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    14.anaeli.review paper.final draft.the use of cannabis sativa as an anti 14.anaeli.review paper.final draft.the use of cannabis sativa as an anti Document Transcript

    • Anaeli Shockey LópezChemistry Department, University of Puerto Rico-CayeyThe use of Cannabis sativa as an anti-inflammatory for Crohn’s DiseaseAbstractThe objective of this paper is to see how the use of Cannabis sativa can be used as ananti-inflammatory for Crohn’s disease. Crohn’s disease is a chronic inflammatory disease of theintestines. It has many side effects, including bowel inflammation. Cannabis sativa is composedof cannabinoids and cannabinoids are composed of cannabidiols. The body has cannabinoidreceptors, such as CB1 and CB2, and the cannabinoids of cannabis, such as TCH (Δ9-tetrahydrocannabinol), attach themselves to the receptors. Each part of the brain that has areceptor has a different function in the body; therefore when cannabis is used the functions arereduced or enhanced. Throughout some research papers, it is proven that Cannabis sativa wouldbe a good option for those who suffer from inflammatory bowel diseases, not only because itreduces inflammation, but also because it helps with other symptoms of the diseases. Eventhough the usage of cannabis is good for more than just inflammatory bowel disease, there aremany legal complications surrounding it. Because of this, synthetic cannabis is being producedand is under investigation.IntroductionSome researchers have had the samequestion as I, what is a successful alterativemedicine that people with Crohn’s disease couldyou to have a relief from their symptoms? Aftersearching for an alternative to all the treatmentsthat are commonly used, I stumbled uponCannabis sativa. On-going experimenting is beingconducted for the use of this as a treatment forCrohn’s disease. Now, the reason I chose toresearch on Crohn’s disease is because of myfather. He has been suffering from this conditionfor more than twenty years and by choosing thistopic I can research on some treatments thatwould help him feel better because, unfortunately,there is no cure.Crohn’s disease is a chronic inflammatorydisease of the intestines in which one of the mayorsymptoms is bowel inflammation. Upon doingsome investigation, it is seen in papers that the useof Cannabis sativa(commonly known asmarijuana) decreases the inflammation of thebowel in inflammatory bowel diseases. Thoughstill under investigation, it is most likely that thereason of this is because of cannabinoid receptorsthat the body has. Cannabinoid receptors areactivated due to cannabinoid components thatexist in Cannabis sativa. One of the mayorcannabinoid chemicals is THC (Δ9-tetrahydrocannabinol) and it is the cannabinoidthat bonds most efficiently with the receptors.As mentioned earlier, the objective of thispaper is to illustrate how the use of Cannabissativa reduces bowel inflammation. It is true thatthere are legal complications and disputes aroundthe subject of cannabis, but that is the reason towhy synthetic cannabis is being produced.Though the effects might not be the same, theywill be similar, therefore, benefiting those whosuffer from inflammatory bowel diseases.Crohn’s DiseaseLike mentioned earlier, Crohn’s disease iscategorized as an inflammatory bowel disease.This means that Crohn’s disease is a chronicinflammatory disease of the intestines.Theinflammation is caused by an activation of theimmune system in the intestines. The immune
    • system of those who suffer from inflammatorybowel diseases is abnormally activated without asign of any invader. Ultimately, this causeschronic inflammation and ulceration. Theulcerations can be in both the small intestine andthe large intestine and the digestive system canalso be affected.There are different types ofCrohn’s disease, such as: Crohn’s colitis, Crohn’senteritis, Crohn’s terminal ileitis andCrohn’sentero-colitis and ileo-colitis. Dependingon what type of Crohn’s disease a person has isthe symptoms he/she will suffer from. Some ofthe symptoms are: abdominal pain, vomiting,diarrhea, loss of appetite, weight loss, rectal painand occasionally, fever, night sweats and rectalbleeding.The reason of why Crohn’s diseaseoccurs is still unknown. Although surgery andmedication, such as anti-inflammatory agents,topical antibiotics, and immune-modulators, existto treat Crohn’s disease, there is no medical cure.