Epilepsy, neuroinflammation and cannabidiol What do we know thus far?

Autores
Pesántez Ríos, Gabriela; Perucca, Emilio; Striano, Pasquale; Caraballo, Roberto Horacio; Pesántez Ríos, Ximena; Pascual Pascual, S. I.; Pesántez Cuesta, Galo
Año de publicación
2026
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Epilepsy is a common neurological disorder associated with recurring seizures that in about one third of individuals are resistant to conventional medications. Neuroinflammation and alterations in the endocannabinoid system are involved in epileptogenesis and represent attractive targets for therapeutic interventions. Randomized placebo-controlled trials have shown that cannabidiol (CBD), one of the main active principles found in the Cannabis plant, significantly reduces seizure frequency in patients with Lennox-Gastaut syndrome, Dravet syndrome, and tuberous sclerosis complex (TSC). The FDA´s approval of a purified formulation of CBD (Epidiolex®) in 2018 marks a significant advance in the management of patients affected by these disorders. This review is focused on the activity of CBD as a neuroinflammatory modulator and antiseizure agent. Experimental evidence from in vitro and in vivo studies indicates that CBD reduces neuronal excitability and seizure activity by a wide range of mechanisms including, but not limited to, modulation of endocannabinoid, adenosine, GPR55, and TRPV1 receptors. It has also been shown that CBD’s molecular actions trigger immunomodulatory effects and inhibit neuroinflammation through reduced concentrations of proinflammatory cytokines, chemokines, reactive oxygen species (ROS) and neurotoxic factors in microglia. We discuss the evidence for CBD’s effects on neuroinflammation, and their implications for inhibition of epileptogenesis and seizure activity. We highlight how further elucidation of CBD’s mechanisms of action, and particularly its effects on neuroinflammation, could lead to a more rational, targeted utilization of this compound, guided by assessment of biomarkers predictive of clinical response. Improved understanding of CBD’s immunomodulatory and anti-inflammatory effects could also facilitate the design of controlled studies to confirm the potential value of this compound in the treatment of types of epilepsy beyond those for which regulatory approval has been already obtained.
Fil: Pesántez Ríos, Gabriela. Centro Nacional de Epilepsia; Ecuador
Fil: Perucca, Emilio. University of Melbourne; Australia
Fil: Striano, Pasquale. Università degli Studi di Genova; Italia
Fil: Caraballo, Roberto Horacio. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Pesántez Ríos, Ximena. Centro Nacional de Epilepsia; Ecuador
Fil: Pascual Pascual, S. I.. Hospital Universitario la Paz; España
Fil: Pesántez Cuesta, Galo. Centro Nacional de Epilepsia; Ecuador
Materia
Cannabidiol
Drug-resistant epilepsy
immunomodulation
neuroinflammation
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/289840
Acceder
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repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Epilepsy, neuroinflammation and cannabidiol What do we know thus far?Pesántez Ríos, GabrielaPerucca, EmilioStriano, PasqualeCaraballo, Roberto HoracioPesántez Ríos, XimenaPascual Pascual, S. I.Pesántez Cuesta, GaloCannabidiolDrug-resistant epilepsyimmunomodulationneuroinflammationhttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3Epilepsy is a common neurological disorder associated with recurring seizures that in about one third of individuals are resistant to conventional medications. Neuroinflammation and alterations in the endocannabinoid system are involved in epileptogenesis and represent attractive targets for therapeutic interventions. Randomized placebo-controlled trials have shown that cannabidiol (CBD), one of the main active principles found in the Cannabis plant, significantly reduces seizure frequency in patients with Lennox-Gastaut syndrome, Dravet syndrome, and tuberous sclerosis complex (TSC). The FDA´s approval of a purified formulation of CBD (Epidiolex®) in 2018 marks a significant advance in the management of patients affected by these disorders. This review is focused on the activity of CBD as a neuroinflammatory modulator and antiseizure agent. Experimental evidence from in vitro and in vivo studies indicates that CBD reduces neuronal excitability and seizure activity by a wide range of mechanisms including, but not limited to, modulation of endocannabinoid, adenosine, GPR55, and TRPV1 receptors. It has also been shown that CBD’s molecular actions trigger immunomodulatory effects and inhibit neuroinflammation through reduced concentrations of proinflammatory cytokines, chemokines, reactive oxygen species (ROS) and neurotoxic factors in microglia. We discuss the evidence for CBD’s effects on neuroinflammation, and their implications for inhibition of epileptogenesis and seizure activity. We highlight how further elucidation of CBD’s mechanisms of action, and particularly its effects on neuroinflammation, could lead to a more rational, targeted utilization of this compound, guided by assessment of biomarkers predictive of clinical response. Improved understanding of CBD’s immunomodulatory and anti-inflammatory effects could also facilitate the design of controlled studies to confirm the potential value of this compound in the treatment of types of epilepsy beyond those for which regulatory approval has been already obtained.Fil: Pesántez Ríos, Gabriela. Centro Nacional de Epilepsia; EcuadorFil: Perucca, Emilio. University of Melbourne; AustraliaFil: Striano, Pasquale. Università degli Studi di Genova; ItaliaFil: Caraballo, Roberto Horacio. