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UK: Cannabis may soothe inflamed bowels

New Scientist

Monday 01 Aug 2005

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Cannabis-based drugs could offer treatment hope to sufferers of
inflammatory bowel disease, UK researchers report.

Cannabis smokers with inflammatory bowel disease (IBD) have often claimed
that smoking a joint seems to lessen their symptoms. So a group of
researchers from Bath University and Bristol University, both in the UK,
decided to explore the clinical basis for the claims.

"There is quite a lot of anecdotal evidence that using cannabis seems to
reduce the pain and frequency of Crohn's disease and ulcerative colitis, so
we decided to see if we could find out what was going on there," says Karen
Wright, a pharmacologist at Bath University. "Historically, it was smoked
in India and China centuries ago for its gastrointestinal properties."

The chronic conditions, known collectively as IBD, are caused by an
over-active immune system which produces severe inflammation in areas of
the gastrointestinal tract. Up to 180,000 people in the UK are thought to
have colitis or Crohn's disease and suffer symptoms of pain, urgent
diarrhoea, severe tiredness and loss of weight. Repeated attacks can lead
to scarring of the colon and fibrosis to the extent that the bowel narrows
to form a stricture, for which a colonectomy - the surgical removal of the
bowel - is the only cure.

Repair trigger

Reports that cannabis eased IBD symptoms indicated the possible existence
of cannabinoid receptors in the intestinal lining, which respond to
molecules in the plant-derived chemicals. Wright and colleagues grew
sections of human colon and examined them in vitro.

To their surprise, the team discovered CB1 cannabinoid receptors - which
are known to be present in the brain - in the endothelial cells which line
the gut. "I think they must be involved in repairing the lining of the gut
when it is damaged," Wright says.

She deliberately damaged the cells to cause inflammation of the gut lining
and then added synthetically produced cannabinoids. "The gut started to
heal: the broken cells were repaired and brought back closer together to
mend the tears," she told New Scientist.

Wright believes that in a healthy gut, natural endogenous cannabinoids are
released from endothelial cells when they are injured, which then bind to
the CB1 receptors. The process appears to set off a wound-healing reaction.
"When people use cannabis, the cannabinoids bind to these receptors in the
same way," she said.

Excess cells

Previous studies have shown that CB1 receptors located on the nerve cells
in the gut respond to cannabinoids by slowing gut motility, therefore
reducing the painful muscle contractions associated with diarrhoea.

But Wright and her team also discovered another cannabinoid receptor, CB2,
in the guts of IBD sufferers, which was not present in healthy guts. These
receptors, which also respond to chemicals in cannabis, appear to be
associated with apoptosis - programmed cell death - and may have a role in
suppressing the overactive immune system and reducing inflammation by
moping up excess cells, she suggests.

"Ideally we would want to be able to stimulate the body's own endogenous
cannabinoid system, which might become dysregulated during long-term
inflammation. Knowing more about how this system actually works will help
us to look for therapeutic targets," Wright says. "We are not advocating
cannabis use, particularly as smoking tobacco exacerbates Crohn's disease
and many smokers of cannabis use tobacco as well."

"Anything that offers hope is good news for sufferers of IBD," says a
spokesperson from the National Association for Colitis and Crohn's Disease,
commenting on the research.

Journal reference: Gastroenterology


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