POTENCIAL TERAPÉUTICO DE LOS FITOCANNABINOIDES EN LA MODULACIÓN DE LA NEUROINFLAMACIÓN EN PATOLOGÍAS NEURODEGENERATIVAS
Resumen
Las enfermedades neurodegenerativas representan un desafío crítico para la salud pública mundial, exigiendo terapias que trasciendan el manejo sintomático. Esta revisión integradora investiga el potencial terapéutico de los fitocannabinoides en la modulación de la neuroinflamación crónica. Metodología: Se basó en el análisis de evidencia de los últimos cinco años extraída de las bases de datos PubMed/MEDLINE y LILACS/BVS sobre la modulación de la inflamación en patologías neurodegenerativas. Resultados: Los compuestos fitocannabinoides parecen actuar de forma pleiotrópica, promoviendo la protección de la barrera hematoencefálica, el rescate del flujo autofágico y la reducción de citoquinas proinflamatorias. Conclusión: La administración de estos compuestos ofrece una estrategia neuroprotectora potencial, aunque la estandarización clínica y la superación de las barreras regulatorias son esenciales para su viabilidad terapéutica universal.
Biografía del autor/a
Doctorando en Ciencias de la Salud en la Universidad del Sur de Santa Catarina (UNISUL).
Graduado en Medicina por la Universidad Federal de Jataí (UFJ).
Graduado en Medicina por la Universidad Federal de Jataí (UFJ).
Graduada en Medicina por la Universidad Nove de Julho.
Graduada en Medicina por la PUC-SP (Pontificia Universidad Católica de São Paulo).
Graduado en Medicina por el Centro Universitario Atenas.
Estudiante de Medicina en la Universidad de Rio Verde.
Graduada en Enfermería por la Universidad Nove de Julho (UNINOVE), Especialista en Investigación Clínica y Estrategia de Salud de la Familia (DNA Posgrado / COREN) y actualmente estudiante de posgrado en Rehabilitación Multidisciplinaria Neurofuncional del Adulto en la Universidad Municipal de São Caetano do Sul (USCS).
Especialista en Vigilancia y Atención en Salud en el Enfrentamiento de la COVID-19 y otras Enfermedades por la Fiocruz Mato Grosso do Sul (FIOCRUZ-MS). Institución actual: Universidad Federal de Piauí.
Referencias
AHMED, H. et al. Metabólitos derivados da microbiota como impulsionadores da comunicação intestino-cérebro. Micróbios intestinais, v. 14, n. 2102878, 2022.
AHLUWALIA, M. et al. Metabolismo endocanabinóide alterado compromete a barreira hematoencefálica e exacerba déficits crônicos após lesão cerebral traumática em camundongos. Exp. Neurol., v. 361, n. 114320, 2023.
ALVES, A. D. F. et al. Use of phytocanabinoids in animal models of Parkinson's disease: Systematic review. Neurotoxicology, v. 105, p. 34-44, 2024. DOI: https://doi.org/10.1016/j.neuro.2024.08.002
ANDERSON, L. L. et al. Farmacocinética dos ácidos fitocanabinoides e efeito anticonvulsivante do ácido canabidiólico em um modelo murino da síndrome de Dravet. Journal of Natural Products, v. 82, n. 11, p. 3047–3055, 2019.
