Terpenes and Their Contribution to Cannabis' Effectiveness for Multiple Sclerosis
Multiple Sclerosis (MS), a chronic neurological disorder affecting approximately 150,000 people in the UK, is characterised by the immune system mistakenly attacking the body's own nerve cells, particularly the myelin sheath that insulates nerve fibres in the brain and spinal cord. This autoimmune attack results in inflammation and damage, disrupting nerve signal transmission and causing neurological symptoms such as muscle weakness, vision loss, and cognitive impairment.
Research has identified T cells and B cells as key players in this autoimmune process. A malfunction in regulatory T cells (T reg cells), which normally suppress harmful immune responses, allows other T cell subtypes (Th1 and Th17) to promote inflammation. Abnormally active B cells interact with T cells to trigger attacks on myelin, leading to a progressive demyelination that impairs nerve conduction and results in neurological deficits.
Early in MS, adaptive immune cells (T and B cells) are actively driving disease progression through autoimmune inflammation. However, as the disease advances, neurodegenerative and inflammatory processes independent of adaptive immunity become more prominent, making the disease harder to control. Additionally, evidence suggests that infection with Epstein-Barr Virus (EBV) may contribute to autoimmune dysregulation, further promoting disease progression.
In light of the limitations of standard treatments for MS and the associated impact on quality of life, interest in alternatives such as cannabis-based therapies has arisen. Cannabis contains compounds like THC and CBD, which interact with the endocannabinoid system in the body. THC, the psychoactive component of cannabis, binds to CB1 and CB2 receptors, causing various effects including pain relief and anti-anxiety.
Recent research has also highlighted the potential benefits of terpenes, a component of cannabis plants. Terpenes have shown synergistic and beneficial effects alongside medicinal cannabis use, and their versatility and usability are due to their ability to interact with human receptors and their ability to cross layers of fat, a highly sought-after feature in drug design. Terpenes, made up of over 200 compounds, include D-Linalool, β-Myrcene, α-Pinene, β-caryophyllene, and limonene, among others.
D-Linalool, commonly found in lavender as well as cannabis, can reduce seizures, anxiety attacks, and have sedative effects in pre-clinical models. β-Myrcene, a common terpene in cannabis, has shown both anti-inflammatory and analgesic (pain relieving) effects. α-Pinene, the most widely found terpene in nature, has been shown to have anti-inflammatory effects via reducing the effects of a potent inflammatory pathway known as nuclear factor-kappa B (NF-κB). β-caryophyllene, a predominant terpene in cannabis, can synergise with THC to have anti-inflammatory and pain relieving effects.
CBD, a non-psychoactive compound, has a broad range of effects including pain relief and reducing symptoms of anxiety and depression. CBD has potent neuro-protective effects, with high enough concentrations (16uM) showing improvement in cognitive function in animal research models. Furthermore, evidence suggests that other compounds in cannabis, such as terpenes, may enhance the effects of THC and CBD or have benefits on their own.
The approval by the American Food and Drug Administration (FDA) has found terpenes to be 'confidently safe for human use'. As research continues to uncover the potential benefits of cannabis-based therapies for MS, a hopeful outlook emerges for those living with this debilitating condition.
- The malfunction in regulatory T cells in Multiple Sclerosis (MS) allows other T cell subtypes to promote inflammation, leading to neurological symptoms like muscle weakness, vision loss, and cognitive impairment.
- As the immune system in MS targets the body's own nerve cells, research suggests that Epstein-Barr Virus (EBV) may contribute to this autoimmune dysregulation, further promoting disease progression.
- In the search for alternatives to conventional treatments for MS, interest in cannabis-based therapies has arisen, as they contain compounds like THC and CBD, which interact with the endocannabinoid system and can provide pain relief, reduce anxiety, and have neuro-protective effects.
- The American Food and Drug Administration (FDA) has found terpenes, a component of cannabis plants, to be 'confidently safe for human use', and they have shown potential benefits for MS patients in areas such as reducing seizures, inflammation, and pain relief, offering a hopeful outlook for those living with the condition.
