Endocannabinoid and Cannabinoid-Like Fatty Acid Amide Levels Correlate with Pain-Related Symptoms in Patients with IBS-D and IBS-C: A Pilot Study

Abstract

AimsIrritable bowel syndrome (IBS) is a functional gastrointestinal (GI) disorder, associated with alterations of bowel function, abdominal pain and other symptoms related to the GI tract. Recently the endogenous cannabinoid system (ECS) was shown to be involved in the physiological and pathophysiological control of the GI function. The aim of this pilot study was to investigate whether IBS defining symptoms correlate with changes in endocannabinoids or cannabinoid like fatty acid levels in IBS patients.MethodsAEA, 2-AG, OEA and PEA plasma levels were determined in diarrhoea-predominant (IBS-D) and constipation-predominant (IBS-C) patients and were compared to healthy subjects, following the establishment of correlations between biolipid contents and disease symptoms. FAAH mRNA levels were evaluated in colonic biopsies from IBS-D and IBS-C patients and matched controls.ResultsPatients with IBS-D had higher levels of 2AG and lower levels of OEA and PEA. In contrast, patients with IBS-C had higher levels of OEA. Multivariate analysis found that lower PEA levels are associated with cramping abdominal pain. FAAH mRNA levels were lower in patients with IBS-C.ConclusionIBS subtypes and their symptoms show distinct alterations of endocannabinoid and endocannabinoid-like fatty acid levels. These changes may partially result from reduced FAAH expression. The here reported changes support the notion that the ECS is involved in the pathophysiology of IBS and the development of IBS symptoms.

Endocannabinoids and acute pain after total knee arthroplasty

“…Although endocannabinoid levels were not examined in serum and synovial fluid from non-OA patients, serum endocannabinoid levels in our study are similar to previous reports of healthy and non-OA patients and did not correlate with pain, suggesting that the serum endocannabinoid tone is not altered by OA [11,16,18,19]. Our negative results in regard to endocannabinoids and chronic OA pain are in agreement with a recent clinical report demonstrating that inhibition of the endocannabinoid hydrolyzing enzyme fatty acid amide hydrolase, and consequent elevation of PEA, OEA, and AEA levels, does not alter pain in OA patients [22].…”

Palmitoylethanolamide normalizes intestinal motility in a model of post‐inflammatory accelerated transit: involvement of CB1 receptors and TRPV1 channels

“…These results rule against a possible anti-prokinetic effect of endogenous PEA following the experimental post-inflammatory functional increase in intestinal motility. Recently, increased PEA levels in the plasma (Fichna et al, 2013) and in the colon (Zhang et al, 2014) of IBS patients have been reported.…”

The Role of the Endocannabinoid System in the Brain–Gut Axis

“…Variants of the CNR1 and FAAH genes have been observed in patients with diarrhea-predominant and alternating forms of IBS 82-84 . Levels of FAAH mRNA are reduced in intestinal tissues of patients with constipation-predominant IBS 85 . These genetic polymorphisms and alterations in gene expression are associated with alterations in GI motility and sensation, supporting the pathophysiologic significance of alterations in the ECS in the gut.…”