Multiple Sclerosis and Cannabinoids
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There are over 100 known cannabinoids and they are being shown to have large effects on the way our bodies work.  Studies are being conducted to see how they  affect different disease processes.  Neurodegenerative diseases are of particular interest.

In the editorial by Cris Constantinescu, titled Therapeutic Cannabinoids in Multiple Sclerosis: immunomodulation revisited, proof is provided that two of the best known cannabinoids, THC and CBD, offer a great treatment option for those with Multiple Sclerosis (MS).  He references a study in the European Journal of Neurology and expands on this.

For background, cannabinoids have effects on the immune system and they have anti-inflammatory effects.  In addition, CBD, in particular, has been shown to have antiepileptic effects, and part of this is how it helps the neurological system.

We talk about the 2 types of cannabinoid receptors, CB1 and CB2, and it’s through the CB2 receptor that CBD reduces inflammation.  Being MS is a neurodegenerative and neuroinflammatory disease (it eats away at the myelin sheath that coats nerves), many experience benefits by reducing the inflammatory reaction the disease causes.

There are not enough studies to validate CBD and its effect on MS.  This does not mean that it is not helpful with the condition, as many with MS taking CBD do get great results…albeit, this is anecdotal proof.  The science does show that a 1:1 combination of CBD and THC, which has been licensed for the treatment of spasticity through an oromucosal spray (Nabiximols), does have effects and part of this is thought to be due to it’s different way of dosing.  It is actually thought to have an effect on gene expression. Perhaps it works better as the CBD:THC absorbs into the mucosal lining and has a faster passage into the brain?

Some food for thought here.  With MS, we are dealing with many aspects of the disease but certainly the neuroinflammatory component is of utmost importance. We know that CB2 receptors are involved with this as they affect pain and inflammation. CB1 receptors, on the other hand, are involved with brain function but not with inflammation.  They are involved with the spasticity component.  Constantinescu also believes that there are ‘enough’ CB1 receptors on the immune cells in people with MS to drive the immune functions to help the condition.  This might be the case but certainly, the CB2 receptors are mostly what governs the pain and inflammation.

I’ll try to simplify this as well as I can to clarify our thoughts on this:

    1. We have two receptors, CB1 and CB2.  They sit on sensory nerve fibers.
    2. CB2 receptors affect the immune system and regulate pain and inflammation.
    3. CB1 receptors are found primarily in the brain and organs but do NOT directly address inflammation.
    4. CBD reduces two ‘nasty’ enzymes that the body produces…and it makes more under stressful situations.  They are called FAAH and MAGL.
    5. FAAH and MAGL eat away at your own endocannabinoids, called Anandamide and 2-AG.
    6. Your body makes Anandamide, which works like THC. The difference is that you do not get ‘high’ from it as your body controls the system. Your body also makes 2-AG, which affects both CB1 and CB2 receptors. It is through the activation of the CB2 receptors, with 2-AG, that inflammation can be addressed.
    7. THC does not affect CB2 receptors, therefore it does not affect inflammation and pain. It does, however, affect the brain’s response as it alters brain function…hence the feeling of being ‘high’ and the effect on spasticity.
    8. Multiple Sclerosis is an inflammatory disease.  It makes sense that the CB2 receptors play a larger role than the CB1 receptors.  Why is this?  We wish to deal with the cause of the problem and certainly inflammation is a major part of the disease.
    9. In effect, CBD helps to reduce the pain and inflammation whereas THC more-so alters the brain’s perception to the pain and inflammation.
    There are no studies with the use of nasal CBD.  Being the mechanism of delivery might be much more beneficial for those with neuroinflammatory/degenerative diseases, like MS, it makes sense for those people to use this delivery if they are not getting desired results with oral methods.  As far as the THC component, I would venture to say that we are not sure if it’s the delivery method or the actual THC in the product that yields the positive results.

At Noetic, we will soon be offering a nasal CBD product.  This is for many reasons.  We like how it can absorb faster and more directly than an oral method, and we’re hoping that those with inflammatory/neurodegenerative conditions will receive positive effects.  We’re hoping everyone gives us feedback!

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