Coronavirus: COVID19 and Cannabis
How the antimicrobial effects of cannabis can help combat viruses like the novel coronavirus, COVID19, and influenza?
Know the facts about the novel coronavirus disease 2019 (COVID19) and help stop the spread of rumors. For up-to-date information, visit CDC’s coronavirus disease 2019 situation summary page.
“Antimicrobial” means, related to microbes, or microorganisms, are microscopic organisms so small that they cannot see them with the naked eye. Microorganisms include bacteria, fungi, archaea, protists. They are among the earliest known life forms. Then there are viruses. Viruses are not alive, they are extremely small, 1000 times smaller than bacteria. They are packets of genetic information that attach and insert their packets of information into cells where they use the cell's machinery to make more copies of the virus. That is how they reproduce and are spread from person to person. An antimicrobial agent kills microorganisms or stops their growth. Antimicrobial agents can be grouped according to the microorganisms they act primarily against. For example, antibiotics are used against bacteria, antifungals are used against fungi, and anti-virals are used against viruses.
Cannabis contains antibacterial cannabinoids with the potential to address antibiotic-resistant infections. All five major cannabinoids including cannabidiol (CBD), cannabichromene (CBC), cannabigerol (CBG), Delta (9)-tetrahydrocannabinol (THC), and cannabinol (CBN), showed potent activity against a variety of methicillin-resistant Staphylococcus aureus (MRSA).
Because cannabinoid receptors are expressed on cells of the immune system, cannabinoids may have the potential to affect disease progression in cases of viral infection like HIV or COVID19 by modulating the body's immune response in relation to a viral infection. This may not necessarily affect the progression but could help support good symptom management.
In the case of HIV, researchers examined the impact of THC administration on immune and metabolic indicators of disease during the initial 6-month asymptomatic phase of infection in an animal model of HIV. Ultimately, THC administration decreased early mortality and was associated with a reduction of viral load and the retention of body mass. THC not only decreased the rate of viral replication but also did not increase viral load or aggravate morbidity. This may be because of the anti-inflammatory effects of THC which appear to have a modulatory effect on disease progression.
But what does this mean for a novel viral flu, like COVID19? Is there any data to suggest that cannabinoids may help combat the spread or help those affected overcome the infection?
There is no research on CBD and COVID19 so all we can do is discuss what we do know and speculate about what we could learn with more research.
The headlines are frightening. Cities in China and Italy are under quarantine and the number of infected people in the United States grows with each passing day. This isn’t just some aberrant cold virus. This is something much more concerning especially if it continues to spread from the areas where it has been identified.
This has caused many people to stock up on food staples, water, and canned goods. Not to mention their favorite remedies for weathering a cold. Fortunately, for most, the COVID19 virus brings only mild to moderate symptoms. Staying indoors and avoiding contact with others is enough to stop the spread and recover. For a few, especially the elderly and those individuals with other comorbidities, symptoms will be severe enough to require hospitalization and some will die.
Which brings us to the question; could CBD help?
There is research suggesting that cannabinoids, including CBD, are immunomodulatory having both antiviral and antibacterial effects. But what does the research say about CBD and viral infections like coronavirus or influenza?
There is scant research on the topic, so we will be covering it in two ways.
First, how do viruses, like coronavirus, infect us and cause illness?
Second, what are the effects of CBD on the immune system in response to coronavirus or influenza?
What is a virus?
A virus is a microscopic biological agent that is packed with information, in the form of DNA or RNA. The virus infects a cell and transforms it into a factory to make many more copies of itself to infect an ever-increasing number of cells. Viruses are not alive but are still capable of using a host cell to reproduce and multiply. Different types of viruses target different types of cells. HIV targets vital immune cells, called T-cells, whereas the novel coronavirus, COVID19, appears to target the epithelial cells that line the lungs. This is a simplified description of what a virus is however it leads us to the next question.
