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research focus
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randomized, placebo-controlled study has assessed the efficacy,
tolerability and safety of five weeks' treatment with a synthetic
tetrahydrocannabinol (THC) analogue in 58 RA patients and
found that pain was significantly reduced and disease activity
significantly suppressed" (6).
Issues of Note
Several issues noted by researchers about cannabis and auto-
immune disease are worth mentioning.
Cannabis Treatment for Autoimmune Disease Must
Be Personalized
"As each autoimmune disease differ [sic] in symptoms, it also
differs in the 'culpable' immune cells and cytokines inciting the
disease. Hence, declaring that cannabis treatment is benefi-
cial for autoimmune diseases does not suffice, and treatment
options should be tailored for each disease." Furthermore, since
each person's body chemistry and endocannabinoid system are
unique, "cannabis or cannabinoid treatment should possibly be
tailored not only per disease but also per person," (6).
Biphasic Effects
Cannabinoids are known to exhibit biphasic effects, that is, low
doses can generate one effect in patients while higher doses
exhibit the opposite effect. For example, studies have shown
that low doses of THC may decrease anxiety, while higher doses
may increase anxiety (15).
These same biphasic effects have been found for canna-
bis's effects on the production of white blood cells: low doses
of cannabinoids may stimulate the production of white blood
cells (T cells, B cells, and cytokines), while higher doses may
decrease production (7-9).
Promotes Infection by Suppressing the Immune System
The discussion thus far has noted the ability of cannabis to
suppresses immune system activity. This suppression helps re-
duce hyperactive immune systems in patients with autoimmune
disease, thereby providing relief. At the same time, however,
we must recognize that a primary role of the immune system
is to fight off infections. In this sense, then, using cannabis to
suppress immune system activity to help with autoimmune
disease may inadvertently increase patients' susceptibility to
infections (8).
References
(1) Antibody and antigen (n.d.). Science Clarified. Retrieved from http://
www.scienceclarified.com/Al-As/Antibody-and-Antigen.html.
(2) S. Dutta, (2021, Mar 16). News-Medical. Retrieved from https://www.
news-medical.net/life-sciences/What-is-an-Ant?"igen.aspx.
(3) Immune response (n.d.). Medline Plus. Retrieved from
https://medlineplus.gov/ency/article/000821.htm.
(4) P. Marrack, J. Kappler, and B.L. Kotzin, Nature Medicine
7(8), 899–905 (2001). https://doi.org/10.1038/90935.
(5) S. Watson, Healthline (2019, Mar 26). Retrieved from https://
www.healthline.com/health/autoimmune-disorders.
(6) V. Giorgi, D. Marotto, A. Batticciotto, F. Atzeni, S. Bongiovanni,
and P. Sarzi-Puttini, ImmunoTargets and Therapy 10,
261–271 (2021). https://doi.org/10.2147/ITT.S267905.
(7) P. Nagarkatti, R. Pandey, S.A. Rieder, V.L. Hegde, and M. Nagarkatti, Future
Medicinal Chemistry 1(7), 1333–1349 (2009). https://doi.org/10.4155/fmc.09.93.
(8) V. Katchan, P. David, and Y. Shoenfeld, Autoimmunity Reviews (2016,
Feb). Retrieved from https://pubmed.ncbi.nlm.nih.gov/26876387/.
(9) P. Massi, et al., Current Pharmaceutical Design (2006). Retrieved
from https://pubmed.ncbi.nlm.nih.gov/16918439/.
(10) Cytokines and inflammation (n.d.). Abcam. Retrieved from https://
www.abcam.com/research-areas/cytokines-and-inflammation.
(11) A. Oláh, et al., Frontiers in Immunology (2017, Nov 10). Retrieved from
https://www.frontiersin.org/articles/10.3389/fimmu.2017.01487/full.
(12) M. Pesce, et al., J Cell Mol Med (2018, Feb). Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5783846/.
(13) A. Malfitano and M. Bifulco, Current Drug Targets - CNS &
Neurological Disorders (2006, Jan). Retrieved from https://
www.researchgate.net/publication/7394957.
(14) C. Bifulco, et al., Digestive Diseases and Sciences (2019). Retrieved
from https://link.springer.com/article/10.1007/s10620-019-05556-z.
(15) L. Sharpe, et al, J. Transl. Med. (2020, Oct 2). Retrieved
from https://pubmed.ncbi.nlm.nih.gov/33008420/.
ab ou t t he au t hor
RUTH FISHER, PhD, is a systems design researcher and analyst.
She analyzes markets to determine how environments shape
outcomes. She is co-founder of CannDynamics, and author of The
Medical Cannabis Primer and Winning the Hardware-Software
Game: Using Game Theory to Optimize the Pace of New Technology
Adoption. Dr. Fisher has worked in the technology and healthcare
sectors on behalf of technology companies, early-stage research-
ers, physicians, and technology start-ups.
