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  Issue 1 (2004)

Inflammatory and itching skin

Endocannabinoids as a new approach for anti-inflammatory effect

Endocannabinoids as natural ligands of cannabinoid receptors are present in nearly all aerobic cells. But why has nature provided these receptors and how can they be used for skin care and dermatological therapy? Possible answers to these questions have been provided by investigations carried out by Professor Dr. Lajos Kemeny from the University of Szeged, Hungary. He established an anti-oxidative and protective effect against UVB-radiation for a commercial dermo-cosmetic product containing the endocannabinoid N-Palmitoyl Ethanolamine (PEA). Relief of symptoms in patients with mild atopic eczema was achieved comparable to those
seen following use of hydrocortisone.

In the past decade the effect of endocannabinoids on many different body functions has been investigated. It has been shown that cognitive functions, control of food intake, addiction to alcohol and drugs as well as release of hormones, immunological responses and varied gastro-intestinal and cardio-vascular functions are all influenced. Cannabinoid receptors might also be involved in the mediation of pain and itching. It is likely that different cannabinoid receptors are responsible for different functions

Professor Dr. Lajos Kemeny, head of the Dermatological Department at the Unversity of Szeged, Hungary, investigated the dermatological effects of various endocannabinoids. For his investigations, he used a dermo-cosmetic product (PHYSIOGEL® A.I. Cream, Stiefel Laboratorium GmbH, Offenbach), which is available in Germany in pharmacies and contains the well-known and already well-established endocannabinoid N-Palmitoyl Ethanolamine (PEA).

Professor Dr. Lajos Kemeny (center) from the Dermatological Department of the University in Szeged, Hungary, attended the 8th general meeting of the Society for Dermopharmacy in Halle/Saale, end of March 2004. In a lecture in the scientific main program he presented the study results for the examination of the effectiveness of a dermocosmetic product containing endocannabinoids.

Anti-Oxidative protection
against UVB-Radiation

In an exploratory study the protective effect against UVB-radiation of this PEA-containing cream was examined in five test subjects. The subjects applied the endocannabinoid cream or the cream base for one month. Thereafter the treated skin areas were irradiated twice daily over a period of 4 weeks with the double minimal erythema dosage (2x MED). To evaluate UV-related damage, biopsies of irradiated vs. non-irradiated skin were taken and the amount of thymidine dimers and protein p53 was detected by antibodies.

Both test methods resulted in a small but significant difference in favour of the endocannabinoid cream. Also erythema was significantly reduced by the PEA- cream. It should be noted that no effect was seen, if the endocannabinoid cream was applied only twenty minutes before the irradiation took place. Thus PEA as the active ingredient is obviously not a UV-absorbant. A broader anti-oxidative protective mechanism must be assumed.

Relief of Symptoms in
Atopic Eczema

The effects of the endocannabinoid cream were examined in a further study in 18 patients suffering from mild atopic eczema. The efficacy of the cream was compared with a 1% hydrocortisone cream, marketed in Hungary, by half-side comparison. 15 patients completed the three-week investigation, while three patients withdrew before the study’s completion due to non-compliance. Results showed that, the two preparations had equivalent efficacy in the inhibition of pruritus, infiltration of the skin and lichenification of the atopic lesions. Whilst hydrocortisone cream reduced erythema more recognizably, the endocannabinoid cream produced a greater reduction in skin dryness in the first week (in each case p < 0,05). Subjective evaluation by the dermatologist and the patients showed no difference between both products.

Mode of action not
finally investigated

Based on the results of these investigations the tested endocannabinoid cream seems to be an effective product in protecting the skin from oxidative damage caused by UV-radiation and for the relief of clinical symptoms which attend mild forms of atopic eczema.

Beyond the investigated range of application, endocannabinoids should be regarded as promising candidates for a new approach to anti-inflammatory effect. However some basic research might still be needed to understand these empirically determined effects. For example, it is not yet clear which cannabinoid receptors are transmitting the observed effects. (tmb)



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