Piglets with Hypoxic-Ischemic Brain Damage Benefit from Cannabidiol and Therapeutic Hypothermia

Cannabidiol (CBD) is a component of the cannabis (marijuana) plant that serves a wide variety of medicinal purposes (the legality of CBD and other cannabis products varies by state). Importantly, cannabidiol has been shown to provide neuroprotection in animal models of hypoxic-ischemic encephalopathy (HIE). HIE is a type of brain injury from oxygen deprivation. In newborns, HIE is often the result of a medical complication or incidence of malpractice during labor and delivery, i.e. a birth injury.

Brain damage from HIE is an evolving process; shortly after the initial oxygen-depriving insult, cells begin to die and release substances that are toxic to other cells. A great deal of research on treatments for HIE focuses on slowing or halting this spread of injury.

Currently, the most widely used and effective treatment for newborns with HIE is therapeutic hypothermia, also known as neonatal cooling. If administered very shortly after birth, therapeutic hypothermia can significantly reduce the extent of permanent brain damage. However, this treatment is often not enough to prevent serious, lasting effects of HIE. Therefore, many researchers are busy looking for alternative or complementary treatments for newborns with HIE. Cannabidiol is one promising option.

Adding cannabidiol to therapeutic hypothermia regimen improves outcomes in piglets

Lorena Barata and colleagues recently published the results of a study on the effects of cannabidiol in brain-damaged piglets. Their study used day-old piglets with hypoxic-ischemic injuries, which were randomized into several different groups. Some were given cannabidiol treatment, while others were given vehicle treatment (i.e. an innocuous solution administered in the same way as cannabidiol). Likewise, some were given therapeutic hypothermia, while others were submitted to normothermia. They also included a control group of non-manipulated piglets.

Throughout the experiment, Barata et al. monitored blood flow, respiration, and brain activity. After the experimental period, the piglets were killed and their brains underwent histological, biochemical, and proton magnetic resonance spectroscopy studies.

The authors found that treatment with cannabidiol was well-tolerated in piglets with hypoxic-ischemic injuries. Cannabidiol alone offered some neuroprotection, but it was much more effective when used in addition to therapeutic hypothermia. Cannabidiol and hypothermia combined provided more neuroprotection than either treatment acting alone. More research is needed before this becomes a standard treatment for HIE in human newborns, but this is a promising result.

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Barata, L., Arruza, L., Rodríguez, M. J., Aleo, E., Vierge, E., Criado, E., … & Hind, W. (2018). Neuroprotection by cannabidiol and hypothermia in a piglet model of newborn hypoxic-ischemic brain damage. Neuropharmacology.

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