Abstract
Respiratory illnesses and its repercussions are becoming more prevalent worldwide. It is necessary to research both innovative treatment and preventative techniques. Millions of confirmed cases and fatalities from the COVID-19 epidemic occurred over the previous two years. According to the review research, cannabinoids are a class of medicines that should be considered for the treatment of respiratory conditions. Cannabinoids and inhibitors of endocannabinoid degradation have illustrated advantageous anti-inflammatory, asthma, pulmonary fibrosis, and pulmonary artery hypotension in numerous studies (in vitro and in vivo). It has been also noted that CB2 receptors on macrophages and T-helper cells may be particularly triggered to lower inflammation in COVID-19 patients. Since the majority of lung tissue contains cannabinoid receptors, cannabis can be an effective medical tool for treating COVID-19 as well as pulmonary infections. Notably, CB2 and CB1 receptors play a major role in immune system modulation and anti-inflammatory activities. In this review, we put forth the idea that cannabis might be helpful in treating pulmonary contagion brought on by viral integration, such as that caused by SARS-CoV-2, haemophilus influenza type b, Streptococcus pneumoniae, influenza virus, and respiratory syncytial virus. Also, a detailed overview of CB receptors, intricate mechanisms, is highlighted connecting link with COVID-19 viral structural modifications along with molecular basis of CB receptors in diminishing viral load in pulmonary disorders supported through evident literature studies. Further, futuristic evaluations on cannabis potency through novel formulation development focusing on in vivo/in vitro systems can produce promising results.
Acknowledgments
Thank you to the department of pharmaceutical sciences and technology (BIT, mesra), my advisor Dr. Padma charan bahera sir and all of coauthors who have supported me.
-
Research ethics: Not applicable.
-
Informed consent: Not applicable.
-
Author contributions: Arya Ghosh, Varnita Karmakar.
-
Competing interests: The authors state no conflict of interest.
-
Research funding: None declared.
-
Data availability: Not applicable.
References
1. WHO coronavirus (COVID-19) dashboard|WHO coronavirus (COVID-19) dashboard with vaccination data. Available from: https://covid19.who.int/ [Accessed 12 Sept 2023].Search in Google Scholar
2. Barbosa, MT, Morais-Almeida, M, Sousa, CS, Bousquet, J. The “big five” lung diseases in CoViD-19 pandemic – a Google trends analysis. Pulmonology 2021;27:71. https://doi.org/10.1016/J.PULMOE.2020.06.008.Search in Google Scholar
3. Wisnivesky, J, De-Torres, JP. The global burden of pulmonary diseases: most prevalent problems and opportunities for improvement. Ann Global Health 2019;85:1. https://doi.org/10.5334/AOGH.2411.Search in Google Scholar
4. Kahn, JS, McIntosh, K. History and recent advances in coronavirus discovery. Pediatr Infect Dis J 2005;24:1. https://doi.org/10.1097/01.INF.0000188166.17324.60.Search in Google Scholar PubMed
5. Vellingiri, B, Jayaramayya, K, Iyer, M, Narayanasamy, A, Govindasamy, V, Giridharan, B, et al.. COVID-19: a promising cure for the global panic. Sci Total Environ 2020;725:138277. https://doi.org/10.1016/J.SCITOTENV.2020.138277.Search in Google Scholar PubMed PubMed Central