ANIL, S. M.; PEERI, H.; KOLTAI, H. Atividade da Cannabis Medicinal contra a Inflamação: Compostos Ativos e Modos de Ação. Front. Pharmacol., v. 13, n. 908198, 2022. DOI: https://doi.org/10.3389/fphar.2022.908198
BEN-SHABAT, S. et al. Cannabinoids, the Blood–Brain Barrier, and Neurodegeneration: Mechanisms, Dysregulation, and Therapeutic Perspectives. Biomolecules, v. 16, n. 2, p. 225, 2026. DOI: https://doi.org/10.3390/biom16020225
BELTRÁN-VELASCO, A. I.; CLEMENTE-SUÁREZ, V. J. Impact of peripheral inflammation on blood-brain barrier dysfunction and its role in neurodegenerative diseases. Int. J. Mol. Sci., v. 26, n. 2440, 2025. DOI: https://doi.org/10.3390/ijms26062440
BHUNIA, S. et al. Cannabidiol for Neurodegenerative Disorders: A Comprehensive Review. Frontiers in Pharmacology, v. 13, p. 98971, 2022. DOI: https://doi.org/10.3389/fphar.2022.989717
BLEBEA, N.-M. et al. Recent Preclinical Evidence on Phytocannabinoids in Neurodegenerative Disorders. Pharmaceuticals, v. 18, n. 6, p. 890, 2025. DOI: https://doi.org/10.3390/ph18060890
CHAGAS, M. H. et al. Effects of cannabidiol in the treatment of patients with Parkinson's disease: An exploratory double-blind trial. Journal of Psychopharmacology, v. 28, n. 11, p. 1088-1098, 2014. DOI: https://doi.org/10.1177/0269881114550355
CHEN, L. et al. Assessing cannabidiol as a therapeutic agent for preventing and alleviating Alzheimer's disease neurodegeneration. Cells, v. 12, n. 23, p. 2672, 2023. DOI: https://doi.org/10.3390/cells12232672
COLES, M. et al. Chronic treatment with medium-dose cannabidiol reverses object recognition memory deficits in female APPSwe/PS1ΔE9 mice. Frontiers in Pharmacology, v. 11, p. 587604, 2020. DOI: https://doi.org/10.3389/fphar.2020.587604
CURY, R. de M. et al. A randomized clinical trial of low-dose cannabis extract in Alzheimer’s disease. J. Alzheimer’s Dis., v. 138, p. 1387-1389, 2025.
DA SILVA, V. K. et al. Novel insights into mitochondrial molecular targets of iron-induced neurodegeneration: Reversal by cannabidiol. Brain Research Bulletin, v. 139, p. 1-8, 2018. DOI: https://doi.org/10.1016/j.brainresbull.2018.01.014
DANZIGER, N.; BERNSTEIN, N. Light Matters: Effect of Light Spectra on Cannabinoid Profile and Plant Development of Medical Cannabis. Industrial Crops and Products, v. 164, n. 113351, 2021. DOI: https://doi.org/10.1016/j.indcrop.2021.113351
DE PAULA FARIA, D. et al. Cannabidiol treatment improves glucose metabolism and memory in streptozotocin-induced alzheimer's disease rat model. International Journal of Molecular Sciences, v. 23, n. 3, p. 1076, 2022. DOI: https://doi.org/10.3390/ijms23031076
DUDEK, K. A. et al. O receptor canabinóide astrocítico 1 promove a resiliência ao atenuar as alterações da barreira hematoencefálica induzidas pelo estresse. Nat. Neurosci., v. 28, p. 766–782, 2025.
ESPADAS, I. et al. Beneficial effects of the phytocannabinoid Δ9-THCV on L-DOPA-induced dyskinesia in Parkinson’s disease. Neurobiology of Disease, v. 141, p. 104892, 2020. DOI: https://doi.org/10.1016/j.nbd.2020.104892
EVANS, C. S.; HOLZBAUR, E. L. F. Quality control in neurons: mitophagy and other selective autophagy mechanisms. J. Mol. Biol., v. 432, n. 1, p. 240–260, 2020. DOI: https://doi.org/10.1016/j.jmb.2019.06.031
FOCK, E.; PARNOVA, R. Mecanismos de proteção da barreira hematoencefálica por ácidos graxos de cadeia curta derivados da microbiota. Cells, v. 12, n. 657, 2023.
GIULIANO, C. et al. Neuroprotective and symptomatic effects of cannabidiol in an animal model of Parkinson’s disease. International Journal of Molecular Sciences, v. 22, n. 16, p. 8920, 2021. DOI: https://doi.org/10.3390/ijms22168920
GUADALUPI, L. et al. O bloqueio farmacológico da degradação de 2-AG atenua as alterações clínicas, neuroinflamatórias e sinápticas na encefalomielite autoimune experimental. Neuropharmacology, v. 252, n. 109940, 2024.
