With the worldwide death toll from the coronavirus rising exponentially, The Lancet drew attention to “accumulating evidence” that indicates “patients with severe COVID-19 might have a cytokine storm syndrome.”
Characterized by intense immune overreaction in the lungs, this little understood syndrome can sicken and kill infected individuals. Respiratory distress is the leading cause of mortality in COVID-19 cases. The critically ill who survive intensive care may suffer long term lung damage, resulting in functional impairment and reduced quality of life.
Science Daily reports that a hyper-inflammatory cytokine storm, involving a surge of immune cells gone haywire, was likely the primary cause of death in several viral outbreaks, including the 1918-20 “Spanish flu” pandemic (which killed more than 50 million people) and, more recently, the H1N1 swine flu and the so-called bird flu.
In cases of acute, viral-induced pulmonary distress, cytokine-storm-targeted therapy would seem to make sense. But treatment with corticosteroids is not a great option because it can exacerbate COVID-19-associated lung injury. “However,” as The Lancet emphasizes, “in hyperinflammation, immunosuppression is likely to be beneficial.”
COULD CANNABIS CALM A CYTOKINE STORM?
Several laboratory studies indicate that cannabinoid compounds – in particular, cannabidiol (CBD) and tetrahydrocannabinol (THC) – are immunosuppressant. This would explain why medical cannabis is beneficial for people with autoimmune diseases and chronic inflammation.
Which begs the question: Could cannabis calm a cytokine storm?
The short answer is we don’t know. There’s a lot that we still don’t understand about cannabis and the immune system.
For many years, scientific inquiry in the United States has been handcuffed by cannabis prohibition, and the federal government continues to thwart research that could shed light on the therapeutic use of cannabis and whole plant CBD-rich oil extracts. The federal stranglehold on cannabis research is the main reason why we know so little about CBD’s clinical potential as an antiviral remedy.
Cannabis prohibition is exacerbating the current crisis in other ways, as well, as we discuss later in this article. For now, let’s turn our attention back to cytokines and cannabinoids.
CBD acts as a potent anti-inflammatory, reducing cytokine production and inhibiting immune cell function.
WHAT ARE CYTOKINES?
Secreted by immune cells, cytokines are a group of proteins that regulate inflammatory responses to disease and infection. There are both pro-inflammatory and anti-inflammatory cytokines.
Overproduction or excess secretion of pro-inflammatory messenger molecules can trigger a dangerous cytokine storm and other aberrant conditions. A cytokine known as tumor necrosis factor alpha (TNFa), for example, is produced in excess in rheumatoid arthritis, a painful, autoimmune disease that afflicts 1.3 million Americans.
The interaction between cytokines, immune cells, and the endogenous cannabinoid system plays an important role in neuroinflammation and neurodegeneration.
It’s well documented that stimulation of the CB2 cannabinoid receptor by THC and its endogenous counterparts can suppress inflammation. Cannabinoid receptor signaling confers therapeutic effects by downregulating inflammatory cytokine expression.
Although cannabidiol has little direct binding affinity for the CB2 receptor, CBD also acts as a potent anti-inflammatory, reducing cytokine production and inhibiting immune cell function.
1. Biles, Mary. Cannabis and the Immune System. Project CBD. May 18, 2019. https://www.projectcbd.org/scien…/cannabis-and-immune-system
2. Das UN. Can Bioactive Lipids Augment Anti-cancer Action of Immunotherapy and Prevent Cytokine Storm? Arch Med Res. 2019 Aug;50(6):342-349. doi: 10.1016/j.arcmed.2019.10.004. Epub 2019 Oct 31. Review. PubMed PMID: 31677539.
3. IACM: Statement of the Board on current corona virus pandemic and the use of cannabinoids, March 25, 2020. http://www.cannabis-med.org/…/b…/ww_en_db_cannabis_artikel.p…
4. Jean-Gilles L, Gran B, Constantinescu CS. Interaction between cytokines, cannabinoids and the nervous system. Immunobiology. 2010 Aug;215(8):606-10. doi: 10.1016/j.imbio.2009.12.006. Epub 2010 Jan 4. Review. PubMed PMID: 20153076.
5. Kaplan BL, Springs AE, Kaminski NE. The profile of immune modulation by cannabidiol (CBD) involves deregulation of nuclear factor of activated T cells (NFAT). Biochem Pharmacol. 2008 Sep 15;76(6):726-37. doi: 10.1016/j.bcp.2008.06.022. Epub 2008 Jul 8. PubMed PMID: 18656454; PubMed Central PMCID: PMC2748879.
6. Kinner SA, Young JT, Snow K, Southalan L, Lopez-Acuña D, Ferreira-Borges C, O’Moore É. Prisons and custodial settings are part of a comprehensive response to COVID-19.Lancet Public Health. 2020 Mar 17;. doi: 10.1016/S2468-2667(20)30058-X. [Epub ahead of print] PubMed PMID: 32197116.
7. Klein TW, Lane B, Newton CA, Friedman H. The cannabinoid system and cytokine network. Proc Soc Exp Biol Med. 2000 Oct;225(1):1-8. doi: 10.1046/j.1525-1373.2000.22501.x. Review. PubMed PMID: 10998193.
8. Klein TW, Newton C, Larsen K, Lu L, Perkins I, Nong L, Friedman H. The cannabinoid system and immune modulation. J Leukoc Biol. 2003 Oct;74(4):486-96. doi: 10.1189/jlb.0303101. Epub 2003 Jul 1. Review. PubMed PMID: 12960289.