THC is highly effective in preventing cytokine storm and ARDS in animal models.
The fact that cells of the immune system produce endocannabinoids and express both CB1 and CB2 cannabinoid receptors provides unique opportunities into investigating how the cannabinoid system can be engineered to suppress inflammation using both exogenous and endogenous cannabinoids. Because cannabinoids are potent suppressors of inflammation as evidenced by their ability to suppress cytokine storm in animal models, they may serve as novel therapeutic agents to treat cytokine storm and ARDS that are seen in patients with or without COVID-19. There is a dire need for novel anti-inflammatory agents that exert broad spectrum cytokine suppression associated with ARDS considering that currently up to 40% of such patients, including those with COVID-19, die because currently there are no FDA-approved drugs that are highly effective against cytokine storm and ARDS. While animal studies are striking, clinical trials with cannabinoids especially with THC are lacking because it is classified as Schedule 1 drug, which makes it difficult to pursue such studies. However, targeting CB2 receptors and modulation of endocannabinoids in patients may offer novel insights into their therapeutic efficacy against ARDS. COVID-19 is a complex disease, and while the nature and role of immune response against the virus is being actively studied, it is clear that hyperimmune response and cytokine storm seem to significantly contribute toward mortality. Thus, while all attempts are being focused on control of viral replication through development of vaccines, it is also critical to ensure that the vaccines do not trigger hyperactivation of immune response. It is equally important to develop new anti-inflammatory therapies that can effectively block the cytokine storm seen in patients with severe form of COVID-19. We believe that cannabinoids hold significant promise as potent anti-inflammatory agents.