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The Effectiveness of Cannabidiol (CBD) On Inflammation

By Sherry Christiansen

Medically reviewed by Dr. George Gavrilos, Dr. Steven Salzman

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Key Takeaways

  1. Inflammation involves a process which includes activating immune cells, cytokines, and other substances.
  2. The endocannabinoid system (ECS) plays a crucial role in modulating the immune system and naturally keeping inflammation in check.
  3. Cannabidiol (CBD) has been shown to have anti-inflammatory and antioxidant properties.
  4. Oxidative stress can cause many negative connotations in the body; antioxidants, such as those found in CBD, can help reduce oxidative stress, thus, lowering inflammation. 

The Effectiveness of Cannabidiol (CBD) On Inflammation

The phytocannabinoids in the Cannabis sativa L. hemp plant, including cannabidiol (CBD), are shown to have anti-inflammatory and antioxidant properties. CBD is non-psychoactive; it employs a variety of beneficial effects, including promoting sleep and relaxation, reducing anxiety, and reducing inflammation linked with many inflammatory diseases.3 There is a growing body of research that suggests that CBD may impact the anti-inflammatory effects in the body. 5

What is Inflammation?

When the body suffers an injury or is introduced to viruses, bacteria, or toxic chemicals, the immune system is activated. The first step in activation is for the body to circulate “first responders” to begin the inflammatory process. The immune system sends out inflammatory cells, cytokines, and other substances, to sound the alarm to other inflammatory cells.1 Acute inflammation is the body’s attempt to trap foreign invaders (e.g., viruses and bacteria) while increasing blood flow to areas that need healing. Chronic inflammation differs from acute inflammation in that symptoms may not be as obvious. Chronic inflammation is when the body keeps circulating inflammatory cells. Chronic inflammation may occur when there is no apparent illness or injury; it doesn’t always subside after the threat or illness is resolved.

Inflammation and the Endocannabinoid System (ECS)

The body’s own endogenous cannabinoid, anandamide: AEA, produces anti-inflammatory effects by binding with the body’s cannabinoid receptors, CB1 and CB2. Activating CB1 and CB2 receptors blocks the enzyme fatty acid amide hydrolase/FAAH which is known to hydrolyze AEA.  Therefore, blocking FAAH allows for AEA’s  anti-inflammatory effects.8  Learn more about the ECS, anandamide, and cannabinoid receptors here.

The Effect of Oxidative Stress on Inflammation

The body’s inability to regulate free radicals often results in oxidative stress, also referred to as Reactive Oxygen Species (ROS). 3 ROS is a group of highly reactive chemicals containing oxygen. 

Chronic inflammation can be caused by oxidative stress. As immune cells fight off invading organisms, they produce free radicals. As a result, healthy cells become damaged, and inflammation develops.3 The endocannabinoid system (ECS) is believed to be responsible for modulating oxidative stress. 3 Learn more about the ECS here. Cannabidiol (CBD), has been identified as a “promising molecule for pharmacotherapy,” 3 that may interact with the ECS to help lower inflammation. The antioxidant property of CBD, like other antioxidants, stops free radical chain reactions by capturing them or converting them to a less toxic form; they do this by donating an electron to the free radicals which reduces their reactivity levels. 3 

How CBD May Reduce Inflammation

CBD has a therapeutic potential to help treat inflammatory diseases associated with oxidative stress. CBD works to reduce inflammation by lowering the levels of pro-inflammatory cytokines, inhibiting T cell proliferation, and inducing T cell apoptosis, which lowers the migration and adhesion levels of immune cells.

CBD reduces peripheral inflammation by interacting with TRPV1, CB2 (weakly) and GPR55 receptors thus, downregulating the enzymes that produce prostaglandins, reactive oxygen species, and cytokines.10 In the CNS, CBD reduces inflammation by inhibiting MAPK and downregulating NF-kB along with reducing of lipid peroxidation via PPARγ Learn more about how CBD lowers various types of inflammation here. 10

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Can CBD Help Reduce Inflammation in COVID-19?

Inflammation is a primary consideration in COVID-19; cytokine storm is a key contributor to the cause of death in many people with COVID-19. Some studies have shown that phytocannabinoids, such as CBD, may be effective at decreasing symptoms of inflammatory cytokine storm, by reducing symptoms that result in a lower level of inflammation. 6 How do cannabinoids have a potential to suppress an overreactive immune system and regulate inflammatory cytokine production?

