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8 cannabis patient care | vol. 3 no. 2 cannapatientcare.com research focus Research Overview: Cannabis and Autoimmune Disorders B Y R U T H F I S H E R , P H D Since autoimmune disease involves malfunction of the immune system, the same research on cannabis and immune system disorders applies to autoimmune disease. And as with more traditional treatments for autoimmune disease, cannabis tends to address immune system disorders by decreasing inflammation and swelling. Immune System Basics Autoimmune disorders occur when our immune systems malfunction. To understand autoimmune disorders, we must, therefore, first understand how the immune system works. Antigens Generate Antibodies Our immune systems are responsible for protecting our bodies from anything harmful, whether coming from outside our bodies or from within. To do this, our immune systems must be able to distinguish between self and non-self. An antigen is any molecule that our immune systems recognize as being non-self. Our bodies are pre-programmed to recognize thousands of different antigens, and they also learn to designate additional molecules as antigens based on experience. When our immune system identifies a molecule in our body as an antigen, it tags it with a unique identifier called an antibody. The antibody signals to the rest of the immune system that the antigen is a non-self-molecule, so it can be destroyed (1). The presence of antibodies tagged to antigens triggers a response by our immune systems, which generates white blood cells ("lympho- cytes") of varying types to kill the antigens and remove them from our bodies (2). Cell Damage Induces Inflammation Inflammation is an immune system response to the presence of viruses, bacteria, injuries, or other sources that damage our cells. During the inflammation process, blood vessels dilate and become permeable, enabling white blood cells and other harm-fighting agents to flow to the area of injury. The dilated blood vessels cause heat and redness, the flood of white blood cells into the area causes swelling, and other immune system agents increase sensitivity to pain. Once the pathogens have been neutralized, our immune systems clean up the debris then repair any damage, restoring our bodies to normal (3). Autoimmune Disease Basics Autoimmune disease occurs when the body mistakes self for non-self: our immune systems mistake specific molecules from our own body's organs and tissues as being toxic antigens. Our immune systems then respond accordingly, by tagging the anti- gens with antibodies and mounting attacks on those cells. Since the molecules mistaken for toxic antigens are generated by nor- mal–that is, ongoing–bodily functions, the attacks by our immune systems on our own cells becomes a persistent process (4). Autoimmune disease is not well-understood by the medical community. It is thought to involve both genes and environ- ment. Specifically, genetic and environmental phenomena in- crease the reactivity of our immune systems, making it easier for our bodies to mistake benign molecules for toxins (4). Autoimmune disease occurs in about 3-6% of the population; it is more common in females and specific forms of the disease are more common in particular ethnic groups. Since the inci- dence of autoimmune disease has been increasing, it suggests environmental factors, including overexposure to chemicals, a Western diet, or underexposure to germs (that is, excessively antiseptic environments), contribute to its development (5). Common forms of autoimmune disease include, for example (5): • Rheumatoid arthritis (RA): The immune system attacks joints, causing joint soreness and stiffness. • Multiple sclerosis (MS): The immune system attacks the insulation (that is, myelin sheath) that protects nerve fib- ers and enables the smooth flow of signaling between the brain, spinal cord, and the rest of the body. • Inflammatory bowel disease (IBD): The immune system attacks the lining of the intestinal wall, causing digestive problems. Essentially, autoimmune disease involves hyperactivi- ty of the immune system. This hyperactivity causes two sets of problems. First, as the immune system attacks cells from