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Pesántez Ríos, Ximena. Centro Nacional de Epilepsia; EcuadorFil: Pascual Pascual, S. I.. Hospital Universitario la Paz; EspañaFil: Pesántez Cuesta, Galo. Centro Nacional de Epilepsia; EcuadorFrontiers Media2026-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/pdfhttp://hdl.handle.net/11336/289840Pesántez Ríos, Gabriela; Perucca, Emilio; Striano, Pasquale; Caraballo, Roberto Horacio; Pesántez Ríos, Ximena; et al.; Epilepsy, neuroinflammation and cannabidiol What do we know thus far?; Frontiers Media; Frontiers in Pharmacology; 16; 1-2026; 1-91663-9812CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://www.frontiersin.org/articles/10.3389/fphar.2025.1749260/fullinfo:eu-repo/semantics/altIdentifier/doi/10.3389/fphar.2025.1749260info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2026-08-25T14:32:22Zoai:ri.conicet.gov.ar:11336/289840instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982026-08-25 14:32:22.491CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Epilepsy, neuroinflammation and cannabidiol What do we know thus far?
title Epilepsy, neuroinflammation and cannabidiol What do we know thus far?
spellingShingle Epilepsy, neuroinflammation and cannabidiol What do we know thus far?
Pesántez Ríos, Gabriela
Cannabidiol
Drug-resistant epilepsy
immunomodulation
neuroinflammation
title_short Epilepsy, neuroinflammation and cannabidiol What do we know thus far?
title_full Epilepsy, neuroinflammation and cannabidiol What do we know thus far?
title_fullStr Epilepsy, neuroinflammation and cannabidiol What do we know thus far?
title_full_unstemmed Epilepsy, neuroinflammation and cannabidiol What do we know thus far?
title_sort Epilepsy, neuroinflammation and cannabidiol What do we know thus far?
dc.creator.none.fl_str_mv Pesántez Ríos, Gabriela
Perucca, Emilio
Striano, Pasquale
Caraballo, Roberto Horacio
Pesántez Ríos, Ximena
Pascual Pascual, S. I.
Pesántez Cuesta, Galo
author Pesántez Ríos, Gabriela
author_facet Pesántez Ríos, Gabriela
Perucca, Emilio
Striano, Pasquale
Caraballo, Roberto Horacio
Pesántez Ríos, Ximena
Pascual Pascual, S. I.
Pesántez Cuesta, Galo
author_role author
author2 Perucca, Emilio
Striano, Pasquale
Caraballo, Roberto Horacio
Pesántez Ríos, Ximena
Pascual Pascual, S. I.
Pesántez Cuesta, Galo
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv Cannabidiol
Drug-resistant epilepsy
immunomodulation
neuroinflammation
topic Cannabidiol
Drug-resistant epilepsy
immunomodulation
neuroinflammation
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.2
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Epilepsy is a common neurological disorder associated with recurring seizures that in about one third of individuals are resistant to conventional medications. Neuroinflammation and alterations in the endocannabinoid system are involved in epileptogenesis and represent attractive targets for therapeutic interventions. Randomized placebo-controlled trials have shown that cannabidiol (CBD), one of the main active principles found in the Cannabis plant, significantly reduces seizure frequency in patients with Lennox-Gastaut syndrome, Dravet syndrome, and tuberous sclerosis complex (TSC). The FDA´s approval of a purified formulation of CBD (Epidiolex®) in 2018 marks a significant advance in the management of patients affected by these disorders. This review is focused on the activity of CBD as a neuroinflammatory modulator and antiseizure agent. Experimental evidence from in vitro and in vivo studies indicates that CBD reduces neuronal excitability and seizure activity by a wide range of mechanisms including, but not limited to, modulation of endocannabinoid, adenosine, GPR55, and TRPV1 receptors. It has also been shown that CBD’s molecular actions trigger immunomodulatory effects and inhibit neuroinflammation through reduced concentrations of proinflammatory cytokines, chemokines, reactive oxygen species (ROS) and neurotoxic factors in microglia. We discuss the evidence for CBD’s effects on neuroinflammation, and their implications for inhibition of epileptogenesis and seizure activity. We highlight how further elucidation of CBD’s mechanisms of action, and particularly its effects on neuroinflammation, could lead to a more rational, targeted utilization of this compound, guided by assessment of biomarkers predictive of clinical response. Improved understanding of CBD’s immunomodulatory and anti-inflammatory effects could also facilitate the design of controlled studies to confirm the potential value of this compound in the treatment of types of epilepsy beyond those for which regulatory approval has been already obtained.
