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The disease-modifying effects of a Sativex-like combination of phytocannabinoids in mice with experimental autoimmune encephalomyelitis are preferentially due to Δ9-tetrahydrocannabinol acting through CB1 receptors.

Abstract
Sativex(®), an equimolecular combination of Δ(9)-tetrahydrocannabinol-botanical drug substance (Δ(9)-THC-BDS) and cannabidiol-botanical drug substance (CBD-BDS), is a licensed medicine that may be prescribed for alleviating specific symptoms of multiple sclerosis (MS) such as spasticity and pain. However, further evidence suggest that it could be also active as disease-modifying therapy given the immunomodulatory, anti-inflammatory and cytoprotective properties of their two major components. In this study, we investigated this potential in the experimental autoimmune encephalitis (EAE) model of MS in mice. We compared the effect of a Sativex-like combination of Δ(9)-THC-BDS (10 mg/kg) and CBD-BDS (10 mg/kg) with Δ(9)-THC-BDS (20 mg/kg) or CBD-BDS (20 mg/kg) administered separately by intraperitoneal administration to EAE mice. Treatments were initiated at the time that symptoms appear and continued up to the first relapse of the disease. The results show that the treatment with a Sativex-like combination significantly improved the neurological deficits typical of EAE mice, in parallel with a reduction in the number and extent of cell aggregates present in the spinal cord which derived from cell infiltration to the CNS. These effects were completely reproduced by the treatment with Δ(9)-THC-BDS alone, but not by CBD-BDS alone which only delayed the onset of the disease without improving disease progression and reducing the cell infiltrates in the spinal cord. Next, we investigated the potential targets involved in the effects of Δ(9)-THC-BDS by selectively blocking CB(1) or PPAR-γ receptors, and we found a complete reversion of neurological benefits and the reduction in cell aggregates only with rimonabant, a selective CB(1) receptor antagonist. Collectively, our data support the therapeutic potential of Sativex as a phytocannabinoid formulation capable of attenuating EAE progression, and that the active compound was Δ(9)-THC-BDS acting through CB(1) receptors.
AuthorsMiguel Moreno-Martet, Ana Feliú, Francisco Espejo-Porras, Miriam Mecha, Francisco J Carrillo-Salinas, Javier Fernández-Ruiz, Carmen Guaza, Eva de Lago
JournalMultiple sclerosis and related disorders (Mult Scler Relat Disord) Vol. 4 Issue 6 Pg. 505-11 (Nov 2015) ISSN: 2211-0356 [Electronic] Netherlands
PMID26590655 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
CopyrightCopyright © 2015 Elsevier B.V. All rights reserved.
Chemical References
  • CNR1 protein, mouse
  • Cannabinoid Receptor Modulators
  • Drug Combinations
  • Neuroprotective Agents
  • Piperidines
  • Plant Extracts
  • Pyrazoles
  • Receptor, Cannabinoid, CB1
  • Cannabidiol
  • Dronabinol
  • nabiximols
  • Rimonabant
Topics
  • Animals
  • Cannabidiol
  • Cannabinoid Receptor Modulators (pharmacology)
  • Dronabinol (pharmacology)
  • Drug Combinations
  • Drug Evaluation, Preclinical
  • Encephalomyelitis, Autoimmune, Experimental (drug therapy, metabolism, pathology)
  • Female
  • Mice, Inbred C57BL
  • Neuroprotective Agents (pharmacology)
  • Photomicrography
  • Piperidines (pharmacology)
  • Plant Extracts (pharmacology)
  • Pyrazoles (pharmacology)
  • Receptor, Cannabinoid, CB1 (antagonists & inhibitors, metabolism)
  • Rimonabant
  • Spinal Cord (drug effects, metabolism, pathology)

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