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Cannabinoide und Immunsystem

Menschen, Mäuse und Zellen

Cannabinoids and the immune system

Of men, mice and cells

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Zusammenfassung

Der Einsatz von Cannabinoiden oder Cannabis in der Medizin wird kontrovers diskutiert. Derzeit sind nur Einzelsubstanzen (Dronabinol, Nabilone®) zur Symptomkontrolle in der Palliativmedizin zugelassen.

Das physiologische Cannabinoidsystem mit den spezifischen Rezeptoren CB1 und CB2 und seinen endogenen Liganden moduliert u.a. Appetit, Schmerzverarbeitung und immunologische Prozesse. Die befürchtete Immunsuppression durch Cannabinoide ließ sich beim Menschen bisher jedoch nicht sicher nachweisen. Lediglich Marijuanarauchen verminderte die bakteriziden Funktionen humaner Alveolarmakrophagen.

Nur im Tierversuch kam es zu verringerter zellulärer Immunität mit stärkerem Tumorwachstum und gehäuften Virusinfekten. In-vitro-Studien zeigten eine Suppression aller Immunzellen, jedoch nur bei Cannabinoidkonzentrationen weit oberhalb pharmakologischer Plasmaspiegel. Zusammenfassend ist eine klinisch relevante Immunsuppression bei der Therapie mit den verfügbaren oralen Cannabinoiden nicht wahrscheinlich, bei anderen Applikationsformen (Inhalation) könnten durchaus lokal immunsuppressive Effekte auftreten.

Abstract

The medical use of cannabis or cannabinoid compounds is controversial. Cannabinoids like the Δ9-THC (tetrahydrocannabinol) or the synthetic derivative Nabilone are available against cancer- and HIV-associated cachexia, nausea and vomiting. Over the last 20 years, the cannabinoid receptors CB1 and CB2 and their endogenous ligands have been found. The involvement of this endogenous cannabinoid signalling system in feeding, appetite, pain perception and immunomodulation could be demonstrated using animal and in vitro studies. Thus, the concern about immunosuppressive effects in humans using medical cannabinoid preparations grew. However, up to now most human studies have failed to demonstrate a well-defined and reproducible immunosuppressive cannabinoid-effect. Only the smoking of marijuana showed a significant local immunosuppression of the bactericidal activity of human alveolar macrophages.

In animal studies, cannabinoids were identified as potent modulators of cytokine production, causing a shift from Th1 to Th2 cytokines. In consequence, a compromised cellular immunity was observed in these animals, resulting in enhanced tumor growth and reduced immunity to viral infections. In vitro, immunosuppressive effects were shown in all immune cells, but only at high micromolar cannabinoid concentrations not reached under normal clinical conditions. In conclusion, there is no evidence that cannabinoids induce a serious, relevant immunosuppression in humans, with the exception of marijuana-smoking which may affect local brocho-alveolar immunity.

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Authors and Affiliations

  1. Abteilung für Anästhesie und Allgemeine Intensivmedizin (B), Medizinische Universität/AKH Wien, Wien

    B. Kraft & H. G. Kress

  2. Abteilung für Anästhesie und Allgemeine Intensivmedizin (B), Medizinische Universität/AKH Wien, Währinger Gürtel 18–20, 1090 , Wien, Österreich

    B. Kraft

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Kraft, B., Kress, H.G. Cannabinoide und Immunsystem. Schmerz 18, 203–210 (2004). https://doi.org/10.1007/s00482-003-0245-7

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  • DOI: https://doi.org/10.1007/s00482-003-0245-7

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