Xeroderma Pigmentosum

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Does Medical Marijuana Relieve Xeroderma Pigmentosum Symptoms?

  1. Can Medical Cannabis Help Skin Cancer?
  2. Using Medical Cannabis for XP
  3. Thoughts About XP and Cannabis
  4. Xeroderma Pigmentosum Causes
  5. XP Types

Xeroderma pigmentosum (XP), also known as DeSanctis-Cacchione syndrome in the most severe form, is a DNA repair disorder that is characterized by skin irritation to sun sensitivity and various other severe complications. It is often considered an inherited disease. These patients suffer from irritated skin, skin discoloration, skin cancers, sensory problems, and degenerative nervous system issues including loss of muscle function and sometimes cognitive deficits. There is no reason to wonder why patients with XP may turn to medical cannabis to help relieve their symptoms and make life more manageable.

Medical cannabis contains almost 150 cannabinoids that can help influence several processes in our body such as immunity, pain perception, and skin cell functionality. This occurs through a system of fat-based neurotransmitters in our bodies called the endocannabinoid system (ECS). When cannabinoids such as Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD) contact cannabinoid receptors CB1 and CB2 of the ECS, plus other receptors, they can positively impact our bodies. 

When it comes to our skin, research has shown that there are plentiful amounts of both CB1 and CB2 receptors found in skin cells, skin nerve fibers, oil-producing sebaceous glands, and hair follicles (1). There is also transient receptor potential (TRP) proteins that are activated by endocannabinoids and play a role in the maintenance of the barrier of the skin. Additionally, peroxisome proliferator-activated receptors (PPAR) are plentiful in the skin and help gene expression of the skin or cutaneous tissue. Theoretically, this research makes cannabis a good potential candidate for helping patients with XP.

Can Medical Cannabis Help Skin Cancer?

There is research available that supports the use of cannabinoids for lesions and skin cancer, but more research is needed to functionally prescribe it for skin cancer patients and those with XP. Scientists have discovered that human melanoma cancer cells are lined with both CB1 and CB2 receptors (8). When cancerous cells are in the body, they don’t follow the normal life cycle of cells and don’t die. Instead, they can keep reproducing, allowing cancer to spread. Activation of CB1 and CB2 receptors inside melanoma cancer cells has been shown to increase cancer cell death in a process called apoptosis.

Though several studies on cannabinoids and using the ECS as a target for melanoma and other skin cancers exist, these studies mostly focus on cancer cells that have been removed from the body and in live mice as opposed to being tested directly in humans. While there is exciting research that shows that melanoma and other cancerous tumors can be reduced with cannabinoids, this research is still in its infancy. Skin cancers and any health concerns should be addressed with your provider, as well as appropriate and recommended treatment options. 

Using Medical Cannabis for XP

While there is research promoting the use of topical cannabinoid products for inflammation of the skin in conditions such as psoriasis, eczema, and acne, there isn’t conclusive research on genetic skin issues and cannabis. 

Some research looking at samples of fibroblasts, a common type of cell found in connective tissues including the skin, compared the effects of THC on the cells of healthy individuals and patients with XP (15). This research showed that there was no observable increase in chromosome breaks or changes between the two groups of patients. This means cannabinoids did not cause further cancerous mutations in this study. The cellular changes were examined for exposure to THC, CBD, cannabinol (CBN), and 11-OHΔ9-THC

On the other hand, there is also research that shows that the cannabinoid receptors that are found in the skin could be involved in the process of developing UV damage and skin cancer in certain circumstances (13). Though this study was performed by examining mice given cancer-causing DMBA cream, researchers found that irradiating cells with UV increases the uptake of cancer-causing cream in the presence of UV radiation and both CB1 and CB2 receptors. They also applied both the cancer-causing cream and ultraviolet irradiation to mice that had an absence of CB1 and CB2 receptors. These mice showed a lower inflammatory response to both the cancer-causing cream and UV radiation. They also showed less skin cancer growth than the mice that had CB receptors in the skin. 

Researchers in this study determined that the cannabinoid receptors allowed more of the toxic cream and UV light to absorb into the skin of the mice (13). However, it is important to note that this study is not saying that the skin cancer was caused by these receptors, but rather they potentially assisted in the absorption of the cancerous stimuli. More research is needed to determine exactly how cannabinoid receptors assisted in the process of cancer development in the presence of cancer-causing substances. 

