Phytochemicals and Cannabinoids from Cannabis Spp. implicated in the treatment of Arthritis
Refers to over 100 medical conditions characterized by inflammation of one or more joints due to infection, trauma or age.
Arthritis is usually managed with the use of non-steroidal inflammatory drugs, mainly COX-1 and Cox-2 inhibitors. There is currently major concern with the use of COX inhibitors which may lead to gastro intestinal ulcers and bleeding and myocardial infarctions with COX-1 and COX-2 respectively.
Ganja has shown effectiveness in the management of the pain and swelling associated with arthritis without the psychotropic effects. In addition THC and CBD have produced no significant COX inhibition at normal doses.
THC is the major cannabinoid in ganja. THC has twenty times the anti-inflammatory potency of aspirin and two times that of hydrocortisone. Its anti-inflammatory actions are mediated by inhibition of PGE-2 synthesis, decrease in platelet aggregation, and inhibition of lipoxygenase thereby preventing the conversion of arachidonic acid to the leukotriene precursor which are also involved in inflammation. Some studies have also noted that the anti-inflammatory effects of the plant may be due to an effect on arachidonate metabolism.
CBD has shown anti-inflammatory properties independent of THC. CBD has also shown anti-inflammatory properties independent of THC. Cannabidiol in arthritis:
- Inhibits glutamate neurotoxicity- Inflammation of the joint is accompanied by elevated levels of glutamate in the synovial fluid. Accumulation of glutamate causes glutamate toxicity, potentiating inflammation and may lead to cell death.
- Acts as an antioxidant more potent than vitamins C and E
- Acts at the vanilloid receptor (also known as the capsaicin receptor) as a TRPV1 agonist to cause desensitization, thereby inhibiting fatty acid amine hydrolase (FAAH) as well as inhibition of anandamide reuptake.
- In mice, CBD inhibits tumour necrosis factor alpha (TNF-a). TNF-a promotes the inflammatory process, induces fever, apoptotic cell death and cachexia.
The TRPV1 receptor provides sensation to heat and pain.
Other cannabinoids which have displayed activity against arthritis experimentally include:
- Cannabigerol (CBG): CBG has demonstrated its effectiveness as a more potent analgesic, lipoxyegnase stimulator and anti erythmic agent than THC. CBG also inhibits the GABA uptake more effectively than THC and CBD.
- Tetrahydrocannabivarin (THCV): THCV caused reduced inflammation in a carrageenan induced arthritic model in mice.
The anti-arthritic benefits of the cannabis plant are not limited to cannabinoids however, and cannabis terpenoids, such as Myrcene and flavonoids such as apigenin have also shown effectiveness in management of the pain and inflammation seen in this condition.
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