Dr. Alexandros Makriyannis Scientifc Research in Hemp

At this year’s Institute of Cannabis Research Conference, I had an opportunity to meet  with renowned researcher Alexandros Makriyannis. Topics on the table this year focused around the evolution of our understanding of cannabis as a medicine: What we know about it today, where we’re focusing current research, and where we’ve been.

What can the historical use of medicinal cannabis tell us?

The history of cannabis use for ailments of the body and mind, across millennia of human history and dozens of cultures, from ancient Mesopotamia to physicians and neurosurgeons serving Queen Victoria at the end of the 19th century, suggests quite a broad range of applications to be identified and understood. When combined with consistent clinical results in modern medical research, cannabis researchers were left to identify how cannabis operated within the body to produce such far ranging results.

This lead directly to the identification of the endocannabinoid system in the 90s, which has become the core of high-level cannabis research in the years since.

What is the endocannabinoid system?

The endocannabinoid system is a group of endogenous cannabinoid receptors found within the brain and nervous systems. In addition to its role mediating the psychoactive effects of cannabis, the endocannabinoid system is involved in a wide assortment of physiological processes, ranging from appetite and pain-sensation to mood and memory. Research also suggests a link between the system and pleasure from locomotive exercise, such as Runner’s High.

How detailed is our current understanding of endocannabinoids?

We’ve identified a number of key components in the endocannabinoid system in the decades since its discovery. Current knowledge is primarily focused on major components of the system identified early in research:

• CB1: The first of two primary endocannabinoid receptors identified, found primarily in the brain and nervous system and primarily targeted by the endocannabinoid Anandamide, the endogenous equivalent to the phytocannabinoid THC, and the endocannabinoid 2-AG, the endogenous equivalent of CBD.
• CB2: Expressed predominantly in the immune system, this second endocannabinoid receptor is a target for 2-AG.

Ultimately, our understanding of the endocannabinoid system remains incomplete. While we’ve identified a number of membrane-associated enzymes which modulate the levels of endocannabinoids – the amidase FAAH and the esterase MGL – we have yet to thoroughly characterize the transporter system involved. Deepening our understanding of the endocannabinoid system and the endocannabinoids and other compounds involved is currently a top priority within cannabis research, as the implications for medical science may reach well beyond cannabinoids and direct regulation of the system via phytocannabinoids and endocannabinoids.

Does this suggest any applications?

A deeper understanding of the endocannabinoid system will lead directly to more targeted development of drugs. Current applications of cannabis-based research is largely limited to direct dosage with phytocannabinoids such as CBD and THC. A thorough understanding of the mechanisms at work in the function of cannabis would allow for the development of more nuanced treatments with even narrower side-effect profiles.

By regulating the endocannabinoid system’s assorted compounds throughout the body, products of cannabis research may offer an assortment of unique nutritional and therapeutic benefits. The involvement of the endocannabinoid system in appetite, pain management, mood, memory, immune response, and myriad other systems suggests an abundance of targeted applications on the horizon.