respiratory health
FAAH

Does This Cannabinoid Gene Increase The Risk Of ARDS? (FAAH)

Written by Mathew Eng, PharmD on April 13th, 2020
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Research on the FAAH gene has mostly focused on its unique effects on pain and drug abuse. However, there is also evidence that certain genetic variants may increase susceptibility to lung failure. Find out how this gene works and who may be affected.

What Is the FAAH Gene?

The FAAH gene helps create an enzyme called fatty acid amide hydrolase (FAAH).

The main function of the FAAH enzyme is to break down certain compounds in the body, including [R]:

Because of its link to cannabinoid and pain receptors, many studies have explored the effects of the FAAH gene on pain relief, drug abuse, and anxiety [R, R].

There is also some evidence that certain variants of FAAH may influence susceptibility to a lung condition called acute respiratory distress syndrome (ARDS), which we’ll focus on in this article [R].

The FAAH gene helps create an enzyme called FAAH, which is responsible for breaking down certain compounds in the body. Variations in FAAH have been linked to a lung condition called acute respiratory distress syndrome (ARDS).

FAAH & Acute Respiratory Distress Syndrome (ARDS)

What Is Acute Respiratory Distress Syndrome?

Acute respiratory distress syndrome (ARDS) is a sudden lung failure caused by blood poisoning (sepsis), severe pneumonia, or other critical conditions. Most ARDS patients require urgent supportive care in the intensive care unit (ICU) to avoid a fatal outcome [R, R, R].

Uncontrolled inflammation caused by excessive cytokine release is the hallmark of ARDS. The stimulation of white blood cells can cause a so-called cytokine storm and do more damage than the infection itself [R, R, R, R, R].

Acute respiratory distress syndrome (ARDS) is a form of lung failure resulting from severe inflammation of the lungs. Causes include respiratory infections and other critical conditions.

How Do Variants Of FAAH Affect ARDS?

Research suggests that a specific variant of the FAAH gene may be associated with lung health. More specifically the ‘A’ allele of rs324420 appears to increase the risk of developing ARDS [R].

One study looked at the genes of over 1,700 critically ill Caucasian patients and found that the ‘A’ allele of rs324420 may increase the risk of ARDS related to lung trauma, sepsis, pneumonia, and other causes [R].

This variant can cause weight gain, which is a risk factor for ARDS. However, even after adjustment for BMI, rs324420 remained independently associated with increased risk of acute lung injury [R].

Why does the ‘A’ allele have this effect? Research shows that the ‘A’ allele reduces the expression of the gene, leading to significantly lower levels of the FAAH enzyme in the body [R].

However, it’s not totally clear why reduced expression of FAAH leads to an increased risk of ARDS. It may be related to evidence that the ‘A’ allele is also linked to lower HDL cholesterol levels [R, R].

HDL cholesterol may have a protective effect against inflammation. Some researchers theorize that by reducing HDL levels, the ‘A’ allele may increase susceptibility to inflammation and ARDS [R].

A certain variant of the FAAH gene is associated with lower levels of the FAAH enzyme and a higher risk of developing ARDS, according to results from Caucasian populations. Some researchers think this happens because this FAAH variant reduces HDL cholesterol, leading to higher levels of inflammation.

Your FAAH Results for Lung Health

SNP Table

variant genotype frequency risk allele
rs324420

 

Primary SNP: 

FAAH rs324420

  • ‘C’ = Not associated with lung conditions
  • ‘A’ = Associated with a higher risk of developing ARDS
  • This association has only been found in Caucasian populations
  • About 8% of people have the ‘AA’ genotype (highest risk)

 

Recommendations

Lifestyle

Regular Exercise

Regular physical activity is one of the best ways to boost HDL levels, reduce inflammatory factors, and improve lung function.

According to some estimates, moderate-to-vigorous aerobic exercise can increase HDL levels by 5% to 10% [R, R].

Exercise also improves lung capacity and may help improve outcomes in those that develop ARDS [R, R].

This is because ARDS often leads to muscle weakness, which then lowers long-term survival chances for those that end up recovering from ARDS [R, R].

Research suggests that ARDS patients who are physically active are more likely to live longer and have better quality of life [R, R].

Weight Management

Research shows that obesity can change how the body metabolizes different types of fat, leading to lower HDL levels [R, R].

