A new study published in the journal ACS Pharmacology & Translational Science finds that cannabinoids may offer a promising multitargeted approach for treating glaucomatous neurodegeneration, especially in patients who experience retinal damage without elevated intraocular pressure (IOP).
Researchers from Jagran Lakecity University and Truba Institute of Pharmacy in India reviewed current evidence indicating that glaucoma, traditionally managed by lowering IOP, can progress even in patients with normal pressure levels. This silent form of the disease poses a significant challenge to treatment and can lead to irreversible vision loss.
The study emphasizes the growing recognition of autoimmunity and neuroinflammation as central components in the death of retinal ganglion cells (RGCs), which are critical for vision. Cannabinoids, known since the 1970s for their IOP-lowering effects, are now being explored for their broader neuroprotective, anti-inflammatory, and immunosuppressive properties.
Researchers note that cannabinoids may act on multiple targets involved in glaucoma’s development, including the gut-retina axis and abnormal Wnt signaling pathways. Additionally, they highlight the role of cannabinoids in inducing epigenetic changes in immune cells tied to autoimmune processes, making them especially relevant for normotensive glaucoma patients.
The authors propose further investigation into cannabinoids as a potential therapy capable of addressing the multifactorial nature of glaucoma beyond traditional pressure management.
The full abstract of the study can be found below.
Abstract
Diseases of multifactorial origin like neurodegenerative and autoimmune diseases require a multitargeted approach. The discovery of the role of autoimmunity in glaucoma and retinal ganglionic cell (RGC) death has led to a paradigm shift in our understanding of the etiopathology of glaucoma. Glaucoma can cause irreversible vision loss that affects up to an estimated 3% of the population over 40 years of age. The current pharmacotherapy primarily aims to manage only intraocular pressure (IOP), a modifiable risk factor in the glaucomatous neurodegeneration of RGCs. However, neurodegeneration continues to happen in normotensive patients (where the IOP is below a reference value), and the silent nature of the disease can cause significant visual impairment and take a massive toll on the healthcare system. Cannabinoids, although known to reduce IOP since the 1970s, have received renewed interest due to their neuroprotective, anti-inflammatory, and immunosuppressive effects on autoimmunity. Additionally, the role of the gut-retina axis and abnormal Wnt signaling in glaucoma makes cannabinoids even more relevant because of their action on multiple targets, all converging in the pathogenesis of glaucomatous neurodegeneration. Cannabinoids also cause epigenetic changes in immune cells associated with autoimmunity. In this Review, we are proposing the use of cannabinoids as a multitargeted approach for treating autoimmunity associated with glaucomatous neurodegeneration, especially for the silent nature of glaucomatous neurodegeneration in normotensive patients.
