What's Behind Charlotte's Web?

When Charlotte Figi was three months old, she experienced her first seizure that lasted for 30 minutes. She was immediately rushed to the hospital for an extensive examination. However, doctors were not able to properly diagnose the symptoms. Both her blood tests and her scans were all normal, and doctors sent Charlotte away with the presumption that the seizures would go away. Over the next few months, Charlotte had frequent seizures lasting up to two to four hours, and her condition was not improving. The team of doctors that monitored Charlotte believed that there were three possible diagnoses for this mysterious condition. The worst-case scenario being Dravet Syndrome (myoclonic epilepsy of infancy or SMEI.)

Dravet Syndrome is a rare form of intractable epilepsy. Intractable seizures can not be controlled by standard medication. Individuals with Dravet Syndrome begin life with normal developments and experience an onslaught of seizures after reaching two years of age. And at age two, Charlotte was experiencing over 300 grand mal seizures per week. Treatment options were sparse and reaching the end of the rope when Charlotte's father, Matt, found a video of a California boy whose Dravet Syndrome was successfully being treated with cannabis (Cannabis sativa). The strain of cannabis was low in tetrahydrocannabinol (THC), the psychoactive compound in marijuana and high in cannabidiol (CBD), which has medicinal properties without psychoactivity. Studies show that CBD has the ability to quiet the excessive electrical and chemical activity in the brain that causes seizures.

Due to Charlotte's young age, health professionals were wary about a medical marijuana treatment option. However, the Stanley Brothers, one of Colorado's largest marijuana growers, soon came to mind. The six brothers were crossbreeding a strain of marijuana that was high in CBD and low in THC. After an extensive debate, it was decided that Charlotte would receive a dose of cannabis oil twice a day in her food. It was found that three to four milligrams of oil per pound of Charlotte's body weight were able to stop and limit the seizures to only two times a day. The marijuana strain that Charlotte and 41 other patients use to relieve symptoms of diseases such as epilepsy and cancer has been named Charlotte's Web in respect to the little girl who gave doctors a new outlook for medical marijuana.

There are eight medical conditions for which patients can use cannabis- cancer, glaucoma, HIV/AIDS, muscle spasms, seizures, severe pain, severe nausea and cachexia or dramatic weight loss and muscle atrophy. There are over 400 natural components in medical marijuana, and 80 of these are solely found in cannabis. These eighty compounds are known as cannabinoids, and they relieve symptoms of diseases by attaching to receptors in the brain that look for similar compounds that occur in the human body, e.g. dopamine. There are five major groups of cannabinoids that have particularly unique medicinal properties, and each one produces different physical and psychological effects. This is how different strains of medical marijuana can be bred to the specific treatment of various symptoms. Each strain contains varying amounts of each cannabinoid.

How the Endocannabinoid System Works: How THC Affects the Brain and Body

Cannabinoids, the active ingredient in medical marijuana, works in the brain via the newly discovered endocannabinoid (EC) system. The EC system is a communication system in the brain and body that regulates many important functions. The natural chemicals produced by the body that interact within the EC system are called cannabinoids, and they react with neural receptors to relieve painful symptoms of serious diseases.

Neurons in the brain communicate with each other through a system of chemical and electrical signals. The chemicals (known as neurotransmitters) are released from a neuron (presynaptic cell), travel across a gap (synapse), and attach to specific receptors on an adjacent neuron (postsynaptic cell). However, the EC system communicates its messages in a "reverse" process. When the postsynaptic neuron is activated, cannabinoids (the messengers of the EC system) are made available from lipid (fat) cells present in the neuron. They are released and travel backwards to the presynaptic neuron, where they attach to cannabinoid receptors. Since cannabinoids act on presynaptic neurons rather than postsynaptic cells, they can control what happens next when these cells are activated. Cannabinoids have the ability to limit the amount of neurotransmitter that gets released, which as a result affect the acuteness of pain that the body feels.

How is Charlotte’s Web Made?

To extract high concentrations of CBD for medical cannabis, chemists at the Stanley brothers’ lab soak high-CBD marijuana in food-grade alcohol to extract cannabinoids. The solution is then heated in a rotary evaporator to remove the alcohol, leaving behind a high-CBD concentrate that is diluted with olive oil.

Throughout the process, a high-performance liquid chromatography (HPLC) machine is used to measure the ratio between CBD and THC in the solution. For medical marijuana patients, a higher CBD concentration is desired, and the Stanley brothers aim for a 30:1 ratio of CBD to THC in order to achieve anti-epileptic effects with negligible psychoactive effects.

As the debate over the legalization of medical cannabis spurs on, it is imperative to realize the beneficial effects that the plant has provided for numerous individuals with serious diseases.

References:

Kile, M. "Need to Know: The science behind medical marijuana." Aljazeera America. March 6, 2015

Young, S. "Marijuana stops child's severe seizures." CNN. August 7, 2013

Compassionate Sciences. Cellular Biology: How Cannabis Works in the Body (2013).

Scholastic Press. The Science of the Endocannabinoid System: How THC Affects the Brain and the Body (2011).

United Patients Group. The Therapeutic Uses of Cannabis and Cannabinoids (2015).

Images Credits:

1.The Synaptic Gap Image is by Wikipedia users Nrets and Looie496 and is distributed via Wikimedia Commons under a CC-BY license.

2. HPLC Image is by Wikipedia user Kjaergaard and is in the public domain.