Cystitis

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Introduction

Cystitis is an infection of the urinary tract. The bladder and other tissues of the urinary tract express CB1, CB2, TRPV1 and PPARα offering therpeutic potential for cannabinoids in the treatment of Cystitis. However, the exact mechanism through which cannabinoids work in Cystitis remains to be elucidated.

Alternative Names

Urinary tract infection/UTI
Bladder infection

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Prescription Advice

To date the only preclinical evidence for cannabinoid treatment of Cystitis was found with CBG. However, this compound is usually only present in small amounts in cannabis (-extracts). Still, as Cystitis is an inflammatory disease, CBD is likely to be beneficial.

Given the nature of the disease, sublingual application may be beneficial.

Please follow generic prescription advice.

Please note that, while based on preclinical and/or clinical research, this prescription advice is solely intended as a guideline to help physicians determine the right prescription. We intend to continuously update our prescription advice based on patient and/or expert feedback. If you have information that this prescription advice is inaccurate, incomplete or outdated please contact us here.

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Literature Discussion

In a rat study, Anandamide was found to induce bladder inflammation pain through TRPV1 suggesting this receptor might be a therapeutic target (Dinis et al., 2004).

Interestingly, the opposite was found in another study where boosting Anandamide levels by preventing its breakdown exerted potent analgesic and anti-inflammatory effects (Wang et al., 2015). FAAH was responsible of breaking down anandamide.

Another rat study found that endocannabinoid PEA and CB1 were upregulated, PPARα was downregulated and CB2 was unchanged upon induction of Cystitis (Pessina et al., 2014). PEA attenuated pain and bladder voiding. This effect was blocked by CB1 and PPARα antagonists.

Several studies found that CB2 was upregulated with Cystitis (Merriam et al., 2008; Tambaro et al., 2014) and that activation of CB2 with Anandamide or PEA attenuated pain and inflammation (Jaggar et al., 1998; Wang et al., 2013, 2014).

CBG reduces acetylcholine-induced contractions in the bladder, suggesting a potential effect to treat bladder disorders (Pagano et al., 2015).

References:

Dinis, P., Charrua, A., Avelino, A., Yaqoob, M., Bevan, S., Nagy, I., and Cruz, F. (2004). Anandamide-evoked activation of vanilloid receptor 1 contributes to the development of bladder hyperreflexia and nociceptive transmission to spinal dorsal horn neurons in Cystitis. J. Neurosci. Off. J. Soc. Neurosci. 24, 11253–11263.

Jaggar, S.I., Hasnie, F.S., Sellaturay, S., and Rice, A.S. (1998). The anti-hyperalgesic actions of the cannabinoid anandamide and the putative CB2 receptor agonist palmitoylethanolamide in visceral and somatic inflammatory pain. pain 76, 189–199.

Merriam, F.V., Wang, Z., Guerios, S.D., and Bjorling, D.E. (2008). cannabinoid receptor 2 is increased in acutely and chronically inflamed bladder of rats. Neurosci. Lett. 445, 130–134.

Pagano, E., Montanaro, V., Di Girolamo, A., Pistone, A., Altieri, V., Zjawiony, J. K., … Capasso, R. (2015). Effect of Non-psychotropic Plant-derived cannabinoids on Bladder Contractility: Focus on Cannabigerol. Natural Product Communications10(6), 1009-1012.

Pessina, F., Capasso, R., Borrelli, F., Aveta, T., Buono, L., Valacchi, G., Fiorenzani, P., Di Marzo, V., Orlando, P., and Izzo, A.A. (2014). Protective Effect of Palmitoylethanolamide in a Rat Model of Cystitis. J. Urol.

Tambaro, S., Casu, M.A., Mastinu, A., and Lazzari, P. (2014). Evaluation of selective cannabinoid CB(1) and CB(2) receptor agonists in a mouse model of lipopolysaccharide-induced interstitial Cystitis. Eur. J. Pharmacol. 729, 67–74.

Wang, Z.-Y., Wang, P., and Bjorling, D.E. (2013). Activation of cannabinoid receptor 2 inhibits experimental Cystitis. Am. J. Physiol. Regul. Integr. Comp. Physiol. 304, R846–R853.

Wang, Z.-Y., Wang, P., and Bjorling, D.E. (2014). Treatment with a cannabinoid receptor 2 agonist decreases severity of established Cystitis. J. Urol. 191, 1153–1158.

Wang, Z.-Y., Wang, P., Hillard, C.J., and Bjorling, D.E. (2015). Attenuation of Cystitis and pain sensation in mice lacking Fatty Acid amide hydrolase. J. Mol. Neurosci. MN 55, 968–976.