Thoughts About XP and Cannabis

Despite the ability of medical cannabis to decrease inflammation in the skin and the results from studies supporting its use in cancerous growths, this research is really just beginning. Because XP patients experience a DNA sequencing defect causing issues repairing their skin, it is important that they understand that they have an increased risk for cancer due to daily exposure to environmental carcinogens (i.e. cigarette smoke, UV radiation from the sun, harsh chemical cleaners, and other known carcinogens). 

 XP patients are encouraged to weigh the benefits and effects of this research before deciding whether to use medical marijuana products. Unfortunately, it is still unclear what cannabis does in this population without direct patient studies and so it cannot be recommended based on scientific evidence at this time.  Please speak with your health care provider before beginning medical marijuana treatments.

Xeroderma Pigmentosum Causes

XP is caused by a mutation of the genes that are responsible for repairing DNA. DNA can be damaged by ultraviolet light from the sun or by chemicals found in cigarettes or cleaning products. Normal cells can repair this damage, but this is not the case in patients with XP (16). Because the cells are not able to repair the DNA properly, cellular abnormalities can form and cause visible damage to the skin resulting in redness and freckling. Unfortunately, this can eventually lead to cell abnormalities and potentially cause skin cancer.

Doctors believe that genomic mutations that lead to XP are related to the DNA repair replication process above which is called nucleotide excision repair (NER) (16). Inherited genes in the nucleotide excision repair process cause some of the natural DNA repair steps to be skipped. XP can also be caused by a genetic mutation of the DNA polymerase eta gene (POLH). When the POHL gene is functioning properly it protects our cells from UV-induced DNA damage. 

XP Types

XP, and its severe DeSanctis-Cacchione syndrome, are typically classified by which gene is causing a defect in the cells’ ability to repair DNA (2). Many of the types of XP produce similar symptoms including sensitivity to sunlight, changes in skin pigmentation, development of liver spots, and skin cancer. Some patients also suffer from neurodegeneration related to the XP. Neurodegeneration causes sensory, balance, and cognitive deficits and the muscles to weaken with loss of function in nerve cells called neurons. This increases the risk of other neurodegenerative diseases developing such as Alzheimer’s or Parkinson’s disease

XP genes are typically classified as xeroderma pigmentosum groups A-G and dependent on which gene is not properly functioning in the body (2). Defects in the POLH gene cause an XP variant that results in similar light sensitivity symptoms and skin pigmentation changes but is considered milder than other types of XP. This form typically does not cause the same developmental delay and hearing loss as severe DeSanctis-Cacchione syndrome does (11). Some XP genomic variants caused by the same defective genes include Cockayne syndrome (CS), cerebro-oculofacial-skeletal syndrome (COFS), and trichothiodystrophy (TTD).

 

Note: Veriheal does not intend to give this as professional medical advice. Do not attempt to self-diagnose, or prescribe treatment based on the information provided on this page. Always consult a physician before making any decision on the treatment of a medical condition.

1. Baswan, S. M., Klosner, A. E., Glynn, K., Rajgopal, A., Malik, K., Yim, S., & Stern, N. (2020). Therapeutic Potential of Cannabidiol (CBD) for Skin Health and Disorders. Clinical, cosmetic and investigational dermatology, 13, 927–942. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7736837/

2. Black J. O. (2016). Xeroderma Pigmentosum. Head and neck pathology, 10(2), 139–144. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4838978/

3. Blazquez C, Carracedo A, Barrado L, et al. Cannabinoid receptors as novel targets for the treatment of melanoma. FASEB J. 2006;20:2633–2635. https://faseb.onlinelibrary.wiley.com/doi/10.1096/fj.06-6638fje

4. Gęgotek, A., Jastrząb, A., Dobrzyńska, M., Biernacki, M., & Skrzydlewska, E. (2021). Exogenous Antioxidants Impact on UV-Induced Changes in Membrane Phospholipids and the Effectiveness of the Endocannabinoid System in Human Skin Cells. Antioxidants (Basel, Switzerland), 10(8), 1260. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8389309/

