Are Cannabinoids the Next Generation of Bone Drugs?

Friday, June 11th, 2010

The original version of this article first appeared in the Lab Bench Science Column of the West Coast Leaf NewsPaper on June 4th 2010.

The Lab Bench

By Jahan Marcu

A research team from the School of Medicine at Temple University, Philadelphia, presented their preliminary cannabinoid and bone data at a scientific meeting in Anaheim, CA in April. Our results add to a growing body of scientific evidence, suggesting a prominent role for the endocannabinoid system in bone development.  For the last year, researchers have been trying to reproduce and build upon previous work on cannabinoids and bone, specifically, by characterizing the effects of removing the CB1 and CB2 receptors from mice.

Few labs have published new discoveries regarding cannabis and bone. However, those that have are surprising so far. Some findings are so profound that the upcoming International Cannabinoid Research Society (ICRS) meeting will have a special symposium to discuss the bone data produced by just a few laboratories.

Research shows that bone cells have cannabinoid receptors and produce endocannabinoids. Bone cells express a lot of CB2 receptors and nerves that traverse our bones produce CB1 receptors. The `anti-cannabinoid’ receptor, GPR55, is also expressed in bone.

These receptors appear to work together to regulate bone health. Some clinical evidence supports the role of cannabinoids in various diseases. The Clinical Endocannabinoid Deficiency (Russo 2004) is thought to underlie many treatment- resistant conditions such as irritable bowel syndrome, fibromyalgia, and chronic pain. Recently, CB1 receptor mutations were linked to migraines, bi-polar disorder, and major depression (Monteleone 2010).

Now CB2 receptor mutations may be linked to lower human bone density and hand-bone strength. Research from Japan and France shows that mutations correlate to osteoporosis in post-menopausal women. The two studies looked at 2,626 elderly adults with and without osteoporosis. A study out in Russia analyzed the hand-bone strength of 574 adults and found that those with CB2 receptor muta- tions had weaker hand-bone strength (Yamada 2007, Karsak 2005, 2009). These all suggest that a less functional receptor is related to poor bone health.

Researchers have been studying how the body responds to traumatic brain injuries (TBI). When TBI occurs in a mouse, endocannabinoids are made and new bone is formed. Thus, cannabinoids may enhance the healing of bones in some instances such as fractures.

Genetically modified mice without the cannabinoid receptors have a deregulated skeleton. Depending on genetic makeup, the animals make too much or too little bone. So, research has shown that cannabinoids can both increase and decrease bone mass. However, all mice without cannabinoid receptors eventually develop severe osteoporosis (Bab 2008).

Plant cannabinoids such as CBDV, CBG, CBN, THC, and THCV may increase the number of bone stem cells in rats (Scutt 2007). Conversely, Anandamide has been shown to increase bone turnover by acti- vating osteoclasts, the cells that remodel or dissolve bone. CBD can inhibit osteoclasts. The infamous diet drug Rimonabandt, or SR141716A, is thought to prevent bone loss in mice by activating GPR55, not the CB1 receptor. Additionally, derivatives like WIN55,212 and some JWH compounds appear to severely inhibit osteoclasts from remodeling bone. Researchers have already speculated that cannabinoids represent a new generation of drugs that could treat a variety of bone diseases. For more information check out this recent review of the scientific literature, which discusses the role of the endocannabinoid system in bone disease and pathology.

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Disclaimer: These views are strictly the views of the author and not those of Temple University or its units.
This blog is not intended to diagnose or treat any disease.

CB2 Receptor Mutations Linked to Bone Health

Monday, September 7th, 2009

Genetic variations, polymorphisms, or mutations on the gene for the Cannabinoid Type 2 (CB2) Receptor have been linked to osteoporosis, low Bone Mineral Density (BMD), and hand bone strength in case controlled Studies (Yamada 2007, Karsak 2005, and Karsak 2009).

Most cannabinoid research on bone has been conducted in rats and mice. These recent case controlled studies in humans have established a significant association between CB2 gene polymorphisms/mutations to certain bone phenotypes; Mutant CB2 receptors lead to bad bones.

The first study (Karsak 2005) looked at CB1 and CB2 receptor DNA in a sample of French post-menopausal patients and female controls. The authors report that certain changes in CB2 receptor, but not the CB1 receptor, were strongly associated with osteoporosis. The authors claim this is the first study to find a link between the CB2 receptor and a disease in human patients. A study published out of Japan replicated these findings in 2007, in a group of pre and post menopausal women.

Furthermore, it has been speculated that CB2 receptor activation can inhibit atherosclerotic plaques. Atherosclerosis is a late onset disorder, that is inversely correlated to bone mineral density.  If your bone density or strength starts decreasing, atherosclerosis progresses. So, CB2 receptor variations could explain the association between the two disorders. THC has already been shown to reduce atherosclerosis in mice by activating the CB2 receptor.

The third study on CB2 genes in humans, examined the role of CB2 DNA or genes on hand bone strength. The author took radio-graphic images and DNA samples from a Chevashian population, an ethnically homogeneous population of people of Bulgaric ancestry that live along the Volga river.

The authors found several recurring, small mutations or SNPs (Small Nucleotide Polymorphisms) were significantly associated certain bone phenotypes. Basically, a less functional form of the CB2  receptor leads to weak hand bone strength.

These studies have showed that the effects of CB2 receptor gene variations have been observed in three different genetic/ethnic backgrounds. Thus supporting a link between the CB2 receptors in humans and bone health. Drugs that activate this receptor are of medical value and importance.

While it appears that cannabinod receptor activation may be positively associated with bone health, no studies have been approved for observing the long term effects of cannabis use/ receptor activation on bone health. An anecdotal answer could be easily derived by comparing different measurements of bone health in long term cannabis users vs. non-users.
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Thanks,
Jahan