CBD as antimicrobial agent

We are probably in a post-antibiotic era. Bacteria are increasingly resistant to the existing pharmacopeia. For economic reasons, new antibiotics are not being developed ambitiously. This is especially so for Gram-negative infections. Encouragingly, CBD and other cannabinoids, while not antibiotics in the traditional sense, have been knownsince the 1970’sto possess someantimicrobial activity, a property which has begun to be investigated more deeply in the last decade or so, particularly with regard to CBD, cannabichromene (CBC), cannabigerol (CBG), THC, and cannabinol (CBN), and with initial focus on six methicillin-resistantStaphylococcus aureus (MRSA) And results have been promising. Synthetic derivatives have also been tested, and a very recent study has reported further antimicrobial characterization of CBG. CBD itself is now in Phase 2 clinical trials for topical treatment of acne and atopic dermatitis, based partly on its known anti-inflammatory property, but with knowledge as well both these conditions have a bacterial component. Even newer data this year suggest that CBD has consistent activity against a wide range of Gram-positive bacteria, including drug-resistant strains. Moreover, this activity extends to at least some Gram-negative ones, including the clinically concerningNeisseria gonorrheae. Critically as well, there does not seem to be gradual resistance by bacteria under study to CBD treatment. It appears, though the molecular target is not known, that CBD’s special mechanism of action is to disrupt bacterial cytoplasmic membranes. More being known about this structure-activity relationship, there is now clear warrant for more research. 

If there is a limitation on CBD as an antibiotic, it is its apparent lack of systemic activity. This is possibly a function of its high serum binding. Even administered in abundance sufficient to kill microbes, the free CBD fraction available in the bloodstream to do work is not enough. It may be that CBD’s core structure can be altered in such a way as to mitigate this binding-effect while retaining antimicrobial activity. This could offer the additional advantage of rendering CBD as a very narrow-spectrum agent, that targets particular bacteria while sparing the natural biome. When CBD does not work, interestingly, against most Gram-negative bacteria, there is present an outer membrane and lipopolysaccharide. With drugs that disrupt membranes, or in the case of LPS-deficiency, Gram-negative bacteria are more vulnerable to CBD. That this is not universally true, and that its converse is not either, there are still subtle pathways to be discovered. 

Meanwhile, there is promise In CBD as part of a structurally new class of antibiotics, in some analog form for systemic use. Trials continue to expand in topical therapy, and one will shortly begin for nasal decolonization ofS. aureus, a current worry in operating rooms. The FDA is impressed enough with CBD, especially in light of its low propensity to induce microbial resistance and its favorable overall safety profile, to have just granted it Qualified Infectious Disease Product status. 

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The foregoing is a report on trends and developments in the cannabinoid industry. No product described herein is intended to diagnose, treat, cure or prevent any disease or syndrome.