CEREBRAL EDEMA AND INTEGRITY OF THE BLOOD BRAIN BARRIER AT END-OF-LIFE
Individuals with cerebral edema frequently experience a dying process that is marked by dysregulation and agony. Many people are unable to find a physical position that supports even a few moments of rest, and many die exhibiting signs of excruciating pain. These individuals often have respiratory distress that is extremely difficult to manage. Steroids provide significant improvement for many, and relief for some, but a modulator of the blood-brain barrier (BBB) during the dying process might improve EOL outcomes for this group of individuals.
The ECS is a modulator of the BBB. Mechoulam (2010) reports that 2-AG reduces cerebral edema and inflammation following trauma to brain tissue by supporting BBB integrity. Through this mechanism, the influx of cytokines, reactive oxygen intermediates, and glutamate into brain tissue is reduced. Fujii et al. (2014) report that CB1 receptor activity reduces cerebral edema by minimizing infiltration of leukocytes through the BBB following brain injury in an animal model. Hind et al. (2015) report in vitro evidence that eCBs are protective in the context of stroke and may be important in normal BBB physiology.
AN EOL-FOCUSED REVIEW OF THC, CBD, AND THCA AS A FEW OF MANY POTENTIAL TARGETERS OF THE ECS
Both THC and CBD have been shown to be neuroprotective in animal studies, with anti-glutamatergic and anti-inflammatory effects (Hampson et al. 1998). Additionally, both THC and CBD have been shown to have an anti-oxidant effect, which in turn, decreases glutamate (Hampson et al. 2000). CBD’s anti-oxidant effect is more powerful than Vitamin C or E (McPartland & Russo 2001). All compounds in cannabis are lipid soluble and are known to easily cross the BBB.
Wide attention was brought to the therapeutic benefits of combining THC and CBD by Russo and Guy (2006).
33