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In vivo leukocyte staining was achieved by intravenous administration of 0. Two measures of leukocyte-endothelial interactions were used to assess articular inflammation: Rolling leukocytes were defined as positively stained blood cells travelling slower than the surrounding blood flow, and adherent leukocytes were defined as positively stained cells that remained stationary for a minimum of 30 seconds.
At each time point, 1-minute recordings of the exposed knee joint were taken at a working distance of 10 cm with a frame capture rate of 25 images per second. At the end of the experiment, rats were euthanised and a dead scan of the knee was taken. Images were analysed offline where mean blood perfusion perfusion units in a defined region of interest approximating the knee joint was calculated.
Inflammation measures were conducted on day 1 post-MIA induction, which corresponds to the peak of inflammation in this OA model. Subsequent recordings were taken at 5, 15, 30, 60, , and minutes after drug administration.
A segment of the saphenous nerve was isolated proximal to the ipsilateral knee joint and placed in 2. The nerve samples were then removed from the fixative and rinsed 3 times with 0.
Epon—araldite resin was used to mount the samples. The samples were placed in a 3: Finally, using an LKB Huxley ultramicrotome with a diamond knife, the samples were sectioned into nm thick slices. The microscope was set at a voltage of One nerve cross-section image was visually partitioned into 9 quadrants and 3 images were captured from quadrants 1, 5, and 9. All fibres were assessed using the G-ratio plugin in ImageJ processing software.
The G-ratio was calculated using the equation where, a is the internal axonal area and A is the total axonal area of the fibre. The higher the G-ratio the higher the degree of demyelination.
Cannabidiol 2-[ 1 R ,6 R methyl 1-methylethenyl cyclohexenyl]pentyl-1,3-benzenediol was obtained from Tocris Bioscience Bio-Techne, Abingdon, United Kingdom. AM CB 1 receptor antagonist; 1- 2,4-dichlorophenyl 4-iodophenyl methyl-Nmorpholinyl-1H-pyrazolecarboxamide and AM CB 2 receptor antagonist; 6-iodomethyl 2-morpholinylethyl indolyl]- 4-methoxyphenyl methanone were obtained from Cayman Chemicals Ann Arbor, MI. Data were tested for Gaussian distribution by the Kolmogorov—Smirnov test.
A P value less than 0. A total of 17 afferent fibres were recorded in this study. On days 14 to 19 post-MIA induction, close i. Example of a single-unit recording whereby CBD attenuated firing evoked by noxious rotation A. The dose-dependent effect of CBD treatment on afferent firing rate was averaged over the 15 minutes after administration C. Effect of contralaterally administered CBD on ipsilateral pain behaviour. Contribution of cannabinoid and noncannabinoid receptors to the analgesic effects of CBD.
One day after i. Contribution of cannabinoid and noncannabinoid receptors to the anti-inflammatory effects of CBD. Pain and disease progression are poorly managed in many patients with OA because of the multifactorial nature of the disease. Intra-articular injection of MIA produces monoarthritis with several features that resemble human OA, including joint pain, intermittent inflammation, and joint nerve damage.
This study aimed to address, for the first time, whether the inflammatory and neuropathic pain associated with MIA could be blocked by local administration of the noneuphoria producing phytocannabinoid CBD. It has previously been shown that the pain associated with the MIA model of OA is mediated in part by the sensitisation of joint afferent fibres.
These electrophysiology data confirm that CBD has a peripheral site of action in knee joints. These observations, along with our electrophysiology data, assert that CBD acts locally in the joint to reduce joint mechanical pain as revealed by improved weight bearing as well as a reduction in centrally mediated secondary allodynia as determined by hind paw withdrawal threshold.
Contralateral injection of CBD had no discernible effect on ipsilateral secondary allodynia confirming that the analgesic effect of intra-articular CBD was localised to the site of administration for this pain test. This may be because electrophysiology is a highly sensitive technique that detects subtle response to test agents in the periphery, whereas pain behaviours are more complex and encompass the entire pain pathway.
The rationale for using two pain behavioural tests in this study was to interrogate different aspects of the pain pathway. Dynamic incapacitance is a measure of spontaneous pain that is associated with joint degeneration or inflammation arising from peripheral sensitisation. Thus, it seems that local injection of CBD is effective at reducing direct nociceptive and inflammatory pain in the joint as well as ameliorating neuropathic features of OA pain.
