Multiple Sclerosis

Multiple Sclerosis (MS) is an autoimmune central nervous system disease that affects the brain and spinal cord. In MS, the immune system attacks myelin that covers nerve fibers and leads to problems associated with communication between your brain and other parts of the body.

  • What is Multiple Sclerosis?
  • Multiple Sclerosis & cannabinoids
  • Text references, literature discussion
    & clinical trials

What is Multiple Sclerosis?

Definition
Multiple Sclerosis (MS) is an autoimmune central nervous system disease that affects the brain and spinal cord. In MS, the immune system attacks myelin. that covers nerve fibers and leads to problems associated with communication between your brain and other parts of the body.1

Symptoms
Currently, there is no cure available to treat MS. However, treatments can provide modification of the disease course, manage symptoms, and improve recovery from attacks.
Many people suffering from MS have a relapsing-remitting disease course that involves periods of new symptoms or relapses that develop over a period of time and ameliorate partially or completely.
Signs and symptoms of MS can vary between people.1

Most symptoms are related to movement and vision and may include the following:

Movement symptoms

  • Weakness or numbness in one or more limbs
  • Electric-shock sensations that occur with certain movements
  • Tremor
  • Lack of coordination
  • Unsteady walking pace
  • Spasms
  • Muscle stiffness

Vision symptoms

  • Partial or complete loss of vision often accompanied by painful eye movement
  • Double vision
  • Blurry vision

Other symptoms

  • Slurred speech
  • Fatigue
  • Pain and/or stinging in part of the body
  • Difficulty with bladder, bowel, or sexual function

Cause
Multiple sclerosis is believed to be an autoimmune disease even though the exact cause of its development is not yet known. This malfunction in the immune system leads to the fatty substance destruction that coats and insulates nerve fibers in the brain and spinal cord.1

Factors that can increase the risk of MS are:

  • Age
    Commonly occurring in the age of 20-40 years old, however, all ages can be affected
  • Sex
    Women are 2-3 times more  likely to develop MS than men to have relapsing-remitting MS
  • Heredity
    Genetics may increase the risk of developing MS
  • Infections
    Particular infections including Epstein-Barr may be linked to MS
  • Race
    White people, especially of Northern European heritage have the highest risk of developing MS
  • Climate
    MS are overrepresented in countries with a temperate climate
  • Smoking
    Smokers are more likely than nonsmokers to develop a second event that confirms relapsing-remitting MS
  • Cannabinoids
  • Cannabinoid receptors
  • Endocannabinoids
  • CBD
  • THC
  • CB1
  • CB2
  • PPARγ
  • PEA
  • Terpenes
  • Strains
  • Enzymes
  • Metabolites
  • Caryophyllene

Strains

Synthesizing & Degrading Enzymes

Metabolites

The connection between Multiple Sclerosis
& cannabinoids

Multiple Sclerosis

Preclinical studies and clinical trials have observed that THC alone or THC combination with CBD may be beneficial in the treatment of MS or symptom relief.2

Despite accumulating research supporting the potential of cannabinoids in the treatment of MS, more evidence is needed.3

Note: If you have any further information relevant to the connection between Multiple Sclerosis and cannabinoids, or find any of the information inaccurate, outdated or incomplete please contact us here.

Text references, literature discussion
& clinical trials

  • Text references
  • Literature discussion
  • Clinical trials
Review

In C57BL/6 mice, inflammation and neuronal demyelination were individually decreased by CBD and PEA (Rahimi et al., 2015).

However, anti-inflammatory and anti-demyelinating activities were shown to be decreased by co-administration of both cannabinoids, proposing antagonism between both cannabinoid pathways.

In a mouse model of MS, Sativex oromucosal spray (50% THC and 50% CBD) was compared with each phytocannabinoid alone to assess their effect. It was observed that motor deterioration was similarly reduced by CBD-BDS and Sativex, whereas THC-BDS exhibited a weaker effect. The effect of CBD was via PPARγ receptors while THC effect was via CB2 and primarily CB1 receptors (Feliú et al., 2015).

In the rat model of experimental autoimmune encephalitis / multiple sclerosis, it was found that CBD exhibits immunoregulatory activities through induction of CD4+CD25−CD69+LAG3+ cells in MOG35-55-activated APC/TMOG co-cultures (Kozela et al., 2015).

Gene profiling found that CBD exhibits its immunoregulatory activities in activated memory TMOG cells via inhibiting pro-inflammatory genes, T cell proliferation, and potentially T-cell memory while enhancing anti-inflammatory genes (Kozela et al., 2016).

In the Experimental Autoimmune Encephalitis (EAE) mouse model of Multiple Sclerosis, it was shown that daily use of a 1% CBD cream could exhibit neuroprotective activities against EAE (Giacoppo et al., 2015).

References
Clinical Trials

In several clinical trials, spasticity, muscle stiffness, neuropathic pain, etc. were treated by cannabis extracts or Sativex, a 50/50% mixture of synthetic THC and CBD in patients that did not show response to conventional treatment (Rog et al., 2007; Zajicek et al., 2012).

In an observational, prospective, multicenter, non-interventional study, symptomatic relief was achieved in 74.6% of patients upon treatment with THC/CBD mixture (Flachenecker et al., 2014).

However, it was also reported that not all cannabinoids may produce a therapeutic effect on the symptoms of MS (Ball et al., 2015; Centonze et al., 2009). Treatment with THC may produce some side effects including dizziness and nausea (Wade et al., 2006).

One meta-study concluded that muscle spasms and central pain were reduced by several cannabinoids (particularly THC and CBD), whereas no effect was seen in treating tremors associated with MS (Koppel et al., 2014).

References

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