title: Inhibitory effect of standardized cannabis sativa extract and its ingredient cannabidiol on rat and human bladder contractility.
abstract: OBJECTIVE
  To evaluate the effect of a Cannabis sativa extract enriched in cannabidiol (CBD) botanic drug substance (BDS) and pure CBD, on bladder contractility in vitro. Cannabis based-medicines, including CBD-enriched extracts, have been shown to reduce urinary urgency, incontinence episodes, frequency, and nocturia in patients with multiple sclerosis.
  
  
  METHODS
  Strips were cut from male Wistar rats and the human bladder body and placed in organ baths containing Krebs solution. Contractions were induced by electrical field stimulation, acetylcholine, KCl, and α,β-methylene adenosine triphosphate.
  
  
  RESULTS
  CBD BDS significantly reduced the contractions induced by acetylcholine, but not those induced with electrical field stimulation, KCl, or α,β-methylene adenosine triphosphate in the isolated rat bladder. The inhibitory effect of CBD BDS was not significantly modified by the cannabinoid or opioid receptor antagonists or by modulators of calcium levels, but it was increased by ruthenium red and capsazepine, 2 transient receptor potential vanilloid type-1 blockers. In humans, CBD BDS and pure CBD significantly reduced acetylcholine-induced contractions, an effect that was not changed by the transient receptor potential vanilloid type-1 blockers.
  
  
  CONCLUSIONS
  Our data have suggested that CBD BDS reduces cholinergic-mediated contractility and that this effect is modulated by transient receptor potential vanilloid type-1 in rats but not in humans. CBD is the chemical ingredient of CBD BDS responsible for such activity. If confirmed in vivo, such results could provide a pharmacologic basis to explain, at least in part, the efficacy of Cannabis medicines in reducing incontinence episodes in patients with multiple sclerosis.
authors.affiliation: Department of Experimental Pharmacology and Endocannabinoid Research Group, University of Naples Federico II, Naples, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Capasso
authors.forename: Gabriella
authors.initials: G
authors.lastname: Aviello
authors.forename: Francesca
authors.initials: F
authors.lastname: Borrelli
authors.forename: Barbara
authors.initials: B
authors.lastname: Romano
authors.forename: Matteo
authors.initials: M
authors.lastname: Ferro
authors.forename: Luigi
authors.initials: L
authors.lastname: Castaldo
authors.forename: Vittorino
authors.initials: V
authors.lastname: Montanaro
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Altieri
authors.forename: Angelo A
authors.initials: AA
authors.lastname: Izzo
mesh_terms: D000109:Acetylcholine / Q000494:pharmacology; D000818:Animals; D002185:Cannabidiol / Q000494:pharmacology*; D002188:Cannabis; D018679:Cholinergic Agonists / Q000494:pharmacology; D006801:Humans; D066298:In Vitro Techniques; D008297:Male; D009103:Multiple Sclerosis / Q000150:complications; D009119:Muscle Contraction / Q000187:drug effects*; D009130:Muscle, Smooth / Q000187:drug effects* / Q000502:physiology; D010936:Plant Extracts; D051381:Rats; D017208:Rats, Wistar; D001743:Urinary Bladder / Q000187:drug effects; D014549:Urinary Incontinence / Q000517:prevention & control
chemical_list: D018679:Cholinergic Agonists; D010936:Plant Extracts; D002185:Cannabidiol; D000109:Acetylcholine