6. Ali, I, Alharbi, OML. COVID-19: disease, management, treatment, and social impact. Sci Total Environ 2020;728:1. https://doi.org/10.1016/J.SCITOTENV.2020.138861.Search in Google Scholar
7. Onay, A, Ertaş, A, Süzerer, V, Yener, İ, Yilmaz, MA, Ayaz-Tilkat, E, et al.. Cannabinoids for SARS-CoV-2 and is there evidence of their therapeutic efficacy? Turk J Biol 2021;45:570–87. https://doi.org/10.3906/BIY-2105-73.Search in Google Scholar
8. Carrazco-Montalvo, A, Armendáriz-Castillo, I, Tello, CL, Morales, D, Armas-Gonzalez, R, Guizado-Herrera, D, et al.. First detection of SARS-CoV-2 variant B.1.1.529 (Omicron) in Ecuador. New Microbes New Infect 2022;45:100951. https://doi.org/10.1016/J.NMNI.2022.100951.Search in Google Scholar
9. Das, K. Herbal plants as immunity modulators against COVID-19: a primary preventive measure during home quarantine. J Herb Med 2022;32:100501. https://doi.org/10.1016/J.HERMED.2021.100501.Search in Google Scholar
10. Anil, SM, Shalev, N, Vinayaka, AC, Nadarajan, S, Namdar, D, Belausov, E, et al.. Cannabis compounds exhibit anti-inflammatory activity in vitro in COVID-19-related inflammation in lung epithelial cells and pro-inflammatory activity in macrophages. Sci Rep 2021;11:2. https://doi.org/10.1038/S41598-021-81049-2.Search in Google Scholar PubMed PubMed Central
11. Khalsa, JH, Maggirwar, SB, Bunt, G. Cannabis/cannabinoids for treating COVID-19 associated neuropsychiatric complications. J Neuroimmune Pharmacol 2021;16:718–21. https://doi.org/10.1007/S11481-021-10013-8/METRICS.Search in Google Scholar
12. Kicman, A, Pędzińska-Betiuk, A, Kozłowska, H. The potential of cannabinoids and inhibitors of endocannabinoid degradation in respiratory diseases. Eur J Pharmacol 2021;911:174560. https://doi.org/10.1016/J.EJPHAR.2021.174560.Search in Google Scholar PubMed
13. Krishna Kumar, K, Shalev-Benami, M, Robertson, MJ, Hu, H, Banister, SD, Hollingsworth, SA, et al.. Structure of a signaling cannabinoid receptor 1-G protein complex. Cell 2019;176:448–58.e12. https://doi.org/10.1016/J.CELL.2018.11.040.Search in Google Scholar
14. Mannekote Thippaiah, S, Iyengar, SS, Vinod, KY. Exo- and endo-cannabinoids in depressive and suicidal behaviors. Front Psychiatr 2021;12:636228. https://doi.org/10.3389/FPSYT.2021.636228/BIBTEX.Search in Google Scholar
15. Walsh, KB, Andersen, HK. Molecular pharmacology of synthetic cannabinoids: delineating CB1 receptor-mediated cell signaling. Int J Mol Sci 2020;21:6115. https://doi.org/10.3390/IJMS21176115.Search in Google Scholar
16. Xing, C, Zhang, C, Xie, X-Q. Cannabinoid receptor CB2 structure and CB2/Gi signaling mechanisms. FASEB J 2019;33:493.12. https://doi.org/10.1096/FASEBJ.2019.33.1_SUPPLEMENT.493.12.Search in Google Scholar
17. Kaur, R, Ambwani, R, Singh, S. Endocannabinoid system: a multi-facet therapeutic target. Curr Clin Pharmacol 2016;11:110–17. https://doi.org/10.2174/1574884711666160418105339.Search in Google Scholar PubMed
18. Spicuzza, L, Haddad, EB, Birrell, M, Ling, A, Clarke, D, Venkatesan, P, et al.. Characterization of the effects of cannabinoids on Guinea-pig tracheal smooth muscle tone: role in the modulation of acetylcholine release from parasympathetic nerves. Br J Pharmacol 2000;130:1720. https://doi.org/10.1038/SJ.BJP.0703497.Search in Google Scholar
19. Fantauzzi, MF, Aguiar, JA, Tremblay, BJM, Mansfield, MJ, Yanagihara, T, Chandiramohan, A, et al.. Expression of endocannabinoid system components in human airway epithelial cells: impact of sex and chronic respiratory disease status. ERJ Open Res 2020;6:1–19. https://doi.org/10.1183/23120541.00128-2020.Search in Google Scholar PubMed PubMed Central
