If you want to know the effects of CBD (cannabidiol), then this article will allow you to have a wholehearted understanding of CBD.
First, the medical use of hemp (industrial hemp)
Hemp is the THC (tetrahydrocannabinol) content of less than 0.3% of cannabis, cannabidiol (CBD) is the main chemical component of the medicinal plant cannabis.
Unlike THC, CBD not only has no hallucinogenic effect but also has great value in reducing inflammation, pain, anxiety, psychiatric disorders, epilepsy, and other applications.
Research data show that the endocannabinoid system (ECS) is responsible for managing appetite, memory, emotional behavior, and the perception of pain.
CBD is a substance that resembles the structure and function of endogenous cannabinoids, by regulating signaling pathways and related receptors, thus alleviating the patient’s related neurological disorders.
Considering the good therapeutic effect of CBD and fewer side effects, the market for CBD in the field of medicinal use has a wide scope for expansion in the future.
Cannabidiol (CBD) is the main chemical component of the medicinal plant cannabis, extracted from the female cannabis plant, with anti-inflammatory, antiseptic, analgesic, anti-anxiety, antipsychotic, antioxidant, improve learning and memory, neuroprotective, and reduce intestinal motility.
Can be used to treat anorexia, AIDS, epilepsy, multiple atherosclerosis and Parkinson’s disease, prevention of myocardial infarction, inhibition of glioma cell metastasis and inhibition of sex hormone secretion.
1, Cannabidiol (CBD) is used to treat anxiety, insomnia, or sleep disorders.
CBD helps to relieve a person’s anxiety and other emotions. The human body has an endocannabinoid system (ECS), which is responsible for managing appetite, memory, emotional behavior, and the perception of pain.
When problems arise, endocannabinoids are released and then bind to two receptors called CB1 and CB2. CB1 receptors are found throughout the body, but the highest concentrations of CB1 are located in the nervous and immune systems, and CBD is a substance that resembles the structure and function of endocannabinoids.
CBD interacts with CB1 receptors and has been scientifically shown to enhance CB1 receptor activity, thereby regulating a variety of physiological and psychological processes and contributing to the treatment of many diseases.
Meanwhile, 5-HT1A is an important serotonin receptor that helps brain cells transmit serotonin signals. Serotonin controls factors such as appetite and sleep, and CBD can act as a 5-HT1A agonist, reducing anxiety and improving people’s moods.
The HelloMD online community and the Brightfield Group did a survey of 2,400 members of the medical marijuana community to analyze data on CBD users. The top three main issues respondents wanted to address with cannabidiol were anxiety, insomnia or sleep problems, joint pain, and inflammation.
These are the three most prevalent problems in today’s society, and cannabidiol’s effectiveness in treating them has received the most attention.
CBD is more widely used in the relief of anxiety and insomnia. More than 65 percent of respondents said they use cannabidiol products for anxiety, and nearly 60 percent believe that cannabidiol has a relieving effect on insomnia or sleep problems.
More than 50 percent of patients with joint pain and inflammation utilize cannabidiol products. In addition to this, respondents believe it can also act as an antidepressant, relieve muscle tension or stress, and relieve migraines.
The majority of consumers have a positive attitude towards CBD (cannabidiol) products. Cannabidiol products are preferred by more consumers than traditional medications. 80% of respondents said they approve of the effectiveness of cannabidiol products, and 42% have replaced other traditional prescription and over-the-counter medications with cannabidiol products.
More than 40 percent of users believe that cannabidiol products are far more effective than over-the-counter medications, and about 30 percent of respondents believe that cannabidiol products are far more effective than prescription medications. Very few respondents had a negative attitude toward the effectiveness of cannabidiol products.
2, Cannabidiol (CBD) for pain relief and anti-inflammatory
Studies have shown that CBD can help reduce chronic pain by affecting ECS receptor activity, reducing inflammation and interacting with neurotransmitters. The endocannabinoid system (ECS) binds to ECS receptors in the nervous system via neurotransmitters.
For example, one study in rats found that CBD injections reduced the pain response to surgical incisions, and another study in rats found that oral CBD treatment significantly reduced sciatic nerve pain and inflammation. Several studies have also found that the combination of CBD and THC is effective in treating the pain associated with multiple sclerosis and arthritis.
Due to its potential anti-inflammatory, low toxicity and non-neurotoxicity, CBD has been used as a therapeutic agent for collagenous arthritis and has been shown to be effective in the treatment of rheumatoid arthritis.
In vitro experiments have shown that CBD significantly reduces TNF and NO production by peritoneal macrophages and that CBD exerts anti-inflammatory effects through dual inhibition of cyclooxygenase and lipoxygenase.
A variety of chronic diseases such as hepatitis, pneumonia, nephritis are related to the generation of excess free radicals and inflammatory response, CBD has a better anti-inflammatory antioxidant function.
