Luckily, research is advancing at an incredible rate and there are some promising studies to show how cannabis can treat a variety of medical. It has also been approved by FDA for various orphan diseases for exploratory trials. CBD improved brain and liver function in a fulminant hepatic Ten to twelve-week-old female mice with weight over 25 g were subjected. The effect of cannabis use on chronic liver disease (CLD) from Hepatitis followed by alcoholic and nonalcoholic-fatty liver diseases (ALD and NAFLD) Interestingly, a recent study revealed that cannabidiol (CBD), the main.
Disease (ALD) CBD Alcohol For Disorders Liver and
In early May, a federal court declined to protect cannabidiol CBD , a chemical produced by the cannabis plant, from federal law enforcement, despite widespread belief in its medical value. The ruling was contrary to existing evidence, which suggests the chemical is safe and could have multiple important uses as medicine.
Many cannabis advocates consider it a miracle medicine , capable of relieving conditions as disparate as depression, arthritis and diabetes. The perception of its widespread medical benefits have made the chemical a rallying cry for legalization advocates.
The primary psychoactive ingredient in marijuana is tetrahydrocannabinol THC. But THC is only one of the scores of chemicals — known as cannabinoids — produced by the cannabis plant. So far, CBD is the most promising compound from both a marketing and a medical perspective. While studies have shown CBD to have anti-inflammatory, anti-pain and anti-psychotic properties , it has seen only minimal testing in human clinical trials, where scientists determine what a drug does, how much patients should take, its side effects and so on.
Despite the government ruling, CBD is widely available over the counter in dispensaries in states where marijuana is legal. The piece, reported by Dr Sanjay Gupta, featured a little girl in Colorado named Charlotte, who had a rare life-threatening form of epilepsy called Dravet syndrome.
At age five, Charlotte suffered grand mal seizures a week, and was constantly on the brink of a medical emergency. It was controversial to pursue medical marijuana for such a young patient, but when they gave Charlotte oil extracted from high-CBD cannabis, her seizures stopped almost completely. The frequency of the outcomes of the study including liver cirrhosis, complications of cirrhosis, mortality, liver cancer, and unfavorable discharge disposition were all lower among patients with cannabis use Table S1.
During propensity matching, 4, of 4, cannabis users were successfully matched to an equal number of nonusers Table S2. The frequencies of demographic and comorbid characteristics became statistically identical among the matched cannabis versus noncannabis users. Furthermore, matching eliminated the aOR for having cannabis use disorder with respect to different factors Table S3.
After matching, cannabis users had lower frequencies for liver cirrhosis and its complications, lower frequencies of higher Baveno4 scores, and unfavorable discharges. But the frequency of mortality and liver cancer were similar between cannabis users and nonusers Table 2. On regression analysis Table 3 and Figure 2 , when compared to nonusers, cannabis users had lower prevalence rate ratio for liver cirrhosis aPRR: They had a cirrhosis prevalence rate of Furthermore, cannabis users had decreased frequencies of ascites and portal hypertension, while other complications of cirrhosis were similar across noncannabis users.
The adjusted prevalence of liver cancer and in-hospital mortality was similar across both cannabis and noncannabis user groups.
While the LOS was similar among both groups 5. After redesigning the propensity matching with cirrhosis as a predictor of cannabis use, the associations between cannabis use and healthcare utilization was similar to the previous model, which did not match with cirrhosis, but adjusted for cirrhosis as a predictor Table S4.
Our study utilizing a large dataset spanning records from to of NIS revealed novel associations between cannabis use and chronic liver disease among HCV infected individuals. Using propensity matching to effectively eliminate many confounding differences, our studies revealed that cannabis use was associated with more favorable HCV infection outcomes. Compared to other population studies performed before , which all suggested that cannabis use resulted in steatosis and cirrhosis among HCV [ 12 — 14 ], our results revealed the contrary.
These three earlier studies had limited sample sizes , , and subjects and included patients with alcohol and tobacco use, which might have resulted in a different outcome compared to our study. Cannabinoids act through CB-1 and CB-2 receptors, with pro- and antifibrotic effects respectively. Early studies mostly rationalized with the fact that HCV was associated with a significant induction in hepatic CB-1 receptor expression [ 30 ].
Although these three newer studies had larger samples sizes , , and subjects , they did not eliminate many chronic liver diseases from diverse etiologies.
Our analysis extended on these previous studies in an attempt to overcome limitations of sample size and inclusions of liver disease from non-HCV infection and other synergistic etiologies. We also excluded other causes of CLD and used a more recent nationally representative dataset. Further, we additionally investigated a larger array of clinical outcomes and health care utilization indicators.
