Therapeutic Prospects of Cannabinoids in the Immunomodulation of Prevalent Autoimmune Diseases
Introduction: Cannabinoids such as ▵-9-THC and CBD can downregulate the immune response by modulating the endocannabinoid system. This modulation is relevant for the treatment of prevalent autoimmune diseases (ADs), such as multiple sclerosis (MS), systemic lupus erythematosus (SLE), diabetes mellitus type 1 (DMT1), and rheumatoid arthritis (RA). These conditions require new therapeutic options with fewer side effects for the control of the autoimmune response. Objective: to conduct a literature review of preclinical scientific evidence that supports further clinical investigations for the use of cannabinoids (natural or synthetic) as potential immunomodulators of the immune response in ADs. Methodology: A systematic search was carried out in different databases using different MeSH terms, such as Cannabis sativa L., cannabinoids, immunomodulation, and ADs. Initially, 677 journal articles were found. After filtering by publication date (from 2000 to 2020 for SLE, DMT1, and RA; and 2010 to 2020 for MS) and removing the duplicate items, 200 articles were selected and analyzed by title and summary associated with the use of cannabinoids as immunomodulatory treatment for those diseases. Results: Evidence of the immunomodulatory effect of cannabinoids in the diseases previously mentioned, but SLE that did not meet the search criteria, was summarized from 24 journal articles. CBD was found to be one of the main modulators of the immune response. This molecule decreased the number of Th1 and Th17 proinflammatory cells and the production of the proinflammatory cytokines, interleukin (IL)-1, IL-12, IL-17, interferon (IFN)-γ, and tumor necrosis factor alpha, in mouse models of MS and DMT1. Additionally, new synthetic cannabinoid-like molecules, with agonist or antagonist activity on CB1, CB2, TRPV1, PPAR-α, and PPAR-γ receptors, have shown anti-inflammatory properties in MS, DMT1, and RA. Conclusion: Data from experimental animal models of AD showed that natural and synthetic cannabinoids downregulate inflammatory responses mediated by immune cells responsible for AD chronicity and progression. Although synthetic cannabinoid-like molecules were evaluated in just two clinical trials, they corroborated the potential use of cannabinoids to treat some ADs. Notwithstanding, new cannabinoid-based approaches are required to provide alternative treatments to patients affected by the large group of ADs.
Keywords: Cannabis sativa L; autoimmune disease; cannabidiol; cannabinoids; delta-9-tetrahydrocannabinol; literature review.
Medical Marijuana for Lupus
Cannabis has been used as a medication for millennia. From treating pain to melancholy, we’ve recognized that cannabis has beneficial medical applications. With many states legalizing cannabis for medical purposes, doctors and scientists are looking to see if it can be used as a holistic treatment for different conditions.
Scientists and doctors are now recommending cannabis as a treatment option for a condition called lupus.
What is Lupus?
Lupus is a chronic autoimmune disease that can damage any part of the body, such as skin, joints, and organs. The signs and symptoms of lupus can last for a couple of weeks to several years. There is currently no known cure.
People with lupus have an immune system that cannot recognize the difference between the body’s natural cells and harmful invading cells. Because of this, the immune system creates antibodies to attack and destroy the body’s healthy cells.
Lupus is a common disease, affecting 5 million people worldwide. As many as 16,000 new cases of lupus are reported each year.
Symptoms of Lupus
Lupus can affect many of the body’s systems and organs, creating quite a few symptoms. Symptoms can change over the course of the disease, as well as being inconsistent in duration.
- Extreme fatigue
- Painful or swollen joints
- Pain in chest when breathing deeply
- Butterfly-shaped rash across cheeks and nose
- Swelling in feet, legs, hands, or around eyes
- Sun or light-sensitivity
- Hair loss
- Abnormal blood clotting
- Fingers turning white or blue when cold
- Mouth or nose ulcers
Treatment of Lupus
Currently, there is no treatment for lupus, so physicians focus on treating the symptoms of the disease. The most common treatments include:
- NSAIDs for pain relief and fever
- Corticosteroids to reduce pain and inflammation
- Immunosuppressants to calm a dysfunctional immune system
- Antimalarial drugs to treat blood clotting, inflammation, and rashes.
The problem with the long-term use of these medications is that they can lead to serious side-effects including renal damage and cardiovascular issues.
How Cannabis Can Help Treat Lupus
The endocannabinoid system has receptors located throughout our bodies, including the systems that regulate immunity. Finding out exactly how cannabinoids interact with the immune system still requires research, but there is already mounting evidence that cannabis can help treat many symptoms associated with lupus.
- Suppress the immune system: Cannabis has been shown to suppress the immune system by activating myeloid-derived suppressor cells (MDSCs). MDSCs may help lupus by dampening the hyperactivity of the immune system.
- Relieve inflammation: A study conducted indicates that cannabis can alter the immune system by keeping it from switching on the inflammatory response.
- Pain relief: There have already been several studies done on the ability of cannabis to relieve pain. This coupled with inflammation are two of the most common symptoms of lupus, suggesting cannabis might be able to help.
