Recent research has highlighted a potential role for CBD in reducing lung damage caused by acute respiratory distress syndrome (ARDS) – a common condition seen in patients with COVID-19, lung infections, severe pneumonia, and other respiratory diseases or injuries.
Cannabidiol (CBD) is one of over a hundred naturally occurring compounds found in hemp and cannabis. But unlike other cannabinoids such as THC, CBD is completely non-intoxicating.
It has long been suggested that CBD can have anti-inflammatory properties due to the molecules’ ability to interact with the human endocannabinoid system – a signaling network between cells that can control immune responses.
Recent studies in animals have confirmed that CBD can be used to treat excessive lung inflammation seen in ARDS and other respiratory illnesses.
Studies Suggest CBD can Reduce ARDS-Associated Lung Damage
Early research from the Medical College of Georgia at Augusta University has recently shown that pure CBD can help the lungs recover from ARDS and restore healthy oxygen levels.
“ARDS is a major killer in severe cases of some respiratory viral infections, including [COVID-19],” said immunologist and study author Babak Baban. “We have an urgent need for better intervention and treatment strategies.”
ARDS triggers what researchers call a “cytokine storm.” Cytokines are important molecules secreted by immune cells to communicate and coordinate recovery efforts.
However, in ARDS there is an overproduction of these cytokines, creating a dangerous overactive immune response. In the confusion, immune cells can begin inadvertently attacking the lungs, furthering the damage.
No cure is currently available for ARDS, and most patients with ARDS will require ventilator support. Mechanical ventilators can take over the breathing functions of the patient, giving the lungs a chance to recover from the infection.
However, studies suggest that even with ventilators, approximately 27% of patients with ARDS will die, with the risk of death increases with age and severity of illness.
In their studies, the research team triggered ARDS in mice using three doses of foreign RNA molecules similar to those found in respiratory viruses such as COVID-19.
Afterward, some mice were given a CBD treatment shot in the abdomen every other day for a total of three days. The timeline was specifically designed to mimic a human patient seeking medical care after experiencing troubled breathing.
In mice administered pure CBD, oxygen levels went up and temperatures and cytokine levels went down over time. Additional analysis of the lung tissues further showed that CBD significantly prevented physical lung damage such as scarring and swelling.
The finding suggests that CBD can quell the overactive immune response seen in ARDS.
However, if CBD is given too early, co-author and physician-scientist Dr. Jack Yu said it may interfere with the body’s healthy immune response.
A second study by the research team has further shown that one way CBD appears to reduce ARDS-associated lung damage is through increasing the anti-inflammatory molecule, apelin.
Apelin levels decrease during viral infection, but “CBD almost brought it back to a normal level,” Yu said.
Because of the association, the team suggests that low apelin levels could be an early indicator of ARDS, however, whether CBD protects the lungs through other mechanisms as well will require additional studies.
Synthetic CBD for COVID-19 Currently in Phase-1 Clinical Trial
The growing research interest surrounding the use of CBD to treat ARDS has led to the development of a synthetic CBD-based drug, ARDS-003, which has been granted FDA approval to begin phase-1 clinical trials.
The drug is under development by Tetra-Bio-Pharma, a pharmaceutical company focused on cannabinoid-derived drug development.
Unlike pure CBD, which is purified from the cannabis plant, ARDS-003 is synthetically derived but can interact with the same immune signaling network CBD does – the human endocannabinoid system.
“We have extensive preclinical evidence that the active pharmaceutical ingredient in ARDS-003 has a profound effect in inhibiting factors that lead to excessive immune system activation,” Tetra Bio-Pharma CEO Guy Chamberland told Forbes.
The randomized, double-blind, placebo-controlled clinical study is scheduled to begin enrollment in December 2020. If successful, the company plans to begin phase 2 studies in the second quarter of 2021.
CBD May Also Prevent Lung Damage in Other Respiratory Diseases
While most research on the use of CBD is currently centered around COVID-19, ARDS can be seen in a variety of respiratory illnesses such as influenza, pneumonia, sepsis, and other physical lung and chest injuries.
A Brazilian research team has found that CBD can improve lung function and inflammation in mice with acute lung injuries.
CBD has also been shown to reduce airway inflammation in mice with allergic asthma, the most common type of asthma that can be triggered through allergens such as pollen, dust, and smoke.
Considering the positive effects observed with CBD thus far and the importance of the endocannabinoid system in the human body, Baban’s research team said in their study that “it is plausible CBD may be used as a therapeutic candidate in the treatment of various inflammatory conditions.”