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Cannabis-based drugs could offer new hope for
inflammatory bowel
disease patients
04 Aug 2005
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Researchers investigating anecdotal evidence that
cannabis relieves
some of the symptoms of inflammatory bowel disease
(IBD) have
discovered a potential new target for
cannabis-derived drugs for
treatment of the disease.
This finding, published in the journal
Gastroenterology today (Monday
1 August), could bring new hope for the
sufferers of diseases like Crohn's and ulcerative
colitis1 with the
possibility that cannabis-derived drugs may help
to heal the gut
lining, which is damaged during the course of
disease.
Both Crohn's and ulcerative colitis - often
referred to under the
umbrella term of IBD - cause patients' immune
systems to go into
overdrive, producing inflammation in different
areas of the
gastrointestinal tract.
This inflammation can cause pain, urgent
diarrhoea, severe tiredness
and loss of weight, and is most commonly diagnosed
in young adults of
both sexes between the ages of 15 and 25.
Patients with IBD who are also users of cannabis
often report that
their symptoms are alleviated following cannabis
use, suggesting that
the gut is able to respond to some of the
molecules found in cannabis.
Investigating this phenomenon, researchers from
the
worked with colleagues at the
the interaction of cannabis with specific
molecules, known as
receptors, found on the surface of cells in the
gut.
Examining gut samples from healthy people and IBD
patients, the
researchers looked at two specific receptors,
called CB1 and CB2,
which are known to be activated by the presence of
molecules found in
cannabis.
They discovered that whilst CB1 is present in
healthy people, the
presence of CB2 increases in IBD patients as their
disease progresses.
The researchers believe that the presence of CB2
receptor only during
the disease-state may be linked to its known role
in suppression of
the immune system. In other words, it is part of
the body's natural
mechanisms that attempt to restore the normal
healthy state of the gut.
If so, this makes it an ideal candidate for the
development of new
cannabis-derived drugs to help IBD patients. They
also found that the
CB1 receptor helps to promote wound healing in the
lining of the gut.
"This gives us the first evidence that very
selective cannabis-derived
treatments may be useful as future therapeutic
strategies in the
treatment of Crohn's and ulcerative colitis,"
said Dr Karen Wright
from the University's Department of Pharmacy and
Pharmacology.
"This is because some extracts from cannabis,
known as cannabinoids,
closely resemble molecules that occur naturally in
our body, and by
developing treatments that target this system, we
can help the body
recover from some of the effects of these
diseases."
Ordinarily, CB1 and CB2 have the task of
recognising and binding to a
family of substances called
"endocannabinoids" that occur naturally in
our bodies. Once these receptors have detected the
presence of
specific molecules in their surrounding
environment, a chain of
biochemical signals is activated which culminates
in switching immune
responses on or off - depending on what their
function is.
"The normal job of the CB1 and CB2 receptors
is to help moderate
diverse responses throughout the body, but their
presence in the gut
means that they could be useful targets for the
development of
cannabis-derived drugs for controlling the
progression of IBD," said
Dr Wright.
"The research shows that whilst cannabis use
may have some benefits
for patients with IBD, the psychoactive effects
and the legal
implications associated with herbal cannabis use
make it unsuitable as
a treatment. Targeting drug development to
components of the in-built
cannabinoid system could be the way forward."
Cannabis-based medicines that help alleviate the
pain endured by
Multiple Sclerosis patients have already been
given a licence for use
in
of the advances in this field.
The research was funded by the Wellcome Trust and
an NHS Research Grant.
Case studies of people with colitis or Crohn's are
available from
National Association for Colitis and Crohn's
Disease on +44 (0)1727
830038.
1Figures from the National Association for Colitis
and Crohn's
Disease. There is no national database of people
with Crohn's or
Colitis - the figures are taken from estimates
published by the
British Society for Gastroenterology in 2004.
Inflammatory Bowel Disease
* Inflammatory Bowel Disease (IBD) is an umbrella
term referring to
two chronic diseases that cause inflammation of
the intestines:
ulcerative colitis (UC) and Crohn's disease (CD).
Crohn's disease
* Between 30,000 and 60,000 people in the
3,000 and 6,000 new cases are diagnosed each year.
* In 1996, a study from
number of children diagnosed with CD between 1983
and 1993
* In 1999 a study of children in
over 10 years in the incidence of CD.
* CD can affect anywhere from the mouth to the
rectum but most
commonly affects the small intestine.
* It causes inflammation, deep ulcers and scarring
to the wall of the
intestine and often occurs in patches with healthy
tissue in between.
There is no cure for CD at present.
* The main symptoms are pain, urgent diarrhoea,
severe tiredness and
loss of weight.
* CD is quite often associated with other
inflammatory conditions
affecting the joints, skin and eyes. Most patients
will be treated
with drugs, including steroids, to reduce
inflammation or by means of
special liquid feeds to rest the bowel. Surgery
may be required to
remove narrowed or damaged parts of the intestine.
* The condition is named after Dr Burril Crohn,
one of the three
doctors who first identified the disease in 1932.
* The cause of CD
has not yet been identified.
Ulcerative Colitis
* Between 60,000 and 120,000 people in the
* Between 6,000 and 12,000 new cases are diagnosed
each year.
* Ulcerative Colitis affects men and women
equally.
* The number of new cases each year has not risen
recently, but is not
decreasing.
* Ulcerative Colitis affects the colon (large
intestine) or rectum.
Inflammation and ulcers develop on the inside
lining of the colon
resulting in pain, urgent and bloody diarrhoea,
and continual tiredness.
* There is no cure for Ulcerative Colitis at
present.
* The condition varies as to how much of the colon
is affected and the
severity of the symptoms also fluctuates
unpredictably over time.
Patients are likely to experience flare-ups in
between intervals of
reduced symptoms or remission.
* Most patients will be treated with drugs,
including steroids, to
control or reduce the inflammation. Some people
need surgery to remove
the affected part of the colon, if their symptoms
do not respond to
treatment with drugs.
* The cause of UC has not yet been identified. The
is one of the
reputation for quality research and teaching. In
17 subject areas the
View a full list of the University's press
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