Both CB 1 and CB 2 receptor antagonists failed to block the CBD-mediated improvements in hind paw withdrawal threshold and weight bearing. Although CBD has been shown to act as an inverse agonist at CB 2 receptors and a full antagonist at CB 1 receptors, 40 it has also been shown to act through GPR55, serotonin receptors eg, 5-HT 1A , and various transient receptor potential ion channels. Transient receptor potential vanilloid-1 is known to be involved in MIA-induced peripheral sensitisation, 17 therefore, antagonist experiments were performed to test the involvement of this ion channel in CBD-mediated analgesia.
This mechanism of action has been previously reported in in vitro studies using human embryonic kidney HEK cells and using cell membranes from mouse and rat brains. Cannabidiol has been shown to inhibit fatty acid amide hydrolase FAAH and the uptake of anandamide. Intra-articular injection of MIA produced an acute inflammatory response on day 1 after injection.
This acute phase of inflammation was evinced by an increase in leukocyte trafficking and a moderate increase in joint blood flow. Local application of CBD significantly reduced these acute, inflammatory changes corroborating what has previously been reported in other inflammatory models.
Opening of TRPV1 ion channels causes the peripheral release of inflammatory neuropeptides which promote neurogenic inflammation and enhanced leukocyte trafficking in joints. A central hypothesis of this study was that early inhibition of OA-related inflammation with CBD would reduce the development of persistent joint pain.
Prophylactic treatment of OA joints with CBD on days 1 to 3 after MIA induction prevented secondary allodynia at day 14, but had no effect on hind limb weight bearing. Inflammation associated with MIA diminishes by day 7, 4 therefore the pain associated with end-stage OA in this model is largely due to joint degeneration and peripheral neuropathy.
Thus, by abolishing early inflammation with prophylactic treatment, CBD attenuates central sensitisation and neuropathic pain development in OA. The G-ratio data would benefit from future studies examining the expression of a biomarker for peripheral nerve damage to further support this finding. Several cannabis compounds, including CBD, have been shown to be neuroprotective in other musculoskeletal disorders. In a preclinical model of multiple sclerosis, CBD was shown to improve clinical recovery and rotarod scores in animals, correlating with and indicative of a neuroprotective effect.
Cannabidiol is a noneuphoria producing compound and has a more desirable side effect profile compared with other cannabinoid compounds and commonly prescribed analgesics. Animal studies where CBD was administered systemically showed that the animals had no signs of adverse side effects. Successful relief of OA symptoms by peripherally administered CBD suggests a therapeutic option that has a low chance of adverse effects which is more desirable for patients.
This study showed for the first time that local CBD administration inhibited pain and peripheral sensitisation in established OA. By attenuating this initial inflammatory response with CBD, end-stage OA pain and peripheral neuropathy were abrogated.
Thus, CBD may be a safe therapeutic to treat OA pain locally as well as block the acute inflammatory flares that drive disease progression and joint neuropathy. All experimental protocols were approved by the Dalhousie University Committee on Laboratory Animals, which acts in accordance with the standards put forth by the Canadian Council for Animal Care.
Availability of data and materials: Philpott conducted the pain behaviour experiments, the inflammation measurements IVM and LASCA , performed the G-ratio measurements, analysed data, and helped draft the manuscript.
O'Brien conducted all electrophysiology experiments, analysed the data, and helped draft the manuscript. McDougall conceived the study, participated in its design and coordination, helped analyse data, and helped draft the manuscript. All authors read and approved the final manuscript. Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. National Center for Biotechnology Information , U. Published online Sep 1.
Author information Article notes Copyright and License information Disclaimer. Published by Wolters Kluwer Health, Inc. The work cannot be changed in any way or used commercially without permission from the journal. This article has been cited by other articles in PMC. Abstract Osteoarthritis OA is a multifactorial joint disease, which includes joint degeneration, intermittent inflammation, and peripheral neuropathy.
