title: Lack of effect of cannabis-based treatment on clinical and laboratory measures in multiple sclerosis.
abstract: The endocannabinoid system (ECS) is involved in the pathophysiology of multiple sclerosis (MS), and relief from pain and spasticity has been reported in MS patients self-medicating with marijuana. A cannabis-based medication containing Delta(9)-tetrahydrocannabinol and cannabidiol (Sativex) has been approved in some countries for the treatment of MS-associated pain. The effects of this pharmaceutical preparation on other clinically relevant aspects of MS pathophysiology, however, are still unclear. In 20 MS patients, we measured the effects of Sativex on clinically measured spasticity and on neurophysiological and laboratory parameters that correlate with spasticity severity or with the modulation of the ECS. Sativex failed to affect spasticity and stretch reflex excitability. This compound also failed to affect the synthesis and the degradation of the endocannabinoid anandamide, as well as the expression of both CB1 and CB2 cannabinoid receptors in various subpopulations of peripheral lymphocytes.
authors.affiliation: Clinica Neurologica, Dipartimento di Neuroscienze, Università Tor Vergata, Via Montpellier 1, 00133 Rome, Italy. centonze@uniroma2.it
authors.forename: Diego
authors.initials: D
authors.lastname: Centonze
authors.forename: Francesco
authors.initials: F
authors.lastname: Mori
authors.forename: Giacomo
authors.initials: G
authors.lastname: Koch
authors.forename: Fabio
authors.initials: F
authors.lastname: Buttari
authors.forename: Claudia
authors.initials: C
authors.lastname: Codecà
authors.forename: Silvia
authors.initials: S
authors.lastname: Rossi
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Cencioni
authors.forename: Monica
authors.initials: M
authors.lastname: Bari
authors.forename: Stefania
authors.initials: S
authors.lastname: Fiore
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bernardi
authors.forename: Luca
authors.initials: L
authors.lastname: Battistini
authors.forename: Mauro
authors.initials: M
authors.lastname: Maccarrone
mesh_terms: D000328:Adult; D001095:Arachidonic Acids / Q000378:metabolism; D002185:Cannabidiol; D002186:Cannabinoids / Q000627:therapeutic use*; D013759:Dronabinol; D004338:Drug Combinations; D063388:Endocannabinoids; D005260:Female; D006801:Humans; D008214:Lymphocytes / Q000187:drug effects / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D009128:Muscle Spasticity / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D010146:Pain / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D010936:Plant Extracts / Q000627:therapeutic use*; D053284:Polyunsaturated Alkamides / Q000378:metabolism; D043884:Receptor, Cannabinoid, CB1 / Q000378:metabolism; D043885:Receptor, Cannabinoid, CB2 / Q000378:metabolism; D012026:Reflex, Stretch / Q000187:drug effects; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001095:Arachidonic Acids; D002186:Cannabinoids; D004338:Drug Combinations; D063388:Endocannabinoids; D010936:Plant Extracts; D053284:Polyunsaturated Alkamides; D043884:Receptor, Cannabinoid, CB1; D043885:Receptor, Cannabinoid, CB2; D002185:Cannabidiol; D013759:Dronabinol; C587251:nabiximols; C078814:anandamide