Researchers seek to better understand the link between asthma and cannabis

Significant improvement in asthma patients after using cannabis

According to a recent study by the Israel Medical Association, asthmatic patients treated with cannabis reduced their dependence on inhalers (ventolin type) and significantly improved lung function, up to 8 times that of the drugs produced. The Ministry of Health still refuses to allow asthma patients to receive this treatment.

Asthma does not appear in the list of diseases that can qualify for authorization for medical cannabis, although in the past in 1996 some lucky patients with asthma received a license from the Ministry of Health.

As with other autoimmune diseases, many asthma patients claim that smoking cannabis helps them considerably and relieves seizures, but probably because there are not enough studies and perhaps because there are not enough studies. This is an anti-tobacco action, governments are reluctant to add this disease to the list.

Asthma sufferers can now hope for it to be possible, after specialists at the Institute of Pulmonary Medicine at Jerusalem's Sha'arei Zedek Medical Center saw the results of three patients with severe asthma whose condition improved significantly after treatment with cannabis.

Doctors decided to look into the matter in depth and in a new scientific article published this month (April 2020) in the monthly journal of the Medical Association, they review existing research on cannabis and asthma and describe the improvement in their three patients.

Nothing helped asthma until the usefulness of cannabis was revealed

In the monthly journal of the Medical Association, the article begins with a description of the cases of 3 severe asthma patients who experienced significant improvement in their disease following treatment with medical cannabis. All patients have already been treated with a long-term inhaler used daily to prevent seizures, as well as an emergency inhaler used to stop a seizure that has already started.

Case: Patient # 1

The first patient, a 30-year-old man who has suffered from severe asthma since childhood, was treated with high doses of inhaled corticosteroids, beta receptor agonists and montelukast. Despite being treated for many of his recurring asthma attacks, he continued and during a major attack he had to be connected to a life support.

When the patient first tried using cannabis for pleasure, he noticed a significant improvement in his respiratory symptoms. He applied to the Institute of Pulmonary Medicine at Shaare Zedek Medical Center in Jerusalem for authorization of medical cannabis for his asthma.

A routine FEV1 (Tiffeneau's coefficient) lung capacity test that monitors the amount of air exhaled in the first second of intense exhalation confirmed that the patient has severe pulmonary obstruction. Inhaling salbutamol, an asthma medication believed to open the airways and increase lung capacity, resulted in a minimum 2% improvement in lung capacity, as measured by the FEV1 test.

The next step, the researchers let the patient consume low doses by vaporizing 0,1g of cannabis, then repeat the FEV1 test again. This time, a 16% increase in lung capacity was measured, an 8-fold improvement compared to that induced by salbutamol. He began to receive cannabis vaporization treatment and for the next three years he had no asthma attacks and did not need an emergency inhaler.

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Case: Patient # 2

A 36-year-old woman diagnosed with asthma, who had about XNUMX recurrent attacks was treated daily with inhaled fluticasone and seretide and in times of spontaneous attack, with corticosteroids for systemic use in addition to an emergency bronchodilator .

The severity of his illness necessitated an increase in the daily dose of medication, except that at the medium dosage, the medication caused him a serious side effect of candidiasis (fungal infection, sores in the oral cavity).

For about two years, the patient was treated with medical cannabis, consumed by vaporization 3-4 times a week. Since starting treatment, she reported that she had no more seizures and that she did not feel the need to use an emergency inhaler. However, she still uses the asthma preventative medication because she suffered from interruptions (apneas) or reductions (hypopneas) of breathing during sleep.

Case: Patient # 3

A 34-year-old man with asthma had to use an emergency inhaler at least 3 times a week despite regular use of corticosteroids and beta-agonists to prevent seizures.

Following a serious car accident causing him multiple fractures, chronic pain, he received medical cannabis for his pain. When he started treatment with cannabis for pain, he also saw a marked improvement in his respiratory symptoms. Since then, he no longer needs an inhaler.