3, Cannabidiol (CBD) neuroprotective effect
CBD has a certain neuroprotective effect, its activity mechanism for the regulation of certain important signaling pathways, activation of key genes PPARγ transcription and reduce the occurrence of neuroinflammation, etc. CBD has a certain inhibitory effect on refractory epilepsy, and can reduce the frequency of seizures.
CBD is able to respond to oxidative stress damage in the human body in several ways. Oxidative stress (OS) is a free radical-mediated reactive effect that is an important factor in cellular aging and damage.
Preclinical and clinical studies have shown that CBD has good pharmacokinetic properties and can rapidly cross the blood-brain barrier after injection, with significant cerebral neuroprotective effects.
CBD also has inhibitory effects on Parkinson’s disease (PD) and Alzheimer’s disease (AD). It has been found that β-amyloid peptide aggregation and microglia activation are strongly associated with the development of AD.
CBD mediates the inhibition of the neurotoxic substance MPP + (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine), which is closely related to PD, mainly through neuronal proteins and trkA (nerve growth factor receptor), and MPP + can lead to neuronal cell death and neuronal synapse deficiency.
4, Cannabidiol (CBD) anti-tumor
CBD is mainly used to treat cancer by inhibiting cancer cell appreciation or inducing apoptosis. CBD also has a certain inhibitory effect on glioma, leukemia, and prostate cancer.
Under serum-free conditions, CBD and tamoxifen (anti-estrogen) co-incubated with C6 glioma cells exhibited some inhibitory effects on gliomas. CBD induces apoptosis in human glioma cells U87 and U373 through mechanisms such as cysteine activation and involvement of reactive oxygen species.
CBD induces apoptosis in human glioma cells U87 and U373 through the regulation of NOX4 and p22 CBD can also block the proliferation or induce apoptosis of prostate cancer cells.
5., Cannabidiol (CBD) intervenes in metabolic and immune regulation
CBD has been shown to have a beneficial effect on the control of early-stage diabetes by modulating the levels of inflammatory factors and controlling the production of interferon, etc. CBD can reduce the incidence of diabetes by inhibiting the development of pancreatitis and the production of inflammatory Th-1 related cytokines; on the other hand, for early-stage diabetes, CBD treatment can On the other hand, for early diabetes, CBD treatment can greatly reduce the level of pro-inflammatory factor IL-12.
Other major medical uses
Studies have shown that CBD has a protective function against vascular, ischemic liver injury, and liver injury caused by chronic alcoholism. Since CBD has PPARγ activation-mediated vasodilatory activity, and PPARγ ligands play a critical role in controlling inflammation, atherosclerosis, type II diabetes, tumors, and obesity, CBD can act as a promoter of PPARγ and play a role in vascular protection.
In addition, CBD has significant antibacterial activity against methicillin-resistant Staphylococcus aureus EMRSA-15 and EMRSA-16 and fluoroquinolone-resistant Staphylococcus aureus SA-1199B, with a minimum inhibitory concentration range of 0.5-2 μg/ml.
Second, cannabis-extracted drugs emerge in the field of innovative medicines
First cannabis extract drug receives FDA approval.On June 25, 2018, the FDA announced the marketing approval of pharmaceutical company GW’s Epidiolex (cannabidiol, CBD) oral liquid for the treatment of patients over 2 years of age with Lennox-Gastaut syndrome and Dravet syndrome, the first FDA-approved marketing of a drug containing purified cannabis extracts Epidiolex is an oral, high-purity liquid formulation of cannabidiol (CBD) extract.
For indication, Lennox-Gastaut syndrome is a severe form of childhood epilepsy and is one of the most difficult to treat common epilepsy syndromes in children, accounting for approximately 5-10% of childhood epilepsy.
The peak incidence of the disorder is between the ages of 3 and 5 years, and approximately 80% of childhood seizures are delayed into adulthood; Dravet syndrome, also known as severe myoclonic epilepsy in infants (severemyoclonic epilepsyinfarlcy, SMEI), is a clinically rare and refractory epilepsy syndrome that is insensitive to all antiepileptic drugs, with an overall incidence is approximately 1/20,000-40,000 and accounts for approximately 29.5% of all types of pediatric myoclonic epilepsy.
The efficacy of Epidiolex in the treatment of epilepsy was demonstrated in three (516 patients were recruited) randomized, double-blind, placebo-controlled clinical trials which showed that Epidiolex, in combination with other drugs, was effective in reducing the frequency of seizures compared to placebo.
1, Phase III clinical data on Epidiolex for LGS syndrome published in The Lancet
In January 2018, The Lancet, a leading international medical journal, published the results of GW Pharma’s phase III clinical trial of Epidiolex for the treatment of rare epilepsy in Lennox-Gastaut syndrome (LGS).
