Invited Review: Amyotrophic Lateral Sclerosis, the Endocannabinoid System, and Exogenous Cannabinoids: Current State and Clinical Implications-Article

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This review article explores the potential therapeutic role of cannabinoids in the treatment of Amyotrophic Lateral Sclerosis (ALS) by investigating their interaction with the endocannabinoid system (ECS). Despite ALS's complex and multifaceted pathophysiology, leading to varied manifestations, current FDA-approved therapies demonstrate limited effectiveness. Cannabinoids such as THC and CBD have emerged as promising compounds due to their antioxidative, anti-inflammatory, and neuroprotective properties demonstrated in pre-clinical studies.<br /><br />In transgenic ALS models, specifically SOD1G93A mouse models, cannabinoids have shown potential in delaying disease onset and progression. These studies indicate that cannabinoids might improve motor and non-motor symptoms, like rigidity, sleep disturbances, and pain, commonly associated with ALS. The ECS's role in ALS pathogenesis is emphasized, suggesting its components as prospective biomarkers and therapeutic targets.<br /><br />Clinical studies, although limited and small-scale, suggest cannabinoids may alleviate symptoms but fail to establish their efficacy as disease-modifying therapies. The review calls for rigorously designed clinical trials to examine the effect of cannabinoids on ALS progression and survival rates. The possibility of cannabinoids contributing to symptom palliation and improving patients' quality of life is highlighted, given their relatively safe tolerability.<br /><br />Furthermore, the review points to several cannabis compounds, including the phytocannabinoid beta-caryophyllene and others, that may offer anti-inflammatory and neuroprotective benefits, suggesting that a combination of cannabinoids could tackle multiple ALS symptoms. The authors conclude that while current evidence is preliminary, the utilization of cannabis-based formulations for symptom management and potential disease modification in ALS holds promise. However, additional research is needed to verify these benefits and elucidate the full therapeutic potential of cannabinoids in ALS treatment.

Keywords

cannabinoids

Amyotrophic Lateral Sclerosis

ALS

endocannabinoid system

THC

CBD

SOD1G93A mouse model

symptom palliation

beta-caryophyllene

neuroprotective properties

clinical trials

amyotrophic lateral sclerosis

ALS