Page 33 - JCBP-2-1

Journal of Clinical and
Basic Psychosomatics The endocannabinoid system

symptoms, a development of paramount therapeutic exacerbate this inflammatory response. In PSD, symptoms
import. This development holds particular promise in such as fatigue, pain, and gastrointestinal distress can be
addressing the multifaceted nature of PSD, where the attributed to immune dysregulation and inflammation.
interplay between emotional well-being and physical Modulating the ECS to govern immune function may help
symptoms is a defining feature [122] . mitigate these symptoms [128,129] .

In PSD, dysregulation of the ECS may contribute Scientific research is diligently exploring the
to heightened stress levels. Conversely, modulating the therapeutic potential of ECS modulation, particularly the
ECS through various means, such as lifestyle changes, use of cannabinoids, in the management of conditions
pharmacological interventions, or even cannabinoids associated with immune dysregulation and chronic
from external sources like cannabis, may offer therapeutic inflammation. These studies strive to provide scientific
potential in managing stress-related symptoms associated insights into the role of the ECS in alleviating immune-
with PSD. However, it is essential to note that the effects related psychosomatic symptoms [130] .
can vary among individuals, and more research is needed
to fully understand the complex interplay between ECS The ECS’s interaction with immune function,
and stress in the context of PSD. particularly through CB2Rs in immune cells, carries
significant implications for understanding and addressing
3.2. Modulation of immune function and immune dysregulation linked to psychosomatic
inflammation symptoms. This is achieved by inhibiting the extracellular
The ECS intricately governs the regulation of immune signal-regulated kinase (ERK) pathway through mitogen-
function, placing a pronounced emphasis on CB2Rs, activated protein kinase-phosphatase (MKP) induction
which are abundant in immune cells. These receptors are (Figure 1E). The ECS’s capacity to govern immune responses
predominantly expressed in cells of the immune system and inflammation at the molecular level opens potential
and play a pivotal role in modulating the body’s immune avenues for therapeutic interventions in these intricate
responses. The interplay between the ECS and immune conditions, with ongoing scientific research contributing
function is of great scientific intrigue due to its potential to our understanding of this intricate relationship [131] .
implications for comprehending and addressing conditions Despite significant progress in understanding the
characterized by immune dysregulation, including PSD [123] .
interaction between the ECS and immune function or
CB2Rs are prevalent in various immune cells, including inflammation, several critical gaps persist in the current
leukocytes, monocytes, macrophages, B-cells, T-cells, research landscape. The specific mechanisms underlying
and natural killer cells (Figure 1C and D). Their presence how cannabinoids, both endogenous and exogenous,
in these cells underscores the significance of CB2Rs in influence immune responses remain incompletely
governing immune responses. While CB2Rs are most elucidated, necessitating further exploration. Cell-
widespread in immune cells, they are also found in tissues specific effects of cannabinoids on different immune
associated with the immune system, such as the spleen and cell types, including T-cells, B-cells, and macrophages,
tonsils. Furthermore, they are expressed in bone marrow, a need to be thoroughly investigated to provide a nuanced
hub of immune cell production [123-125] . understanding of their impact. Limited clinical evidence

Activation of CB2Rs in immune cells induces anti- exists regarding the efficacy and safety of cannabinoids
inflammatory effects. Stimulation of CB2Rs inhibits the in treating inflammatory and immune-related disorders,
production of proinflammatory cytokines and chemokines, emphasizing the need for robust clinical trials. Establishing
which are molecules responsible for initiating and dose-response relationships, understanding long-term
amplifying inflammatory responses (Figure 1E). The ECS effects and safety profiles, and exploring interactions with
plays a pivotal role in maintaining immune homeostasis, the gut microbiome are essential for translating preclinical
ensuring that the immune system responds appropriately findings into effective therapeutic strategies. In addition,
to threats while averting excessive or chronic inflammation. addressing the variability in individual responses to
This immunomodulatory function aids in sustaining a cannabinoids based on genetic, environmental, and
balanced and regulated immune response [126,127] . lifestyle factors is crucial for developing personalized
Immune dysregulation is a prevalent feature of PSD, approaches to cannabinoid-based therapies. Closing
with symptoms often linked to chronic inflammation these gaps in knowledge will contribute to harnessing
and imbalances in the immune system. Chronic stress, a the therapeutic potential of the ECS in modulating
recurrent element in PSD, can induce chronic low-level immune function and inflammation for various health
inflammation. Dysregulation of the ECS can further conditions [131-140] .

Volume 2 Issue 1 (2024) 9 https://doi.org/10.36922/jcbp.2288