Have you ever wondered why people catch the flu virus during the winter? Colder temperatures cause the outer covering of a virus, or envelope, to become a rubbery gel that shields the virus as it passes from person to person. This rubbery coating goes away as temperatures warm up in the spring and summer making it harder for a virus to survive outside the host, decreasing transmission rates. Also, spending the winter indoors with other people doesn’t help to avoid the flu each year.
How fast a virus replicates in our body affects how strongly our immune system reacts. If the immune system overreacts, it can cause a reaction called a “cytokine storm” where the body overproduces immune cells and their activating compounds (cytokines), Cytokines are part of our immune system response which is a complex system designed to recognize, react, and respond to infections or disease. A flu infection is often associated with a surge of activated immune cells into the lungs. This cytokine storm can be so destructive that it can be fatal. This was at least partly to blame for some of the deaths caused by the deadly flu pandemic of 1918 which was also a coronavirus, like COVID19.
How does a virus infect us?
There are three stages of a viral infection.
Exposure to and contraction of the virus: The virus enters the body and is exposed to living cells
Binding to the cell: The virus binds to the cell and injects its pack of information in the form of DNA (or RNA)
Replication: Viral DNA (or RNA) hijacks the cell to replicate more viruses.
How does the Immune System Respond to Viruses like Coronavirus and Influenza?
When the body is exposed to viruses, like coronavirus and influenza, the first thing the body does is to increase body temperature to slow down viral replication. The next thing the body does is decrease the amount of tryptophan that the body produces to starve the virus of an essential amino acid, which is an integral part of proteins that they need to make more copies of themselves.
Tryptophan is also related to inflammation, anxiety, and mood, which may explain why our mood drops when we get sick. Serotonin, a chemical produced by nerve cells requires tryptophan for its synthesis. Low levels of tryptophan cause a drop in serotonin levels which leads to feeling depressed.
These are all adaptive immune responses that have evolved over eons of nearly constant exposure to microbes and viruses, designed to help us survive in the world and overcome infections like COVID19 and influenza. Each time we become infected, the body produces antibodies and remembers how to make those antibodies so that the next time the body is infected it can quickly mount a quick and effective immune response.
Three main types of immune cells
Another way the body protects itself from infection is by trigging a process known as cellular apoptosis. Apoptosis is a normal cellular process in which old, damaged, or infected cells are deconstructed and broken down in an orderly manner so that the cellular machinery can be recycled. This process is modulated by the endocannabinoid system (ECS) which is exactly where CBD works!
What is the role of the Endocannabinoid System (ECS) in our immune response?
The ECS is responsible for modulating the regulation of other key systems related to our immune response to viral infections like COVID19 or influenza. The endocrine system regulated our hormones, the nervous system regulates our neurotransmitters and the immune system, as we’ve discussed, regulates cytokines, macrophages, T Cells, and NK cells.
There is a growing body of evidence that cannabinoids and their receptors influence the immune system affecting viral pathogenesis and viral replication.
As we discussed previously, with the deadly 1919 flu which killed millions around the world, an overactive immune response to infections like COVID19 and influenza can be just as deadly as an under-active response. Balance is the key and when we are talking about our bodies we are talking about homeostasis. Homeostasis is the tendency of a living system to maintain internal stability, by coordinating the response of its parts to any situation or stimulus that would affect its normal condition or function.
In the case of a viral infection like COVID19 or influenza what we want is a sufficiently strong initial response and then a decreased response as the immune system can successfully fight off the infection. An overly aggressive immune response can do so much collateral damage that the patient dies, along with the virus.
As we mentioned earlier, viral replication rates are key in determining how aggressively the immune system will respond to an infection like COVID19 or influenza. Some viruses, like the H5N1, the bird flu virus, have very high replication rates. This can cause an over-reaction by the immune system resulting in a cytokine storm. This is the body’s scorched earth approach to fighting off an infection and is just as likely to kill the person as it is to defeat the infection.
How does Cannabidiol (CBD) affect the immune response?
