Non-Intoxicating Cannabinoids in Visceral Pain

Area of Science:

• Pharmacology and Gastroenterology
• Cannabinoid Science

Background:

• Cannabis products are increasingly used for inflammatory bowel disease (IBD) symptom management, especially abdominal pain.
• Existing research on cannabis for IBD primarily focuses on delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD), with mixed clinical results.
• THC acts on classical cannabinoid receptors (CBRs), while CBD and other nonintoxicating cannabinoids (niCBs) have broader mechanisms.

Purpose of the Study:

• To review preclinical data on niCBs for treating abdominal pain associated with IBD.
• To focus on the non-CBR mechanisms of action for niCBs in pain management.
• To explore the potential of niCBs to rectify abnormal intestinal motility and provide anti-inflammatory and analgesic effects.

Main Methods:

• Systematic review of preclinical studies investigating niCBs.
• Analysis of studies focusing on niCBs' interaction with non-CBR targets like transient receptor potential channels and voltage-gated ion channels.
• Examination of evidence supporting the entourage effect of combining niCBs.

Main Results:

• niCBs demonstrate potential for anti-inflammatory and analgesic effects relevant to IBD.
• Many niCBs exert therapeutic effects through non-CBR pathways, targeting ion channels and other receptors.
• The entourage effect suggests that combining niCBs may enhance their therapeutic potency.

Conclusions:

• niCBs represent a promising therapeutic avenue for IBD-related abdominal pain, distinct from THC and CBD.
• Their non-psychotropic nature and diverse mechanisms of action, particularly non-CBR pathways, warrant further investigation.
• Future research should explore the clinical efficacy and optimal combinations of niCBs for IBD symptom management.