Like many great discoveries in medicine, it began with the “Aha” moment when Canadian physician Dr. Vincent Maeda realized that leg ulcers could be infiltrated by the lipophilic cannabinoid compounds, which in turn could reach the large number of cannabinoid receptors below.
Very few people are more committed to finding a better wound management solution than Dr. Maeda, who runs, among other things, a Class III wound clinic that takes care of hard-to-heal leg ulcers in the Greater Toronto Area.
“casing [the outside skin, cutaneous membranes and mucous membranes] And wounding is the health care field with the worst outcome measures,” Maeda explains. However, when you look at the massive expenditures — the United States spends upwards of $80 billion annually on wounds. And most of what I can give you is absurdity and it’s just ridiculous bandages that do nothing. “.
Leg wounds that refuse to heal
Unless we get older, or take care of someone over seventy, we’re unlikely to think much of leg ulcers, which are defined as long-term ulcers that take more than two weeks to heal.
I certainly didn’t until my brother, who has been blessed with a heart set of varicose veins from a young age, started developing leg injuries that refused to close.
The largely sedentary lifestyle meant that the already compromised venous outflow was not strong enough to provide the conditions to treat some harmless bumps and scrapes, which later turned into blunt wounds in the open leg.
Standard leg ulcer care follows the “Wound Bed Preparation” model (in Dr. Maida’s words, “silly bandages”), along with pressure dressings to help the veins return and speed healing. Antibiotics are also routinely prescribed for any concomitant infection, although according to Maeda, there is a tendency for them to be overprescribed.
In my brother’s case, twice-weekly visits for a change of clothes over three months were enough to see his wounds close. But according to Dr. Maeda, he was one of the lucky 40% whose ulcers healed in less than twelve weeks. The remaining 60% can persist for years with open leg wounds, which in the worst case can lead to amputations, sepsis, and even death.
Opioids slow wound healing
Ulcers are also generally very painful, with Maeda about 70% of patients being prescribed opioids for pain control.
Not only does pain reduce the body’s ability to heal, but the opioids themselves are now thought to do so Slows healing of chronic wounds. As the opioid crisis continues to wreak havoc across North America, it is clear that an alternative approach to wound pain management and overall healing must be found.
Which brings me back to the moment of Dr. Maeda’s lamp.
Determined to find a more effective alternative to the current wound bed preparation protocol, Maeda embarked on a master’s degree at the Dalai Lama School of Public Health in Toronto.
He recalls, “Working in a country like Canada, where the path of legalization (medical cannabis) was developing, was one of those epiphany moments, I realized that there was potential to use cannabis and its metabolites in the arena from skin and wounds.”
And so the early stages of his research began with the study of preclinical data regarding the wound-healing properties of the compounds found in cannabis.
Cannabis Epiphany
It should be noted at this point that we are not only talking about cannabinoids THC And Convention on Biological Diversity, but also terpenes like Beta Caryophyllene, and flavonoids quercetin, diosmin and hesperidin. In fact, a Food and Drug Administration It is called approved drug Daflon It is already on the market in we For the treatment of venous circulatory disorders by combining the flavonoids diosmin and hesperidin.
But what makes these cannabis compounds so well suited for ulcer healing is their ability to directly enter through a wound and reach the endocannabinoid receptors below.
Maeda explains, “The surface of our skin is relatively intact, and whether it’s mucous membranes or dermal membranes, you won’t get as much absorption through a healthy integument. But when you have a wound, you don’t have the epidermis. And different molecular families can more quickly penetrate through the skin.” open wound layer.”
“And this is where it gets exciting,” says Maeda, “because we now know that the endocannabinoid system is always present in our bodies from head to toe. It is the most important chemical signaling system from a homeostasis point of view in our bodies. It is not just represented and expressed on cell surfaces. Rather, recent research is showing how much it affects the intracellular level, opening this new spectrum of ability to modify genes, also known as epigenetic mechanisms, etc.”
So, unlike the usual challenges of topical cannabis creams that struggle to permeate through the dermis, to manage wounds at least, it’s a treatment match made in heaven.
Promising preliminary results
The results that Dr. Maeda has seen with his patients seem to prove it.
Using a proprietary blend of cannabis compounds based on his systematic review of the data, Dr. Maeda began treating patients initially at the wound clinic.
“My wound practice was the perfect environment to try and devise something that hopefully will improve the unsatisfactory status quo,” he says. “So I recruited the worst of the worst, and was able to heal the worst of the worst, which makes me think if I could heal the worst of it, imagine what I could do for everyday wounds.”
Preliminary results By cataloging the experience of two elderly patients who, despite having endured their wounds for more than six months, found complete closure using Dr. MEDA’s cannabis-based treatment within 73 days. Not only that, the patients’ pain was reduced so much that by day 63 no other analgesics were needed.
For more open label study Self-financed by Dr. Maeda, where fourteen complex patients with intractable leg ulcers were treated using his formula combined with pressure dressings, 79% of patients were found to have complete wound closure in 34 days.
Impressive though it is, Maida is the first to acknowledge that these are preliminary results for a small group of patients, and he hopes that a letter of intent from an international biotech company will eventually lead to the additional stages of clinical trials required to obtain his topical cannabis-based drug. to the market.
In the meantime, Dr. Maeda remains very much a man on a mission.
So, I’ve started the race, he says, I’ll run fast on the track. And then, in the end, I must hand over to the others who are going to take the marathon forward. And if nothing else, it’s my turn. This is my job…and I think the finish line will save Incredible opportunities for the world of integration and wounding.”
Mary Beals, United kingdomJournalist, Educator and Project Convention on Biological Diversity Contributing writer, is author The Convention on Biological Diversity the book (Harper Collins, United kingdom). Dr. Vincent Maeda’s full interview can be heard on cannabis sounds Podcast hosted by Mary Biles.
Copyright, Project Convention on Biological Diversity. It may not be reprinted without permission.
References
- Victoria K. Shanmugam et al. Relationship between opioid therapy and healing rate in chronic wounds. Wound repair regeneration. 2017 Jan; 25 (1): 120-130.
- Sachiko Koyama et al. Beta-caryophyllene promotes wound healing through multiple ways. PLor s One 14 (12): e0216104
- Gopalakrishnan et al. Quercetin accelerates skin wound healing in mice by increasing levels of VEGF And TGF-1 Indian J Exp Biol 2016 Mar; 54 (3): 187-95.
- Ramlet AA. Clinical benefits of Daflon 500 mg in the most severe stages of chronic venous insufficiency. Blood vessels. 2001 Aug; 52 Supplement 1:s 49-56
- Maeda et al. Topical cannabis-containing drugs – a new paradigm and treatment for non-uremic calcific leg ulcers: an open-label trial. Int Wound J 2020 Oct; 17 (5): 1508-1516
- Maeda et al. Topical cannabis-containing drugs–a new adjuvant treatment for venous leg ulcers: an open-label trial. Experimental dermatology. 2021 September; 30 (9): 1258–1267.