20. Karpin´ska, O, Baranowska-Kuczko, M, Kloza, M, Ambroz˙ewicz, E, Kozłowski, T, Kasacka, I, et al.. Activation of CB1 receptors by 2-arachidonoylglycerol attenuates vasoconstriction induced by U46619 and angiotensin II in human and rat pulmonary arteries. Am J Physiol Regul Integr Comp Physiol 2017;312:R883–93. https://doi.org/10.1152/AJPREGU.00324.2016.Search in Google Scholar PubMed
21. Nagre, N, Nicholson, G, Cong, X, Lockett, J, Pearson, AC, Chan, V, et al.. Activation of cannabinoid-2 receptor protects against Pseudomonas aeruginosa induced acute lung injury and inflammation. Respir Res 2022;23:1–13. https://doi.org/10.1186/S12931-022-02253-W/FIGURES/6.Search in Google Scholar
22. Rice, W, Shannon, JM, Burton, F, Fiedeldey, D. Expression of a brain-type cannabinoid receptor (CB1) in alveolar Type II cells in the lung: regulation by hydrocortisone. Eur J Pharmacol 1997;327:227–32. https://doi.org/10.1016/S0014-2999(97)89665-3.Search in Google Scholar PubMed
23. Moldoveanu, B, Otmishi, P, Jani, P, Walker, J, Sarmiento, X, Guardiola, J, et al.. Inflammatory mechanisms in the lung. J Inflamm Res 2008;1:1–11. https://doi.org/10.2147/JIR.S4385.Search in Google Scholar
24. Carayon, P, Marchand, J, Dussossoy, D, Derocq, JM, Jbilo, O, Bord, A, et al.. Modulation and functional involvement of CB2 peripheral cannabinoid receptors during B-cell differentiation. Blood 1998;92:3605–15. https://doi.org/10.1182/BLOOD.V92.10.3605.422K05_3605_3615.Search in Google Scholar
25. Chouinard, F, Lefebvre, JS, Navarro, P, Bouchard, L, Ferland, C, Lalancette-Hébert, M, et al.. The endocannabinoid 2-arachidonoyl-glycerol activates human neutrophils: critical role of its hydrolysis and De Novo leukotriene B4 biosynthesis. J Immunol 2011;186:3188–96. https://doi.org/10.4049/JIMMUNOL.1002853.Search in Google Scholar
26. Chouinard, F, Turcotte, C, Guan, X, Larose, M-C, Poirier, S, Bouchard, L, et al.. 2-Arachidonoyl-glycerol- and arachidonic acid-stimulated neutrophils release antimicrobial effectors against E. coli, S. aureus, HSV-1, and RSV. J Leukoc Biol 2013;93:267. https://doi.org/10.1189/JLB.0412200.Search in Google Scholar
27. Galiègue, S, Mary, S, Marchand, J, Dussossoy, D, Carrière, D, Carayon, P, et al.. Expression of central and peripheral cannabinoid receptors in human immune tissues and leukocyte subpopulations. Eur J Biochem 1995;232:54–61. https://doi.org/10.1111/J.1432-1033.1995.TB20780.X.Search in Google Scholar PubMed
28. Preet, A, Qamri, Z, Nasser, MW, Prasad, A, Shilo, K, Zou, X, et al.. Cannabinoid receptors, CB1 and CB2, as novel targets for inhibition of non-small cell lung cancer growth and metastasis. Cancer Prev Res 2011;4:65. https://doi.org/10.1158/1940-6207.CAPR-10-0181.Search in Google Scholar PubMed PubMed Central
29. Small-Howard, AL, Shimoda, LMN, Adra, CN, Turner, H. Anti-inflammatory potential of CB1-mediated cAMP elevation in mast cells. Biochem J 2005;388:465. https://doi.org/10.1042/BJ20041682.Search in Google Scholar PubMed PubMed Central
30. Turcotte, C, Blanchet, MR, Laviolette, M, Flamand, N. Impact of cannabis, cannabinoids, and endocannabinoids in the lungs. Front Pharmacol 2016;7. https://doi.org/10.3389/FPHAR.2016.00317.Search in Google Scholar
