Steve Ottersberg - Physiological Basis of the Endocannabinoid System, and Phytocannabinoids - AHS19

The purpose of this talk is to provide a physiological basis for understanding the function of the ECS and how genetics and diet influence endocannabinoid tone. From the physiological basis of the ECS this presentation will build upon the pharmacology and pharmacogenomics to provide rationale for determining the most effective clinical approach to endocannabinoid therapies. Polymorphisms in the genes for the component enzymes and receptors of the ECS can influence the clinical outcome of cannabinoid therapies. One poignant example of this are ultra-fast variants of CYP2C9 are poor candidates for oral consumption of Delta-9-THC due to the rapid conversion of Delta-9-THC into 11-OH-THC. 11-OH-THC is poorly tolerated due to intensity of euphoric effect and long terminal plasma half-life (up to 72 hours).