The Effect of Cannabis on the Clinical and Cytokine Profiles in Patients with Multiple Sclerosis

Abstract

Background. Multiple studies have reported that cannabis administration in multiple sclerosis patients is associated with decreased symptom severity. This study was conducted to evaluate the prevalence of cannabis abuse in multiple sclerosis cases and to evaluate the effect of cannabis on serum cytokines in such cases. Patients and Methods. A total of 150 multiple sclerosis cases along with 150 healthy controls were included during the study period. All cases were subjected to history taking, neurological examination, and routine investigations. Cases were asked about cannabis intake which was confirmed by a urine test. Serum cytokines including IL-1, IL-2, IL-4, IL-10, IL-12, IL-17, IL-22, IFN-γ, IFN-β1, and TNF-α were ordered for all cases and controls. Results. Twenty-eight cases were cannabis abusers (MS/cannabis group, 18.67%). The remaining 122 cases represented the MS group. There was no significant difference between the three groups regarding age, disease duration, or MS type. Male gender was more predominant in the MS/cannabis group, and the number of relapses was significantly lower in the same group. Fifteen cases (53.6%) reported that their symptoms were improved by cannabis. Proinflammatory cytokines were significantly elevated in the MS group compared to the MS/cannabis and control groups. Additionally, anti-inflammatory cytokines had significantly lower values in the MS group compared to the MS/cannabis and control groups. Most clinical symptoms were significantly improved in the MS/cannabis group compared to the MS group apart from sexual dysfunction, bladder symptoms, and visual disturbances. Mild side effects of cannabis were also reported. Conclusion. Cannabis may have a positive impact on the cytokine and clinical profiles in cases with multiple sclerosis.

The Anti-Inflammatory Effects of Cannabis Sativa Extracts on LPS-Induced Cytokines Release in Immune and Non-Immune Cells in Vitro

“…The results of this study were similar to those of other studies, where it was shown that cannabinoids and cannabis extracts efficiently inhibit inflammation by suppressing the levels of pro-inflammatory cytokines. For example, cannabis users who suffered from multiple sclerosis had significantly lower levels of many pro-inflammatory cytokines, such as TNF-α, IL-1, IL-6, IL-12, and IFN-γ, and higher levels of the antiinflammatory cytokine IL-10, in comparison with non-cannabis users [17,44]. Another study reported that cannabis extract high in CBD was superior to pure CBD in reducing the IL-6 and IL-8 levels in an alveolar epithelial cell line, A549, while cannabis extract high in THC used on the same cell line showed only minor anti-inflammatory activity and was more cytotoxic.…”

The Anti-Inflammatory Effects of Cannabis sativa Extracts on LPS-Induced Cytokines Release in Human Macrophages

“…The results of this study were similar to those of other studies, where it was shown that cannabinoids and cannabis extracts efficiently inhibit inflammation by suppressing the levels of pro-inflammatory cytokines. For example, cannabis users who suffered from multiple sclerosis had significantly lower levels of many pro-inflammatory cytokines, such as TNF-α, IL-1, IL-6, IL-12, and IFN-γ, and higher levels of the anti-inflammatory cytokine IL-10, in comparison with non-cannabis users [ 17 , 44 ]. Another study reported that cannabis extract high in CBD was superior to pure CBD in reducing the IL-6 and IL-8 levels in an alveolar epithelial cell line, A549, while cannabis extract high in THC used on the same cell line showed only minor anti-inflammatory activity and was more cytotoxic.…”

“…The anti-inflammatory effects of cannabis extracts, as well as their active ingredients, are well documented [ 16 ]. For instance, cannabis users suffering from multiple sclerosis had lower levels of pro-inflammatory cytokines (TNF-α, IL-1, IL-6, and IFN-γ) and higher levels of anti-inflammatory cytokines (IL-10) as compared with non-cannabis users [ 17 ]. Cannabis extracts high in CBD and THC suppressed the expression of IL-6, IL-1β, MCP-1, and TNF-α genes induced by TNF-α/IFN-γ in human 3D EpiDermFT tissue [ 18 ].…”

The Therapeutic Potential of the Endocannabinoid System in Age-Related Diseases

“…In contrast, a recent prospective case control study showed that the levels of pro-inflammatory cytokines such as IL-1, IL-2, IL-6, IL-17, IL-22, TNF-α, and IFN-γ were significantly increased in the MS group when compared to the MS/cannabis and control groups. Moreover, the same study showed that in the MS population, anti-inflammatory cytokines such as IL-4, IL-10, and interferon-β1 (IFN-β1) had significantly lower values [ 278 ].…”