HAO, F.; FENG, Y. Cannabidiol (CBD) enhanced the hippocampal immune response and autophagy of APP/PS1 Alzheimer’s mice. Life Sciences, v. 264, p. 118624, 2021. DOI: https://doi.org/10.1016/j.lfs.2020.118624
HASBI, A.; GEORGE, S. R. Neuroproteção multicamadas por canabinoides em doenças neurodegenerativas. Explor. Neuroprot. Ther., v. 5, n. 100498, 2025. DOI: https://doi.org/10.37349/ent.2025.100498
HERMUSH, V. et al. Effects of cannabidiol-rich oil on behavioral disturbances in patients with dementia: a placebo-controlled randomized clinical trial. Frontiers in Medicine, v. 9, p. 951889, 2022. DOI: https://doi.org/10.3389/fmed.2022.951889
HUANG, X. et al. Inflamação periférica e ruptura da barreira hematoencefálica: efeitos e mecanismos. CNS Neurosci. Ther., v. 27, p. 36–47, 2021.
JIANG, X. et al. Cannabidiol protects the BBB through PPARγ. Biomed. Pharmacother., 2021.
JURGA, M. et al. Cannabis-Based Phytocannabinoids: Overview, Mechanism of Action, Therapeutic Application, Production, and Affecting Environmental Factors. International Journal of Molecular Sciences, v. 25, n. 20, p. 11258, 2024. DOI: https://doi.org/10.3390/ijms252011258
KANG, S. et al. Cannabidiol induces autophagy to protects neural cells from mitochondrial dysfunction by upregulating SIRT1. Front. Cell Neurosci., v. 15, n. 654340, 2021. DOI: https://doi.org/10.3389/fncel.2021.654340
KIM, J. et al. Cannabinoids CBDA and THCA rescue memory deficits and reduce amyloid-beta and tau pathology in an Alzheimer’s-like mouse model. International Journal of Molecular Sciences, v. 24, n. 7, p. 6827, 2023. DOI: https://doi.org/10.3390/ijms24076827
LACERDA, M. et al. Farmacocinética de fitocanabinoides não psicotrópicos. Pharmaceutics, v. 17, n. 2, 2025.
LANGEN, U. H. et al. Desenvolvimento e biologia celular da barreira hematoencefálica. Annu. Rev. Cell Dev. Biol., v. 35, p. 591–613, 2019. DOI: https://doi.org/10.1146/annurev-cellbio-100617-062608
LAZARJANI, M. P. et al. Processing and Extraction Methods of Medicinal Cannabis: A Narrative Review. Journal of Cannabis Research, v. 3, n. 32, 2021. DOI: https://doi.org/10.1186/s42238-021-00087-9
MOU, Y. et al. A microbiota intestinal interage com o cérebro por meio da inflamação crônica sistêmica. Front. Immunol., v. 13, n. 796288, 2022.
NTSAPI, C. et al. Exploring cannabinoid modulation on autophagy mechanisms in Alzheimer's disease: a review. Frontiers in Pharmacology, v. 16, p. 1748368, jan. 2026. DOI: https://doi.org/10.3389/fphar.2025.1748368
NUNEZ-LUMBRERAS et al. Cannabinoid receptors and BBB permeability. Neurochem. Int., 2020.
PAES-COLLI, Y. et al. Phytocannabinoids and Cannabis-Based Products as Alternative Pharmacotherapy in Neurodegenerative Diseases: From Hypothesis to Clinical Practice. Frontiers in Cellular Neuroscience, v. 16, p. 917164, 2022. DOI: https://doi.org/10.3389/fncel.2022.917164
PALOMARES, B. et al. THCA is a potent PPARγ agonist. Br. J. Pharmacol., 2020.
PFAU, S. J. et al. Características da heterogeneidade da barreira hematoencefálica entre regiões cerebrais reveladas pela análise de células vasculares e perivasculares. Nat. Neurosci., v. 27, p. 1892–1903, 2024.
PIMENTEL, E. G.; LEME, R. S. Canabinoides e Neuroproteção em Idosos. Arace, 2026.
