In ulcerative colitis patients, endocannabinoid levels dropped significantly in the placebo group over 8 weeks but remained stable in cannabis-treated patients, with changes correlating to symptom improvements.
Gastroenterologists, IBD researchers, endocannabinoid system scientists
Endocannabinoid levels declined in placebo-treated UC patients but remained stable with cannabis
What the researchers found
In UC patients treated with placebo, levels of PEA, AEA, and arachidonic acid decreased significantly over 8 weeks, while levels remained stable in cannabis-treated UC patients. Reduction in bowel movements correlated with changes in AEA and OEA, and quality-of-life improvement correlated with 2-AG levels.
Why it matters
This study provides mechanistic evidence that cannabis may work in UC by modulating endocannabinoid tone, offering a biological explanation for symptom improvement and potentially guiding more targeted cannabinoid therapies.
The numbers in context
13 Crohn's and 9 UC patients received cannabis; 17 CD and 10 UC received placebo; PEA, AEA, and AA decreased significantly in UC placebo group; endocannabinoid levels stable in cannabis-treated UC; FAAH levels increased in UC biopsies; symptom correlations with AEA, OEA, and 2-AG.
How the study worked
Sub-analysis of a randomized controlled trial examining endocannabinoid levels in blood and colon biopsies from IBD patients treated with cannabis or placebo for 8 weeks, plus in vitro Caco-2 cell experiments.
What this study cannot tell us
Very small sample sizes per group; sub-analysis of a larger trial; blood endocannabinoid levels may not reflect tissue-level changes; Crohn's patients showed no endocannabinoid changes.
How to read the evidence
Sub-analysis of RCT with very small sample sizes, providing preliminary mechanistic evidence.
When this study was published
Data from 8-week cannabis vs placebo trial.
The bigger picture
Understanding how cannabis affects endocannabinoid signaling in inflammatory bowel disease could lead to treatments that target specific cannabinoid pathways without requiring whole-plant cannabis.
Questions still open
- Why did cannabis affect endocannabinoid levels in UC but not Crohn's disease? Would targeted endocannabinoid-modulating drugs be as effective as whole-plant cannabis?
Common questions
Does cannabis help ulcerative colitis?
What are endocannabinoids?
Read the original research
Endocannabinoid Levels in Ulcerative Colitis Patients Correlate With Clinical Parameters and Are Affected by Cannabis Consumption.
Frontiers in endocrinology, 12, 685289
Citation
Tartakover Matalon, Shelly; Azar, Shahar; Meiri, David; Hadar, Rivka; Nemirovski, Alina; Abu Jabal, Narjes; Konikoff, Fred Meir; Drucker, Liat; Tam, Joseph; Naftali, Timna. (2021). Endocannabinoid Levels in Ulcerative Colitis Patients Correlate With Clinical Parameters and Are Affected by Cannabis Consumption.. Frontiers in endocrinology, 12, 685289. https://doi.org/10.3389/fendo.2021.685289
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