Inflammation

Overview

Inflammation underlies a vast range of conditions — from autoimmune diseases (rheumatoid arthritis, IBD, lupus) to metabolic syndrome and neurodegeneration. The endocannabinoid system is deeply integrated with immune function: CB2 receptors are highly expressed on immune cells and modulate cytokine production, T-cell activation, and macrophage function.

CBD has demonstrated anti-inflammatory effects through multiple mechanisms: PPARγ agonism (reducing NF-κB-driven cytokine production), adenosine reuptake inhibition (increasing anti-inflammatory adenosine signaling), and TRPV1 desensitization (reducing neurogenic inflammation). CBG shows particularly strong anti-inflammatory effects in IBD models through CB2 agonism and direct inhibition of inflammatory mediators.

For inflammatory bowel disease (IBD), a 2013 Biochemical Pharmacology study found CBG significantly reduced colitis severity in a murine model. Human observational data from IBD patients using cannabis consistently show symptom improvement, but RCTs are limited. A 2013 Clinical Gastroenterology and Hepatology RCT (n=21) found inhaled cannabis significantly improved Crohn's disease activity scores.

For rheumatoid arthritis, a 2006 Rheumatology RCT (n=58) found nabiximols significantly reduced pain on movement and at rest, and improved sleep quality versus placebo — the first controlled trial of a cannabinoid in RA.

The challenge for inflammation indications is that preclinical evidence is very strong but human RCTs are small and limited. The anti-inflammatory effects of cannabinoids are real but the clinical translation requires larger trials.