From April 28, 2015-October 15, 2015, a total of 171 patients with LGS were enrolled whose seizures were not controlled by their currents AED treatment control, were randomized to receive Epidiolex (cannabidiol) or placebo on top of their current treatment.
The clinical trial was double-blind controlled, with 86 patients treated with the Epidiolex formulation and 85 patients treated with a placebo group control.
All patients received 14 weeks of treatment, with 2 weeks of a progressively higher dose treatment phase and the remaining 12 weeks of a stable maintenance treatment phase (2.5 mg/Kg in the initiation phase and 20 mg/kg in the maintenance phase).
Epidiolex was able to significantly reduce the number of seizures. As shown in Figures 3 and 4, according to the intervals of ≥25%, ≥50%, ≥75% and 100% reduction in the number of epileptic episodes, the experimental group showed outstanding performance in reducing the percentage of epileptic episodes in the initiation and maintenance treatment phases, and 6% of the patients in the maintenance treatment phase reduced the number of episodes to 0.
In each interval of the initiation and maintenance treatment phases, the experimental group and the control group mostly showed significant reduction in the number of epileptic episodes. The majority of the experimental and control groups showed statistically significant differences (p<0.01%).
The experimental group showed a significant advantage in terms of the year-on-year reduction in the mean number of epilepsy episodes per month for all patients in both the initiation and maintenance phases.
As shown in Figure 5, the mean reduction in the number of epilepsy episodes per month was 21.13 in the experimental group compared with the control group during the initiation treatment phase (EMD, estimate median difference), and 23.27 in the maintenance treatment phase.
Since some participants in the experimental and control groups dropped out during the trial, as shown in Figure 6, the reduction in the number of epileptic episodes per month was even more pronounced after excluding the data from those who dropped out in the middle of the trial.
The average reduction in the number of epilepsy episodes per month was 26.06 during the initiation phase and 31.03 during the maintenance phase. The data showed that patients treated with Epidiolex showed a lower number of seizures overall and showed a statistically significant difference compared to the control group (p<0.01%).
At the end of the 14-week trial, a satisfaction questionnaire was administered to patients in the experimental and control groups. From the data, patients treated with Epidiolex showed a higher level of satisfaction, with the experimental group being three times more likely than the control group to be in a significantly better condition (very much improved) (18% vs. 6%). These results imply that pidiolex treatment had a positive impact on the patients’ condition.
In terms of overall results, the median reduction in the number of single-month seizures was more pronounced in patients taking Epidiolex compared to placebo (43.9% vs. 21.8%), with the primary endpoint of the study being the 14-week treatment period (a two-week dose escalation followed by 12 weeks of maintenance).
As for side effects, 86% of patients in the experimental group experienced side effects (74 of 86) and 69% of patients in the control group experienced side effects (59 of 85), which were mild or moderate, mainly in the form of diarrhea, drowsiness, fever, loss of appetite, and vomiting, but were generally manageable.
2, Phase III clinical results of Epidiolex for Dravet syndrome published in the New England Journal of Medicine
In May 2017, GW Pharma published the Phase III clinical results of its cannabidiol (CBD) liquid formulation Epidiolex in the treatment of rare epilepsy in Dravet syndrome in the leading international journal – The New England Journal of Medicine.
The trial enrolled 120 patients with Dravet syndrome at a dose of 20 mg/kg/day in the experimental group and a double-blind placebo group in the control group, with the primary clinical endpoint being the change in seizure onset frequency at the end of the 14-week window treatment period compared to pre-treatment.
The primary clinical focus showed that cannabidiol was effective in relieving the number of seizures in patients. Patients were treated with 14 weeks of CBD or placebo after 4 weeks of observation, and from the results of the data in Table 3, the median number of seizures per month decreased from 12.4 to 5.9 in the CBD group, while the number of seizures decreased significantly from 14.9 to 14.1 per month in the placebo group.
From the results of this clinical endpoint, the proportional reduction in the number of episodes compared to pre-treatment was more than 50% and twice as high in the experimental group as in the control group, implying that the experimental group reduced the frequency of epilepsy by at least 50%.
In terms of specific proportions, 43% of patients in the CBD group had half the number of episodes, while only 17% of patients in the placebo group had half the number of episodes.
Another 4.9% of patients with seizures disappeared with CBD, while there were no cases of complete control in the placebo group.
In terms of side effects, the experimental group had a higher probability of side effects than the control group, mainly in terms of diarrhea, vomiting, fatigue, fever, and drowsiness, but overall they were mild or moderate and relatively manageable.
Ninety-three percent of the patients in the CBD group and 75% of the patients in the control group experienced some degree of side effects, and 89% of all side effects in the patients belonged to mild or moderate side effects (84% of the side effects in the CBD group and 95% of the side effects in the control group).