Fil: Pesántez Ríos, Gabriela. Centro Nacional de Epilepsia; Ecuador
Fil: Perucca, Emilio. University of Melbourne; Australia
Fil: Striano, Pasquale. Università degli Studi di Genova; Italia
Fil: Caraballo, Roberto Horacio. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Pesántez Ríos, Ximena. Centro Nacional de Epilepsia; Ecuador
Fil: Pascual Pascual, S. I.. Hospital Universitario la Paz; España
Fil: Pesántez Cuesta, Galo. Centro Nacional de Epilepsia; Ecuador
description Epilepsy is a common neurological disorder associated with recurring seizures that in about one third of individuals are resistant to conventional medications. Neuroinflammation and alterations in the endocannabinoid system are involved in epileptogenesis and represent attractive targets for therapeutic interventions. Randomized placebo-controlled trials have shown that cannabidiol (CBD), one of the main active principles found in the Cannabis plant, significantly reduces seizure frequency in patients with Lennox-Gastaut syndrome, Dravet syndrome, and tuberous sclerosis complex (TSC). The FDA´s approval of a purified formulation of CBD (Epidiolex®) in 2018 marks a significant advance in the management of patients affected by these disorders. This review is focused on the activity of CBD as a neuroinflammatory modulator and antiseizure agent. Experimental evidence from in vitro and in vivo studies indicates that CBD reduces neuronal excitability and seizure activity by a wide range of mechanisms including, but not limited to, modulation of endocannabinoid, adenosine, GPR55, and TRPV1 receptors. It has also been shown that CBD’s molecular actions trigger immunomodulatory effects and inhibit neuroinflammation through reduced concentrations of proinflammatory cytokines, chemokines, reactive oxygen species (ROS) and neurotoxic factors in microglia. We discuss the evidence for CBD’s effects on neuroinflammation, and their implications for inhibition of epileptogenesis and seizure activity. We highlight how further elucidation of CBD’s mechanisms of action, and particularly its effects on neuroinflammation, could lead to a more rational, targeted utilization of this compound, guided by assessment of biomarkers predictive of clinical response. Improved understanding of CBD’s immunomodulatory and anti-inflammatory effects could also facilitate the design of controlled studies to confirm the potential value of this compound in the treatment of types of epilepsy beyond those for which regulatory approval has been already obtained.
publishDate 2026
dc.date.none.fl_str_mv 2026-01
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
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info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/289840
Pesántez Ríos, Gabriela; Perucca, Emilio; Striano, Pasquale; Caraballo, Roberto Horacio; Pesántez Ríos, Ximena; et al.; Epilepsy, neuroinflammation and cannabidiol What do we know thus far?; Frontiers Media; Frontiers in Pharmacology; 16; 1-2026; 1-9
1663-9812
CONICET Digital
CONICET
url http://hdl.handle.net/11336/289840
identifier_str_mv Pesántez Ríos, Gabriela; Perucca, Emilio; Striano, Pasquale; Caraballo, Roberto Horacio; Pesántez Ríos, Ximena; et al.; Epilepsy, neuroinflammation and cannabidiol What do we know thus far?; Frontiers Media; Frontiers in Pharmacology; 16; 1-2026; 1-9
1663-9812
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/https://www.frontiersin.org/articles/10.3389/fphar.2025.1749260/full
info:eu-repo/semantics/altIdentifier/doi/10.3389/fphar.2025.1749260
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
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eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/vnd.openxmlformats-officedocument.wordprocessingml.document
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dc.publisher.none.fl_str_mv Frontiers Media
publisher.none.fl_str_mv Frontiers Media
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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