Studies also indicate that obesity is a strong risk factor for ARDS. Those who are overweight are much more likely to develop this respiratory condition [R, R].

Quit Smoking

Smoking can affect fat metabolism, which is why HDL levels are often significantly lower in smokers [R, R].

Those who quit smoking can expect a rapid increase of HDL within a couple of weeks of quitting, according to research [R].

Smoking also makes the lungs much more susceptible to infections, injury, and ARDS. For those that smoke, quitting can be one of the best ways to help prevent ARDS and other lung-related conditions [R, R, R].

Avoid Pollution

Exposure to air pollution has been associated with reduced HDL levels and function (through its increased oxidative damage) in human studies [R, R, R, R].

In addition, multiple studies have associated long-term exposure to high air pollution levels with increased chances of developing ARDS and dying from it [R, R, R].

Exercise, a healthy weight, quitting smoking, and avoiding air pollution can all help increase HDL cholesterol levels, improve lung health, and reduce the risk of respiratory conditions.

Diet

Diets That Boost HDL

A good way to raise HDL levels is to make sure you are eating healthy fats. This means replacing saturated and trans fats in the diet with healthier unsaturated fats [R].

The Mediterranean diet, in particular, has been shown to improve HDL levels and lower the levels of cytokines that can cause inflammation [R].

Some components of the Mediterranean diet include:

  • Plenty of fruits, vegetables, and nuts
  • Lean meats and fish (and limiting red meat)
  • Using healthy fats, especially olive oil

This diet has also been associated with improved lung health, especially in smokers. A study of 207 smokers found that those eating a Mediterranean diet had better lung function than those on a Western diet [R, R, R].

The Mediterranean diet may help boost HDL cholesterol while improving lung function in some people.

Olive Oil

Olive oil (an important component of the Mediterranean diet) has been shown to not only increase HDL levels, but also improve the stability and functionality of HDL particles in the body [R, R].

In animal studies, olive oil was able to alter immune function by stimulating the development of white blood cells and blocking cytokine production [R, R].

Some evidence suggests that certain compounds found in olive oil may have antiviral effects as well [R].

Another study in rats found that olive oil may help protect against lung tissue damage caused by oxidative stress [R].

Olive oil can help raise HDL cholesterol levels. It may also have antiviral effects and help protect the lungs against injury from oxidative stress.

Dietary Polyphenols

Polyphenols are antioxidant compounds naturally found in plants. Eating a diet rich in polyphenols has been associated with a better blood fat profile, including higher HDL levels [R, R, R, R].

Food sources of polyphenols include red berries, apples, oranges, vegetables, olive oil, dark chocolate, green tea, coffee, and red wine. 

Adequate Zinc Intake

In people deficient in zinc (such as in hemodialysis patients or those with uncontrolled diabetes), supplementation with this nutrient restored blood zinc and increased HDL levels. However, zinc seems to have no effect on the blood fat profile of people with a sufficient intake of this mineral [R, R, R, R].

In a study of 116 people, those who developed ARDS had lower blood zinc levels than both people in the ICU who didn’t develop this complication and healthy volunteers. The same study found that zinc deficiency stimulated the development of lung injuries due to mechanical ventilation in mice [R].

To avoid zinc deficiency, consider adding zinc-rich foods to your diet. Some of these include seafood (especially oysters), beef, pork, beans, and pumpkin seeds [R].

Supplements

Omega-3 Fatty Acids

A number of studies show that omega-3 fatty acids, such as the fish oils EPA and DHA, can moderately increase HDL while also reducing triglycerides and inflammation [R, R].

Several studies also suggest that omega-3 fatty acids may improve lung function, primarily by reducing inflammation in the airways [R, R, R].

Importantly, 2 meta-analyses concluded that omega-3 supplementation may improve ARDS symptoms and reduce its death rate [R, R].

In addition, a study of 642 people with asthma found that higher EPA and DHA levels were associated with a reduced risk of airway hyperreactivity [R].

Omega-3 fish oils, like EPA and DHA, have been shown to increase HDL and improve outcomes related to ARDS.

Royal Jelly

Royal jelly improved HDL levels in old (but not young) people with high blood cholesterol and in patients with diabetes [R, R].

