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Cancer-specific Cytotoxicity of Cannabinoids
By: Dennis Hill
First let's look at what keeps cancer cells alive, then we will
come back and examine how the cannabinoids CBD (cannabidiol) and THC
(tetrahydrocannabinol) unravels cancer's aliveness.
In every cell there is a family of interconvertible
sphingolipids that specifically manage the life and death of that cell.
This profile of factors is called the "Sphingolipid Rheostat." If
ceramide (a signaling metabolite of sphingosine-1- phosphate) is high,
then cell death (apoptosis) is imminent. If ceramide is low, the cell
will be strong in its vitality.
Very simply, when THC connects to the CB1 or CB2 cannabinoid
receptor site on the cancer cell, it causes an increase in ceramide
synthesis which drives cell death. A normal healthy cell does not
produce ceramide in the presence of THC, thus is not affected by the
cannabinoid.
The cancer cell dies, not because of cytotoxic chemicals, but
because of a tiny little shift in the mitochondria. Within most cells
there is a cell nucleus, numerous mitochondria (hundreds to thousands),
and various other organelles in the cytoplasm. the purpose of the
mitochondria is to produce energy (ATP) for cell use. As ceramide starts
to accumulate, turning up the Sphingolipid Rheostat, it increases the
mitochondrial membrane pore permeability to cytochrome c, a critical
protein in energy synthesis. Cytochrome c is pushed out of the
mitochondria, killing the source of energy for the cell.
Ceramide also causes genotoxic stress in the cancer cell nucleus
generating a protein called p53, whose job it is to disrupt calcium
metabolism in the mitochondria. If this weren't enough, ceramide
disrupts the cellular lysosome, the cell's digestive system that
provides nutrients for all cell functions. Ceramide, and other
sphingolipids, actively inhibit pro-survival pathways in the cell
leaving no possibility at all of cancer cell survival.
The key to this process is the accumulation of ceramide in the
system. This means taking therapeutic amounts of cannabinoid extract,
steadily, over a period of time, keeping metabolic pressure on this
cancer cell death pathway.
How did this pathway come to be? Why is it that the body can
take a simple plant enzyme and use it for healing in many different
physiological systems? This endocannabinoid system exists in all animal
life, just waiting for it's matched exocannabinoid activator.
This is interesting. Our own endocannabinoid system covers all
cells and nerves; it is the messenger of information flowing between our
immune system andthe central nervous system (CNS). It is responsible
for neuroprotection, and micro- manages the immune system. This is the
primary control system that maintains homeostasis; our well being.
Just out of curiosity, how does the work get done at the
cellular level, and where does the body make the endocannabinoids? Here
we see that endocannabinoids have their origin in nerve cells right at
the synapse. When the body is compromised through illness or injury it
calls insistently to the endocannabinoid system and directs the immune
system to bring healing. If these homeostatic systems are weakened, it
should be no surprise that exocannabinoids perform the same function. It
helps the body in the most natural way possible.
To see how this works we visualize the cannabinoid as a three
dimensional molecule, where one part of the molecule is configured to
fit the nerve or immune cell receptor site just like a key in a lock.
There are at least two types of cannabinoid receptor sites, CB1 (CNS)
and CB2 (immune). In general CB1 activates the CNS messaging system, and
CB2 activates the immune system, but it's much more complex than this.
Both THC and anandamide activate both receptor sites. Other cannabinoids
activate one or the other receptor sites. Among the strains of
Cannabis, C. sativa tends toward the CB1 receptor, and C. indica tends
toward CB2. So sativa is more neuroactive, and indica is more
immunoactive. Another factor here is that sativa is dominated by THC
cannabinoids, and indica is predominately CBD (cannabidiol).
It is known that THC and CBD are biomimetic to anandamide, that
is, the body can use both interchangeably. Thus, when stress, injury, or
illness demand more from endogenous anandamide than can be produced by
the body, its mimetic exocannabinoids are activated. If the stress is
transitory, then the treatment can be transitory. If the demand is
sustained, such as in cancer, then treatment needs to provide sustained
pressure of the modulating agent on the homeostatic systems.
Typically CBD gravitates to the densely packed CB2 receptors in
the spleen, home to the body's immune system. From there, immune cells
seek out and destroy cancer cells. Interestingly, it has been shown that
THC and CBD cannabinoids have the ability to kill cancer cells directly
without going through immune intermediaries. THC and CBD hijack the
lipoxygenase pathway to directly inhibit tumor growth. As a side note,
it has been discovered that CBD inhibits anandamide reuptake. Here we
see that cannabidiol helps the body preserve its own natural
endocannabinoid by inhibiting the enzyme that breaks down anandamide.
This brief survey touches lightly on a few essential concepts.
Mostly I would like to leave you with an appreciation that nature has
designed the perfect medicine that fits exactly with our own immune
system of receptors and signaling metabolites to provide rapid and
complete immune response for systemic integrity and metabolic
homeostasis.
~Dennis Hill
Bibliography
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NIH Public Access: A house divided: ceramide, sphingosine, and
sphingosine-1-phosphate in programmed cell death Tarek A. Taha, Thomas
D. Mullen, and Lina M. Obeid Division of General Internal Medicine,
Ralph H. Johnson Veterans Administration Hospital, Charleston, South
Carolina 29401; and Department of Medicine, Medical University of South
Carolina, Charleston, South Carolina 29425 Corresponding author: Lina M.
Obeid, M.D., Department of Medicine, Medical University of South
Carolina, 114 Doughty St., P.O.Box 250779, Charleston, South Carolina
29425. E-mail: obeidl@musc.edu