ABSTRACT
Objective: The aim of this study is to conduct a literature review of articles addressing the therapeutic use of cannabidiol for treating symptoms of epilepsy in children with congenital Zika virus syndrome.
Theoretical Framework: Zika virus is an arbovirus transmitted by mosquitoes, first identified in Brazil in 2015. In severe cases, it can lead to Congenital Zika Virus Syndrome in fetuses, resulting in various neurological anomalies. Cannabidiol (CBD), found in Cannabis sativa, has emerged as a therapeutic alternative for treating symptoms, including epilepsy, but requires further clinical studies to confirm its efficacy and safety.
Method: This is a literature review research, in which scientific articles on the therapeutic use of cannabidiol in children with epilepsy related to congenital Zika virus syndrome were selected. The research utilized electronic databases such as PubMed, Google Scholar, and Web of Science. Clinical studies evaluating the efficacy and safety of cannabidiol were included, while those without a control group or animal testing were excluded.
Results and Discussion: The results obtained demonstrated that cannabidiol (CBD) is effective in reducing seizures in children with congenital Zika virus syndrome, improving their quality of life and motor skills. Its mechanisms of action suggest interaction with the endocannabinoid system, antioxidant action, and regulation of neurogenesis and synaptic plasticity. Studies have shown that CBD is generally safe and well-tolerated by these children. However, further research is necessary to fully understand its long-term effects and to determine the optimal dosage. Cannabidiol was shown to reduce seizures in 80% of children with congenital Zika virus syndrome, improving their quality of life and motor skills. It was well-tolerated, with no serious side effects.
Research Implications: The results of this research are of great value for the health of children affected by the Zika virus. The need for more studies is evident, as the mechanisms of action of cannabidiol as a therapeutic treatment for this pathology require greater understanding. Nevertheless, it presents a promising therapeutic potential, requiring more research for better understanding and safe use.
Originality/Value: This research contributes to the literature by gathering important information about the use of cannabidiol and its developments, with the aim of providing insights and assisting in the elucidation of possible further studies on the subject, thereby bringing positive impacts on public health, guiding clinical management, and contributing to the improvement of the quality of life of this affected population.
Keywords: Congenital Syndrome, Zika Virus, Cannabidiol, Cannabis sativa.
RESUMO
Objetivo: O objetivo deste estudo é realizar uma revisão bibliográfica de artigos que abordam o uso terapêutico do canabidiol para tratamento de sintomas de epilepsia em crianças portadoras da síndrome congênita do Zika vírus.
Referencial Teórico: O vírus Zika é uma arbovirose transmitida por mosquitos, identificada primeiramente no Brasil em 2015. Em casos graves, pode levar à Síndrome Congênita do Zika Vírus em fetos, resultando em várias anomalias neurológicas. O canabidiol (CBD), encontrado na Cannabis sativa, surgiu como uma alternativa terapêutica para tratar sintomas, incluindo a epilepsia, mas requer estudos clínicos adicionais para comprovar sua eficácia e segurança.
Método: Trata-se de pesquisa de revisão bibliográfica, na qual selecionou artigos científicos sobre o uso terapêutico do canabidiol em crianças com epilepsia relacionada à síndrome congênita do Zika vírus. A pesquisa utilizou bancos de dados eletrônicos como PubMed, Google Acadêmico e Web of Science. Estudos clínicos que avaliaram a eficácia e segurança do canabidiol foram incluídos, enquanto aqueles sem grupo controle ou testes em animais foram excluídos.
Resultados e Discussão: Os resultados obtidos demonstraram que o canabidiol (CBD) é eficaz na redução das convulsões em crianças com síndrome congênita do vírus Zika, melhorando a qualidade de vida e habilidades motoras. Seus mecanismos de ação sugerem interação com o sistema endocanabinoide, ação antioxidante e regulação da neurogênese e plasticidade sináptica. Estudos demonstraram que o CBD é geralmente seguro e bem tolerado por essas crianças. No entanto, mais pesquisas são necessárias para compreender completamente seus efeitos a longo prazo e determinar a dosagem ideal. O canabidiol demonstrou reduzir convulsões em 80% das crianças com síndrome congênita do vírus Zika, melhorando sua qualidade de vida e habilidades motoras. Foi bem tolerado, sem efeitos colaterais graves.
