In this review, the role of the endocannabinoid system (ECS) in disease and signalling is explored. The ECS is the most widespread system of receptors and ligands in the body; it is involved in dozens of processes throughout the body, from inflammation to neurological growth and repair. Because it is so widespread and extensive, it is also involved in many different diseases.
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In the brain, dysregulation or altered endocannabinoid signalling is related to neurodegenerative disorders and impaired memory functioning. Elsewhere in the body, if the ECS goes wrong, it can trigger or exacerbate inflammatory and autoimmune disorders.
This paper assembles the facts about the ECS, the major diseases it could potentially be used as an avenue for treatment for, and the mechanisms by which this could be achieved. Overall, the picture is far from complete.
The sheer extent of the ECS is already daunting, even without the complexity of the interactions that are taking place being taken into account. Both CB1 and CB2 receptors are expressed extensively in the brain, central nervous system, and many bodily tissues.
CB2 receptors are mostly immune system modulators, but they seem to play a vital role in memory in the brain, as well as mood stabilization and neuroprotection. CB1 receptors are mostly found in the central nervous system, but they are also found in many different tissues in the body.
CB1 and CB2 receptors are not the only endocannabinoid receptors and nor do they operate individually. There are several other partial endocannabinoid receptors that have been discovered recently, adding to the complexity. It seems that the regulatory and signal-mediating role of the ECS is beyond our understanding at this time.
This presents a challenge to anyone trying to develop effective ECS based therapies. Because a dose of cannabinoids that is administered to have a certain effect in one place, it is almost certainly going to affect other parts of the body too.
Multiple sclerosis (MS) is an autoimmune disease caused by the loss of a protein called myelin that protects the connections between neurons in the brain. Connections are lost and the functioning of the individual is impaired.
Cannabinoids have been investigated for their ability to reduce the symptoms of MS, they were relatively successful. This is probably due to CB1 and CB2 receptor activation. Some cannabinoids have been shown to be neuroprotective but it is unclear whether MS would be positively affected by cannabinoid administration. This is being investigated.
Huntington’s disease (HD), a neurodegenerative disease, is thought to be partly a consequence or cause of ECS dysregulation. CB1 expression is reduced in early Huntington’s, implying a role. It is believed that CB1 activation could ameliorate or treat Huntington’s.
Alzheimer’s is the most common form of dementia. Again, a dysregulated ECS is thought to be a part of the progression of the disease as it is so important in neurogenesis and brain health. The same is true for traumatic brain injury.
The potential for therapies for so many common and horrifying diseases via the ECS should make it the target of significant scientific effort in the future. There are many different diseases and conditions that could be treated with ECS interaction but nobody knows how yet.