IntroductionRheumatoid arthritis (RA) is a debilitating autoimmune disease affecting approximately 1% of the global population and is associated with significant morbidity and mortality. Given the known anti-inflammatory effects of cannabinoids,we investigated the therapeutic potential of a high-CBD extract,termed CBD-X,by assessing its effects on immune cells and disease progression. This study investigates the therapeutic potential of a high-CBD extract (CBD-X) in RA.MethodsWe evaluated the effects of CBD-X on cells involved in RA pathogenesis using macrophages and primary human neutrophils as ex vivo models. In addition,two murine models of RA were applied: collagen-induced arthritis (CIA) and collagen antibody-induced arthritis (CAIA).ResultsEx vivo experiments demonstrated that CBD-X inhibited the secretion of pro-inflammatory cytokines,including IL-1β from macrophages and IL-8,IL-6,and TNF-α from human neutrophils,suggesting its potential to modulate inflammatory responses. Moreover,CBD-X attenuated NF-κB p65 and Akt phosphorylation downstream LPS-activation signal in neutrophils. To further evaluate its therapeutic effects,we employed two murine models of RA: collagen-induced arthritis (CIA) and collagen antibody-induced arthritis (CAIA). In both models,CBD-X treatment resulted in a significant reduction of leukocyte levels in the blood,primarily through the suppression of neutrophil and monocyte populations,which play a central role in RA pathogenesis. Additionally,CBD-X reduced neutrophil migration to the joints in the CAIA model,highlighting its potential to alleviate joint inflammation. Furthermore,it modulated the neutrophil-to-macrophage ratio (NMR),an important marker of RA progression,an effect that was not observed with dexamethasone treatment,suggesting a distinct mechanism of immune regulation. Notably,CBD-X promoted the pro-resolving macrophages to the rheumatic joints. Importantly,CBD-X exerted its anti-inflammatory effect by downregulating TNF-α and MCP-1 while upregulating IL-10,a key anti-inflammatory cytokine involved in immune homeostasis.DiscussionThese findings indicate that CBD-X has a significant potential as a therapeutic agent for RA,offering a promising approach to modulate immune responses and reduce inflammation in RA patients.
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