CBD and the Immune System: complex Interactions

There is a huge variety of small molecules in our body that help it function, day in, dayout. Some really well known ones are testosterone, estrogen and serotonin (theso-called ‘happy chemical’). In the 90s a group of scientists discovered that a group of these small molecules had a strong resemblance to cannabinoids, and that cannabinoids from plants worked in the same places in our body as these so-called ‘endocannabinoids’. What these scientists discovered is that our body has an endocannabinoid system, with receptors for these endocannabinoids distributed all throughout our body (1). We will dive deeper into the endocannabinoid system in a later blog, but today I want to focus on one part that is influenced by these endocannabinoids; our immune system.

The endocannabinoid system plays an important role in keeping the body in homeostasis, keeping metabolic processes in balance. As such, the endocannabinoid system also helps to keep the immune system in balance. This is also where most medical research in regards to CBD (and other cannabinoids) in relation to the immune system focuses on. Since these plant cannabinoids can affect the same receptors in the endocannabinoid system as our own endocannabinoids. So, where has medical research focused on specifically? CBD acts as an immunosuppressor (1) (2), which means that it tempers the immune response to stimuli. At first, this may sound like a bad thing, but there are quite a few medical conditions where this could be considered beneficial! For instance, in rheumatic arthritis (3), multiple sclerosis (2), asthma (4) and sepsis (5), all areas where CBD is being investigated as a possible drug to help with symptoms.  

What all these conditions have in common is that the immune system is not behaving as it should, and scientists think that CBD could help with regulating the immune system, to lessen symptoms in a wide range of diseases. Let us have a look at arthritis specifically. During arthritis immune cells get into the joints and cause inflammation and severe damage of cartilage. Current arthritis treatments focus on limiting the immune response, but tend to have side effects related to infection or immune disturbances (3). CBD might help alleviate the symptoms of arthritis, without having the increased risk of infection (3). Indirectly, it is also believed that CBD might help with some illnesses that develop in conjunction with arthritis, such as signs of depression and hypertension (3). The situation is similar for the other medical conditions mentioned, promising signs that CBD would be beneficial (2) (5).

A public hypothesis arose based on the ongoing research into CBD and the immune system: the downregulating effect of CBD can help keeping the immune system in balance, thereby preventing many adverse conditions. However, it is important to keep in mind that the immune system is an incredibly complex and vast system within our body, and that most research into CBD (or other cannabinoids) and the immune system is still very much ongoing. It seems that treatments will have to be made specifically for each disease, and that there is no one-size fits-all approach possible, due to the immense complexity and complicated interplay between all sorts of molecules that make up the immune system (1) (3).

With these things in mind, I want to shortly discuss a topic that is on everyone’s mind lately, COVID-19 (or the coronavirus). Some purveyors of CBD oil explicitly mention the effects CBD might have on the immune system (6). There is no current scientific evidence that would lead doctors to recommend taking CBD in relation to the coronavirus. Are there possible places within the chain of symptoms of the coronavirus where CBD might play a positive role? Maybe (7), but that is something that should be left up to clinical trials and rigorous medical and scientific research. We just do not know yet.

Especially in these times it is important that we all listen to the experts, and right now the experts are telling us that social distancing is what works. Let us all stick with that, and all other advice from local governments.  

Forup-to-date information on COVID-19, visit https://www.who.int/emergencies/diseases/novel-coronavirus-2019


1. Schurman, L.D., et al. Molecular  Mechanism and Cannabinoid Pharmacology. Handbook of Experimental  Pharmacology. Berlin, Heidelberg : Springer, 2019.

2. Targeting Cannabinoid Signaling in the Immune System:  “High”-ly Exciting Questions, Possibilities, and Challenges. Olah,  A., Szekanecz, Z. and Biro, T. 1487, s.l. : Frontiers in Immunology,  2017, Vol. 8. doi: 10.3389/fimmu.2017.01487.

3. Joints for joints: cannabinoids in the treatment of  rheumatoid arthritis. Lowin, T., Schneider, M. and Pongratz, G. 3,  s.l. : Current opinion in Rheumatology, 2019, Vol. 31.

4. Cannabidiol reduces airway inflammation and fibrosis  in experimental allergic asthma. Vuolo, F., et al. 029,  s.l. : European Journal of Pharmacology, 2018, Vol. 11.

5. Cannabis Sativa Revisited – Crosstalk between  microRNA Expression, INflammation, Oxidative Stress, and Endocannabinoid  Response System in Critically Ill Patients with Sepsis. Dinu, A.R., et al. 307, cells : MDPI, 2020, Vol. 9.  doi:10.3390/cells9020307.

6. [Online]  https://www.naturalproductsinsider.com/regulatory/cbd-companies-fda-crosshairs-new-round-warning-letters.

7. COVID-19: consider cytokine storm syndromes and  immuno suppression. Mehta, Puja, et al. 2020, The Lancet, pp. 395, 10229,  p1033-1034.