- The director of the Spanish medical team, José Antonio Martínez Orgado, explained the progress of this research to Dinafem and stated that, very possibly, clinical testing will begin at the end of this year or the start of 2017. Although more than a decade ago he was unaware of the existence of cannabinoids, he now knows that their properties are suitable for helping new-born babies that have problems during childbirth. And, he believes that now is the perfect time for researchers like him to convince health institutions about the benefits of cannabis for treating human beings, even from the first moments of life.
José Antonio Martínez Orgado has spent more than 13 years carrying out research into the properties of cannabinoids within his area of work, neonatology. He is currently a doctor at the San Carlos Clinical Hospital in Madrid and leads a research team that studies the properties of CBD (cannabidiol) and its possible use for new-borns, specifically, those that suffer any kind of brain damage due to neonatal hypoxia or asphyxia. “In simple terms, we are talking about what is known as when a child lacks oxygen during its birth”, he explained to Dinafem. Combating the damage cause by hypoxia in new-born babies has been one of his aims since 1993.
His contact with cannabis was coincidental, when some time ago a professional from the Faculty of Biology at the Complutense University remarked to him that cannabinoids could be useful for his study. He admits that back then he had not even heard of them; in fact, there was not as much information as at present and few groups specialised in them.
So, he decided to gather information about the subject and realised that “they had properties that were absolutely perfect for treating brain damage". He began by trying out a cannabinoid with effects very similar to those of THC, but “due to a series of more or less chance circumstances, we ended up working with cannabidiol”.
Martín Orgado states that there are three mechanisms that can cause damage to the brain (by damage we mean a traumatism, lack of oxygen or injury) and they are usually interconnected; inflammation, free radicals and neurotransmitters (whose purpose is to activate neurons) that are freed in the brain and, and when this happens excessively, it also causes problems.
The coincidence, says the professional, is that cannabinoids in general and cannabidiol in particular are “extremely potent” antioxidants and anti-inflammatories and they act on these three things at the same time. “This makes them almost ideal because there are few substances that we can find which manage to do this”. “Their properties are absolutely perfect”, he remarks.
What happens, according to Orgado, is that an episode of 'hypoxia' is followed by what is known as 'reperfusion', which means that the blood flows again, loaded with oxygen. Because of this excess oxygen, some molecules become unstable as well as toxic for the cells. These are free radicals, which are prolonged in time and spatially expand the area of injury (which becomes increasingly larger over successive hours and days).
An antioxidant such as CBD limits the production of these free radicals, thus making the final injury much smaller along with the neurological damage. “CBD is a very powerful antioxidant and what’s good news is that there are more illnesses linked to oxidative stress, especially among new-borns, in which it could also be effective,” says the doctor. During this 'reperfusion', it is not only oxygen but also white cells that reach the brain, trying to remove dead cells from the area.
It is for this purpose that they liberate a substance that eventually destroys the damaged cells but which can also affect the healthy ones and also attract the white cells, as a consequence of which the intensity and extent of the damage are increased. “That’s what happens after an insect bite; over the next few hours a warm red area appears and this becomes increasingly larger and more irritating,”
The inflammation, moreover, produces in the brain a swelling known as an oedema, which can affect blood circulation. This is why “a potent anti-inflammatory such as CBD is extraordinarily useful and beneficial as it reduces another of the vicious circles that extend and expand brain damage,” he states.
Since he began his journey into the world of medical cannabis more than ten years ago, as part of a small group of researchers that collaborates intensely with different national and foreign universities, the medical properties of cannabis have become almost the sole line of his research. He works with pure botanical extract, non-synthetic CBD obtained from a cannabis plant that has been genetically modified so that it almost exclusively produces cannabidiol.
However, how is this cannabis component administered to babies? Martínez Orgado explains that, as cannabinoids are lipids, fatty substances that do not dissolve directly in water, they needed to create a system for applying them. They did so in collaboration with a British pharmaceutical company, with whom they have created a means of intravenous supply. He adds that it has still not been applied to humans however they hope that it will be an effective treatment, although “it is almost impossible for the patient to be 100% cured”.
At present, the treatment is applied following the childbirth, when it is already known that the child has suffered hypoxia, because it is currently impossible to know which babies are going to need it. The use of cannabidiol, as carried out on animals, should take place thirty minutes or an hour after the birth of the baby. Despite the urgency, “there are parts of the brain that are already damaged and practically no treatment at the moment manages to cure them”. However, with his study they have seen that although the subject will not return to complete normality, they almost do.
The doctor affirms that they have a research study awaiting study, and in it they have discovered that CBD could act up to 12 or 18 hours after the birth and be effective. Furthermore, he says that it is possible to apply before the birth. “One of the things that we are going to do over the coming months is start a new research study in order to see if the administration of cannabidiol to the mother will reach the child. That is the most probable outcome", he believes.
The course of treatment currently followed with children that have suffered asphyxia is hypothermia, lowering the temperature of their body. “What we are now studying is how cannabidiol acts in conjunction with that hypothermia to see if the results improve or if the treatment is more effective”. The fact is that this treatment (without cannabinoids), “the only one there is and that which everyone accepts must be used”, only benefits half of the children at the moment. Martínez Orgado wants to see if his method would be beneficial for lots more.
Very soon it will be possible to discover its effects on humans. “The idea is to begin clinical tests at the end of this year or the start of next year”, says the expert. The research group has already begun negotiations with the United States Medicine Agency, which “is quite a lot more agile than its European counterpart”. However, before getting down to work they will have to carry out some more tests in order to be certain there will no problems or secondary effects and, afterwards, they will begin to recruit children in the United States and Europe in order to attain their goal.
Martínez Orgado is confident that everything will go well because, according to him, cannabidiol has practically no side effects. He knows that this is the time for researchers like him to be able to convince health authorities that there is no danger in using these products derived from the cannabis plant. Having said that, he is aware that it is always necessary to do things in the most scientific way possible.
He gives an example: he says, as everyone is aware, heroin is deadly, opiates in general are, however “we use them regularly in medicine, such as with morphine”. What happens is that they are used in a controlled way and nobody complains about it. He adds that, for a long time, cocaine was added as an analgesic to injections for teeth and, although “everyone knows that it is bad, in can be used in a controlled manner”.
With regard to cannabidiol, he says that its “benefits far outweigh the risks”. “It is really amazing, not only can it reduce brain damage, but it also has beneficial effects on the lungs, heart, blood pressure and lots more things”. His work with CBD and that of his willing team is offering an important source of hope to the families facing such a difficult scenario, childbirth, which as a general rule, is meant to bring more joy than sadness.