The Entourage Effect in Cannabis Medicinal Products: A Comprehensive Review

This study explores the complementary or synergistic effects of medicinal cannabis constituents, particularly terpenes, concerning their therapeutic potential, known as the entourage effect. A systematic review of the literature on cannabis “entourage effects” was conducted using the PRISMA model. T...

Full description

Saved in:
Bibliographic Details
Main Authors: Rebeca André, Ana Patrícia Gomes, Catarina Pereira-Leite, António Marques-da-Costa, Luis Monteiro Rodrigues, Michael Sassano, Patricia Rijo, Maria do Céu Costa
Format: Article
Language:English
Published: MDPI AG 2024-11-01
Series:Pharmaceuticals
Subjects:
Online Access:https://www.mdpi.com/1424-8247/17/11/1543
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850267170874851328
author Rebeca André
Ana Patrícia Gomes
Catarina Pereira-Leite
António Marques-da-Costa
Luis Monteiro Rodrigues
Michael Sassano
Patricia Rijo
Maria do Céu Costa
author_facet Rebeca André
Ana Patrícia Gomes
Catarina Pereira-Leite
António Marques-da-Costa
Luis Monteiro Rodrigues
Michael Sassano
Patricia Rijo
Maria do Céu Costa
author_sort Rebeca André
collection DOAJ
description This study explores the complementary or synergistic effects of medicinal cannabis constituents, particularly terpenes, concerning their therapeutic potential, known as the entourage effect. A systematic review of the literature on cannabis “entourage effects” was conducted using the PRISMA model. Two research questions directed the review: (1) What are the physiological effects of terpenes and terpenoids found in cannabis? (2) What are the proven “entourage effects” of terpenes in cannabis? The initial approach involved an exploratory search in electronic databases using predefined keywords and Boolean phrases across PubMed/MEDLINE, Web of Science, and EBSCO databases using Medical Subject Headings (MeSH). Analysis of published studies shows no evidence of neuroprotective or anti-aggregatory effects of <i>α</i>-pinene and <i>β</i>-pinene against <i>β</i>-amyloid-mediated toxicity; however, modest lipid peroxidation inhibition by <i>α</i>-pinene, <i>β</i> pinene, and terpinolene may contribute to the multifaceted neuroprotection properties of these <i>C. sativa</i> L. prevalent monoterpenes and the triterpene friedelin. Myrcene demonstrated anti-inflammatory proprieties topically; however, in combination with CBD, it did not show significant additional differences. Exploratory evidence suggests various therapeutic benefits of terpenes, such as myrcene for relaxation; linalool as a sleep aid and to relieve exhaustion and mental stress; D-limonene as an analgesic; caryophyllene for cold tolerance and analgesia; valencene for cartilage protection; borneol for antinociceptive and anticonvulsant potential; and eucalyptol for muscle pain. While exploratory research suggests terpenes as influencers in the therapeutic benefits of cannabinoids, the potential for synergistic or additive enhancement of cannabinoid efficacy by terpenes remains unproven. Further clinical trials are needed to confirm any terpenes “entourage effects.”
format Article
id doaj-art-ecbd490453e64b339cf51f49e835ff62
institution OA Journals
issn 1424-8247
language English
publishDate 2024-11-01
publisher MDPI AG
record_format Article
series Pharmaceuticals
spelling doaj-art-ecbd490453e64b339cf51f49e835ff622025-08-20T01:53:54ZengMDPI AGPharmaceuticals1424-82472024-11-011711154310.3390/ph17111543The Entourage Effect in Cannabis Medicinal Products: A Comprehensive ReviewRebeca André0Ana Patrícia Gomes1Catarina Pereira-Leite2António Marques-da-Costa3Luis Monteiro Rodrigues4Michael Sassano5Patricia Rijo6Maria do Céu Costa7Escola de Ciências e Tecnologias da Saúde (ECTS), CBIOS—Universidade Lusófona’s Research Center for Biosciences & Health Technologies, Campo Grande 376, 1749-024 Lisboa, PortugalEscola de Ciências e Tecnologias da Saúde (ECTS), CBIOS—Universidade Lusófona’s Research Center for Biosciences & Health Technologies, Campo Grande 376, 1749-024 Lisboa, PortugalEscola de Ciências e Tecnologias da Saúde (ECTS), CBIOS—Universidade Lusófona’s Research Center for Biosciences & Health Technologies, Campo Grande 376, 1749-024 Lisboa, PortugalSOMAÍ Pharmaceuticals, R. 13 de Maio 52, 2580-507 Carregado, PortugalEscola de Ciências e Tecnologias da Saúde (ECTS), CBIOS—Universidade Lusófona’s Research Center for Biosciences & Health Technologies, Campo Grande 376, 1749-024 Lisboa, PortugalSOMAÍ Pharmaceuticals, R. 13 de Maio 52, 2580-507 Carregado, PortugalEscola de Ciências e Tecnologias da Saúde (ECTS), CBIOS—Universidade Lusófona’s