RAKOTOARIVELO, V. et al. The impact of the cannabinoid receptor CB2 in inflammatory diseases: an update. Molecules, v. 29, n. 14, p. 3381, 2024. DOI: https://doi.org/10.3390/molecules29143381
RUVER-MARTINS, A. C. et al. Cannabinoid extract in microdoses ameliorates mnemonic and nonmnemonic Alzheimer’s disease symptoms: a case report. J. Med. Case Rep., v. 16, n. 1, p. 277, 2022. DOI: https://doi.org/10.1186/s13256-022-03457-w
SAINZ MARTINEZ, A. et al. Extraction Techniques for Bioactive Compounds of Cannabis. Natural Product Reports, v. 40, p. 676–717, 2023. DOI: https://doi.org/10.1039/D2NP00059H
SÁNCHEZ-FERNÁNDEZ, N. et al. A combination of Δ9-tetrahydrocannabinol and cannabidiol modulates glutamate dynamics in the hippocampus. Neurotherapeutics, v. 21, n. 5, p. e00439, 2024. DOI: https://doi.org/10.1016/j.neurot.2024.e00439
SCUDERI, C. et al. Cannabidiol promotes amyloid precursor protein ubiquitination and reduction of beta amyloid expression in SHSY5YAPP+ cells through PPARγ involvement. Phytotherapy Research, v. 28, n. 7, p. 1007-1013, 2014. DOI: https://doi.org/10.1002/ptr.5095
SINGH, S. K. et al. Therapeutic potential of acidic cannabinoids: an update. Journal of Cannabis Research, jan. 2026. DOI: https://doi.org/10.1186/s42238-026-00387-y
SKRZYPCZAK-WIERCIOCH, A.; SAŁAT, K. Modelo de neuroinflamação induzida por lipopolissacarídeo: mecanismos de ação, aplicação em pesquisa e direções futuras. Molecules, v. 27, n. 5481, 2022.
SMITH, S. et al. Fitocanabinoides — Avaliação de seu papel terapêutico na neuroinflamação. Explor. Neuroprot. Ther., v. 4, p. 325–348, 2024. DOI: https://doi.org/10.37349/ent.2024.00087
SOMOGYI, P. et al. Synaptic targets and cellular sources of nerve terminals expressing the cannabinoid CB1 receptor. European Journal of Neuroscience, v. 61, p. e16652, 2025. DOI: https://doi.org/10.1111/ejn.16652
SUZUKI, S. et al. O ácido canabigerólico (CBGA) inibe o canal iônico TRPM7 através de seu domínio quinase. Function, v. 5, n. 1, p. zqad069, 2024. DOI: https://doi.org/10.1093/function/zqad069
VELAYUDHAN, L. et al. Cannabidiol for behavioral symptoms in Alzheimer's disease (CANBiS-AD): a randomized, double-blind, placebo-controlled trial. International Psychogeriatrics, v. 36, n. 8, p. 1270-1272, 2024. DOI: https://doi.org/10.1017/S1041610224000516
VITALE, R. M. et al. Identificação dos ácidos canabidiólico e canabigerólico como inibidores de MTDL AChE, BuChE e BACE-1 contra a doença de Alzheimer. Phytotherapy Research, v. 39, n. 1, p. 233–245, 2025.
VRECHI, T. A. M. et al. Cannabidiol induces autophagy via ERK1/2 activation in neural cells. Sci. Rep., v. 11, n. 5434, 2021. DOI: https://doi.org/10.1038/s41598-021-84879-2
WANG, Z. et al. Cannabidiol induces autophagy and improves neuronal health associated with SIRT1 mediated longevity. GeroScience, v. 44, n. 3, p. 1505–1524, 2022. DOI: https://doi.org/10.1007/s11357-022-00559-7
WU, S.; RAJIAH, T.; ALI, A. B. Therapeutic Potential for Cannabidiol on Alzheimer's Disease-Related Neuroinflammation: A Systematic Review and Meta-Analysis. International Journal of Molecular Sciences, v. 26, n. 24, p. 11963, 2025. DOI: https://doi.org/10.3390/ijms262411963
ZHANG, Q. et al. Δ9-Tetrahidrocanabinol Induz Disrupção da Barreira Hematoencefálica: Envolvendo a Ativação do CB1R e Estresse Oxidativo. Neuropharmacology, v. 270, n. 110366, 2025. DOI: https://doi.org/10.1016/j.neuropharm.2025.110366
ZHENG, X. et al. Proteínas de junção estreita relacionadas à barreira hematoencefálica e suas vias de sinalização regulatórias no acidente vascular cerebral isquêmico. Biomed. Pharmacother., v. 165, n. 115272, 2023.