5. Gupta, A. K., & Talukder, M. (2021). Cannabinoids for skin diseases and hair regrowth. Journal of Cosmetic Dermatology, 20(9), 2703–2711. https://onlinelibrary.wiley.com/doi/10.1111/jocd.14352

6. Hashim, P. W., Cohen, J. L., Pompei, D. T., & Goldenberg, G. (2017). Topical cannabinoids in dermatology. Cutis, 100(1), 50–52. https://cdn.mdedge.com/files/s3fs-public/Document/July-2017/CT100001050.PDF

7. Kim, H. Y., Ahn, S. H., Yang, I. J., Park, S. Y., & Kim, K. (2020). Effect of Hataedock Treatment on Epidermal Structure Maintenance through Intervention in the Endocannabinoid System. Evidence-based complementary and alternative medicine : eCAM, 2020, 3605153. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6998750/

8. Milando, R., & Friedman, A. (2018). Cannabinoids: Potential role in inflammatory and neoplastic skin diseases. American Journal of Clinical Dermatology, 20(2), 167–180. https://static1.squarespace.com/static/5dab51c52920995e635d4295/t/5e4bbe406ddc335ff28de578/1582022212575/Milando2019AmJClinDermatol.pdf

9. Pehlivan, S., Yazici, A. B., Aydin, N., Nursal, A. F., Kurnaz, S., Ongel Atar, A., Sever, U., Kincir, Z., Pehlivan, M., & Cetinay Aydin, P. (2018). Possible association between DNA repair gene variants and cannabis dependence in a Turkish cohort: A pilot study. Psychiatry and Clinical Psychopharmacology, 28(4), 402–407. https://www.tandfonline.com/doi/full/10.1080/24750573.2018.1468615

10. Sheriff, T., Lin, M. J., Dubin, D., & Khorasani, H. (2020). The potential role of cannabinoids in dermatology. The Journal of dermatological treatment, 31(8), 839–845. https://pubmed.ncbi.nlm.nih.gov/31599175/

11. U.S. National Library of Medicine. (2020, August 18). Xeroderma pigmentosum: Medlineplus genetics. MedlinePlus. Retrieved November 20, 2021, from https://medlineplus.gov/genetics/condition/xeroderma-pigmentosum/

12. Zarkovic, N. (2020). Roles and functions of Ros and RNS in cellular physiology and pathology. Cells, 9(3), 767. https://www.mdpi.com/2073-4409/9/3/767/htm

13. Zheng D, Bode AM, Zhao Q, et al. The cannabinoid receptors are required for ultraviolet-induced inflammation and skin cancer development. Cancer Res. 2008;68(10): 3992–3998. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2390870/

14. Zimmerman, S., & Zimmerman, A. M. (1990). Genetic effects of marijuana. International Journal of the Addictions, 25(sup1), 19–33. https://www.tandfonline.com/doi/abs/10.3109/10826089009067003

15. Zimmerman, A. M., Stick, H., & San, R. (1978). Nonmutagenic action of cannabinoids in vitro. Pharmacology, 16(6), 333–343. https://www.karger.com/Article/Abstract/136789

16. U.S. National Library of Medicine. (2020, August 18). Xeroderma pigmentosum: Medlineplus genetics. MedlinePlus. Retrieved December 15, 2021, from https://medlineplus.gov/genetics/condition/xeroderma-pigmentosum/#causes  

17. DE WEERD-KASTELEIN, E., KEIJZER, W. & BOOTSMA, D. Genetic Heterogeneity of Xeroderma Pigmentosum demonstrated by Somatic Cell Hybridization. Nature New Biology 238, 80–83 (1972). https://www.nature.com/articles/newbio238080a0

18. Pehlivan, S., Yazici, A. B., Aydin, N., Nursal, A. F., Kurnaz, S., Ongel Atar, A., Sever, U., Kincir, Z., Pehlivan, M., & Cetinay Aydin, P. (2018). Possible association between DNA repair gene variants and cannabis dependence in a Turkish cohort: A pilot study. Psychiatry and Clinical Psychopharmacology, 28(4), 402–407. https://www.tandfonline.com/doi/full/10.1080/24750573.2018.1468615

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Content Medically Reviewed By: Dr. Abraham Benavides, MD
Content Medically Reviewed By: Dr. Abraham Benavides, MD
Contributors: Sarah Walker Learn More About The Experts

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