CBD has been shown to calm and promote a healthy immune response by boosting or blunting the immune response depending on the state of the system. It may be surprising to hear that something like CBD can booth increase and decrease immune response but in fact, it’s perfectly consistent with CBD and the ECS’s modulatory role in maintaining balance and homeostasis across all our important body systems.
Take cancer for example:
- Healthy cells with low inflammation are not affected by CBD.
- Healthy cells with high inflammation, CBD reduces it.
- In cancer cells, CBD will increase inflammation.
Most substances only work in one direction however CBD works in both directions, acting as a constraint on various body systems modulated by the ECS.
THC works in one direction against the CB1 receptor which research suggests is immunosuppressive. This means that it is probably not a good idea to use THC during a viral infection.
Unlike THC, CBD calms the immune response during periods of over-inflammation which means it may be helpful in cases when an overactive immune response to a virus, like COVID19 or influenza, is more dangerous to the patient than the virus itself. Remember, inflammation is a normal reaction to an immune response which we want at the onset of a viral infection.
Can CBD Help with Coronavirus’ like COVID19 and Influenza?
There is no evidence that CBD can help with coronavirus’, like COVID19 and influenza. The real benefit for CBD may be related to its ability to modulate an overactive immune response as we saw in the case of viral MS ameliorating motor deficits and reducing microglial activation and inflammatory cytokine production.
Additionally, there are other effects that CBD has on the body which may be helpful in cases of infection by a coronavirus like COVID19 and influenza. The ability of the body to use apoptosis, programmed cell death, to maintain healthy cells in the body can be useful when fighting off a viral infection. If a cell that has been infected by a virus undergoes apoptosis before the virus has completed it’s replication, that will slow the rate at which the virus reproduces attenuating the immune response.
CBD has been shown to have a direct effect on apoptosis resulting in significantly more cell death in virus-infected cells that in cells that were not infected. This suggests that CBD can induce apoptosis in virally infected cells, but not healthy cells. This selective ability of CBD to modulate the effects of the immune system on virally infected cells helps it to fight off an infection without causing excessive damage to healthy cells.
I point to these studies because in both cases they used a virus to initiate damage to the cells.
Can CBD affect viral replication?
There was only one study that looked at the effects of CBD on viral replication. In cases of viral hepatitis CBD inhibited viral replication by 86.4%
Studies on chronic inflammation and autoimmune disorders have shown that CBD can suppress interferon, but not always. An interferon is a natural substance that helps the body’s immune system fight infection and other diseases, such as cancer.
Once again the “biphasic” dual effects of CBD apply. This finding comes from another study that looked at HIV and found that THC, but not CBD, suppressed interferon levels in both healthy and HIV+ patients. This suggests that while THC may impair antiviral responses, it may also have protective effects on neuroinflammation associated with prolonged HIV infection.
Unlike THC, CBD did not suppress the key immune responders, interferon, but can help to down-regulate an overactive immune response by modulating the ECS which is tasked with maintaining homeostasis within the immune system. CBD either inhibits or enhances the production of key immune responders like interferon or inflammatory cytokines in response to immune cell activation demonstrating that cellular activation dictates the effects of CBD.
Let’s talk a little bit more about inflammatory cytokines and how they related to T-cells, one of the other key immune cells. Cytokines are used by the immune system to fight infection. They help key immune cells to discriminate between foreign bodies (not-self) with healthy cells (self).
T-cells are the sentries of the immune system monitoring the body for intruders, signaling the central nervous system to marshall an immune response and rally the troops to fight off an infection. As we have discussed CBD boosts two of the T-cells powerful weapons interferon and inflammatory cytokines when T-cell function is lacking. However, when T-cell activity is too strong, CBD will suppress the activity, which is key to maintaining balance and homeostasis in autoimmune and inflammatory states.
