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Pathology

Pathology refers to the deviations from a healthy system, thereby characterizing a disease state. Just like any physiological system in the body, the endocannabinoid system (ECS) can be dysregulated as well. As a system that tries to keep a balance in the body, this dysregulation is typically caused by other pathological changes in the body. In addition, there are theories which suggest the ECS dysregulation could also be the cause of such changes.

ECS dysregulation due to pathology

The endocannabinoid system (ECS) is responsible for maintaining homeostasis in the body. It has been shown that changes in the ECS are evident in various disease states, such as Parkinson’s disease, depression, anxiety, post-traumatic stress disorder (PTSD), amyotrophic lateral sclerosis (ALS), and others.1, 2, 3, 4, 5 By up- or down-regulating the system, for example by producing more endocannabinoids, the ECS tries to compensate for dysregulations of endocannabinoid system in pathology. Targeting a dysregulated ECS might help symptom treatment. However, in those cases, it should not be expected to cure the underlying pathological disorder.

ECS dysregulation as a source of pathology

Some scientists argue that an intrinsic dysregulation of the endocannabinoid system (ECS) can be the cause of pathology in humans.6, 7 According to them, these patients need to use cannabis products to bring their ECS back to the levels that are considered normal in healthy people. They concur that the symptoms can include migraines, fibromyalgia, irritable bowel syndrome, autism spectrum disorder.6, 7 For example, a study in humans has found that the ECS is associated with serotonin release from platelets in patients that suffer from migraines, but not when they are headache-free.8 With regards to the irritable bowel syndrome, Izzo and colleagues were able to show that a lower CB1-receptor concentration lead to decreased gastrointestinal motility, leading to constipation in mice.9 However, to confirm the hypothesis, further studies need to be done in humans. It is important to note that some cannabis-based product users that suffer from effects such headaches or sleep problems, after quitting the products (for example, when they go on vacation to a place where they cannot bring their cannabis products), claim that their products help them with their naturally low ECS tone. In many cases, however, these people suffer from a dependence or an addiction to the products. Always consult a medical professional for information on this topic. References:
  1. Akirav, Irit (2011). Role of the Endocannabinoid System in Anxiety and Stress-Related Disorders, Anxiety Disorders. Anxiety Disorders. InTech.
  2. Espejo-Porras, Francisco; Fernandez-Ruiz, Javier; de Lago, Eva (2018). Analysis of endocannabinoid receptors and enzymes in the post-mortem motor cortex and spinal cord of amyotrophic lateral sclerosis patients. Amyotrophic lateral sclerosis & frontotemporal degeneration, 1--10.
  3. Micale, Vincenzo; Tabiova, Katarina; Kucerova, Jana; Drago, Filippo (2015). Role of the Endocannabinoid System in Depression: from Preclinical to Clinical Evidence BT - Cannabinoid Modulation of Emotion, Memory, and Motivation. Cannabinoid Modulation of Emotion, Memory, and Motivation (97--129). Springer New York.
  4. Pisani, Valerio; Madeo, Graziella; Tassone, Annalisa; Sciamanna, Giuseppe; Maccarrone, Mauro; Stanzione, Paolo; Pisani, Antonio (2011). Homeostatic changes of the endocannabinoid system in Parkinson's disease. Movement Disorders, 26(2), 216--222.
  5. Vinod, K. Yaragudri; Hungund, Basalingappa L. (2006). Role of the endocannabinoid system in depression and suicide. Trends in Pharmacological Sciences, 27(10), 539--545.
  6. Russo, Ethan B. (2004). Clinical endocannabinoid deficiency (CECD): can this concept explain therapeutic benefits of cannabis in migraine, fibromyalgia, irritable bowel syndrome and other treatment-resistant conditions?. Neuro endocrinology letters, 25(1-2), 31--9.
  7. Smith, Steele Clarke; Wagner, Mark S. (2014). Clinical endocannabinoid deficiency (CECD) revisited: can this concept explain the therapeutic benefits of cannabis in migraine, fibromyalgia, irritable bowel syndrome and other treatment-resistant conditions?. Neuro endocrinology letters, 35(3), 198--201.
  8. Volfe, Z.; Dvilansky, A.; Nathan, I. (1985). Cannabinoids block release of serotonin from platelets induced by plasma from migraine patients. International journal of clinical pharmacology research, 5(4), 243--246.
  9. Izzo, Angelo A.; Fezza, Filomena; Capasso, Raffaele; Bisogno, Tiziana; Pinto, Luisa; Iuvone, Teresa; Esposito, Giuseppe; Mascolo, Nicola; Di Marzo, Vincenzo; Capasso, Francesco (2001). Cannabinoid CB 1 -receptor mediated regulation of gastrointestinal motility in mice in a model of intestinal inflammation. British Journal of Pharmacology, 134(3), 563--570.