CBD for Asthma
What is Asthma
Asthma is the most common chronic disease among children globally with over 339 million people living with asthma worldwide. And according to the World Health Organization, asthma is vastly under-diagnosed and under-treated, creating a substantial burden to both individuals and families, often restricting the individuals’ activities for a lifetime.
Characterized by restricted breathing, asthma is often misdiagnosed as allergies as the symptoms are very similar and mostly only seen when triggered. However, even when asymptomatic, asthma is a chronic inflammatory disease affecting the lungs that is always present.
Anyone can develop asthma, although it seems that some people are more susceptible and may experience more severe symptoms. For example, although asthma is more common in children, compared to adults, they are four times less likely to die from it. Moreover, boys are more likely than girls to develop asthma, but women are more likely to get asthma than men. So, although the cause of asthma is still presently unknown, because of these patterns, genetic abnormalities are considered the most likely factor.
Pathophysiology of Asthma
In healthy individuals, allergens generally cause few minimal problems. However, in asthma patients, an allergen or other substance entering the lungs causes the immune system to perceive the substance as foreign, triggering an abnormal immune and inflammatory response as well as a hyper-reactivity of the airways.
It is this inflammation in the bronchial tubes that is the primary characteristic of asthma is characterized by inflammation. This bronchial inflammation is caused by immune cells called T-helper cells (Th1 and Th2) that produce pro-inflammatory proteins called cytokines that are produced when the lungs experience a trigger. These rising levels of cytokines, IL-13 in particular, also results the secretion of excess mucus that further obstructs to the airways. And finally, the airways of asthma patients also then to contract too much and too easily when triggered, which together causes wheezing, chest tightness, and other asthmatic symptoms.
Symptoms of Asthma
Symptoms can be triggered by allergens and non-allergens alike, with the most common symptoms including:
- Coughing, wheezing, shortness of breath
- Chest tightness and difficulty breathing
- Shortness of breath
- Tightness, pain, or pressure in your chest
- Trouble sleeping because of breathing problems
Because an asthma attack can get worse quickly, it's important to recognize and treat the symptoms of an asthma attack immediately. These include:
- Severe wheezing when breathing both in and out
- Coughing that won't stop
- Very rapid breathing
- Chest pain or pressure
- Tightened neck and chest muscles, called retractions
- Difficulty talking
- Feelings of anxiety or panic
- Pale, sweaty face
- Blue lips or fingernails
Asthma Classification & Types
Doctors rank how bad asthma is by its symptoms and as follows:
Mild intermittent asthma: Mild symptoms less than twice a week with nighttime symptoms occurring less than twice a month
Mild persistent asthma: Symptoms three to six times a week with nighttime symptoms occurring three to four times a month. Asthma attacks might also affect activities.
Moderate persistent asthma: Symptoms three to six times a week with nighttime symptoms occurring three to four times a month. Asthma attacks might also affect activities.
Severe persistent asthma: Ongoing symptoms that occur both day and night and notably limit activities.
Types of asthma include:
- Adult-onset asthma that can start at any age, but it's more common in people younger than 40
- Status asthmaticus which are long-lasting asthma attacks that don’t go away when using bronchodilators that are medical emergencies that need treatment right away
- Asthma in children
- Exercise-induced bronchoconstriction that happens during physical activity, when breathing in air that’s drier than what’s in the body causing airways to narrow
- Allergic asthma triggered by allergens
- Nonallergic asthma that flares in extreme weather (e.g., heat of summer or the cold of winter)
- Occupational asthma that usually affects people who work around chemical fumes, dust, or other irritating things in the air
- Eosinophilic asthma which is a severe form marked by high levels of white blood cells called eosinophils. It usually affects adults between 35 and 50 years old.
- Nocturnal asthma where symptoms get worse at night
- Cough-variant asthma which, unlike with other types, the only symptom is a long-term cough
Asthma Medications & Treatments
If left undiagnosed or not properly treated, asthma can lead to death. There is currently no cure for asthma, with medications and treatments focussing on symptoms management.
Patients will often have two medications on hand. One medication is usually for long-term disease management, often including corticosteroids, such as Symbicort, Flovent, and Advair.
However, steroids are powerful drugs and can be dangerous if misused. The second type of medication is quick-acting medication called bronchodilators for the fast relief of symptoms. These are designed to open up the airways and help remove mucus.
If used too long, these medications may cause significant side effects such as infections in the mouth, dental problems, a weakened immune system, diabetes, and even stunted growth in children. Additionally, many patients cannot control or can only partially control their asthma with medication. Especially in cases of severe asthma, patients find little to no relief with medication.
CBD for Asthma
Research and Scientific Evidence on taking CBD for asthma
The clinical evidence for Cannabidiol (CBD) as a viable treatment option for Asthma is in its infancy, but promising, with much of the data illustrating the effects of CBD and the endocannabinoid system (ECS) on asthma.
