Cannabidiol and Other Cannabinoids in Demyelinating Diseases

Abstract

A growing body of preclinical evidence indicates that certain cannabinoids, including cannabidiol (CBD) and synthetic derivatives, may play a role in the myelinating processes and are promising small molecules to be developed as drug candidates for management of demyelinating diseases such as multiple sclerosis (MS), stroke and traumatic brain injury (TBI), which are three of the most prevalent demyelinating disorders. Thanks to the properties described for CBD and its interesting profile in humans, both the phytocannabinoid and derivatives could be considered as potential candidates for clinical use. In this review we will summarize current advances in the use of CBD and other cannabinoids as future potential treatments. While new research is accelerating the process for the generation of novel drug candidates and identification of druggable targets, the collaboration of key players such as basic researchers, clinicians and pharmaceutical companies is required to bring novel therapies to the patients.

Sistema endocannabinoide y el rol del cannabis medicinal en el tratamiento de la espasticidad: una revisión narrativa

“…La más reciente revisión sistemática y metaanálisis publicado por Cochrane (70) reportó que el nabiximol reduce la percepción de espasticidad en personas con EM, comparado con placebo (OR 2,51 [IC 95 % 1,04; I 2 = 67 %]). Igualmente, reduce el dolor crónico (OR 4,23 [IC 95 % 1,(11)(12)(13)(14)(15)(16)17]) y mejora la impresión del estado global de salud según el PGIC (patient global impression of change) ( OR 1,80 [IC 95 % 1,36; I 2 = 0 %]). El National Institute for Health and Care Excellence (NICE) del Reino Unido recomendó en 2019 ofrecer una prueba terapéutica de cuatro semanas con Sativex ® a los pacientes con EM con espasticidad refractaria (13).…”

“…En el siglo XIX, el médico irlandés William Brooke O'Shaughnessy introdujo el cannabis como medicamento por sus propiedades antiinflamatorias, analgésicas y anticonvulsivantes (1). La caracterización en 1960 de los primeros fitocannabinoides, ∆ 9 -tetra-hidrocannabinol (THC) y cannabidiol (CBD), hecha por Ralph Mechoulam, sumada al aumento del uso recreativo de la planta, incentivó aún más la investigación, y en 1990 se lograron identificar los receptores humanos y más adelante los ligandos endógenos.…”

The Endocannabinoid System in Glial Cells and Their Profitable Interactions to Treat Epilepsy: Evidence from Animal Models

“…The oligodendrocytes responsible for the mature myelin production are generated from the oligodendrocyte progenitor cells (OPC). The cells are distributed throughout certain regions in the CNS, being more abundant in the white matter (WM) [230,231].…”

Increased White Matter Coherence Following Three and Six Months of Medical Cannabis Treatment

“…Although the exact mechanism of action remains unknown, evidence suggests potential roles for CBD modulation of several receptor subtypes including G protein–coupled receptor 55 (GPR55), serotonin 1A receptor (5-HT1A), transient receptor potential cation channel subfamily V member 1 (TRPV1), peroxisome proliferator–activated receptor-gamma (PPAR-γ), and potentially some activity at cannabinoid receptor subtypes (CB1 and CB2). 33–36 Additional preclinical work has also provided some evidence that THC may be associated with neurogenesis, anti-inflammatory effects, and prevention of neurodegenerative processes in animal models of disease, as well as in older animals via CB1 receptor–mediated processes and inhibition of enzymatic hydrolysis of acetylcholine. 37 …”