Research Center for Biosciences & Health Technologies, Campo Grande 376, 1749-024 Lisboa, PortugalEscola de Ciências e Tecnologias da Saúde (ECTS), CBIOS—Universidade Lusófona’s Research Center for Biosciences & Health Technologies, Campo Grande 376, 1749-024 Lisboa, PortugalThis study explores the complementary or synergistic effects of medicinal cannabis constituents, particularly terpenes, concerning their therapeutic potential, known as the entourage effect. A systematic review of the literature on cannabis “entourage effects” was conducted using the PRISMA model. Two research questions directed the review: (1) What are the physiological effects of terpenes and terpenoids found in cannabis? (2) What are the proven “entourage effects” of terpenes in cannabis? The initial approach involved an exploratory search in electronic databases using predefined keywords and Boolean phrases across PubMed/MEDLINE, Web of Science, and EBSCO databases using Medical Subject Headings (MeSH). Analysis of published studies shows no evidence of neuroprotective or anti-aggregatory effects of <i>α</i>-pinene and <i>β</i>-pinene against <i>β</i>-amyloid-mediated toxicity; however, modest lipid peroxidation inhibition by <i>α</i>-pinene, <i>β</i> pinene, and terpinolene may contribute to the multifaceted neuroprotection properties of these <i>C. sativa</i> L. prevalent monoterpenes and the triterpene friedelin. Myrcene demonstrated anti-inflammatory proprieties topically; however, in combination with CBD, it did not show significant additional differences. Exploratory evidence suggests various therapeutic benefits of terpenes, such as myrcene for relaxation; linalool as a sleep aid and to relieve exhaustion and mental stress; D-limonene as an analgesic; caryophyllene for cold tolerance and analgesia; valencene for cartilage protection; borneol for antinociceptive and anticonvulsant potential; and eucalyptol for muscle pain. While exploratory research suggests terpenes as influencers in the therapeutic benefits of cannabinoids, the potential for synergistic or additive enhancement of cannabinoid efficacy by terpenes remains unproven. Further clinical trials are needed to confirm any terpenes “entourage effects.”https://www.mdpi.com/1424-8247/17/11/1543cannabiscannabinoidsterpene(s)entourage effectinfluencers
spellingShingle Rebeca André
Ana Patrícia Gomes
Catarina Pereira-Leite
António Marques-da-Costa
Luis Monteiro Rodrigues
Michael Sassano
Patricia Rijo
Maria do Céu Costa
The Entourage Effect in Cannabis Medicinal Products: A Comprehensive Review
Pharmaceuticals
cannabis
cannabinoids
terpene(s)
entourage effect
influencers
title The Entourage Effect in Cannabis Medicinal Products: A Comprehensive Review
title_full The Entourage Effect in Cannabis Medicinal Products: A Comprehensive Review
title_fullStr The Entourage Effect in Cannabis Medicinal Products: A Comprehensive Review
title_full_unstemmed The Entourage Effect in Cannabis Medicinal Products: A Comprehensive Review
title_short The Entourage Effect in Cannabis Medicinal Products: A Comprehensive Review
title_sort entourage effect in cannabis medicinal products a comprehensive review
topic cannabis
cannabinoids
terpene(s)
entourage effect
influencers
url https://www.mdpi.com/1424-8247/17/11/1543
work_keys_str_mv AT rebecaandre theentourageeffectincannabismedicinalproductsacomprehensivereview
AT anapatriciagomes theentourageeffectincannabismedicinalproductsacomprehensivereview
AT catarinapereiraleite theentourageeffectincannabismedicinalproductsacomprehensivereview
AT antoniomarquesdacosta theentourageeffectincannabismedicinalproductsacomprehensivereview
AT luismonteirorodrigues theentourageeffectincannabismedicinalproductsacomprehensivereview
AT michaelsassano theentourageeffectincannabismedicinalproductsacomprehensivereview
AT patriciarijo theentourageeffectincannabismedicinalproductsacomprehensivereview
AT mariadoceucosta theentourageeffectincannabismedicinalproductsacomprehensivereview
AT rebecaandre entourageeffectincannabismedicinalproductsacomprehensivereview
AT anapatriciagomes entourageeffectincannabismedicinalproductsacomprehensivereview
AT catarinapereiraleite entourageeffectincannabismedicinalproductsacomprehensivereview
AT antoniomarquesdacosta entourageeffectincannabismedicinalproductsacomprehensivereview
AT luismonteirorodrigues entourageeffectincannabismedicinalproductsacomprehensivereview
AT michaelsassano entourageeffectincannabismedicinalproductsacomprehensivereview
AT patriciarijo entourageeffectincannabismedicinalproductsacomprehensivereview
AT mariadoceucosta entourageeffectincannabismedicinalproductsacomprehensivereview