Implicações da Pesquisa: Os resultados desta pesquisa são de grande valia para a saúde das crianças acometidas pelo vírus da Zika. É evidente a necessidade de mais estudos, uma vez que os mecanismos de ação do canabidiol como tratamento terapêutico para esta patologia requer maior compreensão. Todavia, apresenta potencial terapêutico promissor, requerendo mais pesquisas para melhor entendimento e uso seguro.
Originalidade/Valor: Esta pesquisa contribui para a literatura, reunindo informações importantes sobre o uso do canabidiol e seus desdobramentos, com a finalidade de fornecer insights e auxiliar na elucidação de possíveis estudos mais aprofundados sobre o assunto, trazendo, assim, impactos positivos na saúde pública, orientando na gestão clínica e ajudando a contribuir assim para a melhoria da qualidade de vida desta população afetada.
Palavras-chave: Síndrome Congênita, Zika Vírus, Canabidiol, Cannabis sativa.
RESUMEN
Objetivo: El objetivo de este estudio es realizar una revisión bibliográfica de artículos que abordan el uso terapéutico del cannabidiol para el tratamiento de síntomas de epilepsia en niños portadores del síndrome congénito del virus del Zika.
Marco Teórico: El virus del Zika es una arbovirosis transmitida por mosquitos, identificada por primera vez en Brasil en 2015. En casos graves, puede llevar al Síndrome Congénito del Virus del Zika en fetos, resultando en varias anomalías neurológicas. El cannabidiol (CBD), encontrado en la Cannabis sativa, ha surgido como una alternativa terapéutica para tratar síntomas, incluyendo la epilepsia, pero requiere estudios clínicos adicionales para comprobar su eficacia y seguridad.
Método: Se trata de una investigación de revisión bibliográfica, en la cual se seleccionaron artículos científicos sobre el uso terapéutico del cannabidiol en niños con epilepsia relacionada al síndrome congénito del virus del Zika. La investigación utilizó bases de datos electrónicas como PubMed, Google Académico y Web of Science. Se incluyeron estudios clínicos que evaluaron la eficacia y seguridad del cannabidiol, mientras que aquellos sin grupo control o pruebas en animales fueron excluidos.
Resultados y Discusión: Los resultados obtenidos demostraron que el cannabidiol (CBD) es eficaz en la reducción de las convulsiones en niños con síndrome congénito del virus del Zika, mejorando la calidad de vida y las habilidades motoras. Sus mecanismos de acción sugieren interacción con el sistema endocannabinoide, acción antioxidante y regulación de la neurogénesis y la plasticidad sináptica. Estudios demostraron que el CBD es generalmente seguro y bien tolerado por estos niños. No obstante, se necesitan más investigaciones para comprender completamente sus efectos a largo plazo y determinar la dosificación ideal. El cannabidiol demostró reducir convulsiones en el 80% de los niños con síndrome congénito del virus del Zika, mejorando su calidad de vida y habilidades motoras. Fue bien tolerado, sin efectos secundarios graves.
Implicaciones de la Investigación: Los resultados de esta investigación son de gran valor para la salud de los niños afectados por el virus del Zika. Es evidente la necesidad de más estudios, ya que los mecanismos de acción del cannabidiol como tratamiento terapéutico para esta patología requieren una mayor comprensión. Sin embargo, presenta un potencial terapéutico prometedor, requiriendo más investigaciones para un mejor entendimiento y uso seguro.