Activation of cannabinoid receptors prevents antigen-induced asthma-like reaction in guinea pigs
A 2008 animal study published in the Journal of Cellular and Molecular Medicine, researchers evaluated the effects of the CB1 and CB2 receptor agonist CP55, 940 (CP) on antigen-induced asthma-like reaction in sensitized guinea pigs. In addition, they also tested the ability of the CB2 receptor antagonist SR144528 (SR) and CB1 receptor antagonist AM251 (AM) to interfere with the effects of CP.
Lung tissue samples from guinea pigs who displayed clear-cut asthma-like reactions to the inhaled antigens were taken for histopathological and morphometric analyzes along with other immunological and inflammatory parameters, CB1 and CB2 receptor protein expression. From the data, the researchers posited that there is clear evidence that the cannabinoid receptor agonist CP55,940 (CP) is able to counteract the allergen-induced functional, biochemical and histopathological lung changes in a guinea pig model of allergic asthma.
They concluded that non-psychoactive cannabinoid analogues (such as CBD) may present with bronchodilator and anti-inflammatory activity via the selective targeting of CB1 and CB2 receptors. This could mean that the therapeutic use of these cannabinoids as adjuncts in the treatment of allergic asthma warrants attention.
Evaluation of Serum Cytokines Levels and the Role of Cannabidiol Treatment in Animal Model of Asthma
In a 2015 study published in Mediators of Inflammation, researchers evaluated the role of serum cytokine levels in an animal model of asthma, and the potential anti-inflammatory role of CBD in its treatment.
Twenty-one rats were split into three groups: a control group, an asthma control group, and a final asthmatic group receiving 5 mg/kg of CBD. A serum cytokine assay was performed to measure the levels of several cytokines in the serum of the rats. They found that CBD treatment inhibited the both the production of all but one cytokine as well as blunted Th1 and Th2 responses, indicating that CBD has potent immunosuppressive and anti-inflammatory properties.
The researchers concluded that CBD demonstrated a protective effect on inflammatory responses in the animal model of asthma. In addition, they found CBD inhibits the production of the cytokines implicated in mucus hyper-secretion, an important characteristic of asthma and contributes to the exacerbation of symptoms. They concluded that their findings suggest a potential for a new asthma treatment since CBD controls the exaggerated inflammatory response that could very well translate to humans.
Cannabidiol reduces airway inflammation and fibrosis in experimental allergic asthma
In another, larger animal study from 2019 and published in the European Journal of Pharmacology, researchers investigated the role of CBD in reducing airway inflammation and fibrosis in experimental allergic asthma.
The researchers induced allergic asthma in 140 mice. They analyzed respiratory mechanics, collagen fiber content in airway and alveolar septa, cytokine levels, and CB1 and CB2 expression to evaluate the effects of CBD on these parameters. Moreover, expressions of CB1 and CB2 in induced sputum of asthmatic individuals and their correlation with airway inflammation and lung function were also evaluated.
They found that CBD treatment, regardless of dosage, decreased airway hyper-responsiveness. However, static lung elastance was only reduced with high dosages. They also found that there was a significant decrease in collagen fiber content as well as the markers associated with inflammation. In asthmatic patients, the data indicated that there was a marked, inverse correlation between CB1 levels and lung function.
This lead them to conclude that CBD treatment decreased the inflammatory and remodeling processes in the model of allergic asthma, with the mechanisms of action appearing to be mediated by CB1/CB2 signaling. However, the protective CBD effects on the inflammatory response appear to be more complex, and generally independent of receptor agonism.
Anecdotal Evidence on CBD use for asthma
Anecdotal evidence suggests that some asthma sufferers need to use their rescue inhalers less frequently when vaporizing or nebulizing CBD. Similarly, those who have tried CBD oil or capsules found that it seems to have reduced the frequency and intensity of attacks and improve breathing.
CBD as a Complementary Treatment for asthma
Many people suffering from asthma also report having sleep problems, feelings of anxiety and depression. In one large case series study investigating the effects of CBD on anxiety and sleep, the results indicate CBD helps improve sleep and/or anxiety in clinical populations. Similarly, CBD can further support asthma sufferers by reducing stress, anxiety, depression while also helping to promote REM sleep that is thought to help improve overall mood.
Scientific and anecdotal evidence both suggest that CBD can support asthma sufferers with researchers having shown its potential to reduce bronchial inflammation, inhibit mucus production and prevent airway obstruction. However, it is also important to remember that asthma is a serious, chronic condition which can have a short as well as long-term impact on health. If you or a loved one are suffering from asthma and want to try CBD, talk to your medical practitioner first. He or she can help put together a plan that includes CBD along with other treatment options to help you deal with it safely and effectively.