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Neuro-Behcet’s autoimmune disease is a rare, chronic auto-inflammatory disease that most commonly affects men and women in their 20s and 30s. Studies have shown cannabis can help with pain management and has anti-inflammatory properties that could potentially help in the treatment of the disease.
Overview of Neuro-Behcet’s Autoimmune Disease
Neuro-Behcet’s autoimmune disease, also commonly referred to as Behcet’s syndrome, is a very rare disorder that causes chronic inflammation in blood vessels. The disease causes the body’s immune system to become overly active and mistakenly attack its own healthy cells.
The symptoms of Neuro-Behcet’s autoimmune disease vary between individuals. The most common symptoms include painful mouth sores that appear like canker sores, eye redness and inflammation, skin rashes and lesions, joint swelling, abdominal pain, diarrhea, and painful genital sores. In some cases, the inflammation associated with the disease can cause swelling in the brain and subsequently headaches, poor balance and disorientation, or swelling of the arteries that potentially blocks blood flow and leads to the formation of blood clots or aneurysms.
The cause of Neuro-Behcet’s autoimmune disease remains unknown, but according to Mayo Clinic, it’s likely caused by a combination of genetic and environmental factors.
There is no cure for Neuro-Behcet’s autoimmune disease, but treatments can help reduce the disease’s symptoms. Pain and anti-inflammatory medications are often used during flare-ups. Skin creams, mouth rinses and eye drops containing anti-inflammatory medicines are used to manage skin sores, mouth sores and inflamed eyes. In addition, immunosuppressive drugs meant to suppress the immune system and keep it from attacking healthy cells are used to control the disease.
Findings: Effects of Cannabis on Neuro-Behcet’s Autoimmune Disease
While researchers have yet to directly examine the effects of cannabis on Neuro-Behcet’s autoimmune disease, studies have shown that cannabis is effective at reducing chronic inflammation caused by other diseases and that it reduces pain associated with inflammatory-related diseases.
Two major cannabinoids found in cannabis, tetrahydrocannabinol (THC) and cannabidiol (CBD), have demonstrated effectiveness at reducing inflammation related to a variety of conditions. THC reduces the development of the chronic inflammatory disease atherosclerosis and reduces airway inflammation caused by the flu virus (Fimiani, et al., 1999) (Buchweitz, et al., 2008). CBD reduces joint inflammation and inhibits the progression of arthritis, another autoimmune disease (Sumariwalla, et al., 2004) (Nagarkatti, et al., 2009). CBD has also shown to effectively reduced edema (Costa, et al., 2004). Cannabis lowers digestive track inflammation caused by inflammatory bowel disease (Naftali, Mechulam, Lev & Konikoff, 2014). Studies also suggest that the cannabinoids in marijuana may be beneficial in certain types of cancers that are triggered by chronic inflammation (Nagarkatti, et al., 2009).
Cannabis may also help in treating Neuro-Behcet’s autoimmune disease by suppressing the immune system, therefore preventing it from attacking as many healthy cells. Cannabinoid receptors (CB1 and CB2) are found on the cells of the immune system. Cannabinoids like THC and CBD trigger these receptors, which stimulates an immunosuppression response as cytokine and chemokine production is downregulated and t-regulatory cells are upregulated. A review article analyzing the research of THC’s effect on inflammation concluded that it could potentially serve as a potent treatment modality against inflammatory disorders (Nagarkatti, et al., 2009).
Cannabis can help with the pain caused by chronic inflammation diseases. THC and CBD act on CB1 and CB2, which have been shown to be involved in the mediation of pain associated with inflammation (Clayton, Marshall, Bountra & O’Shaughnessy, 2002) (Elikottil, Gupta & Gupta, 2009) (Kehl, et al., 2003). Studies have also found that reduction in inflammation caused by CBD subsequently reduced pain (Costa, et al., 2007).
States That Have Approved Medical Marijuana for Neuro-Behcet’s Autoimmune Disease
Currently, only the state of Illinois has approved medical marijuana for the treatment of Neuro-Behcet autoimmune disease. However, in Washington D.C., any condition can be approved for medical marijuana as long as a DC-licensed physician recommends the treatment. In addition, a number of other states will consider allowing medical marijuana to be used for the treatment of Neuro-Behcet autoimmune disease with the recommendation from a physician. These states include: California (any debilitating illness where the medical use of marijuana has been recommended by a physician), Connecticut (other medical conditions may be approved by the Department of Consumer Protection), Massachusetts (other conditions as determined in writing by a qualifying patient’s physician), Nevada (other conditions subject to approval), Oregon (other conditions subject to approval), Rhode Island (other conditions subject to approval), and Washington (any “terminal or debilitating condition”).
