With the worldwide death toll from the coronavirus rising exponentially, The Lancet drew attention to “accumulating evidence” that indicates “patients with severe COVID-19 might have a cytokine storm syndrome.”
Characterized by intense immune overreaction in the lungs, this little understood syndrome can sicken and kill infected individuals. Respiratory distress is the leading cause of mortality in COVID-19 cases. The critically ill who survive intensive care may suffer long term lung damage, resulting in functional impairment and reduced quality of life.
Science Daily reports that a hyper-inflammatory cytokine storm, involving a surge of immune cells gone haywire, was likely the primary cause of death in several viral outbreaks, including the 1918-20 “Spanish flu” pandemic (which killed more than 50 million people) and, more recently, the H1N1 swine flu and the so-called bird flu.
In cases of acute, viral-induced pulmonary distress, cytokine-storm-targeted therapy would seem to make sense. But treatment with corticosteroids is not a great option because it can exacerbate COVID-19-associated lung injury. “However,” as The Lancet emphasizes, “in hyperinflammation, immunosuppression is likely to be beneficial.”
Several laboratory studies indicate that cannabinoid compounds – in particular, cannabidiol (CBD) and tetrahydrocannabinol (THC) – are immunosuppressant. This would explain why medical cannabis is beneficial for people with autoimmune diseases and chronic inflammation.
Which begs the question: Could cannabis calm a cytokine storm?
The short answer is we don’t know. There’s a lot that we still don’t understand about cannabis and the immune system.
For many years, scientific inquiry in the United States has been handcuffed by cannabis prohibition, and the federal government continues to thwart research that could shed light on the therapeutic use of cannabis and whole plant CBD-rich oil extracts. The federal stranglehold on cannabis research is the main reason why we know so little about CBD’s clinical potential as an antiviral remedy.
Cannabis prohibition is exacerbating the current crisis in other ways, as well, as we discuss later in this article. For now, let’s turn our attention back to cytokines and cannabinoids.
Several laboratory studies indicate that cannabinoid compounds – in particular, cannabidiol (CBD) and tetrahydrocannabinol (THC) – are immunosuppressant. This would explain why medical cannabis is beneficial for people with autoimmune diseases and chronic inflammation.
Which begs the question: Could cannabis calm a cytokine storm?
The short answer is we don’t know. There’s a lot that we still don’t understand about cannabis and the immune system.
For many years, scientific inquiry in the United States has been handcuffed by cannabis prohibition, and the federal government continues to thwart research that could shed light on the therapeutic use of cannabis and whole plant CBD-rich oil extracts. The federal stranglehold on cannabis research is the main reason why we know so little about CBD’s clinical potential as an antiviral remedy.
Cannabis prohibition is exacerbating the current crisis in other ways, as well, as we discuss later in this article. For now, let’s turn our attention back to cytokines and cannabinoids.
Could CBD be a viable candidate for reducing mortality in critically ill patients infected with COVID-19? A couple of dozen websites are already proclaiming that CBD has antiviral applications, as if this was an established medical fact.
Actually, thus far there is only “fragmentary evidence” that points to “possible use of CBD in viral infections,” according to a team of British and Italian scientists who recently addressed this issue in the online journal Cannabis and Cannabinoid Research. The authors referenced an in vitro study, which suggested that CBD had a direct antiviral effect against the Hepatitis C virus. But other than a single preclinical study involving Hep C, there is scant scientific evidence supporting the alleged antiviral properties of CBD.
The authors cited another study, which found that CBD reduced neuroinflammation in a virus-induced animal model of multiple sclerosis. But they acknowledge that this could have more to do with CBD’s efficacy as an anti-inflammatory compound rather than direct antiviral activity. Similarly, anecdotal accounts of using cannabidiol to treat viral infections, such as shingles and Herpes, “are plausible on the basis of the anti-inflammatory and analgesic properties of CBD,” the scientists acknowledged, without asserting an intrinsic antiviral effect.
CBD is currently undergoing clinical trials in Israel as a treatment for graft-versus-host disease (GVHD), a potentially fatal condition (with a mortality rate exceeding 80 percent) caused by systemic immune rejection of an organ or bone marrow transplant. Thus far, the results are encouraging. GHVD and COVID-19 fatalities both involve extreme immune overreactions, but there’s a crucial difference: GVHD is not triggered by a virus. And CBD has never been tested as a remedy for a viral-induced cytokine storm.
Many therapeutic applications of CBD and THC are related to their anti-inflammatory prowess. But that’s not the whole story. The interplay between cannabinoids and the immune system is complex, adaptive, and bidirectional.
In certain situations, cannabinoids can potentiate immune activity. A 2014 study by Louisiana State University scientists demonstrated that regular cannabis use can increase white blood cell counts in immune deficiency disorders such as HIV, suggesting a proinfammatory, immune-boosting effect. That’s the exact opposite of what’s needed to mitigate a viral-induced cytokine storm.
Given the conflicting data on the impact of cannabinioids on immune function, medical scientists are reevaluating their ideas about inflammation and immunosuppression. As Mary Biles reported for Project CBD: “A new wave of research and mounting anecdotal evidence points towards cannabinoids having an adaptive, immunomodulating effect, rather than just suppressing immune activity.”
The ability of cannabinoids to both suppress and enhance immune function lends credence to the notion that the endocannabinoid system is involved in bidirectional immunomodulation, keeping inflammation in check under healthy conditions but enabling an inflammatory response when needed to fight infection.
Dr. Garcia de Palau, a Spanish cannabis clinician, sums it up this way: “I believe [cannabis] is immunosuppressive when there is a hyper-immune response, but otherwise it regulates and corrects the immune system. In fact, you could say it functions like the endocannabinoid system, bringing equilibrium to the organism.”