Typically you would use an auto-immune medication to suppress overactive immune function and an anti-viral medication to boost immune function. Neither can do both or respond directly according to the needs of the system. That’s what makes the bi-phasic effects of CBD so interesting. The ability to boost or decrease immune response depending on the conditions in the body is nothing short of remarkable. And this is different from THC which has only a one-directional effect on the immune system, suppressing it.
Interferon is part of the system which detects a virus and helps key immune cells tell self from not-self. The best study we have seen showing the immune-suppressing or immune-boosting effects of CBD in models of infection supports the notion that CBD has a modulatory effect on the immune system. While CBD itself is immune-suppressive, involving both the direct suppression of activation of various immune cell types and the promotion of regulatory cells, which, in turn, promote the induction of apoptosis and control other immune cell targets. The data itself is worth digging into and the chart at the end includes several studies showing the immune-enhancing effects.
Previously we mentioned how T-cells dropped during the acute phase of SARS, which is also a type of coronavirus, similar to COVID19. This effect points to the lethality of these viruses and how difficult it can be for our immune system to mount an effective response.
CBD, HIV and the Coronavirus
What does CBD, HIV and the novel coronavirus COVID19 have to do with one another? HIV is a virus that specifically targets the immune system, specifically T Cells. T-Cells are key immune cells that help the body to recognize and kill virus-infected cells. When infected by HIV, T-cells are unable to recognized and help other key immune cells to fight off the infection. Studies on the SARS virus showed a significant drop in T cells during the critical period of the disease.
This is unexpected since T-cells should be increased in response to a viral infection, not committing cellular suicide. This brings us to reports that HIV drugs may help treat patients with the novel coronavirus even suggesting the mechanism by which they may be working. Researchers have even pinpointed a similar mode of action for two viral proteins found in both HIV-1 to COVID19.
What this research is suggesting is that the novel coronavirus, COVID19, shares some similar pathways to HIV and that similar treatment for HIV may be helpful in cases of COVID19. This shouldn’t be misconstrued to imply that COVID19 was engineered to share similar pathways to HIV but that viruses often exploit similar weaknesses in our bodies defenses and that COVID19 may be affecting t-cells decreasing the effectiveness of our immune response.
So what have we learned?
T-cells in the lungs are important for understanding the respiratory effects of coronavirus’ like COVID19 and influenza. Levels of T cells in the lungs are also important. This causes the lungs to fill up with mucous, the equivalent of snot or phlegm, which the immune system uses to keep critical immune cells from being quickly washed away. With COVID, this means the lungs are filled with fluid and are unable to effectively absorb oxygen causing oxygen levels to drop in the body which can be fatal.
One side effect of CBD is lower blood pressure. We don’t know how CBD and angiotensin receptors interact, that research hasn’t been done yet. But we do know how CBD calms hyperactivation of the immune response in the lungs.
When the immune system mounts a response to an infection it sets off a cascade of signals which ramp up the immune response causing inflammation that makes the cells of the lungs “leaky”. In a study that looked at the effects of CBD on mice who were given a lung infection. Researchers found that calmed inflammatory immune response and improved lung function.
CBD appears to help calm overactive immune response, quieting the cytokine storm that can be so deadly.
This is our immune system in action, a complicated patchwork evolved of millions of years as an artifact of an arms race against ever-evolving threats from the environment.
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About Randy’s Club
Founded by the Strause Family in 2015, Randy’s Club offers a line of CBD health and beauty products developed by research scientists and optimized for improved bioavailability and permeability across the skin. Randy’s Remedy products include its extra -strength and everyday lotions, a daily oral emulsion, and a pet formulation. These products were created after noticing a lack of scientifically formulated products in the cannabis hemp market. They were inspired by our experience using medical cannabis with Randy Strause. Randy, a husband, and father, passed away from brain cancer in 2010, but the memory of the benefits he felt is in every bottle of Randy’s Remedy that we make. Inspired to develop a line of products that could deliver the benefits of CBD efficiently and effectively, the Strause group partnered with a leading research organization to develop and optimized oromucosal and topical formulations that deliver CBD better than any other product on the market.
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