CBD and Alzheimer’s Disease

One of the most cited items that CBD can address behind epilepsy is Alzheimer’s Disease.  How is it that CBD could relate to that disease?

What is CBD?

As a quick review, Cannabidiol (CBD) is a compound that comes from the hemp plant family.  Unlike its cousin, THC, it is safe, non-addictive, and legal in most states. CBD has become a very popular item for people to take to help with a variety of ailments.

There actually is quite a list of items that CBD is purported to help with: Alzheimer’s Disease, Vascular Dementia, Dementia with Lewy bodies (DLB), Parkinson’s Disease, Frontotemporal Dementia and Huntington’s Disease.  Research is currently ongoing at many reputable institutions including the National Institute of Health and the National Institute for Aging.

What is Alzheimer’s Disease?

According to the Alzheimer’s Association, here are 10 Early Symptoms of Alzheimer’s:

  1. Memory loss that disrupts daily life
  2. Challenges in planning or solving problems
  3. Difficulty completing familiar tasks at home, at work, or leisure
  4. Confusion with time or place
  5. Trouble understanding visual images and spatial relations
  6. New problems with words when speaking or writing
  7. Misplacing things and losing the ability to retrace steps
  8. Decreased and poor judgement
  9. Withdrawal from work and social activities
  10. Changes in mood and personality

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Let’s discuss Alzheimer’s Disease.  It is the most common cause of dementia. This is a general term for memory loss and other cognitive disabilities serious enough to interfere with daily life. Sixty to eighty percent of dementia is actually Alzheimer’s Disease.  The biggest risk factor is age, but over 200,000 people have early onset Alzheimer’s, and it appears this rate may be increasing. The concerning reality is that as the baby boomer wave ages, there is expected to be a tripling in Alzheimer’s Disease in the next 50 years.  This is a progressive disease and worsens with time. At the moment, there is no cure. All current treatment is geared to slow progression.

The most common early symptom is not remembering newly learned information.  That’s because the disease targets the part of the brain that affects learning. Unfortunately, as the disease progresses it impacts more and more of the brain’s functions. Disorientation, mood and behavior changes begin to occur with more frequency.  Then, there is a deepening confusion about events, and suspicion of friends, family, and caregivers starts. Finally, there’s difficulty speaking and swallowing.

When studied via autopsy, people with Alzheimer’s have plaques (holes) throughout their brain tissue.  It is this severe brain destruction which causes the many symptoms associated with Alzheimer’s. Recent studies have shown that CBD can reduce or remove the impact of oxygen build-up and other inflammation-related impacts. In addition, it has been shown that CBD, through its interaction with CB2 receptors in the brain, actually promotes growth and development of brain cells.  Consider that for a moment – the disease kills brain cells and destroys the brain’s physical structure, but CBD builds it up.

What do studies show regarding CDB and Alzheimer’s?

In a study conducted on transgenic mice with Alzheimer’s, long-term treatment with CBD was shown to prevent development of social recognition memory deficits. This study, published in 2014, stated that Alzheimer’s Disease typically has a wide variety of brain issues: Impairments in cognitive ability and widespread pathophysiological changes caused by neurotoxicity, neuroinflammation, oxidative damage, and altered cholesterol homeostasis. Other studies have shown that CBD can reverse some of these problems by impacting inflammation and oxidative repairs.  This study considered whether long-term exposure to CBD would actually prevent the damage. They found that social recognition deficit which normally developed in the mice was prevented through long-term treatment.

In an older study from 2004, CBD was shown to have a neuroprotective effect on cells. In Alzheimer’s, there is a type of damage that occurs called beta-amyloid-induced toxicity.  Research has shown that exposure to a protein called beta-amyloid causes brain cells to become toxic and die.  This was shown to be caused by oxidation, increased enzyme destruction, DNA fragmentation and increased cellular calcium.  In this study, they pretreated cells with CBD and then exposed them to beta-amyloid. The results showed that cellular survival was drastically increased, and it was due to reversal or prevention of the same damage noted without pretreatment.  In other words, treatment with CBD helped prevent or stop damage that is typically seen in Alzheimer’s disease patients. It must be kept in mind that this study was on rat brain cells in culture dishes, not in rats or humans. So, there is a leap to live human brains.

In 2007, a study showed that when live mice were injected with a brain damaging peptide (like study above, but with live mice brains) and then treated with CBD damage was significantly less than those injected with just a placebo. In fact, the protection was “dose dependent” meaning that it related to the amount of CBD given, so that it most likely was a result of the CBD and nothing else.