Propolis

Propolis improved blood fat profile, including HDL levels, in one clinical trial on 67 healthy volunteers and one on 94 people with type 2 diabetes. It also had this effect in diabetic rats [R, R, R].

N-Acetylcysteine

In 2 clinical trials on 10 people with high blood fat levels and 24 diabetic men, supplementation with N-acetylcysteine (NAC) increased HDL levels [R, R]. 

NAC can improve lung function and reduce oxidative stress in patients with chronic obstructive pulmonary disease (COPD), which is a risk factor for ARDS [R, R, R].

Schisandra

In a clinical trial on 28 obese women, supplementation with schisandra fruit extract increased HDL levels (and improved other metabolic parameters) [R].

Similarly, different schisandra extract and their components improved blood fat profile, including HDL levels, in mice fed high-fat diets and diabetic rats [R, R, R].

Both schisandra extract and its compound schisantherin A reduced lung inflammation and ARDS caused by bacterial lipopolysaccharide (LPS) in mice [R, R].

YiQiFuMai, a Chinese injection with schisandra, ginseng, and dwarf lilyturf (Ophiopogon japonicus), had similar effects in another study in mice [R].

Black Cumin Seed

The trials of black cumin seed to improve blood fat profile produced controversial results. A meta-analysis of 17 clinical trials concluded that only black cumin seed powder, but not the oil, could increase HDL levels [R, R, R].

In animal studies, black seed extract prevented lung inflammation and damage caused by a chemotherapeutic drug (bleomycin), sulfur mustard gas, and hydrochloric acid [R, R, R, R].

Berberine

Berberine is a compound found in several different types of plants that are commonly used in traditional medicine, such as Barberry, Oregon Grape, and Goldenseal.

A scientific review of 16 studies totalling over 2,100 people concluded that berberine may increase HDL levels, as well as lower LDL, triglycerides, and total cholesterol [R].

Other reviews have found similar results, although in all the reviews the researchers acknowledge that the quality of studies are generally low [R, R, R].

There is also some evidence that berberine may have antimicrobial properties, which could potentially be beneficial against respiratory infections. 

A mouse study suggests that berberine may block virus replication, reduce inflammation, and prevent tissue damage in mice infected with influenza A (H1N1) virus [R].

Cell studies show that berberine may have activity against multiple types of bacteria, viruses, and parasites. However, its effect in humans is unclear until further research is done [R, R, R, R].

Berberine, a compound found in several plants, may help improve HDL levels. Animal and cell studies also suggest that berberine may have antimicrobial activity.

Cocoa Extract

The cocoa (or cacao) bean is what chocolate is made from. Certain compounds inside this bean may help raise HDL cholesterol levels, according to multiple clinical trials [R, R, R, R].

For example, a small study of 25 people found that supplementation with cocoa powder for 12 weeks increased HDL by 24% more than the control group [R].

Several studies propose that cocoa extract may have antiviral and antiparasitic effects as well [R, R].

According to a study in guinea pigs, cocoa powder may also improve asthma symptoms [R].

Supplementation with cocoa extract can potentially increase HDL. It may also have antimicrobial properties and help with asthma symptoms, according to animal studies.

Author photo
Mathew Eng
PharmD

Mathew received his PharmD from the University of Hawaii and an undergraduate degree in Biology from the University of Washington.

Mathew is a licensed pharmacist with clinical experience in oncology, infectious disease, and diabetes management. He has a passion for personalized patient care and believes that education is essential to living a healthy life. His goal is to motivate individuals to find ways to manage their chronic conditions.

Disclaimer

The information on this website has not been evaluated by the Food & Drug Administration or any other official medical body. This information is presented for educational purposes only, and may not be used to diagnose or treat any illness or disease.

Also keep in mind that the “Risk Score” presented in this post is based only on a select number of SNPs, and therefore only represents a small portion of your total risk as an individual. Furthermore, these analyses are based primarily on associational studies, which do not necessarily imply causation. Finally, many other (non-genetic) factors can also play a significant role in the development of a disease or health condition — therefore, carrying any of the risk-associated genotypes discussed in this post does not necessarily mean you are at increased risk of developing a major health condition.

Always consult your doctor before acting on any information or recommendations discussed in this post — especially if you are pregnant, nursing, taking medication, or have been officially diagnosed with a medical condition.

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