Endocannabinoid system – pathology and pathway
The endocannabinoid system represents a complex and independent neurotransmitter system with a central role in maintaining homeostasis within the nervous and immune systems.
In this lecture, Nikolaos Grigoriadis reviewed the biological foundations of the endocannabinoid system, its mechanisms of action in the central nervous system and immune response, and the growing experimental and clinical evidence supporting its neuroprotective and immunomodulatory functions, with particular relevance for Multiple Sclerosis and other neuroinflammatory conditions.
Key Insights from the Lecture:
- The endocannabinoid system is an intrinsic regulatory network composed of endogenous cannabinoids, cannabinoid receptors (CB1 and CB2), and metabolic enzymes, playing a key role in maintaining neural and immune homeostasis.
- CB1 receptors are predominantly expressed in the central nervous system, where they modulate synaptic transmission and prevent excessive neuronal activity, while CB2 receptors are mainly associated with immune and inflammatory processes.
- Endocannabinoids act as retrograde neurotransmitters, fine-tuning excitatory and inhibitory signaling in response to neuronal activity.
- Experimental models demonstrate a neuroprotective and immunomodulatory role of endocannabinoids, including reduced neuronal damage, modulation of microglial activation toward a neuroprotective phenotype, and decreased pro-inflammatory cytokine production.
- In neuroinflammatory conditions such as Multiple Sclerosis, cannabinoid signaling is associated with effects on inflammation, spasticity, pain, and blood–brain barrier integrity.
- Therapeutic strategies that enhance endogenous cannabinoid signaling may offer clinical benefit, as direct administration of endocannabinoids is limited by molecular instability.
About the speaker:

Nikolaos Grigoriadis
Professor of Neurology at the Aristotle University of Thessaloniki
Dr Nikolaos Grigoriadis graduated from the Faculty of Medicine of the Aristotle University of Thessaloniki. He did his PhD thesis and residency in Neurology in the same institution. He has been specialized in clinical and experimental Neuroimmunology and CNS immunopathology in a number of research centers and institutions abroad.
He is now Professor of Neurology at the Aristotle University of Thessaloniki and Head of the of the B’ Dept of Neurology, AHEPA University Hospital, the MS Centre and the Laboratory of Experimental Neurology and Neuroimmunology (www.neuroimmunology.gr).
Professor Grigoriadis is member of various international scientific committees such as the European School of Neuroimmunology, ParadigMS, the subcommittee of ENS for Multiple Sclerosis, the ECTRIMS committee (until 2010), Co-founder and Secretary of the Hellenic Academy of Neuroimmunology (www.helani.gr). He is President of the Hellenic Neurological Society. He is Ad Hoc reviewer in more than 40 international scientific journals, co-ordinator in more than 40 multicenter clinical trials for MS and principal investigator in collaborative research projects for experimental cell therapies in CNS autoimmune demyelination.
His field of interests are: Neuroimmunology; Multiple sclerosis; experimental models of autoimmune diseases (EAE etc); neurodegeneration; immunomodulation; cell therapies. He has published more than 180 papers in peer reviewed journals. He has been awarded several times for his scientific work.
