What is arthritis?
Arthritis is one of the most common ailments in the US, affecting nearly 20 million individuals. This number is expected to reach 30 million by 2025. Arthritis is a blanket term that comes from the latin words for “joint inflammation.” It refers to hundreds of conditions that cause the breakdown or malfunction of the joints, but there are two overwhelmingly common types: rheumatoid arthritis and osteoarthritis. Both produce painful swelling and limit mobility of the affected joint.
There are no drugs that can reverse the painful effects of either type of arthritis, and NSAIDs are the most common form of treatment for arthritic pain. However, a brighter future is being painted as we speak. CBD has shown great potential in reducing the pain associated with arthritis, especially in rheumatoid arthritis, which is an autoimmune condition. It is the first substance that has shown extensive promise in actually addressing the underlying causes rather than the resultant pain.
What is osteoarthritis?
Arthritis refers to swelling of the joints. Osteo comes from the greek word meaning “bone.” Therefore, osteoarthritis refers to inflammation of the bone and the cartilage that protects it in the joint. Specifically, it occurs in the hips, knees, and fingers of people from middle age and on. Sometimes it is simply referred to as wear and tear, as it generally is the result of a lifetime of use, but then why do some people never experience the full pain of arthritis?
Even in osteoarthritis, inflammatory reactions to wear and tear are actually corrosive to the joint in their own way. Cartilage is comprised of protein, extracellular matrix (a mixture of proteins and growth factors), and chondrocytes. Chondrocytes are cells that maintain a slow but steady degradation and regeneration of the material around them. After significant trauma or years of use, due to genetic and other factors, these chondrocytes fall out of homeostasis. They continue to degrade tissue but fail to regenerate it at the same rate.
This results in a net loss of cartilage, and after enough progression the bone can become exposed, producing more inflammatory factors that perpetuate the cycle. It is well known that endocannabinoids are involved in homeostasis, and there is a higher level of the endocannabinoids anandamide and 2-AG in the cerebrospinal fluid of those with osteoarthritis. Some researchers believe this leads to overstimulation of cannabinoid receptors in joints, causing the cells to become unbalanced. CBD is able to moderate the levels of endocannabinoids produced and acts as an inhibitor on the receptors, blocking their corrosive action.
What is rheumatoid arthritis?
Rheumatoid arthritis (RA) occurs when the immune reaction that takes place in osteoarthritis goes unchecked by the homeostatic mechanisms in place to prevent it. In general, people with RA also express a gene that allows the cells that comprise their synovial lining to have larger gaps between them. In the case of immune activation near a joint, immune hormones and proteins that stimulate a further immune response are able to enter the synovial fluid through these gaps. Once inside, they are able to carry out a full on assault of the damaged joint.
The part that is still widely misunderstood is why there isn’t a stronger protection against this particular autoimmune reaction. For some reason, certain antigens called rheumatoid factors that are produced by damaged joint cells actually bind to the base of the MHC-II proteins on immune cells, rather than the antibody on their end that 99.9% of other antigens bind to. The body is incapable of making antibodies that target our own tissue, this is the basis of autoimmune prevention. Rheumatoid factors are able to go around this step by binding with the base of the protein and skipping the antibody altogether. For this reason, rheumatoid factors are able to induce an inflammatory immune response as though they were foreign pathogens instead of innate self-tissue.
Additionally, chondrocytes from the joints of RA patients at the time of joint replacement surgery show extremely high levels of apoptosis, or programmed cell death. This is abnormal for cartilaginous cells, and indicts the endocannabinoid system as a possible mediator of this debilitating disease. If an imbalance in endocannabinoids is one of the root causes, then surely that could explain why so many find relief from the symptoms of RA with CBD oil and other phytocannabinoid preparations.