(Schoenfeld, Wu. 2010)Cannabis sativaCannabis sativa, commonly known asmarijuana, has been used as a medicine forapproximately five thousand years. Cannabissativa is composed of cannabinoids and thosecannabinoids are composed of cannabidiols.Although many cannabinoids exist, the primaryone that affects the body is THC (Δ9-tetrahydrocannabinol). Depending on the amountof THC that is in your body is how much theeffect will be. The more THC, the more theeffects will be. Through investigations, it isknown that cannabinoids have a directinvolvement with the anti-inflammatory action ofcannabis. (Burstein, Zurier. 2009)In the human body two mayor cannabinoidreceptors exist: CB1 and CB2. (Pertwee. 2008)THC is mediated by the CB1receptor, whichproduces certain responses of the body. (Cooper,Haney. 2009). Mainly, CB1receptors are locatedin the brain and CB2in the immune system. Thereceptor that most affects the body with the use ofcannabis is CB1. Each part of the brain that hasCB1receptors affects a different function of thebody. Among the parts of the brain that haveCB1receptors are: the basal ganglia, thecerebellum, the medulla, the cerebral cortex, thehypothalamus, the hippocampus and the spinalcord. How exactly does THC affect those parts ofthe brain? Well, THC mimics or blocks theactions of neurotransmitters (chemicals thatallows neurons to communicate with each other)therefore interfering with normal functions.Withthe use of cannabis, these are the effects on eachpart of the brain. The basal ganglia and thecerebellum bothsubside movement. The medullasubsides, majorly, nausea/vomiting. The cerebralcortex increases cognitive function. Thehypothalamus induces appetite and thehippocampus not only induces learning andmemory but also reduces stress. Last, but notleast, the spinal cord reduces peripheralsensations, including pain.Cannabis is also being used for othersicknesses, not just inflammatory bowel diseases.Some of these are: multiple sclerosis, ADHD(Attention Deficit Hyperactivity Disorder),cancer, AIDS (Acquired immune deficiencysyndrome), glaucoma, insomnia, asthma,migraines, etc.Cannabis sativa on Inflammatory BowelDiseasesThe use of Cannabis sativa as an anti-inflammatory for inflammatory bowel diseases isa relatively recent treatment; therefore, not thatmany studies have been conducted for this.However, those studies that have been conductedhave given a positive feedback to the use ofcannabis as an anti-inflammatory. Studies havebeen done on mice and surveys have been done onhumans.A research was conducted by Capasso, etal. (2008)in which it was discussed whether ornotcannabidiol inhibits inflammatoryhypermotility in mice. Since the mice didn’t haveany inflammation, a stimulus was created usingirritant croton oil. In the results, it was establishedthat cannabidiol is in fact active when there is aninflammatory stimulus and that the inhibition
    • percentage increases when there is largerquantities of cannabidiol. In conclusion, throughthis experiment with mice, it is observed that theuse of cannabidiol is helpful in normalizingintestinal functions, including inflammation.Sincecannabidiol is extracted from cannabinoids andcannabinoids are components of cannabis, thismeans cannabis is useful for reducing intestinalinflammation.Another research, similar to the onespoken about in the earlier paragraph, wasconducted by Borrelli, et al. (2009). Thisinvestigation also included the usage of mice todetermine the effects of cannabidiol on colitis.Colitis is another inflammatory bowel disease,therefore the effects that cannabidiol has on it willbe similar to the effects it will have on Crohn’sdisease. To cause the inflammation, intracolonicadministration of dinitrobenzene acid was inducedto the mice. It was found that the cannabidiolreduced the colon injury (inflammation) and itwas concluded that it was a likely safe method fortreating colitis.Some studies have been done withhumans but those are conducted through surveys.Through said surveys, in one study performed byLal, et al. (2011) on Crohn’s disease andulcerative colitis, it was found that it relievedabdominal pain, diarrhea and reduced appetite.The most important aspect of the study was thatthe abdominal pain in inflammatory diseases wasreduced with the use of cannabis. This is because,ultimately, this means that the intestinalinflammation was reduced. A good hypothesis towhy this happens is because of endocannabinoids(substances that are produced within the body thatactivate cannabinoid receptors). As said bySabatino, et al. (2011) and the article,endocannabinoids agonists (substance thatinitiates a response when connected to a receptor),such as anandamide, are involved in theprotection of the gut against inflammation.Another study, using surveys, wasconducted by Naftali, et al. (2011) to see what theeffects of Cannabis sativa were on patients withCrohn’s disease. This study proves that out ofthirty patients that undertook the