Traditional Uses of Cannabinoids and New Perspectives in the Treatment of Multiple Sclerosis

Abstract

Recent findings highlight the emerging role of the endocannabinoid system in the control of symptoms and disease progression in multiple sclerosis (MS). MS is a chronic, immune-mediated, demyelinating disorder of the central nervous system with no cure so far. It is widely reported in the literature that cannabinoids might be used to control MS symptoms and that they also might exert neuroprotective effects and slow down disease progression. This review aims to give an overview of the principal cannabinoids (synthetic and endogenous) used for the symptomatic amelioration of MS and their beneficial outcomes, providing new potentially possible perspectives for the treatment of this disease.

Targeting Endocannabinoid Metabolism: an Arrow with Multiple Tips Against Multiple Sclerosis

“…The involvement of ECS in MS was originally established in the EAE mouse model of the disease. In this model, it was observed, in parallel with the entrance in the chronic phase, a profound neurodegeneration leading to hind‐limb spasticity, elevated levels in the brain and spinal cord of AEA, its congener palmitoylethanolamide ( 3 , PEA, Figure 3), and 2‐AG, with respect to non‐spastic EAE mice and healthy controls [96,97,98,99,100] . Interestingly, spasticity was rapidly increased after administration of a CB1R agonist, thus supporting the evidence that mitigation of hind limb spasticity is CB1R dependent and possibly derives from an endogenous compensatory mechanism mediated by the elevated ECs levels [101,102] .…”

Neural Stem Cells and Cannabinoids in the Spotlight as Potential Therapy for Epilepsy

“…Indeed, medical- Cannabis is being used or proposed to treat glaucoma, depression, neuralgia, neurodevelopmental forms of refractory epilepsy, and cancer [ 103 , 109 , 110 , 111 , 112 , 113 , 114 , 115 , 116 , 117 ]. Particularly, Cannabis usage has been helping patients suffering from multiple sclerosis-associated neuropathic pain and tremors, ameliorating tremors and bradykinesia in Parkinson’s disease patients, relieving neuropsychiatric symptoms shown by most individuals with Alzheimer’s disease and in anxiety/mood disorders [ 118 , 119 , 120 , 121 , 122 , 123 ].…”

Cannabinoid Actions on Neural Stem Cells: Implications for Pathophysiology

“…Despite its unknown etiology, an immune response and consequent infiltration of immune cells into the CNS together with demyelinating events culminates in oligodendrocyte loss and neuronal degeneration. Some of the resulting symptoms are spasticity, tremors, ataxia, bladder dysfunction and neuropathic pain, with a high impairment of the quality of life of the patient [378,379,380]. MS patients that consumed cannabis reported relief regarding several of these symptoms, highlighting a possible role for cannabinoids in MS [380,381,382,383,384,385].…”

“…Some of the resulting symptoms are spasticity, tremors, ataxia, bladder dysfunction and neuropathic pain, with a high impairment of the quality of life of the patient [378,379,380]. MS patients that consumed cannabis reported relief regarding several of these symptoms, highlighting a possible role for cannabinoids in MS [380,381,382,383,384,385]. Furthermore, the neuroprotective effects of these molecules in MS has been thoroughly described in the literature, since they are able to diminish oligodendrocyte death and increase remyelination whilst having an anti-inflammatory role [231,386,387].…”