31. Liu, DX, Liang, JQ, Fung, TS. Human coronavirus-229E, -OC43, -NL63, and -HKU1 (Coronaviridae). Encycl Virol 2021;1–5:428. https://doi.org/10.1016/B978-0-12-809633-8.21501-X.Search in Google Scholar
32. Keshavarz Valian, N, Pourakbari, B, Asna Ashari, K, Hosseinpour Sadeghi, R, Mahmoudi, S. Evaluation of human coronavirus OC43 and SARS-COV-2 in children with respiratory tract infection during the COVID-19 pandemic. J Med Virol 2022;94:1450–6. https://doi.org/10.1002/JMV.27460.Search in Google Scholar
33. Poutanen, SM. Human coronaviruses. Princ Pract Pediatr Infect Dis 2018;1148–1152. https://doi.org/10.1016/B978-0-323-40181-4.00222-X.Search in Google Scholar
34. Abdul-Rasool, S, Fielding, BC. Understanding human coronavirus HCoV-NL63. Open Virol J 2010;4:76. https://doi.org/10.2174/1874357901004010076.Search in Google Scholar PubMed PubMed Central
35. Papi, A, Brightling, C, Pedersen, SE, Reddel, HK. Asthma. Lancet 2018;391:783–800. https://doi.org/10.1016/S0140-6736(17)33311-1.Search in Google Scholar PubMed
36. Giannini, L, Nistri, S, Mastroianni, R, Cinci, L, Vannacci, A, Mariottini, C, et al.. Activation of cannabinoid receptors prevents antigen-induced asthma-like reaction in Guinea pigs. J Cell Mol Med 2008;12:2381. https://doi.org/10.1111/J.1582-4934.2008.00258.X.Search in Google Scholar
37. Bozkurt, TE, Kaya, Y, Durlu-Kandilci, NT, Onder, S, Sahin-Erdemli, I. The effect of cannabinoids on dinitrofluorobenzene-induced experimental asthma in mice. Respir Physiol Neurobiol 2016;231:7–13. https://doi.org/10.1016/J.RESP.2016.05.012.Search in Google Scholar
38. Vuolo, F, Abreu, SC, Michels, M, Xisto, DG, Blanco, NG, Hallak, JE, et al.. Cannabidiol reduces airway inflammation and fibrosis in experimental allergic asthma. Eur J Pharmacol 2019;843:251–9. https://doi.org/10.1016/J.EJPHAR.2018.11.029.Search in Google Scholar PubMed
39. Barratt, SL, Creamer, A, Hayton, C, Chaudhuri, N. Idiopathic pulmonary fibrosis (IPF): an overview. J Clin Med 2018;7. https://doi.org/10.3390/JCM7080201.Search in Google Scholar
40. Bronova, I, Smith, B, Aydogan, B, Weichselbaum, RR, Vemuri, K, Erdelyi, K, et al.. Protection from radiation-induced pulmonary fibrosis by peripheral targeting of cannabinoid receptor-1. Am J Respir Cell Mol Biol 2015;53:555–62. https://doi.org/10.1165/RCMB.2014-0331OC/SUPPL_FILE/DISCLOSURES.PDF.Search in Google Scholar
41. Cinar, R, Gochuico, BR, Iyer, MR, Jourdan, T, Yokoyama, T, Park, JK, et al.. Cannabinoid CB1 receptor overactivity contributes to the pathogenesis of idiopathic pulmonary fibrosis. JCI Insight 2017;2:4. https://doi.org/10.1172/JCI.INSIGHT.92281.Search in Google Scholar PubMed PubMed Central
42. Fu, Q, Zheng, Y, Dong, X, Wang, L, Jiang, CG. Activation of cannabinoid receptor type 2 by JWH133 alleviates bleomycin-induced pulmonary fibrosis in mice. Oncotarget 2017;8:103486. https://doi.org/10.18632/ONCOTARGET.21975.Search in Google Scholar
43. Wawryk-Gawda, E, Chłapek, K, Zarobkiewicz, MK, Lis-Sochocka, M, Chylińska-Wrzos, P, Boguszewska-Czubara, A, et al.. CB2R agonist prevents nicotine induced lung fibrosis; 2019;44:344–51. https://doi.org/10.1080/01902148.2018.1543368.Search in Google Scholar PubMed
44. Ojo, AS, Balogun, SA, Williams, OT, Ojo, OS. Pulmonary fibrosis in COVID-19 survivors: predictive factors and risk reduction strategies. Pulm Med 2020;2020. Article no. 6175964. https://doi.org/10.1155/2020/6175964.Search in Google Scholar PubMed PubMed Central
