Immunomodulatory Potential of Cannabidiol in Multiple Sclerosis: a Systematic Review
Open Access
- 25 January 2021
- journal article
- review article
- Published by Springer Science and Business Media LLC in Journal of Neuroimmune Pharmacology
- Vol. 16 (2), 251-269
- https://doi.org/10.1007/s11481-021-09982-7
Abstract
Multiple sclerosis (MS) is the most common chronic autoimmune disease of the central nervous system. Efficacy of treatments for MS is associated with risk of adverse effects, and effective and well-tolerated drugs remain a major unmet need. Cannabis (Cannabis sativaL., fam. Cannabaceae) and cannabinoids are popular among MS patients to treat spasticity and pain. Cannabinoids are endowed with remarkable immunomodulating properties, and in particular the non-psychotropic cannabinoid cannabidiol (CBD) is increasingly recognized as anti-inflammatory and immunosuppressive, nevertheless with excellent tolerability even at high doses. In this systematic review, we retrieved and critically evaluated available evidence regarding the immune and disease-modifying effects of CBD in experimental autoimmune encephalomyelitis (EAE) and in MS. Evidence in rodent models of EAE strongly supports CBD as effective, while clinical evidence is still limited and usually negative, due to paucity of studies and possibly to the use of suboptimal dosing regimens. Better characterization of targets acted upon by CBD in MS should be obtained in ex vivo/in vitro studies in human immune cells, and higher doses should be tested in well-designed clinical trials with clinically relevant efficacy endpoints.Keywords
Funding Information
- Università degli Studi dell'Insubria
This publication has 87 references indexed in Scilit:
- Pharmacogenetics of new analgesicsBritish Journal of Pharmacology, 2011
- Cannabidiol inhibits pathogenic T cells, decreases spinal microglial activation and ameliorates multiple sclerosis‐like disease in C57BL/6 miceBritish Journal of Pharmacology, 2011
- Functional Characterization of Low-Prevalence Missense Polymorphisms in the UDP-Glucuronosyltransferase 1A9 GeneDrug Metabolism and Disposition, 2009
- Characterization of Human Hepatic and Extrahepatic UDP-Glucuronosyltransferase Enzymes Involved in the Metabolism of Classic CannabinoidsDrug Metabolism and Disposition, 2009
- The diverse CB1 and CB2 receptor pharmacology of three plant cannabinoids: Δ9‐tetrahydrocannabinol, cannabidiol and Δ9‐tetrahydrocannabivarinBritish Journal of Pharmacology, 2008
- Cannabinoids in multiple sclerosis (CAMS) study: safety and efficacy data for 12 months follow upJournal of Neurology, Neurosurgery & Psychiatry, 2005
- Cannabinoid-based drugs as anti-inflammatory therapeuticsNature Reviews Immunology, 2005
- Immunomodulatory effects of orally administered cannabinoids in multiple sclerosisJournal of Neuroimmunology, 2003
- Chemical Basis of Hashish ActivityScience, 1970