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A Critical Review of the Role of the Cannabinoid Compounds Δ9-Tetrahydrocannabinol (Δ9-THC) and Cannabidiol (CBD) and their Combination in Multiple Sclerosis Treatment.
Molecules. 2020 Oct 25; 25(21)M

Abstract

Many people with MS (pwMS) use unregulated cannabis or cannabis products to treat the symptoms associated with the disease. In line with this, Sativex, a synthetic combination of cannabidiol (CBD) and Δ9-tetrahydrocannabinol (Δ9-THC) has been approved to treat symptoms of spasticity. In animals, CBD is effective in reducing the amounts of T-cell infiltrates in the spinal cord, suggesting CBD has anti-inflammatory properties. By doing this, CBD has shown to delay symptom onset in animal models of multiple sclerosis and slow disease progression. Importantly, combinations of CBD and Δ9-THC appear more effective in treating animal models of multiple sclerosis. While CBD reduces the amounts of cell infiltrates in the spinal cord, Δ9-THC reduces scores of spasticity. In human studies, the results are less encouraging and conflict with the findings in animals. Drugs which deliver a combination of Δ9-THC and CBD in a 1:1 ratio appear to be only moderately effective in reducing spasticity scores, but appear to be almost as effective as current front-line treatments and cause less severe side effects than other treatments, such as baclofen (a GABA-B receptor agonist) and tizanidine (an α2 adrenergic receptor agonist). The findings of the studies reviewed suggest that cannabinoids may help treat neuropathic pain in pwMS as an add-on therapy to already established pain treatments. It is important to note that treatment with cannabinoid compounds may cause significant cognitive dysfunction. Long term double-blind placebo studies are greatly needed to further our understanding of the role of cannabinoids in multiple sclerosis treatment.

Authors+Show Affiliations

Behavioural Neuroscience Laboratory, Neuropsychopharmacology Division, School of Psychology, Faculty of Science and Health, Dublin City University, Glasnevin, Dublin 9, Ireland.Behavioural Neuroscience Laboratory, Neuropsychopharmacology Division, School of Psychology, Faculty of Science and Health, Dublin City University, Glasnevin, Dublin 9, Ireland.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

33113776

Citation

Jones, Éamon, and Styliani Vlachou. "A Critical Review of the Role of the Cannabinoid Compounds Δ9-Tetrahydrocannabinol (Δ9-THC) and Cannabidiol (CBD) and Their Combination in Multiple Sclerosis Treatment." Molecules (Basel, Switzerland), vol. 25, no. 21, 2020.
Jones É, Vlachou S. A Critical Review of the Role of the Cannabinoid Compounds Δ9-Tetrahydrocannabinol (Δ9-THC) and Cannabidiol (CBD) and their Combination in Multiple Sclerosis Treatment. Molecules. 2020;25(21).
Jones, É., & Vlachou, S. (2020). A Critical Review of the Role of the Cannabinoid Compounds Δ9-Tetrahydrocannabinol (Δ9-THC) and Cannabidiol (CBD) and their Combination in Multiple Sclerosis Treatment. Molecules (Basel, Switzerland), 25(21). https://doi.org/10.3390/molecules25214930
Jones É, Vlachou S. A Critical Review of the Role of the Cannabinoid Compounds Δ9-Tetrahydrocannabinol (Δ9-THC) and Cannabidiol (CBD) and Their Combination in Multiple Sclerosis Treatment. Molecules. 2020 Oct 25;25(21) PubMed PMID: 33113776.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Critical Review of the Role of the Cannabinoid Compounds Δ9-Tetrahydrocannabinol (Δ9-THC) and Cannabidiol (CBD) and their Combination in Multiple Sclerosis Treatment. AU - Jones,Éamon, AU - Vlachou,Styliani, Y1 - 2020/10/25/ PY - 2020/08/11/received PY - 2020/10/02/revised PY - 2020/10/07/accepted PY - 2020/10/29/entrez PY - 2020/10/30/pubmed PY - 2021/4/13/medline KW - animal models KW - cannabidiol KW - cannabinoid KW - cognition KW - experimental autoimmune encephalomyelitis KW - inflammation KW - multiple sclerosis KW - neuropathic pain KW - neuroprotection KW - spasticity KW - Δ9-tetrahydrocannabinol JF - Molecules (Basel, Switzerland) JO - Molecules VL - 25 IS - 21 N2 - Many people with MS (pwMS) use unregulated cannabis or cannabis products to treat the symptoms associated with the disease. In line with this, Sativex, a synthetic combination of cannabidiol (CBD) and Δ9-tetrahydrocannabinol (Δ9-THC) has been approved to treat symptoms of spasticity. In animals, CBD is effective in reducing the amounts of T-cell infiltrates in the spinal cord, suggesting CBD has anti-inflammatory properties. By doing this, CBD has shown to delay symptom onset in animal models of multiple sclerosis and slow disease progression. Importantly, combinations of CBD and Δ9-THC appear more effective in treating animal models of multiple sclerosis. While CBD reduces the amounts of cell infiltrates in the spinal cord, Δ9-THC reduces scores of spasticity. In human studies, the results are less encouraging and conflict with the findings in animals. Drugs which deliver a combination of Δ9-THC and CBD in a 1:1 ratio appear to be only moderately effective in reducing spasticity scores, but appear to be almost as effective as current front-line treatments and cause less severe side effects than other treatments, such as baclofen (a GABA-B receptor agonist) and tizanidine (an α2 adrenergic receptor agonist). The findings of the studies reviewed suggest that cannabinoids may help treat neuropathic pain in pwMS as an add-on therapy to already established pain treatments. It is important to note that treatment with cannabinoid compounds may cause significant cognitive dysfunction. Long term double-blind placebo studies are greatly needed to further our understanding of the role of cannabinoids in multiple sclerosis treatment. SN - 1420-3049 UR - https://www.unboundmedicine.com/medline/citation/33113776/A_Critical_Review_of_the_Role_of_the_Cannabinoid_Compounds_Δ9_Tetrahydrocannabinol__Δ9_THC__and_Cannabidiol__CBD__and_their_Combination_in_Multiple_Sclerosis_Treatment_ L2 - https://www.mdpi.com/resolver?pii=molecules25214930 DB - PRIME DP - Unbound Medicine ER -