45. Thenappan, T, Ormiston, ML, Ryan, JJ, Archer, SL. Pulmonary arterial hypertension: pathogenesis and clinical management. BMJ 2018;360:4. https://doi.org/10.1136/BMJ.J5492.Search in Google Scholar
46. Sadowska, O, Baranowska-Kuczko, M, Gromotowicz-Popławska, A, Biernacki, M, Kicman, A, Malinowska, B, et al.. Cannabidiol ameliorates monocrotaline-induced pulmonary hypertension in rats. Int J Mol Sci 2020;21:7077. https://doi.org/10.3390/IJMS21197077.Search in Google Scholar PubMed PubMed Central
47. Lu, X, Zhang, J, Liu, H, Ma, W, Yu, L, Tan, X, et al.. Cannabidiol attenuates pulmonary arterial hypertension by improving vascular smooth muscle cells mitochondrial function. Theranostics 2021;11:5267–78. https://doi.org/10.7150/THNO.55571.Search in Google Scholar
48. Krzyżewska, A, Baranowska-Kuczko, M, Jastrząb, A, Kasacka, I, Kozłowska, H. Cannabidiol improves antioxidant capacity and reduces inflammation in the lungs of rats with monocrotaline-induced pulmonary hypertension. Molecules 2022;27:3327. https://doi.org/10.3390/MOLECULES27103327.Search in Google Scholar PubMed PubMed Central
49. Ciotti, M, Maurici, M, Santoro, V, Coppola, L, Sarmati, L, De Carolis, G, et al.. Viruses of respiratory tract: an observational retrospective study on hospitalized patients in Rome, Italy. Microorganisms 2020;8:5. https://doi.org/10.3390/MICROORGANISMS8040501.Search in Google Scholar PubMed PubMed Central
50. Buchweitz, JP, Karmaus, PWF, Harkema, JR, Williams, KJ, Kaminski, NE. Modulation of airway responses to influenza A/PR/8/34 by Δ9-tetrahydrocannabinol in C57BL/6 Mice. J Pharmacol Exp Therapeut 2007;323:675–83. https://doi.org/10.1124/JPET.107.124719.Search in Google Scholar PubMed
51. Rosário-Ferreira, N, Preto, AJ, Melo, R, Moreira, IS, Brito, RMM. The central role of non-structural protein 1 (NS1) in influenza biology and infection. Int J Mol Sci 2020;21:5. https://doi.org/10.3390/IJMS21041511.Search in Google Scholar
52. Matuschak, GM, Lechner, AJ. Acute lung injury and the acute respiratory distress syndrome: pathophysiology and treatment. Mo Med 2010;107:252–8.Search in Google Scholar
53. Ragaller, M, Richter, T. Acute lung injury and acute respiratory distress syndrome. J Emerg Trauma Shock 2010;3:43–51. https://doi.org/10.4103/0974-2700.58663.Search in Google Scholar PubMed PubMed Central
54. Vlastos, D, Zeinah, M, Ninkovic-Hall, G, Vlachos, S, Salem, A, Asonitis, A, et al.. The effects of ischaemic conditioning on lung ischaemia – reperfusion injury. Respir Res 2022;23:5. https://doi.org/10.1186/S12931-022-02288-Z.Search in Google Scholar
55. Weyker, PD, Webb, CAJ, Kiamanesh, D, Flynn, BC. Lung ischemia reperfusion injury: a bench-to-bedside review. Semin Cardiothorac Vasc Anesth 2013;17:28–43. https://doi.org/10.1177/1089253212458329.Search in Google Scholar PubMed
56. Karmaus, PWF, Chen, W, Crawford, R, Kaplan, BLF, Kaminski, NE. Δ9-tetrahydrocannabinol impairs tihe inflammatory response to influenza infection: role of antigen-presenting cells and the cannabinoid receptors 1 and 2. Toxicol Sci 2013;131:419. https://doi.org/10.1093/TOXSCI/KFS315.Search in Google Scholar PubMed PubMed Central
57. Tahamtan, A, Samieipoor, Y, Nayeri, FS, Rahbarimanesh, AA, Izadi, A, Rashidi-Nezhad, A, et al.. Effects of cannabinoid receptor type 2 in respiratory syncytial virus infection in human subjects and mice; 2017;9:217–30. https://doi.org/10.1080/21505594.2017.1389369.Search in Google Scholar PubMed PubMed Central