cannabistreatment, twenty-one of them improved theirsymptoms. Since bowel inflammation is one ofthose symptoms, obviously, it means that usingcannabis reduced that. It also establishes that theamount of drugs taken by the patients and theamount of surgeries that were preformed on themwere reduced. In conclusion, this study provesthat cannabis would be a successful treatment forthe vast majority of those suffering from Crohn’sdisease.Legalization IssuesThere has always been a great debate onwhether cannabis should be legalized or not.Currently, many countries have legalized it, butmany still have not. Because it has been foundthat cannabis has a medical advantage but it is notlegal everywhere, synthetic cannabis is beingproduced. According to the Drug Foundation, thisis a recent development of a drug and is still notconsidered safe for human consumption. Thissynthesis of cannabis has different cannabinoidstructures than actual cannabinoids but they affectthe cannabinoid system of the brain in a similarways. The synthetic cannabinoids are liquid intheir original state and solidify when they arecombined with dry herbs. Very little research dataexists around this subject and the health effects ofusing synthetic cannabis are still unknown.ConclusionsCrohn’s Disease is an inflammatory boweldisease that mostly affects the intestines. Itsinflammation is caused by the immune system,which activates in the intestines when no threat isthere.Cannabis sativa, commonly known asmarijuana, is composed of cannabinoids andcannabidiol which have been found to have adirect relationship with the anti-inflammatoryagent of cannabis. Since the body has cannabinoidreceptors, the cannabinoids that composeCannabis Sativa, particularly THC (Δ9-tetrahydrocannabinol), attach to the receptorscausing the specific functions of each part of thebrain to be reduced or enhanced.From the
    • research papers it can be concluded that Cannabissativa has a positive effect on individualssuffering from Crohn’s disease. By usingcannabis, abdominal pain in Crohn’s diseasepatients was reduced greatly (proven by studiesmentioned earlier) and this means that intestinalinflammation was reduced. Even though there arelegal complications regarding cannabis, syntheticcannabis is being produced, but it is still not safefor human consumption and experimenting isbeing conducted so eventually it will be.References1. Borrelli F, Aviello G, Romano B, Orlando P,Capasso R, Maiello F, Guadagno F, Petrosino S,Capasso F, Di Marzo V, Izzo A. 2009.Cannabidiol, a safe and non-psychotropicingredient of the marijuana plant Cannabis sativa,is protective in a murine model of colitis. J MolMed 87:1111–1121.Doi :10.1007/s00109-009-0512-x2. Burstein S, Zurier R. 2009. Cannabinoids,Endocannabinoids, and Related Analogs inInflammation. [Internet] [Cited 2012 Nov 24]AAPS J.11(1): 109–119.doi: 10.1208/s12248-009-9084-5 Available from:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2664885/3. Capasso R, Borrelli F, Aviello G, Romano B,Scalisi C, Capasso F, Izzo AA. 2008.Cannabidiol, extracted from cannabis sativa,selectively inhibits inflammatory hypermotility inmice. Br J Pharmacol 154(5):1001-8.4. Cooper Z, Haney M. 2009. Actions of delta-9-tetrahydrocannabinol in cannabis.Int RevPsychiatry. [Internet] [Cited 2012 Nov 24] 21(2):104–112.doi: 10.1080/09540260902782752Available from:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2731700/5. Di Sabatino A, Battista N, Biancheri P, RapinoC, Rovedatti L, Astarita G, Vanoli A, Dainese E,Guerci M, Piomelli D, Pender S, Pender L,Pender F, MacDonald T, MacDonald T,Maccarrone M, Corazza G, Corazza R. 2011. Theendogenous cannabinoid system in the gut ofpatients with inflammatory boweldisease.[Internet] Mucosal Immunology 4: 574–583; doi:10.1038/mi.2011.18 Available from:http://www.nature.com/mi/journal/v4/n5/full/mi201118a.html6. Lal S, Prasad N, Ryan M, Tangri S, SilverbergM, Gordon A, Steinhart H. 2011. Cannabis useamongst patients with inflammatory boweldisease. European Journal of Gastroenterology&Hepatology 23(10):891-8967. Naftali T, Bar Lev L, Yableknovitz D, Half Eand Konikoff F. 2011. Treatment of Crohn’sDisease with Cannabis: An Observational Study.[Internet]. [Cited 2012 Nov 24] 13:455-457Available from:http://www.letfreedomgrow.com/cmu/Crohns-ar11aug-01.pdf8. Pertwee RG. 2008. Ligands that targetcannabinoid receptors in the brain: from THC toanandamide and beyond. Institute of MedicalSciences, Aberdeen, UK.13(2):147-59.9. Schoenfeld A, Wu G. 2010. Crohn’s Disease.[Internet] [Cited 2012 Nov 24] Available from:http://www.medicinenet.com/crohns_disease/article.htm10. Synthetic cannabinoids. Available from:http://www.drugfoundation.org.nz/synthetic-cannabinoids