Administering Cannabis for Lupus
There are many methods of ingesting cannabis and each has its own benefits and detriments. For example, smoking cannabis may deliver quick relief, but also releases carcinogens and an open flame can burn away many of the cannabinoids. Vaporization may be healthier than smoking, and it does deliver relief faster and with less cannabis, but the relief is not long-lasting. Edibles are another option for administering cannabis and provide long-lasting relief but can take time to kick in, which is not ideal when in need of quick relief.
When it comes to lupus, the method of ingestion can be important, especially if you’re a patient on other medications.
- Vaporization: This is the ideal method for patients who are still on prescribed medications.
- Cannabis oil: This can be taken via a syringe or capsules and is ideal if you’re a patient wanting to switch to a cannabis-only regimen.
- Edibles: Edibles can provide long-lasting relief if you have the extra time to wait for them to kick in. This can be particularly helpful if lupus symptoms are preventing you from sleeping at night.
- Topicals: Topical creams and ointments infused with THC and CBD can help with pain and inflammation in the joints.
Best Strains for Lupus
Finding the right strain can be a process of trial and error. The strain that works best for one patient may not provide the same benefits or success to another. Some patients respond better to CBD oil or a strain with a high-CBD to THC ratio, while others prefer equal amounts of THC to CBD. Other patients respond better to a high-THC strain of cannabis. Some strains to investigate include:
: This strain has a high CBD to THC ratio, sometimes providing as much as 17% CBD compared to 6% THC. It’s good for pain, stress, and inflammation symptoms. : Another high CBD strain, Harlequin has a 5:2 CBD to THC ratio. Harlequin is good for those suffering from pain, inflammation, and depression. : This high CBD strain, Sour Tsunami, boasts properties that relieve fatigue, pain, and inflammation. (a.k.a. GSC): This award-winning strain is noted for its high levels of THC. GSC helps stress, pain, depression, and insomnia. : Routinely testing at 20-28% THC, The White is great for insomnia, depression, pain, and inflammation. : This high-THC strain boasts levels of 20-24%. Death Star helps with pain, insomnia, stress, and depression. It might also help kick nausea as well.
Cannabis can be used as a treatment for many of the symptoms of lupus. The medicinal plant has been used for millennia to treat pain, inflammation, anxiety, insomnia, and depression. Keep in mind however that because lupus can damage organs and body tissues, it should never be self-diagnosed or self-treated. Always talk with your doctor before beginning a cannabis regimen, especially if you are taking other medications.
Can i take cbd oil for lupus
Abstract Number: 1136
Survey of Medical Cannabis Use in Lupus and Scleroderma
Wassim Karkache 1 and Catherine Ivory 2 , 1 University of Ottawa, Ottawa, ON, Canada, 2 University of Ottawa Faculty of Medicine, Rheumatology, Ottawa, ON, CANADA, Ottawa, ON, Canada
Session Type: Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: Despite the lack of research regarding medical cannabis, marijuana and its by-products have gained popularity over the last decades. A 2019 Statistics Canada report revealed that approximately 16% of Canadians used marijuana in the last year. A Canadian study also revealed that 80% of rheumatologist participants were questioned by their patients weekly regarding medical marijuana; and in a similar study, 75% of participants were not comfortable prescribing medical marijuana. Despite being a common and debilitating feature in rheumatic diseases, there is little attention given to the study of medical options for the management of pain. The effects, both positive or negative of medical marijuana in patients suffering from lupus or scleroderma, is still unclear. We conducted a survey amongst patient diagnosed with lupus or scleroderma to evaluate their beliefs, concerns and personal experience if any with medical cannabis.
Methods: Patients with diagnosed lupus or scleroderma were recruited from the Ottawa Hospital division of Rheumatology. Consent was implied with completion of the survey and answers remained anonymous. Inclusion criteria: age >18, diagnosis of systemic lupus or scleroderma and able to complete survey in English or French. Data analysis of the results of the survey are qualitative.
Results: On preliminary results, 20% of participants are actively using medical cannabis, primarily in the form of CBD oil or inhaled. In those patients taking medical cannabis, they reported no significant side effects. Of those not using cannabis, 49% of participants considered using it, and 62% would like further discussion with their rheumatologist regarding pros and cons of medical cannabis. Among our participants, the most common reasons for use of medical cannabis were insomnia, anxiety, and pain. The majority (97%) were aware that there can be side effects, and this was often the reason for wanting more information. The main elements important to the discussion was trust in their treating physician, having a non-judgemental approach, the degree of uncontrolled pain/symptoms and need for alternatives as well as receiving reliable information.
Conclusion: Our survey results suggest that a proportion of our patients have already tried medical cannabis, and most have an interest in the use of cannabis to help with symptoms not relieved by standard therapies to date. We need to be prepared to better guide our patients with respect to medical cannabis. These results will highlight common reasons/indications for medical cannabis use in this patient population. This study will ultimately assist with broadening patient perspective on medical cannabis, its impact on our patients and guide us in elaborating new strategies when discussing medical cannabis.