58. Tahamtan, A, Tavakoli-Yaraki, M, Rygiel, TP, Mokhtari-Azad, T, Salimi, V. Effects of cannabinoids and their receptors on viral infections. J Med Virol 2015;88:1–12. https://doi.org/10.1002/JMV.24292.Search in Google Scholar PubMed
59. Mohammed, A, Alghetaa, HFK, Miranda, K, Wilson, K, Singh, NP, Cai, G, et al.. Δ9-tetrahydrocannabinol prevents mortality from acute respiratory distress syndrome through the induction of apoptosis in immune cells, leading to cytokine storm suppression. Int J Mol Sci 2020;21:1–21. https://doi.org/10.3390/IJMS21176244.Search in Google Scholar PubMed PubMed Central
60. Khodadadi, H, Salles, ÉL, Jarrahi, A, Chibane, F, Costigliola, V, Yu, JC, et al.. Cannabidiol modulates cytokine storm in acute respiratory distress syndrome induced by simulated viral infection using synthetic RNA. Cannabis Cannabinoid Res 2020;5:197–201. https://doi.org/10.1089/CAN.2020.0043.Search in Google Scholar PubMed PubMed Central
61. Xiong, Y, Yao, H, Cheng, Y, Gong, D, Liao, X, Wang, R. Effects of monoacylglycerol lipase inhibitor URB602 on lung ischemia-reperfusion injury in mice. Biochem Biophys Res Commun 2018;506:578–84. https://doi.org/10.1016/J.BBRC.2018.10.098.Search in Google Scholar PubMed
62. Yin, H, Li, X, Xia, R, Yi, M, Cheng, Y, Wu, Y, et al.. Posttreatment with the fatty acid amide hydrolase inhibitor URB937 ameliorates one-lung ventilation – induced lung injury in a rabbit model. J Surg Res 2019;239:83–91. https://doi.org/10.1016/j.jss.2019.01.009.Search in Google Scholar PubMed
63. Zeng, J, Li, X, Cheng, Y, Ke, B, Wang, R. Activation of cannabinoid receptor type 2 reduces lung ischemia reperfusion injury through PI3K/Akt pathway. Int J Clin Exp Pathol 2019;12:4096.Search in Google Scholar
64. Huang, W, Xiong, Y, Chen, Y, Cheng, Y, Wang, R. NOX2 is involved in CB2-mediated protection against lung ischemia-reperfusion injury in mice. Int J Clin Exp Pathol 2020;13:277.Search in Google Scholar
65. Tahamtan, A, Tavakoli-Yaraki, M, Shadab, A, Rezaei, F, Marashi, SM, Shokri, F, et al.. The role of cannabinoid receptor 1 in the immunopathology of respiratory syncytial virus. Viral Immunol 2018;31:1–7. https://doi.org/10.1089/VIM.2017.0098.Search in Google Scholar PubMed
66. Nguyen, LC, Yang, D, Nicolaescu, V, Best, TJ, Ohtsuki, TO, Chen, S-N, et al.. Cannabidiol inhibits SARS-CoV-2 replication and promotes the host innate immune response. bioRxiv 2021;1:17. https://doi.org/10.1101/2021.03.10.432967.Search in Google Scholar PubMed PubMed Central
67. Rossi, F, Tortora, C, Argenziano, M, Di Paola, A, Punzo, F. Cannabinoid receptor type 2: a possible target in SARS-CoV-2 (CoV-19) infection? Int J Mol Sci 2020;21:3809. https://doi.org/10.3390/IJMS21113809.Search in Google Scholar PubMed PubMed Central
68. Byrareddy, SN, Mohan, M. SARS-CoV2 induced respiratory distress: can cannabinoids be added to anti-viral therapies to reduce lung inflammation? Brain Behav Immun 2020;87:120–1. https://doi.org/10.1016/J.BBI.2020.04.079.Search in Google Scholar
69. van Breemen, RB, Muchiri, RN, Bates, TA, Weinstein, JB, Leier, HC, Farley, S, et al.. Cannabinoids block cellular entry of SARS-CoV-2 and the emerging variants. J Nat Prod 2022;85:176–84. https://doi.org/10.1021/ACS.JNATPROD.1C00946/ASSET/IMAGES/LARGE/NP1C00946_0004.JPEG.Search in Google Scholar
