Arthritis is one of the most widespread health conditions in the United States, affecting over 54 million men and women and 300,000 children. Arthritis appears in many forms, with the most common being osteoarthritis (OA), followed by rheumatoid arthritis (RA) and psoriatic arthritis.
As of today, there is no cure for arthritis (as well as rheumatic conditions), rather recommendations for combination therapies such as increasing physical activity, weight loss, OTC pain relievers, crutches or canes, surgery, and cannabinoid therapy due to recent research.
What is the Endocannabinoid System?
Our Endocannabinoid System (ECS) is the largest neurotransmitter system in the body, composed of endocannabinoids, cannabinoid receptors, and metabolizing enzymes. Endocannabinoids are arguably one of the most widespread and versatile signaling molecules known to man. Two key endocannabinoids that have been identified are anandamide (AEA) and 2-arachidonoyl glycerol (2-AG). The endocannabinoids activate different receptors throughout the body and brain called CB1 and CB2 receptors. CB1 receptors are found in high levels in the brain and central nervous system; whereas CB2 receptors are found in numerous immune cells and the peripheral nervous system. Modulation and activation of the cannabinoid receptors by endocannabinoids can have various effects within the body.
How does ECS play a role in arthritis and rheumatoid conditions?
In a study with 32 osteoarthritis patients and 13 rheumatoid arthritis patients, it was found that cannabinoid CB1 and CB2 receptor protein and RNA, as well as the endocannabinoids AEA and 2-AG are present in the synovia of patients with end-stage OA and RA. This study helps to predict that the cannabinoid receptor system present in the connective tissue that lines the inside of a joint (synovium) may be an important therapeutic target for the treatment of pain and inflammation associated with both OA and RA. As was seen in this study, the endocannabinoids were present in the OA and RA patients where in healthy volunteers, those endocannabinoids were not present.
In additional studies, the presence of cannabinoid receptors on cells of the immune system and anecdotal and historical evidence suggests that cannabis use has potent immunomodulatory effects. This has led to research directed at understanding the function and role of these receptors within the context of immunomodulating effects of cannabis in humans, animals and in vitro studies of immune cells, such as t-cells that have also provided important evidence.
Researched pain and inflammation relieving benefits of cannabinoids
Cannabinoids are commonly investigated as pain-relieving agents, but in recent years more evidence has accumulated on their potential immunomodulatory effect, supported by results in animal models of certain rheumatic diseases. While results that demonstrate the same effect in humans are lacking, cannabinoids and cannabis remain potential options to alleviate the pain associated with rheumatic diseases, as they were shown as safe and causing little to no adverse effects.
It has also been suggested that cannabinoids have an inflammatory-modulating benefit that could offer therapeutic effects, as cannabinoids were shown to have overall anti-inflammatory effects on immune cells. These results were reinforced by studies in animal models of RA and systemic sclerosis.
Animal models also suggest a possible therapeutic quality for cannabinoids in RA, with three studies using a rodent model with collagen-induced arthritis showing a beneficial effect of the cannabinoid CBD and synthetic cannabinoids JWH-133 and HU-308. These substances were found to be associated with clinical improvement. CBD was associated with a decrease in cytokine release and production as well as a decrease in lymphocyte proliferation.
A study with 31 patients with RA suffering from chronic pain were given Sativex (a THC-CBD mouth spray legally prescribed in UK and mainland Europe) and 27 were given a placebo, the controlled trial showed a significant analgesic effect and disease activity suppression. Pain parameters and sleep both improved. In addition, the study found no serious adverse effects in the active treatment group.
We know through research that CBD has a wide spectrum of biological activity, including anti-inflammatory activity. This is why its activity in the prevention and treatment of diseases whose development is associated with inflammation has been tested. Based on current research results, the potential to utilize CBD for the treatment of diabetes, arthritis, as well as cardiovascular disease, cancer, anxiety, psychosis, epilepsy, neurodegenerative diseases, and skin disease is being considered. Clinical studies have confirmed that CBD reduces the levels of pro-inflammatory cytokines, inhibits t-cell proliferation, induces t cell apoptosis and reduces migration and adhesion of immune cells.
In addition, CBD creates a physiological response with several inflammatory mediator receptors within us. These are known as the PPARy, GPR, and Adenosine A2A Receptors.
The anti-inflammatory contributions of THC are also extensively studied, showing PGE-2 synthesis, decreased platelet aggregation, and stimulation of lipoxygenase, all actions related to reducing inflammation. THC has 20 times the anti-inflammatory potency of aspirin and twice that of hydrocortisone.
Benefits of minor cannabinoids and terpenes
Other minor cannabinoids in the cannabis plant may also contribute to anti-inflammatory activity. cannabichromene (CBC) was studied with mice, showing that it helped to increase intestinal motility by lessening intestinal inflammation.
Animal studies have also shown Cannabigerol (CBG) to reduce the effects of inflammatory-related conditions such as inflammatory bowel disease. CBG has also been shown to have potent pain relieving abilities.
The terpenes in cannabis additionally show analgesic and anti-inflammatory attributes. Myrcene is analgesic and blocks inflammation. The sesquiterpene, B-caryophyllene, also shows promising anti-inflammatory and analgesic properties.
If you are seeking data-driven answers to your questions about this cannabinoid therapy and arthritis, Realm of Caring (RoC) can help. RoC has 8 years of collected data and research based on individuals utilizing plant-based therapies. They can guide you through product selection, dosing and administration, how to talk with your doctor, and the results individuals are realizing.