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A more recent study from 2017, reviewed laboratory and clinical studies on the potential role of CBD in Parkinson’s disease (PD), Alzheimer’s disease (AD), multiple sclerosis (MS), Huntington’s disease (HD), amyotrophic lateral sclerosis (ALS), and cerebral ischemia. This showed that pre-clinical data supports CBD improving PD, AD and MS patients.  However, the data set is small, and it is suggested that many more larger studies are needed to make these specific claims. It did suggest that treatment for epilepsy is supported and that clinical studies supporting various products about to come on the market were justified.

In a second article from 2017, pretreatment of mesenchymal cells with CBD offered protection against damage. It is interesting to note that this study is suggesting that proteins are changed at the level of RNA transcription via downregulation in the presence of CBD.  This is saying that having CBD present impacts the cellular mechanisms to protect the cells from damage that would otherwise occur. They also showed by microscopic study of brain tissue that CBD stopped the appearance of a specific protein that is associated with damage in Alzheimer’s Disease patients.

In a third article from 2017, it was shown that CBD treatment to live animals with Alzheimer’s Disease were also protected, and that the treatment was enhanced when taken with THC, and further that the psychotropic effects of the THC were muted by the CBD.  This is an interesting study in that it occurred in live animals with fully intact brains. It also demonstrated proof of principal that CBD is protective in Alzheimer’s Disease affected animals.

One of the more recent articles has drawn an interesting conclusion related to THC.  As you recall, this is the active material in marijuana that causes a person to get high.  This study showed that THC not only inhibited the enzyme that is related to the build up of beta amyloid proteins, but also kept them from aggregating. This means that the build up of the damaging protein is considerably lessened.  This is a very new concept that is actively being pursued.

Why aren’t we moving faster on this?

The biggest block to further studies of THC and CBD as potential major drugs in the Alzheimer’s arsenal is the federal government.  At the moment, marijuana is still listed as a Class 1 controlled substance. This puts it in the same class as LSD and Heroin. Class 1 means that there is no currently accepted medical use, a lack of accepted safety for use under medical supervision and a high potential for abuse. Any organization receiving Federal Money (for example NIH grants) is not able to study more than 1 milligram.  For comparison, the low-dose aspirin many take to combat heart issues is about 80 mg. If a clinical study were done on thousands of patients taking just 1 mg/day you would need more than 2 pounds per day.  Clearly, for there to be a medical future for THC we need to get some changes in this policy. However, current federal law (though not the current administration’s interpretation of that law) says that CBD oils derived from hemp are legal.

Bottom Line

In conclusion, there have been many studies related to CBD as a treatment or protective agent for patients with Alzheimer’s Disease.  These have shown reasons from a molecular perspective that CBD has provided protection. We know the disease is related to the buildup of beta amyloid proteins in the brain.  Some recent studies have suggested that THC can actually remove these proteins, and that CBD can lessen the psychotropic effects of THC and offer protection against the oxidation and other cellular damage that results from this protein build up.  While it should never be considered at this point in time that CBD is a treatment for Alzheimer’s Disease, and certainly in no way is it an approved treatment, it is clear that there is a very promising possibility that CBD could become a key piece in the complicated disease known as Alzheimer’s Disease.

References:

  1. https://www.ncbi.nlm.nih.gov/pubmed/25024347
  2. https://www.ncbi.nlm.nih.gov/pubmed/15030397
  3. https://www.ncbi.nlm.nih.gov/pubmed/17592514
  4. https://www.ncbi.nlm.nih.gov/pubmed/28412918
  5. https://www.mdpi.com/1422-0067/18/1/26
  6. https://www.ncbi.nlm.nih.gov/pubmed/28217094
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2562334/

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Dr. Harry Zollars (Pharm D)

Harry, COO of Skollarz LLC, is a practicing Pharmacist with over 5 years of experience in the community setting. He graduated highest honors with a Doctor of Pharmacy and a Specialization in Pharmacy Education and a Certificate in Pharmacy Informatics.In addition to his academic career, he was an integral part of several research labs that studied organic chemistry synthesis modifications as well as analyzing and defining structural activity relationship maps of somatostatin derivatives.Harry is currently a Pharmacy Manager, Secretary of the Illinois Pharmacist Association Executive Board, Lead Luminary of the Illinois Community Pharmacy Enhanced Network, Adjunct Pharmacy School Professor, and Pharmacy School Advisory Board Member.He recently was awarded the IPhA Distinguished Young Pharmacist Award.

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