Landmark Study: CBD is the prototypical member of an exciting new class of potential antibiotics

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Cutting-edge research published just this month tells us that cannabidiol (CBD) is a much better antibiotic than we previously understood.

To begin with, CBD kills more kinds of bugs than we thought – some two dozen – including those considered by the U.S. Centers for Disease Control to be the most dangerous bacteria out there: Methicillin-resistant Staphylococcus aureus (MRSA); multidrug-resistant Streptococcus pneumoniae; vancomycin-resistant enterococci (VRE); Clostridioides (previously Clostridium) difficile; and Neisseria gonorrhoea.

The gonorrhea finding is especially significant for two reasons. The CDC has put what the World Health Organization and others are calling Super Gonorrhea, on their list of the 5 most dangerous pathogens in the world (also included is C. difficile, above). Second, this is the first time CBD has been shown to kill some types of Gram-negative bacteria – bacteria that have an extra outer membrane, an additional line of defense that makes it harder for antibiotics to kill.  

Surprisingly, say the researchers, CBD “possessed excellent potency” against three other Gram-negative bacteria as well, those that cause life-threatening meningitis, airway infections such as bronchitis and pneumonia, and Legionnaires’ disease.

CBD was also found to be effective at killing bacteria in biofilm, that slimy build-up that serves to protect bacteria and that you find, for example, on the dental plaque on the surface of teeth.

And, crucially, they “demonstrate that CBD does not lead to resistance after repeated exposure.” We see how important drug resistance is in the context of the coronavirus. As the virus evolves it can develop different capabilities of concern; for example, to be more contagious and, especially worrisome, the potential ability to evade – resist – vaccines.

In the context of drug-resistant bacteria, the CDC has warned us that we’ve entered a post-antibiotic era where “You and I are living in a time when some miracle drugs no longer perform miracles and families are being ripped apart by a microscopic enemy.” So the fact that CBD doesn’t contribute to this – lead to the evolution of drug-resistant pathogens – is absolutely huge.

As is the work by these first class investigators. Their findings are published in Nature, the world’s leading peer-reviewed research journal, and represents the collaborative effort of 22 primary scientists plus team members, employed in three universities and four biotech firms that span three countries – the US, Australia, and New Zealand.

And they’re careful to add a caveat to their findings: these weren’t human trials, they were experiments conducted in the lab, exposing the various pathogens to CBD in test tubes or on a plate, and by applying CBD topically to infections induced in the thighs of mice.

Moving to human trials will require overcoming one specific hurdle: when CBD is given orally or by injection it binds to proteins in the blood – it’s “captured” by the blood – leaving none available to go after bacteria. The solution involves simple chemistry – reengineering the CBD so it binds to bacteria, not blood.

This is entirely doable these days. So much so that the labs are working on developing CBD analogs that are not only capable of being delivered systemically like any other antibiotic, but are fine-tuned to target each bacterium of interest. As opposed to the current broad spectrum antibiotics that kill not only the problem pathogen but the commensals as well – those bacteria that we need to maintain health. Narrow spectrum CBD analogs are a big step in drug development and allow us to peer into the (near) future of antibiotic therapy. The researchers summarize:

CBD represents the prototypical member of an exciting structural class of antibiotics, with potential to develop new analogs that have narrow spectrum selective Gram-negative activity against [for example] the dangerous pathogen N. gonorrhoeae. Given recent concerns over the rise of ‘super gonorrhea’ the discovery of a new class of compounds that is active against the major types of N. gonorrhoeae resistance is an important development, though tempered by the need to develop an analog suitable for systemic treatment.

The CEO of Botanix, one of the biotech firms conducting the CBD analog work, said in a news release that the research showed vast potential for the development of effective treatments to fight the growing global threat of antibiotic resistance, and he concludes:

Our Company is now primed to commercialise viable antimicrobial treatments which we hope will reach more patients in the near future. This is a major breakthrough that the world needs now.

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