Unveiling the Potential of Cannabinoids in Multiple Sclerosis and the Dawn of Nano-Cannabinoid Medicine

Multiple sclerosis is the predominant autoimmune disorder affecting the central nervous system in adolescents and adults. Specific treatments are categorized as disease-modifying, whereas others are symptomatic treatments to alleviate painful symptoms. Currently, no singular conventional therapy is universally effective for all patients across all stages of the illness. Nevertheless, cannabinoids exhibit significant promise in their capacity for neuroprotection, anti-inflammation, and immunosuppression. This review will examine the traditional treatment for multiple sclerosis, the increasing interest in using cannabis as a treatment method, its role in protecting the nervous system and regulating the immune system, commercially available therapeutic cannabinoids, and the emerging use of cannabis in nanomedicine. In conclusion, cannabinoids exhibit potential as a disease-modifying treatment rather than merely symptomatic relief. However, further research is necessary to unveil their role and establish the safety and advancements in nano-cannabinoid medicine, offering the potential for reduced toxicity and fewer adverse effects, thereby maximizing the benefits of cannabinoids.

Therapeutic Prospects of Cannabinoids in the Immunomodulation of Prevalent Autoimmune Diseases

Cannabinoids such as ▵-9-THC and CBD can downregulate the immune response by modulating the endocannabinoid system. This modulation is relevant for the treatment of prevalent autoimmune diseases (ADs), such as multiple sclerosis (MS), systemic lupus erythematosus (SLE), diabetes mellitus type 1 (DMT1), and rheumatoid arthritis (RA). These conditions require new therapeutic options with fewer side effects for the control of the autoimmune response. Objective: to conduct a literature review of preclinical scientific evidence that supports further clinical investigations for the use of cannabinoids (natural or synthetic) as potential immunomodulators of the immune response in ADs.

Immune Responses Regulated by Cannabidiol.

Authors: James M. Nichols and Barbara L.F. Kaplan
Cannabis and Cannabinoid Research, 4 September 2019

Introduction: Cannabidiol (CBD) as Epidiolex® (GW Pharmaceuticals) was recently approved by the U.S. Food and Drug Administration (FDA) to treat rare forms of epilepsy in patients 2 years of age and older. Together with the increased societal acceptance of recreational cannabi…

The influence of THC:CBD oromucosal spray on driving ability in patients with multiple sclerosis-related spasticity.

Authors: Elisabeth G. Celius, Carlos Vila
Brain and Behavior, 6 April 2018

BACKGROUND: Driving ability is a key function for the majority of patients with multiple sclerosis (MS) to help maintain daily interactions. Both physical and cognitive disability, as well as treatments, may affect the ability to drive. Spasticity is a common symptom associate…

Oral administration of cannabis with lipids leads to high levels of cannabinoids in the intestinal lymphatic system and prominent immunomodulation.

Authors: Atheer Zgair, Jong Bong Lee, Jonathan C. M. Wong, Dhiaa A. Taha, Jehan Aram, et al
Scientific Reports, 6 November 2017

Cannabidiol (CBD) and ∆9-tetrahydrocannabinol (THC) have well documented immunomodulatory effects in vitro, but not following oral administration in humans. Here we show that oral co-administration of cannabinoids with lipids can substantially increase their intestinal lympha…

Randomized controlled trial of Sativex to treat detrusor overactivity in multiple sclerosis.

Authors: R. B. C. Kavia, D. De Ridder, C. S. Constantinescu, C. G. Stott, C. J. Fowler
Multiple Sclerosis Journal, November 2016

BACKGROUND: Bladder dysfunction is a common feature of multiple sclerosis (MS). OBJECTIVE: In this study we aimed to assess the efficacy, tolerability and safety of Sativex(®) (nabiximols) as an add-on therapy in alleviating bladder symptoms in patients with MS. METHODS: We un…

Clinical Endocannabinoid Deficiency Reconsidered: Current Research Supports the Theory in Migraine, Fibromyalgia, Irritable Bowel, and Other Treatment-Resistant Syndromes.

Authors: Ethan B. Russo
Cannabis and Cannabinoid Research, 1 July 2016

Medicine continues to struggle in its approaches to numerous common subjective pain syndromes that lack objective signs and remain treatment resistant. Foremost among these are migraine, fibromyalgia, and irritable bowel syndrome, disorders that may overlap in their affected p…

Cannabinoids and autoimmune diseases: A systematic review

Authors: Valeria Katchan, Paula David, Yehuda Shoenfeld
Autoimmunity Reviews, June 2016

Cannabinoids have shown to have a variety effects on body systems. Through CB1 and CB2 receptors, amongst other, they exert an effect by modulating neurotransmitter and cytokine release. Current research in the role of cannabinoids in the immune system shows that they possess…

Cannabidiol for the Prevention of Graft-versus-Host-Disease after Allogeneic Hematopoietic Cell Transplantation: Results of a Phase II Study.

Authors: Moshe Yeshurun, Ofer Shpilberg, Corina Herscovici, Liat Shargian, Juliet Dreyer, et al
Biology of Blood and Marrow Transplantation, October 2015

Graft-versus-host-disease (GVHD) is a major obstacle to successful allogeneic hematopoietic cell transplantation (alloHCT). Cannabidiol (CBD), a nonpsychotropic ingredient of Cannabis sativa, possesses potent anti-inflammatory and immunosuppressive properties. We hypothesized…

Δ⁹-Tetrahydrocannabinol attenuates allogeneic host-versus-graft response and delays skin graft rejection through activation of cannabinoid receptor 1 and induction of myeloid-derived suppressor cells.

Authors: Jessica M. Sido, Prakash S. Nagarkatti, Mitzi Nagarkatti
Journal of Leukocyte Biology, September 2015

Immune cells have been shown to express cannabinoid receptors and to produce endogenous ligands. Moreover, activation of cannabinoid receptors on immune cells has been shown to trigger potent immunosuppression. Despite such studies, the role of cannabinoids in transplantation…

Medical Marijuana for Treatment of Chronic Pain and Other Medical and Psychiatric Problems: A Clinical Review.

Authors: Kevin P. Hill
JAMA, 23 June 2015

IMPORTANCE: As of March 2015, 23 states and the District of Columbia had medical marijuana laws in place. Physicians should know both the scientific rationale and the practical implications for medical marijuana laws. OBJECTIVE: To review the pharmacology, indications, and law…

Role of Endocannabinoid Activation of Peripheral CB1 Receptors in the Regulation of Autoimmune Disease.

Authors: Jessica Margaret Sido, Prakash S. Nagarkatti, Mitzi Nagarkatti
International Reviews of Immunology, 2015

The impact of the endogenous cannabinoids (AEA, 2-AG, PEA, and virodamine) on the immune cell expressed cannabinoid receptors (CB1, CB2, TRPV-1, and GPR55) and consequent regulation of immune function is an exciting area of research with potential implications in the preventio…