Sickle Cell Anemia: The Role of Evolution and Cannabis

Sickle cell anemia is a life-threatening genetic disease
found primarily in African-Americans. A 5,000-year-old genetic mutation
originating in Africa, it causes the normally oval-shaped red-blood cells to
bend into a sickle shape.

Sickle cell is a recessive genetic trait. Each parent must
pass on the sickle cell gene to their child for sickle cell anemia to develop.
If only one parent passes on the gene, then the child has sickle cell trait,
which does not have the life-threatening consequences of sickle cell anemia. It
will only develop when the child receives a sickle cell gene from both parents.

Sickle-shaped blood cells break apart easily and die within
20 days, resulting in a shortage of red blood cells and insufficient oxygen
leading to a multitude of physiological problems. Sounds horrid and it is, yet
sickle cell anemia is the textbook example of evolution through natural
selection.

Malaria is a disease caused by the introduction of the
protozoan parasite Plasmodium falciparum
through a mosquito bite. One of the most deadly of all infectious diseases,
there were almost 200 million infections in 2013 resulting in over 600,000
deaths. Ninety percent of the deaths occur in sub-Saharan Africa with over 75
percent of these deaths occurring in children under five years of age.

People with sickle cell trait
receive significant protection from malaria, increasing the likelihood that a
child with sickle cell
trait will live long enough to reproduce as compared to a child without
sickle cell trait who develops malaria from the bite of an infected mosquito
and dies at an early age.

The anemia resulting from sickle cell disease results in an
insufficient supply of oxygen slowing growth in infants and children, delaying
puberty in teens and increasing infections. Its most common manifestation is
not a result of insufficient oxygen but is caused by the sickle shaped cells
blocking blood flow through the minuscule blood vessels in the chest, abdomen,
joints and bones.

This blockage causes periodic episodes known as sickle cell
crisis. Coupled with impaired oxygenation from misshapen blood cells, symptoms
can be extremely painful varying in intensity and lasting from a few hours to
weeks on end. Currently the pain is treated with both non-steroidal
anti-inflammatory agents (NSAIDs) and opioid based prescription
pharmaceuticals.

Cannabis provides
pain relief without the negative side effects of opioid medications—which are
exacerbated in patients with any kind of anemia—allowing patients to consume
significantly fewer prescription pharmaceuticals. In addition, the
neuroprotective properties of cannabis can reduce the eye and nerve damage
prevalent amongst people afflicted with sickle cell, while its powerful
anti-inflammatory agents reduce the inflammation caused by the blockage of
blood vessels mitigating both damage and pain.

Alleviating pain
and inflammation from arthritis, cancer and a host of other ailments has been
documented by multiple studies and is one of the main reasons people use
cannabis medicinally. That it would also be effective for the pain and
inflammation associated with sickle cell would be a no-brainer but no
scientific study to validate the millenniums’ worth of anecdotal evidence has
been done—until now.

As he has done in
past research on using cannabis to treat pain in AIDS and cancer patients, Dr.
Donald Abrams, Chief of Hematology and Oncology at San Francisco General
Hospital, is now seeking to find out if sickle cell anemia patients can obtain
similar pain reductions through the use of cannabis. Focusing on the
cannabinoid CBD, which is noted for its ability to reduce both inflammation and
pain, Dr. Abrams is looking to determine whether vaporized cannabis reduces
pain in sickle cell anemia patients who are taking opioid medications for
chronic pain.

Patients selected
to participate in the study will spend two five-day periods at San Francisco
General Hospital inhaling cannabis three times a day using a Volcano vaporizer.
Qualified patients can receive up to $560 for participating. Although earning
money for vaporizing cannabis seems too good to be true, this is serious
science. This study is on-going, and they need more qualified patients. If you
are a sickle cell patient or know of one, call (415) 476-4082 x146 to find out
about participating.