Abstract
Introduction: Although the recreational cannabis use is expressive worldwide, the literature about medical potential of cannabis extracts, including its anti-inflammatory properties, remains inconclusive. Methods: We screened all articles, published on the PubMed database, on inflammatory mediators and any information about cannabis use from 1980 to March 2019. Results: Six studies were included, and the main findings were as follows: (i) among healthy volunteers and cannabis users, cannabinoids seemed to decrease the inflammatory response, thus decreasing the immune response, which led to a higher risk of infections; (ii) among patients with multiple sclerosis, cannabinoids seemed to have little impact on the inflammatory markers’ levels. Discussion: Although cannabis use can produce immune inflammatory suppression in healthy people, this effect is not robust enough to change inflammatory mediators’ levels in situations of highly dysfunctional inflammatory activation. Nevertheless, the impact of cannabinoids in clinical outcomes of these conditions remains to be determined.
References
1.
United Nations Office of Drugs and Crime. World Drug Report 2018. Nations Publication. Sales No. E.18.XI.9
.2.
Schlicker
E
, Kathmann
M
. Modulation of transmitter release via presynaptic cannabinoid receptors
. Trends Pharmacol Sci
. 2001 Nov
;22
(11
):565
–72
. 3.
Mechoulam
R
. Marihuana chemistry
. Science
. 1970
;168
(3936
):1159
–66
. 4.
Biegon
A
, Kerman
IA
. Autoradiographic study of pre- and postnatal distribution of cannabinoid receptors in human brain
. Neuroimage
. 2001
;14
(6
):1463
–8
. 5.
Carlini
EA
, Nappo
SA
, Galduróz
JCF
, Noto
AR
. Drogas psicóticas: o que são e como agem
. Revista IMESC no. 3
. 2001
;9
–35
.6.
Ribeiro
JAC
, Machado
JQ
. A Cannabis e suas aplicações terapêuticas
. Porto
: Universidade Fernando Pessoa- Faculdade de Ciências da Saúde
; 2014
.7.
Kagen
SL
, Kurup
VP
, Sohnle
PG
, Fink
JN
. Marijuana smoking and fungal sensitization
. J Allergy Clin Immunol
. 1983 Apr
;71
(4
):389
–93
. 8.
Roth
MD
, Whittaker
K
, Salehi
K
, Tashkin
DP
, Baldwin
GC
. Mechanisms for impaired effector function in alveolar macrophages from marijuana and cocaine smokers
. J Neuroimmunol
. 2004 Feb
;147
(1–2
):82
–6
. 9.
Klein
TW
, Lane
B
;Newton
CA
, Friedman
H
. The cannabinoid system and cytokine network
. Proc Soc Exp Biol Med
. 2000 Oct
;225
(1
):1
–8
. 10.
MacCallum
CA
, Russo
EB
. Practical considerations in medical cannabis administration and dosing
. Eur J Intern Med
. 2018
;49
:12
–9
.11.
Verhoeckx
KC
, Korthout
HA
, van Meeteren-Kreikamp
AP
, Ehlert
KA
, Wang
M
, van der Greef
J
, et al. Unheated cannabis sativa extracts and its major compound THC-acid have potential immuno-modulating properties not mediated by CB1 and CB2 receptor coupled pathways
. Int Immunopharmacol
. 2006
;6
(4
):656
–65
. 12.
Rock
EM
, Sticht
MA
, Parker
LA
. Effects of phytocannabinoids on nausea and vomiting
. In: Pertwee
RG
, editor. Handbook of cannabis
. Oxford, UK
: Oxford University Press
; 2014
. p. 435
–54
.13.
Nadal
X
, Del Río
C
, Casano
S
, Palomares
B
, Ferreiro-Vera
C
, Navarrete
C
, et al. Tetrahydrocannabinolic acid is a potent PPARγ agonist with neuroprotective activity
. Br J Pharmacol
. 2017
;174
(23
):4263
–76
. 14.
Sulak
D
, Saneto
R
, Goldstein
B
. The current status of artisanal Cannabis for the treatment of epilepsy in the United States
. Epilepsy Behav
. 2017
;70
(Pt B
):328
–33
. 15.
Bolognini
D
, Rock
EM
, Cluny
NL
, Cascio
MG
, Limebeer
CL
, Duncan
M
, et al. Cannabidiolic acid prevents vomiting in Suncus murinus and nausea-induced behaviour in rats by enhancing 5-HT1A receptor activation
. Br J Pharmacol
. 2013
;168
(6
):1456
–70
. 16.
Rock
EM
, Limebeer
CL
, Petrie
GN
, Williams
LA
, Mechoulam
R
, Parker
LA
. Effect of prior foot shock stress and Δ
. Psychopharmacology
. 2017
;234
:2207
–17
. 17.
Koppel
B
, Brust
J
, Fife
T
, Bronstein
J
, Youssof
S
, Gronseth
G
, et al. Systematic review: efficacy and safety of medical marijuana in selected neurologic disorders: report of the Guideline Development Subcommittee of the American Academy of Neurology
. Neurology
. 2014
;82
(17
):1556
–63
. 18.
Klein
TW
. Cannabinoid-based drugs as anti-inflammatory therapeutics
. Nat Rev Immunol
; 2005
. p. 400
–411
. https://www.nature.com/articles/nri1602.19.