Several states have approved medical marijuana specifically to treat “chronic pain,” a symptom associated with Neuro-Behcet autoimmune disease. These states include: Alaska, Arizona, California, Colorado, Delaware, Hawaii, Maine, Maryland, Michigan, Montana, New Mexico, Ohio, Oregon, Pennsylvania, Rhode Island, Vermont and West Virginia. The states of Nevada, New Hampshire, North Dakota, Montana, Ohio and Vermont allow medical marijuana to treat “severe pain.” The states of Arkansas, Minnesota, Ohio, Pennsylvania, Washington and West Virginia have approved cannabis for the treatment of “intractable pain.”
Recent Studies on Cannabis’ Effect on Neuro-Behcet’s Autoimmune Disease
Behcet’s disease. (2013, March 8). Mayo Clinic. Retrieved from http://www.mayoclinic.org/diseases-conditions/behcets-disease/basics/definition/con-20027549.
Behcet’s syndrome. (2015). National Organization for Rare Disorders. Retrieved from https://rarediseases.org/rare-diseases/behcets-syndrome/.
Buchweitz, J.P., Karmaus, P.W., Williams, K.J., Harkema, J.R. and Kaminski, N.E. (2008, March). Targeted deletion of cannabinoid receptors CB1 and CB2 produced enhanced inflammatory responses to influenza A/PR/8/34 in the absence of presence of Delta9-tetrahydrocannabinol. Journal of Leukocyte Biology, 83(3), 785-96. Retrieved from http://www.jleukbio.org/content/83/3/785.long.
Clayton, N., Marshall, F.H., Bountra, C., and O’Shaughnessy, C.T. (2002, April). CB1 and CB2 cannabinoid receptors are implicated in inflammatory pain. Pain, 96(3), 253-60. Retrieved from http://journals.lww.com/pain/pages/articleviewer.aspx?year=2002&issue=04000&article=00005&type=abstract.
Costa, B., Colleoni, M., Conti, S., Parolaro, D., Franke, C., Trovato, A.E., and Giagnoni, G. (2004, March). Oral anti-inflammatory activity of cannabidiol, a non-psychoactive constituent of cannabis, in acute carrageenan-induced inflammation in the rat paw. Naunyn-Schmiedeberg’s Archives of Pharmacology, 369(3), 294-9. Retrieved from http://link.springer.com/article/10.1007%2Fs00210-004-0871-3.
Costa, B., Trovato, A.E., Comelli, F., Giagnoni, G., and Colleoni, M. (2007, February). The non-psychoactive cannabis constituent cannabidiol is an orally effective therapeutic agent in rat chronic inflammatory and neuropathic pain. European Journal of Pharmacology, 556(1-3), 75-83. Retrieved from http://www.sciencedirect.com/science/article/pii/S001429990601257X.
Elikkottil, J., Gupta, P. and Gupta, K. (2009, November-December). The analgesic potential of cannabinoids. Journal of Opioid Management, 5(6), 341-57. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3728280/.
Fimiani, C., Liberty, T., Aquirre, A.J., Amin, I., Ali, N. and Stefano, G.B. (1999, January). Opiate, cannabinoid, and eicosanoid signaling converges on common intracellular pathways nitric oxide coupling. Prostaglandins & Other Lipid Mediators, 57(1), 23-34. Retrieved from http://www.sciencedirect.com/science/article/pii/S0090698098000689.
Kehl, L.J., Hamamoto, D.T., Wacnik, P.W., Croft, D.L., Norsted, B.D., Wilcox, G.L., and Simone, DA. (2003, May). A cannabinoid agonist differently attenuates deep tissue hyperalgesia in animal models of cancer and inflammatory muscle pain. Pain, 103(1-2). Retrieved from http://journals.lww.com/pain/pages/articleviewer.aspx?year=2003&issue=05000&article=00021&type=abstract.
Nagarkatti, P., Pandey, R., Amcaoglu Rieder, S., Hedge, V.L., & Nagarkatti, M. (2009, October). Cannabinoids as novel anti-inflammatory drugs. Future Medical Chemistry, 1(7), 1333-1349. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2828614/.
Naftali, T., Mechulam, R., Lev, L.B., and Konikoff, FM. (2014). Cannabis for inflammatory bowel disease. Digestive Diseases, 32(4), 468-74. Retrieved from https://www.karger.com/Article/Purchase/358155.
Sumariwalla, P.F., Gallily, R., Tchilibon, S., Fride, E., Mechoulam, R., and Fedmann, M. (2004, March). A novel synthetic, nonpsychoactive cannabinoid acid (HU-320) with antiinflammatory properties in murine collagen-induced arthritis. Arthritis and Rheumatism, 50(3), 985-98. Retrieved from http://onlinelibrary.wiley.com/doi/10.1002/art.20050/full.