The endocannabinoid system (ECS) plays an essential role in modulating inflammatory cytokine storm; this occurs when endocannabinoids—as well as phytocannbinoids—activate cannabinoid receptors. This suggests that the ECS components are likely targets for COVID-19, and other immune related diseases. 6 ECS signaling on the immune system involves several pathways that mediate the release of cytokines. Cannabinoids, such as CBD, work to regulate inflammatory cytokine production, which results in the suppression of an overactive immune response. Therefore, cannabinoids, such as CBD, may be beneficial in treating immune-related disorders, such as COVID-19, due to their immune-regulating properties.6

A newer, 2022 study discovered the ability of two molecules from hemp-based cannabis that were found to mimic the action of the COVID-19 vaccine by inhibiting the virus from being able to enter the human cell. 9

Studies 

A 2017 Arthritis and Pain Study

A 2017 study, published in the journal Pain, evaluated the effectiveness of CBD for pain caused by inflammation in those with osteoarthritis.4 The study authors concluded that CBD was successful in decreasing joint inflammation in animal study subjects. The study found that CBD may help lower arthritic inflammation and pain when applied topically and that CBD may inhibit two types of pain that are usually difficult to treat, including: 4

  • Inflammatory pain 
  • Neuropathic pain

The study authors concluded, CBD may be a safe therapeutic treatment for local osteoarthritis pain as well as being able to block the acute inflammatory flare ups involved in the progression of the disease and joint neuropathy.4

But the report goes on to explain that more human studies are needed to back the claims regarding pain control, while establishing safe parameters about dosing.

A 2018 Study Review Article

A 2018 compilation review of other studies, published in the journal, Molecules, reports “There is a growing body of evidence to suggest that cannabinoids are beneficial for a range of clinical conditions, including pain, inflammation, epilepsy, sleep disorders, the symptoms of multiple sclerosis, anorexia, schizophrenia, and other conditions.” 5

A 2022 Oregan State Research Study

A study, published in January, 2022, discovered cutting-edge research on cannabinoids and coronavirus. The study, conducted by Richard van Breemen, a researcher at Oregon State’s Global Hemp Innovation Center, college of Pharmacy and lInus Pauling Institute at Oregon State University, identified two compounds in hemp, called cannabigerolic acid, or (CBGA) and cannabidiolic acid (CBDA) that exhibited an ability to keep the virus that causes COVID-19 from being able to enter human cells. 9

In his study, Van Breemen discovered that cannabinoids bind to the SARS-CoV-2 spike protein —the same drug target used in COVID-19 vaccines — and prevent it from infecting people. “These cannabinoid acids are abundant in hemp and in many hemp extracts,” van Breemen said. “They are not controlled substances like THC, the psychoactive ingredient in marijuana, and have a good safety profile in humans. And our research showed the hemp compounds were equally effective against variants of SARS-CoV-2, including variant B.1.1.7, which was first detected in the United Kingdom, and variant B.1.351, first detected in South Africa,” says Van Breemen. 9

Resources

  1. Cleveland Clinic. Health Library. Inflammation. https://my.clevelandclinic.org/health/symptoms/21660-inflammation 
  2. Jean-Gilles L., Braitch M., Latif M.L., Aram J., Fahey A.J., Edwards L.J., Robins R.A., Tanasescu R., Tighe P.J., Gran B., et al. Effects of pro-inflammatory cytokines on cannabinoid CB1 and CB2 receptors in immune cells. Acta Physiol. 2015;214:63–74. https://doi.org/10.1111/apha.12474 
  3. Atalay S, Jarocka-Karpowicz I, Skrzydlewska E. Antioxidative and anti-inflammatory properties of cannabidiol. Antioxidants. 2019;9(1):21. https://doi.org/10.3390/antiox9010021  
  4. Philpott HT, O’Brien M, McDougall JJ. Attenuation of early phase inflammation by cannabidiol prevents pain and nerve damage in rat osteoarthritis. Pain. 2017;158(12):2442-2451. https://doi.org/10.1097/j.pain.0000000000001052 
  5. Bruni N, Della pepa C, Oliaro-bosso S, Pessione E, Gastaldi D, Dosio F. Cannabinoid Delivery Systems for Pain and Inflammation Treatment. Molecules. 2018;23(10). https://doi.org/10.3390/molecules23102478 
  6. Onaivi ES, Sharma V. Cannabis for COVID-19: can cannabinoids quell the cytokine storm? Future Science OA. 2020;6(8):FSO625. https://doi.org/10.2144/fsoa-2020-0124  
  7. Arthritis Foundation. Arthritis Foundation CBD Guidance for Adults with Arthritis. https://www.arthritis.org/living-with-arthritis/pain-management/chronic-pain/arthritis-foundation-cbd-guidance-for-adults.php https://www.mdpi.com/1422-0067/21/12/4448/htm 
  8. Schlosburg JE, Kinsey SG, Lichtman AH. Targeting fatty acid amide hydrolase (Faah) to treat pain and inflammation. AAPS J. 2009;11(1):39-44. doi:10.1208/s12248-008-9075-y https://doi.org/10.1208/s12248-008-9075-y
  9. Lundeberg, S. Oregon State University. Oregon State research shows hemp compounds prevent coronavirus from entering human cells. https://today.oregonstate.edu/news/oregon-state-research-shows-hemp-compounds-prevent-coronavirus-entering-human-cells?utm_medium=email&utm_source=newsletter&utm_campaign=HEMP_20220112_NEWS_Weekly Published January 2022.  
  10. Pellati F, Borgonetti V, Brighenti V, Biagi M, Benvenuti S, Corsi L. Cannabis sativa L. and Nonpsychoactive Cannabinoids: Their Chemistry and Role against Oxidative Stress, Inflammation, and Cancer. BioMed Research International. 2018;2018:1-15. doi:10.1155/2018/1691428  https://doi.org/10.1155/2018/1691428
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