70. Raj, V, Park, JG, Cho, KH, Choi, P, Kim, T, Ham, J, et al.. Assessment of antiviral potencies of cannabinoids against SARS-CoV-2 using computational and in vitro approaches. Int J Biol Macromol 2021;168:474–85. https://doi.org/10.1016/J.IJBIOMAC.2020.12.020.Search in Google Scholar PubMed PubMed Central
71. Crippa, JAS, Zuardi, AW, Guimarães, FS, Campos, AC, De Lima Osório, F, Loureiro, SR, et al.. Efficacy and safety of cannabidiol plus standard care vs standard care alone for the treatment of emotional exhaustion and burnout among frontline health care workers during the COVID-19 pandemic: a randomized clinical trial. JAMA Netw Open 2021;4:e2120603. https://doi.org/10.1001/JAMANETWORKOPEN.2021.20603.Search in Google Scholar PubMed PubMed Central
72. Malinowska, B, Baranowska‐kuczko, M, Kicman, A, Schlicker, E. Opportunities, challenges and pitfalls of using cannabidiol as an adjuvant drug in COVID-19. Int J Mol Sci;22:1986. https://doi.org/10.3390/IJMS22041986.Search in Google Scholar PubMed PubMed Central
© 2024 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Editorials
- Doctor patient relationship in AI era: trying to decipher the problem
- “Adiponcosis interplay: adipose tissue, microenvironment and prostate cancer”
- Minireview
- Interplay between male gonadal function and overall male health
- Reviews
- How should we differentiate hypoglycaemia in non-diabetic patients?
- Pozelimab, a human monoclonal immunoglobulin for the treatment of CHAPLE disease
- Cannabis effectiveness on immunologic potency of pulmonary contagion
- Exploring the impact of vitamin D on tendon health: a comprehensive review
- The underlying causes, treatment options of gut microbiota and food habits in type 2 diabetes mellitus: a narrative review
- Original Articles
- Long-term functional outcomes and predictors of efficacy in thulium laser enucleation of the prostate (ThuLEP) for benign prostatic hyperplasia (BPH): a retrospective observational study
- Investigating Majhool date (Phoenix dactylifera) consumption effects on fasting blood glucose in animals and humans
- A novel variant in the FLNB gene associated with spondylocarpotarsal synostosis syndrome
- Exploring pathogenic pathways in carpal tunnel syndrome: sterile inflammation and oxidative stress
Articles in the same Issue
- Frontmatter
- Editorials
- Doctor patient relationship in AI era: trying to decipher the problem
- “Adiponcosis interplay: adipose tissue, microenvironment and prostate cancer”
- Minireview
- Interplay between male gonadal function and overall male health
- Reviews
- How should we differentiate hypoglycaemia in non-diabetic patients?
- Pozelimab, a human monoclonal immunoglobulin for the treatment of CHAPLE disease
- Cannabis effectiveness on immunologic potency of pulmonary contagion
- Exploring the impact of vitamin D on tendon health: a comprehensive review
- The underlying causes, treatment options of gut microbiota and food habits in type 2 diabetes mellitus: a narrative review
- Original Articles
- Long-term functional outcomes and predictors of efficacy in thulium laser enucleation of the prostate (ThuLEP) for benign prostatic hyperplasia (BPH): a retrospective observational study
- Investigating Majhool date (Phoenix dactylifera) consumption effects on fasting blood glucose in animals and humans
- A novel variant in the FLNB gene associated with spondylocarpotarsal synostosis syndrome
- Exploring pathogenic pathways in carpal tunnel syndrome: sterile inflammation and oxidative stress