by E. Mironchik-Frankenberg, DVM.
Cannabis for Inflammatory Conditions. Part 1: General considerations
Inflammatory syndromes include a wide range of diseases and conditions, but they are all share the characteristic of unregulated and uncontrollable inflammation within the body. Scores of humans and their pets suffer from this chronic disease state, many with ineffective or disappointing treatment results. The array of conditions falling under this umbrella is so vast, it includes diagnoses ranging from allergies to cancer.
There is much confusion among pet parents when it comes to understanding this complicated disease process. Therefore, this is the first of a multi-part series on this subject and the different classes of conditions that fall under this umbrella definition. Here, we will try to explain the basics of inflammatory conditions in general, and how cannabis may be of benefit.
Let’s start at the beginning…
Simply put, inflammation is the body’s natural response to injury or illness. It is an essential function of the immune system, in both humans and animals. However, in some cases, this normal response goes awry and can lead to serious adverse health effects from the persistently inflamed state that results.
The normal process in acute inflammation is short-lived. An infectious disease pathogen or injury activates the immune system, it then clears the pathogen, begins the repair process, and then ceases. This is the body’s first line of defense against infection or injury.
To illustrate, let’s take the common example of an insect bite. The insult occurs and the body reacts almost immediately. The resident immune cells present in the tissues of the affected area begin to go to work. They release substances called “inflammatory mediators” that result in the 5 classic signs of inflammation: heat, redness, swelling, pain, and loss of function. Over the next few hours to days, the signs slowly resolve, and the injury is healed. All of us, as well as our pets, have experienced this normal process countless times in our lives.
In some circumstances however, the normal, short-lived inflammatory process does not end there. For instance, if the initial insult cannot be removed or resolved in the normal manner; if it is due to a virus or other pathogen that is difficult to combat; or if there is continuous stimulation of the immune response. In these scenarios, this process continues and results in persistent or “chronic” inflammation. In addition, some individuals may have a malfunction in the normal immune response. This can lead to an autoimmune disease, whereby the immune system mistakenly attacks the healthy cells in the body.
Any of the above situations results in the change of inflammatory cells and mediators that are present and can lead to tissue destruction and other detrimental changes, which can persist for months to years, or even become permanent.
Chronic inflammation can affect any of the organs or systems in the body, such as the skin, GI tract, muscles and joints, nervous system, etc. Examples of the more common chronic inflammatory conditions in pets are atopic dermatitis and asthma, inflammatory bowel disease (IBD), chronic pancreatitis, arthritis in its various forms, and certain types of cancers.
Traditional treatment for inflammatory conditions in pets usually involves several different types of anti-inflammatory drugs, depending on the cause and severity of the inflammation. Corticosteroids tend to be the mainstay of treatment, but antihistamines and non-steroidal anti-inflammatory drugs (NSAIDS) are often utilized as well. In addition, depending on the location of the insult, other more specific therapies can be used, such as vitamin supplements, chondroprotective agents for joint issues or immunosuppressive and chemotherapy drugs in different cancers or autoimmune diseases.
Unfortunately, many of these medications come with a long list of side effects. In some patients, side effects from the long-term use of corticosteroids can be just as bad (or even worse) than the original disease process. Understandably, pet owners are seeking a viable alternative.
Can cannabis help?
Over the past several decades, multiple studies have proven the anti-inflammatory benefits of phytocannabinoids, terpenoids, and flavonoids, compounds found in the cannabis plant. Cannabinoids have activity at various steps within the inflammatory cascade and can modulate the process. There are multiple mechanisms in which cannabis derived compounds act to combat inflammation, such as decreasing the levels of inflammatory mediators, decreasing the migration of inflammatory cells, and via antioxidant effects. In addition, these molecules also act via cannabinoid receptors, highlighting their important role in the regulation of the immune system, since both CB1 and CB2 receptors have been found on immune cells.
In addition to the science, there may be other, more practical reasons to choose cannabis. Pet owners looking to avoid the side effects of traditional medications, those attempting to decrease polypharmacy, or those seeking a more natural alternative may decide to try this option. In some cases, our pets suffer from conditions for which we have no good treatment, such as in neuropathic pain, or are species that are hard to treat with traditional meds, i.e. cats. In more complicated cases, there may be underlying conditions that preclude the use of corticosteroids, NSAIDS, or other pharmaceuticals.
Cannabinoids have the unique ability to solve multiple problems at once. Not only can they decrease the inflammatory response but may also relieve some of the secondary symptoms of the disease process as well, such as pain, nausea, lethargy, or depression. For pet owners facing the difficulties in managing one of these diseases, cannabis may be a worthy consideration.
Coming up next: Inflammation part 2; arthritis and other musculoskeletal disorders
Ref:
1.https://en.wikipedia.org/wiki/Inflammation
2.https://hellomd.com/blogs/articles/medical-marijuana-as-an-aid-against-inflammation
4. https://www.projectcbd.org/medicine/cbd-steroid-sparing-treatment
5.Nagarkatti, P., Pandey, R., Rieder, S. A., Hegde, V. L., & Nagarkatti, M. (2009). Cannabinoids as novel anti-inflammatory drugs. Future medicinal chemistry, 1(7), 1333–1349. https://doi.org/10.4155/fmc.09.93
6. Klein, T. Cannabinoid-based drugs as anti-inflammatory therapeutics. Nat Rev Immunol 5, 400–411 (2005). https://doi.org/10.1038/nri1602 https://www.nature.com/articles/nri1602