Abbas
AK
, Lichtman
AH
, Pillai
S
. Imunologia celular e molecular
. 8th ed. Rio de Janeiro
: Elsevier
; 2015
.20.
Eisenstein
TK
. Effects of cannabinoids on T-cell function and resistance to infection
. J Neuroimmune Pharmacol
. 2015 Jun
;10
(2
):204
–16
. 2015 Apr 16
. 21.
Contino
M
, Capparelli
E
, Colabufo
NA
, Bush
AI
. Editorial: the CB2 cannabinoid system: a new strategy in neurodegenerative disorder and neuroinflammation
. Front. Neurosci
. 2017
;11
:196
. 22.
Phillips
B
, Ball
C
, Sackett
D
, Badenoch
D
, Straus
S
, Haynes
B
, et al. CEBM- Levels of evidence (March 2009)
. Oxford Centre for Evidence-Based Medicine
. 2009
. https://www.cebm.net/2009/06/oxford-centre-evidence-based-medicine-levels-evidence-march-2009/.23.
Pacifici
R
, Zuccaro
P
, Pichini
S
, Roset
PN
, Poudevida
S
, Farré
M
, et al. Modulation of the immune system in cannabis users
. JAMA
. 2003 Apr 16
;289
(15
):1929
–31
. 24.
Pacifici
R
, Zuccaro
P
, Farré
M
, Poudevida
S
, Abanades
S
, Pichini
S
, et al. Combined immunomodulating properties of 3,4 methylenedioxymethamphetamine (MDMA) and cannabis in humans
. Addiction
. 2007 Jun
;102
(6
):931
–6
. 25.
Sexton
M
, Silvestroni
A
, Möller
T
, Stella
N
. Differential migratory properties of monocytes isolated from human subjects naïve and non-naïve to Cannabis
. Inflammopharmacology
. 2013 Jun
;21
(3
):253
–9
. Epub 2012 Apr 11
. 26.
Katona
S
, Kaminski
E
, Sanders
H
, Zajicek
J
. Cannabinoid influence on cytokine profile in multiple sclerosis
. Clin Exp Immunol
. 2005 Jun
;140
(3
):580
–5
. 27.
Killestein
J
, Hoogervorst
EL
, Reif
M
, Blauw
B
, Smits
M
, Uitdehaag
BM
, et al. Immunomodulatory effects of orally administered cannabinoids in multiple sclerosis
. J Neuroimmunol
. 2003 Apr
; 137
(1–2
): 140
–3
. 28.
Sexton
M
, Cudaback
E
, Abdullah
RA
, Finnell
J
, Mischley
LK
, Rozga
M
, et al. Cannabis use by individuals with multiple sclerosis: effects on specific immune parameters
. Inflammopharmacology
. 2014 Oct
;22
(5
):295
–303
. 29.
Croxford
JL
, Yamamura
T
. Cannabinoids and the immune system: potential for the treatment of inflammatory diseases?
J Neuroimmunol
. 2005 Sep
;166
(1–2
):3
–18
. 30.
Alonso
R
, Contenttini
EC
, Imhoff
G
, Lopez
PA
, Rubestein
A
, Tizio
S
. Barriers against a successful MS treatment: the importance of effectiveness beyond efficacy
. Mult Scler Relat Disord
. 2019
;30
:129
–35
.31.
Patrick
S
, Connick
P
. Psychometric properties of the PHQ-9 in multiple sclerosis: a systematic review
. PLoS One
. 2019 Feb 19
;14
(2
):e0197943
. 32.
Pugliatti
M
, Rosati
G
, Carton
H
, Riise
T
, Drulovic
J
, Vécsei
L
, et al. The epidemiology of multiple sclerosis in Europe
. Eur J Neurol
. 2006
;13
(7
):700
–22
. 33.
Zwibel
HL
, Smrtka
J
. Improving quality of life in multiple sclerosis: an unmet need
. Am J Manag Care
. 2011
;17
(Suppl 5
):S139
–45
.34.
Goodin
DS
, Frohman
EM
, Garmany
GP
Jr, Halper
J
, Likosky
WH
, Lublin
FD
, et al. Disease modifying therapies in multiple sclerosis: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and the MS Council for Clinical Practice Guidelines
. Neurology
. 2002 Jan 22
;58
(2
):169
–78
.35.
Morrison
A
, Polisena
J
, Husereau
D
, Moulton
K
, Clark
M
, Fiander
M
, et al. The effect of English-language restriction on systematic review-based meta-analyses: a systematic review of empirical studies
. Int J Technol Assess Health Care
. 2012 Apr
;28
(2
):138
–44
. 36.
Kramer
JL
. Medical marijuana for cancer
. CA Cancer J Clin
. 2015
;65
(2
):109
–22
. 37.
Allsop
DJ
, Copeland
J
, Lintzeris
N
, Dunlop
AJ
, Montebello
M
, Sadler
C
, et al. Nabiximols as an agonist replacement therapy during cannabis withdrawal: a randomized clinical trial
. JAMA Psychiatry
. 2014
;71
(3
):281
–91
. © 2020 S. Karger AG, Basel
2020
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.
