The Cannabis Sativa plant, as well as its derivatives and components, has been used by humanity for thousands of years. Its use began in Chinese and Indian culture in 2000 BC for medical, recreational, ritualistic, and textile purposes.
Cannabis Sativa has approximately 400 different compounds and at least 60 of them were classified as cannabinoids. Among the most important are: Tetrahydrocannabinol (THC), Cannabigerol (CBG), Cannabinol (CBN), Cannabidiol (CBD), Cannabidioic Acid (CBDA), and Cannabicromeno (CBC).
The biological effect of these compounds in our body is achieved through binding to membrane receptors of the endocannabinoid system known as CB1 and CB2. CB1 receptors are very abundant in the CNS, cerebellum, hippocampus, and basal ganglia, where they mediate the inhibition of various excitatory and inhibitory neurotransmitters. The CB2 receptor is predominantly expressed in immune and hematopoietic cells. The wide distribution of receptors of the endocannabinoid system gives us a clear indication that cannabinoids are associated with different and very diverse cellular processes.Some components present in cannabis, such as delta-9-THC (tetrahydrocannabinol), CBN (cannabinol) have a psychoactive effect (alteration of perception and modification of mood).
However, despite acting on the central nervous system, CBD has no psychoactive effects. On the contrary, it antagonizes the psychotomimetic effects (psychotic similes) that THC and CBN can produce. CBD oil is currently recognized as one of the most widespread forms of presentation in our country for the consumption of cannabinoids in the medicinal context.
Benefits have been reported in its use as an antiepileptic, analgesic, and antiemetic, being so highly useful in the treatment of chronic pain, fibromyalgia, involuntary muscle contractions, and various neurological disorders.
Therapeutic properties and effects of CBD
The following explains the effects and clinical implications of cannabidiol in various body systems.
Central Nervous System
One of the most important and characteristic properties of CBD is its antiemetic effect which prevents nausea and vomiting associated with drugs. Its mechanism is not entirely clear, but it is linked to its action on CB1 and TPRV1 receptors.
CBD has great utility in the prevention of nausea and vomiting produced by chemotherapeutics.CBD also acts as an anticonvulsant through its action on the CB1 receptor and the reduction of plasma calcium concentrations, which is why it can be beneficial in the treatment of epilepsy. In patients with multiple sclerosis, the activation of the CB1 and CB2 receptors decreases neuropathic pain, spasticity, and stiffness of the extremities, improving motor function. Furthermore, it has neuroprotective properties that slow down neuronal degeneration and consequently the progression of the disease. CB1 receptors are highly expressed in primary afferent nociceptors, and CB2s modulate the release of proinflammatory cytokines such as IL-6, IL-1, and TNFα. Therefore, CBD has analgesic activity and could be useful in patients with chronic or neuropathic pain.
Various studies have identified the neuroprotective properties of CBD, which suggests its utility in the treatment of neurodegenerative diseases such as Alzheimer's disease, Huntington's chorea, amyotrophic lateral sclerosis, and Parkinson's disease. CBD's neuroprotective effect stems from its ability to reduce the concerted action of different cytotoxic stimuli (excitotoxicity, oxidative stress, energy failure, mitochondrial dysfunction, proteostasis failure, and inflammation) that compromise neuronal survival. In addition, CBD produces neuroprotective effects through receptors in other neuronal communication systems, such as serotonergic transmission (5HT1A receptors) or adenosine signaling, which have been implicated in the increase in cerebral blood flow after a stroke.
Modulation of the activity of the endocannabinoid system appears to have significant therapeutic potential for the treatment of depression. This antidepressant activity would be based on the increase in monoaminergic neurotransmission, the increase in neuroplasticity, or in the normalization of the activity of the hypothalamic-pituitary-adrenal axis.There are also numerous references that support the possibility that the use of cannabinoids may be of therapeutic utility in bipolar patients.
However, rigorous large-scale clinical trials are essential to provide evidence to clarify the possible role of cannabinoids in the treatment of the bipolar disorder.
Digestive system CBD is considered a strong appetite stimulant due to the activation, at the hypothalamic level, of CB1 receptors. At the hepatic level, it increases lipogenesis, de novo fatty acid synthesis, and weight gain. These effects can be used in the treatment of anorexia nervosa or anorexia associated with AIDS or cancer. Immune system
Different studies carried out with cannabinoid agonists (endogenous and exogenous) have confirmed that CB2R exerts an important immunosuppressive function on different cells of the immune system, thus producing an anti-inflammatory effect.
These findings are of special importance since they open up the possibility of using cannabinoid-based drugs for the treatment of autoimmune diseases, in which the immune system attacks the body's own cells, for example, rheumatoid arthritis, systemic lupus erythematosus, multiple sclerosis, psoriasis, Crohn's disease, etc. Antitumor potential
The antitumor effect of some cannabinoids has been studied, such as THC, CBD, CBG, among others, which have been shown to inhibit the growth of tumor cells, angiogenesis, and metastasis, making it a powerful adjuvant treatment, which it should be better studied in order to be applied in patients with certain types of cancer.
Di Marzo V, Bifulco M, De Petrocellis L. The endocannabinoid system and its therapeutic exploitation. Nat Rev Drug Discov. 2004; 3:771–784
1 Sido JM, Nagarkatti PS, Nagarkatti M. Role of Endocannabinoid Activation of Peripheral CB1 Receptors in the Regulation of Autoimmune Disease. Int Rev Immunol. 2015; 34:403-14
2 Chiurchiù V, Leuti A, Maccarrone M. Cannabinoid signaling and neuroinflammatory diseases: a melting pot for the regulation of brain immune responses. J Neuroimmune Pharmacol 2015; 10: 268-280
3 Aggarwal SK. Use of cannabinoids in cancer care: palliative care. Curr Oncol 2016; 23: S33-6
4 Blessing EM, Steenkamp MM, Manzanares J, Marmar CR. Cannabidiol as a Potential Treatment for Anxiety Disorders. Neurotherapeutics. 2015;12:825-36