Cannabis and asthma: what does science say?

The above three cases, all of which showed significant improvement in asthma after cannabis treatment, greatly impressed doctors at the hospital. Jerusalem Institute of Pulmonary Medicine and decided to delve into scientific publication research to see if there were any studies on the relationship between cannabis and asthma. Here's what they found:

As with most parts of the body, cannabinoid receptors also exist in the health care system. CB1 receptors are dispersed in the nerves of the smooth muscle of the lung, and their role is likely to regulate the muscle tone of the lungs. CB2 receptors are found in immune cells, macrophages and lymphocytes, and are responsible for regulation of inflammation.

When cannabis is consumed, it activates these receptors and causes two main effects:

Airway expansion (bronchodilation): from the 1970s and 1980s, first studies have shown that inhaled THC temporarily widens the airways and significantly (but only in the short term) lung capacity in asthma patients. This result was also achieved consistently in most of the studies carried out since then, with an increase from 150 to 250 ml of the results of the FEV1 test.

This effect of expanding the airways (bronchodilation) begins about 5 minutes after consuming inhaled cannabis and lasts until about two hours later. Consuming edible cannabis has been found to have a similar but less effective effect, its effect only begins about an hour after eating and lasts longer than smoking.

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The bronchodilation effect of cannabis is, at least likely, caused by the attachment of THC to CB1 receptors in the smooth muscle of the lung and its activation, induces muscle relaxation and results in expansion of the airways.

Reduction of inflammation : Asthma is an autoimmune disease caused by an immune response, which tries to attack an intruder and creates an inflammatory response that makes it difficult to breathe. Studies have shown that cannabinoids have an anti-inflammatory effect which limits the overreaction of the immune system in other autoimmune diseases such as multiple sclerosis and the Crohn's disease.

Specifically, asthma does not yet have long-term clinical studies in humans, but studies in mice have shown that the cannabinoids THC and CBN are effective in reducing the symptoms of allergic asthma, in which the immune system has a pathogenic response to allergens in the air. They do this by regulating Th2 cytokines and reducing the allergic response to phlegm (mucus) production due to the presence of allergens.

However, when cannabis is consumed by combustion, smoking itself causes exactly opposite effects to all these beneficial effects, narrowing of the respiratory tract and increase of allergic diseases. Cannabis smoke, like tobacco smoke contains combustion products which, in the long term, may worsen diseases like asthma.

The study notes that vaporization cannabis involves much less dangerous induction products, so in theory it should be less harmful but as of yet no studies have examined this in depth, so it is not possible to determine for sure whether the vaporization long-term cannabis affects health or not.

In addition to the direct effects on the lungs, the study also notes the indirect effects that cannabis can have on asthma. For example, studies on the anti-anxiety effect components of cannabis (like CBD) are mentioned, since anxiety is a known trigger for asthma attacks. On the flip side, high doses of cannabis, especially those high in THC and low in CBD, can also cause anxiety, so this benefit can be reversed.

Another indirect benefit mentioned is the benefit of CBD against tobacco, an addiction that is particularly harmful for asthma patients. The effectiveness of CBD as that helps with smoking cessation has been shown in several studies, one of which even showed a 40% reduction in smoking by smokers when consumed in conjunction with vaporizing CBD. However, it is still not known whether this smoking reduction effect is sustained over time.

In summary, doctors write that although there is compelling evidence for the positive effects of cannabis on short-term lung function, consumption by combustion has harmful long-term effects. Vaporization is probably less dangerous and more research is needed to determine its safety. 

When will theinhaler cannabinoid-based for the relief or treatment of asthma patients? Over time, we hope to better understand the mechanisms of the effect of cannabinoids and perhaps even develop new drugs.

A study written by the magazine: Cannabis

Tags : Anti-inflammatoryasthmainfectionSearchVaporization

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