, 1999, p 84.
  18. Lee MHS, Hancox RJ: Effects of smoking cannabis on lung function. Expert Rev Respir Med 2011;5:537-547.
  19. Schon F, Hart P, Hodgson TR, et al: Suppression of pendular nystagmus by cannabis in a patient with multiple sclerosis. Neurology 1999;53:2209-2210.
  20. Hazekamp A, Heerdink ER: The prevalence and incidence of medicinal cannabis on prescription in The Netherlands. Eur J Clin Pharmacol 2013;69:1575-1580.
  21. Hunt CA, Jones RT: Tolerance and disposition of tetrahydrocannabinol in man. J Pharmacol Exp Ther 1980;213:35-44.
    External Resources
  22. Williamson EM, Evans FJ: Cannabinoids in clinical practice. Drugs 2000;60:1303-1314.
  23. Evans FJ: Cannabinoids: the separation of central from peripheral effects on a structural basis. Planta Med 1991;57(7 suppl):60-67.
  24. Formukong E, Garland LG, Evans AT, et al: Inhibition of A23187 induced release of CTB4 in mouse blood in vivo and human polymorphonuclear cells in vitro by analgesic cannabidiol. Phytother Res 1991;5:258-261.
  25. Formukong EA, Evans AT, Evans FJ: The medicinal uses of cannabis and its constituents. Phytother Res 1989;3:219-231.
    External Resources
  26. Pope H, Gruber A, Yurgelan-Todd D: The residual neuropsychological effects of cannabis: the current status of research. Drug Alcohol Depend 1995;38:25-34.
  27. Anthony JC, Warner L, Kessler R: Comparative epidemiology of dependence on tobacco, alcohol, controlled substances, and inhalants: basic findings from the National Comorbidity Survey. Exp Clin Psychopharmacol 1994;2:244-268.
    External Resources
  28. Wang T, Collet JP, Shapiro S, Ware MA: Adverse effects of medical cannabinoids: a systematic review. CMAJ 2008;178:1669-1678.
  29. Zalesky A, Solowij N, Yucel M, Lubman DI, Takagi M, Harding IH, Lorenzetti V, Wang R, Searle K, Pantelis C, Seal M: Effect of long-term cannabis use on axonal fiber connectivity. Brain 2012;135:2245-2255.
  30. Meier MH, Caspi A, Ambler A, Harrington H, Houts R, Keefe RS, McDonald K, Ward A, Poulton R, Moffitt TE: Persistent cannabis users show neuropsychological decline from childhood to midlife. Proc Natl Acad Sci USA 2012;109:E2657-E2664.
  31. Schreiner AM, Dunn ME: Residual effects of cannabis use on neurocognitive performance after prolonged abstinence: a meta-analysis. Exp Clin Psychopharmacol 2012:20:420-429.
  32. Izzo AA, Sharkey KA: Cannabinoids and the gut: new developments and emerging concepts. Pharmacol Ther 2010;126:21-38.
  33. Izzo AA, Capasso F, Costagliola A, Bisogno T, Marsicano G, Ligresti A, Matias I, Capasso R, Pinto L, Borrelli F, Cecio A, Lutz B, Mascolo N, DiMarzo V: An endogenous cannabinoid tone attenuates cholera toxin-induced fluid accumulation in mice. Gastroenterology 2003;125:765-774.
  34. Massa F, Marsicano G, Hermann H, Cannich A, et al: The endogenous cannabinoid system protects against colonic inflammation. J Clin Invest 2004;113:1202-1209.
  35. Engel MA, Kellermann CA, Burnat G, Hahn EG, et al: Mice lacking cannabinoid CB1-, CB2-receptors or both receptors show increased susceptibility to trinitrobenzene sulfonic acid (TNBS)-induced colitis. J Physiol Pharmacol 2010;61:89-97.
    External Resources
  36. Borrelli F, Aviello G, Romano B, Orlando P, et al: Cannabidiol, a safe and non-psychotropic ingredient of the marijuana plant Cannabis sativa, is protective in a murine model of colitis. J Mol Med (Berl) 2009;87:1111-1121.
  37. Schicho R, Storr, M: Topical and systemic cannabidiol improves trinitrobenzene sulfonic acid colitis in mice. Pharmacology 2012;89:149-155.
  38. Jamontt JM, Molleman A, Pertwee RG, Parsons ME: The effects of delta-tetrahydrocannabinol and cannabidiol alone and in combination on damage, inflammation and in vitro motility disturbances in rat colitis. Br J Pharmacol 2010;160:712-723.
  39. Kimball ES, Schneider CR, Wallace NH, Hornby PJ: Agonists of cannabinoid receptor 1 and 2 inhibit experimental colitis induced by oil of mustard and by dextran sulfate sodium. Am J Physiol Gastrointest Liver Physiol 2006;291:G364-G371.
  40. Alhouayek M, Lambert DM, Delzenne NM, Cani PD, et al: Increasing endogenous 2-arachidonoylglycerol levels counteracts colitis and related systemic inflammation. FASEB J 2011;25:2711-2721.
  41. Lal S, Prasad N, Ryan M, Tangri S, et al: Cannabis use amongst patients with inflammatory bowel disease. Eur J Gastroenterol Hepatol 2011;23:891-896.
  42. Lahat A, Lang A, Ben-Horin S: Impact of cannabis treatment on the quality of life, weight and clinical disease activity in inflammatory bowel disease patients: a pilot prospective study. Digestion 2012;85:1-8.
  43. Naftali T, Lev LB, Yablecovitch D, Half E, Konikoff FM: Treatment of Crohn's disease with cannabis: an observational study. Isr Med Assoc J 2011;13:455-458.
    External Resources
  44. Naftali T, Mechulam R, Gabay G, Marii A, Stein A, Bronstein M, Konikoff FM: Low dose cannabidiol treatment does not affect active Crohn's disease. DDW Conf, Orlando, May 19-21, 2013, No 983.
  45. Zuardi AW: Cannabidiol: from an inactive cannabinoid to a drug with wide spectrum of action. Rev Bras Psiquiatr 2008;30:271-280.
  46. Naftali T, Bar-Lev Schleider L, Dotan I, Lansky EP, Sklerovsky Benjaminov F, Konikoff FM: Cannabis induces a clinical response in patients with Crohn's disease: a prospective placebo-controlled study. Clin Gastroenterol Hepatol 2013;11:1276-1280.

Article / Publication Details

First-Page Preview
Abstract of Off the Wall!

Published online: June 23, 2014
Issue release date: June 2014

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 1

ISSN: 0257-2753 (Print)
eISSN: 1421-9875 (Online)

For additional information: https://www.karger.com/DDI


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