Au revoir, albuterol. Basta, becotide. Vaya con dios, ventolin — CBD (cannabidiol) is here, and it could change the way millions of people treat their asthma.
Asthma is a chronic inflammatory disease of the airways in the lungs, affecting more than 350 million people globally. In the U.S., roughly 1 in 12 people suffer from various types of asthma. Although it has no cure, and can lead to fatal attacks if untreated, many of its symptoms are manageable with the right asthma medication.
However, that’s not always an easy thing to find, as many with the disease don’t respond to the corticosteroid medications (often shortened to “steroids”) that target airway inflammation. Generally, these are administered by metered dose inhalers intended for either quick relief or long-term control.
There are other options, though. A medical study in 1973 showed that cannabis can help bronchodilation, a widening of the bronchi which increases airflow to the lungs. But for many with asthma, the idea of smoking anything is antithetical to the way they care for themselves.
Fortunately, cannabidiol (CBD) oil has been shown to have several ameliorative effects on the illness. And administration can be as simple as placing a drop beneath the tongue.
The airways of people with asthma are always inflamed, which causes them to narrow and produce extra mucus, leading to wheezing, chest tightness, coughing, and shortness of breath. Steroidal inhalers are designed to prevent airway inflammation — which a recent Brazilian study has shown CBD to be capable of, too.
But CBD attacks inflammation in a different way than steroids. Both treatments target the white blood cells that overproduce the immune response primarily implicated in the perpetual inflammation present in the lungs of people with asthma.
However, the two treatments regulate the response of different immune cells. Steroids target eosinophils, white blood cells that aren’t present in the mucus of nearly 47% of 1,000 people with asthma who were enrolled in nine clinical trials sponsored by the National Heart, Lung and Blood Institute.
CBD regulates the immune response of T-helper cells, a more common type of white blood cell. Among the beneficial effects for asthma sufferers are decreased mucus production and the reduction of an immune substance responsible for the maturation of eosinophils, the white blood cells that steroids target.
THC has been credited as a bronchodilator since the 1973 study cited above, but recent research has focused on the bronchodilating properties of another cannabis component — the terpene alpha-pinene.
Terpenes are the aromatic oils that give cannabis its smell and some of its medicinal properties. Alpha-pinene, the most widely-encountered terpenoid in nature, is the one that gives pine forests their smell. And, as we’ve known since 1990, alpha-pinene is also an effective bronchodilator.
In addition, alpha-pinene has several anti-bacterial properties that are strengthened in the presence of CBD. Terpenes may or may not be present in CBD oils, depending on the preparation method used.
A second way that CBD helps prevent airway obstruction is by increasing the body’s levels of anandamide. Anandamide is an endocannabinoid naturally found in the human body and, among other things, responsible for restraining airway obstruction and inflammation.
One of the most serious effects of asthma is the way it can restructure your airways, making it permanently harder to breathe. The causes of airway remodeling are still undetermined, but bronchospasm is among the possibilities researchers are considering.
Bronchospasm describes the spasm and constriction of smooth muscles in the airways, causing them to narrow and creating shortness of breath. When this happens, the theory holds that they may produce a substance responsible for thickening the base layer of membrane.
A 2009 study shows that CBD protects guinea pigs from immune-induced bronchospasm — however it notes that the results cannot automatically be extrapolated to humans.
This is a common refrain when it comes to CBD: the early results are encouraging, but more research is needed. For hundreds of millions of people with asthma around the world, these new studies can’t come fast enough.