Abstract

More than a century after the 1918 influenza pandemic, the emergence of the Coronavirus-Induced Disease of 2019 (COVID-19) viral pandemic is shining a light on the complexities of our immune systems. Over the past 100 years, we have learned that it was not just influenza alone that killed more than 50 million people. The virus often triggered a corresponding overreaction of the immune system [1]. Similarly, with COVID-19, the severity and outcomes are believed to be related to the characteristics of the host’s immune response [2] which is regulated by the host’s endocannabinoid system. Some healthcare experts have postulated that balancing viral-induced inflammation and resulting pathological levels of inflammatory cytokines may positively influence outcomes. A study of the pathogenesis of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) pneumonia found that lung damage was induced by an acute severe systemic inflammatory response (a cytokine storm) with the release of proinflammatory cytokines, including interleukin-6 (IL-6), and tumor necrosis factor α (TNF-α), leading to elevated immune cell infiltration and macrophagic polarization shifts [3-5]. Cannabis has been shown to (i) upregulate SIRT1 and inhibit NF-KB and Notch pathways [6] (ii) attenuate pathological elevation of critical inflammatory cell signaling pathways of necrosis factor-kappa beta (NF-Kβ), (iii) decrease the resulting elevated proinflammatory cytokine levels (including IL-6, and TNF-α, (iv) prevent entry of live SARS-CoV-2 into human epithelial cells [7] and (v) reduce immune cell infiltration of the lung in some studies [8]. Therefore, there is substantial evidence to support the potential for novel cannabis therapies attenuating the clinical presentation of COVID-19.

Keywords:Coronavirus; Phytocannabinoid; SARS-CoV-1; SARS-CoV-2; COVID-19; Cytokine storm