These actions might explain our findings of decreased hepatic cirrhosis and its attendant complications, which are all secondary to portal hypertension from cirrhosis. Likewise, cannabigerol, a nonpsychotropic component of cannabis thwarts the growth of colorectal cancer cells [ 33 ], and tetrahydrocannabinol inhibited glioblastoma cell growth both in vitro and in patients [ 34 ].
Both of these mechanisms and decreased prevalence of cirrhosis might explain why cannabis users had lower prevalence of liver carcinoma. We reveal that cannabis was associated with reduced unfavorable discharge and hospital cost.
These outcomes might be due to less burden of CLD because of the smaller frequency of cirrhosis and carcinoma. Cannabis has been shown to be related to lower mortality among hospitalized cancer patients [ 35 ].
In summary, the effect of cannabis on HCV disease might be multifaceted. First, cannabis might be directly toxic to hepatitis virus in vivo, as is recently shown in vitro [ 19 ].
Second, cannabis users might make HCV patients feel less nauseous and more motivated to take their other antiviral medications and another medical regimen [ 36 ]. Third, cannabis might be associated with decreased hepatic cirrhosis and complications of cirrhosis, thereby resulting in the lower cost and better discharge disposition outcomes among cannabis users.
Thee potential roles played by cannabis use on liver disease progression in HCV positive patients will require additional complementary evaluation by way of prospective studies. The major weaknesses in our study are the cross-sectional design, recall biases, coding errors in the ICDCM application, lack of information on medications such as antiviral therapies, type of cannabis ingested, mode of cannabis use oral versus inhalation , and sensitivity and specificity of ICDCM coding for cannabis use disorder.
Absence of data on which patients received the new direct-acting antiviral therapy is a significant limitation, given that these medications are extremely effective and significantly modulate the progress of HCV liver disease. We mitigated many of these errors by first eliminating other causes of CLD and using a propensity-matched analysis, which directly balanced and eliminated the effect of factors associated with cannabis use in the NIS and allowed a less biased estimation of our outcomes.
However, it is possible that additional unmeasured confounding factors might still impact our observations. These errors are likely to similarly impact both cannabis and noncannabis use groups and would likely decrease our observed effects on cannabis use and the incidence of CLD. Therefore, the true effect of cannabis use on HCV might be stronger than observed estimates in our current study.
Furthermore, the large size of the NIS data allowed us to conduct a very efficient propensity matching and to capture subjects from all over the USA, making our result more generalizable. Our novel study to the best of our knowledge represents the largest population-based study to assess the effect of cannabis use on CLD associated with HCV infection.
Our observations suggest cannabis use might have a positive impact in alleviating complications of portal hypertension, liver cancer, and disease outcomes among HCV infected individuals.
These novel findings require additional prospective and translational molecular research studies to decipher which specific active components of cannabis impact liver disease development during chronic HCV infection.
The relevant data can be accessed at the following link: The funders had no role in the project design, execution, data interpretation, or decision to publish. Canadian Journal of Gastroenterology and Hepatology. Indexed in Science Citation Index Expanded. Subscribe to Table of Contents Alerts. Table of Contents Alerts. Abstract Background and Aim.
Materials and Methods 2. Selection of Cannabis Cohort and Propensity Matching Variables All clinical attributes were either identified as variables demographics, region, and hospital factors in the dataset or retrieved from containing variables using the International Classification of Diseases, Ninth Revision, Clinical Modification ICDCM. Selection flow chart of study populations. Illustrative flow chart of how our study population was grouped for statistical analysis to determine the impact and disease outcomes among HCV infected individuals who use cannabis.
Baseline characteristics of chronic hepatitis C infected patients, by cannabis use status before propensity matching. Outcome characteristics by cannabis use status, after propensity matching. Comparison of liver disease and outcomes among HCV patients.
Adjusted estimates of liver disease, mortality, and outcomes of HCV patients.
Canadian Journal of Gastroenterology and Hepatology
Abbreviations: ALD, alcoholic liver disease; HCC, hepatocellular carcinoma; Exogenous cannabinoid (cannabidiol), Hepatic encephalopathy. Can cannabis protect the liver from alcoholic liver disease and cancer? Read all about the effects of cannabis on liver damage associated with. Cannabis does not appear to alter the course of disease in IBD (for better or Canadian Association of Gastroenterology Position Statement: Use of Cannabis in Gastroenterological and Hepatic Disorders . Cannabidiol (CBD) is a key component of cannabis that lacks . Alcoholic Liver Disease (ALD).