Lack of effect of cannabis-based treatment on clinical and laboratory measures in multiple sclerosis.
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.
Centonze
Diego
D
Clinica Neurologica, Dipartimento di Neuroscienze, Università Tor Vergata, Via Montpellier 1, 00133 Rome, Italy. centonze@uniroma2.it
Mori
Francesco
F
Koch
Giacomo
G
Buttari
Fabio
F
Codecà
Claudia
C
Rossi
Silvia
S
Cencioni
Maria Teresa
MT
Bari
Monica
M
Fiore
Stefania
S
Bernardi
Giorgio
G
Battistini
Luca
L
Maccarrone
Mauro
M
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
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