Cannabinoids, Osteoarthritis, Pain, Neuropathy, Inflammation. Introduction The most prominent form of synovial joint disease, osteoarthritis OA , is characterised by joint degeneration, pain, and in some patients, articular neuropathy. Experimental timeline On day 14 post-MIA induction, 3 sets of noxious rotations, each lasting 5 seconds, were applied 5 minutes apart as a baseline measurement of afferent activity.
Behavioural pain measurements 2. Von Frey hair mechanosensitivity Von Frey hair mechanosensitivity was used as a measure of secondary allodynia. Intravital microscopy Both hind limbs were immobilised and the capsule of the ipsilateral knee was exposed by surgically removing a small ellipse of the overlying skin and superficial fascia. Experimental timeline Inflammation measures were conducted on day 1 post-MIA induction, which corresponds to the peak of inflammation in this OA model.
G-ratio analysis of the saphenous nerve A segment of the saphenous nerve was isolated proximal to the ipsilateral knee joint and placed in 2.
Drugs and reagents Cannabidiol 2-[ 1 R ,6 R methyl 1-methylethenyl cyclohexenyl]pentyl-1,3-benzenediol was obtained from Tocris Bioscience Bio-Techne, Abingdon, United Kingdom. Effect of acute administration of cannabidiol on joint afferent mechanosensitivity A total of 17 afferent fibres were recorded in this study. Table 1 Characterisation of the recorded fibres in the electrophysiology experiments. Open in a separate window. Effect of acute administration of cannabidiol on sodium monoiodoacetate—induced inflammation One day after i.
Discussion Pain and disease progression are poorly managed in many patients with OA because of the multifactorial nature of the disease. Conclusions This study showed for the first time that local CBD administration inhibited pain and peripheral sensitisation in established OA.
Conflict of interest statement The authors have no conflicts of interest to declare. This work was supported by an operating grant provided by The Arthritis Society. Acknowledgements The technical assistance of Allison Reid is gratefully acknowledged. Footnotes Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. Use of the painDETECT tool in rheumatoid arthritis suggests neuropathic and sensitization components in pain reporting.
J Pain Res ; 7: Leukocyte trafficking and pain behavioral responses to a hydrogen sulfide donor in acute monoarthritis. Molecular targets for cannabidiol and its synthetic analogues: Br J Pharmacol ; Weight bearing as a measure of disease progression and efficacy of anti-inflammatory compounds in a model of monosodium iodoacetate-induced osteoarthritis.
Osteoarthr Cartil ; Quantitative assessment of tactile allodynia in the rat paw. It often affects the hip, knee and thumb joints. To deal with this debilitating chronic pain , many people turn to opioid painkillers — which may be a short-term solution for pain management — but ultimately, these types of drugs often end up causing addictions and fatalities from abuse and misuse. Cannabis, and in particular, CBD, can be a powerful alternative to using opioids and help an individual reclaim their wellness by taking a more natural route.
Cannabis Relieves Chronic Pain. CBD is safe, nontoxic, antipsychotic and nonintoxicating, working behind the scenes to address anxiety, depression and inflammation. But you will feel less anxious, less pain and more ease in your body without the high-inducing nature of cannabis with THC. It can be a perfect match for addressing the chronic pain arthritis causes. CBD also impacts the immune system , which makes it helpful for autoimmune conditions like rheumatoid arthritis.
A study published in the journal Rheumatology from Dr. Using cannabis fights inflammation in the joints by activating the pathways of CB2 receptors. CBD, on its own, is a natural anti-inflammatory agent that can relieve pain and stiffness caused by arthritis. Many consumers new to cannabis start with CBD first and with small doses, often called micro-dosing.
A conversation with your caregiver can provide you with a better understanding of what dose to begin with and how often to consume.
As you begin to understand the effects CBD has on your body, you can make adjustments accordingly.
CBD Oil Dosage: General Tips to Assess How Much CBD to Take
Researchers have recently starting focusing on CBD oil's effects on several conditions that cause pain, including rheumatoid arthritis (RA). So far, the results are. Americans are now seeking treatment options to aid in soothing their joint pain. CBD oil for arthritis has plenty of benefits, some of which you. CBD oil is legal in 30 states where medicinal and/or recreational marijuana is legal, . How it helps arthritis, migraines, and dental pain.