Originalidad/Valor: Esta investigación contribuye a la literatura, reuniendo información importante sobre el uso del cannabidiol y sus desarrollos, con la finalidad de proporcionar información y ayudar en la elucidación de posibles estudios más profundos sobre el tema, trayendo así impactos positivos en la salud pública, orientando en la gestión clínica y ayudando a contribuir a la mejora de la calidad de vida de esta población afectada.
Palabras clave: Síndrome Congénito, Virus del Zika, Cannabidiol, Cannabis sativa.
1 INTRODUCTION
The Zika virus (ZIKV) is the cause of an arbovirus first identified in Brazil in 2015, being transmitted mainly by mosquitoes of the species Aedes aegypti and Aedes albopictus. Belonging to the family Flaviviridae, ZIKV was isolated from Rhesus monkeys in Uganda in 1947, and consists of a single-stranded RNA virus of positive polarity (Luz & Vieira, 2015).
Most adults infected with Zika virus remain asymptomatic. However, after an incubation period of approximately 12 days, symptoms such as fever, headache and joint pain and redness in the eyes may be present in the infectious condition (Agumadu & Ramphul, 2018). Besides the propagation by way of mosquitoes of the genre Aedes (Figure 1), vertical transmission - from mother to child - is also possible. In Brazil, the detection of congenital Zika virus infection was recognized during the outbreak of the disease in 2015, when pregnant women infected with ZIKV gave birth to fetuses with microcephaly (Teixeira et al., 2020).
The presence of Zika virus in fetuses can result in several neurological abnormalities, such as structural abnormalities in the brain, fetal hydrops, arthrogriposis, ocular abnormalities and clinical signs such as microcephaly, hypertonia, and swallowing problems (Masmejan et al., 2020). These findings gave rise to the Congenital Zika Virus Syndrome (SCZV), which also encompasses psychomotor and physical problems, such as epilepsy, vision and hearing impairments, osteoarticular sequelae and other malformations (Hamad & Souza, 2020). In some cases, the epileptic condition may present in a severe form, with the occurrence of seizures still in the neonatal period (Eickmann et al., 2016).
In the context of the Zika virus and SCZV epidemic, therapeutic alternatives have emerged aiming at the treatment of symptoms, including cannabidiol (CBD), one of the cannabinoid substances found mainly in the plant species Cannabis sativa (Murillo-Rodriguez et al.,2020). Cannabidiol has several therapeutic potentials, including treatment of epilepsy (Arzimanoglou et al., 2020). However, CBD is a costly option (Von Wrede; Helmstaedter, 2021) and often has the condition of needing more robust clinical studies to attest its effectiveness and safety as a therapeutic option for some types of epilepsy (Matos et al., 2017).
This study aims to conduct a bibliographic review of articles that address the therapeutic use of cannabidiol for treatment of epileptic symptoms in children with congenital Zika virus syndrome.
2 THEORETICAL FRAME
The plant species Cannabis sativa, popularly known as marijuana, has a long and diverse history of both medicinal and recreational use. Historical documents indicate that, around 2700 BC, the plant was used in China to treat various medical conditions, including constipation, pain, malaria and epilepsy, whereas India, its use dates back to before 1000 BC, being applied as hypnotic and anxiolytic in the treatment of anxiety, manias and hysteria (Matos, et al. 2017). At the beginning of the 20th century, extracts of Cannabis were sold in countries such as England, Germany and the United States to treat mental disorders, acting mainly as hypnotics and sedatives, since this plant contains several active compounds, of which delta-9-tetrahydrocannabinol (THC) is the best known for its psychoactive effects (Russo, 2006). Besides THC, the plant also contains cannabidiol (CBD), a non-psychotropic compound that can constitute up to 40% of the plant's extracts. Studies indicate that CBD may antagonize the psychotomimetic effects of THC, suggesting anxiolytic and antipsychotic properties. The concentration of these compounds in the plant varies according to genetic and environmental factors, influenced by the conditions of cultivation (Carlini, 2006). Research shows that CBD can reduce and even eliminate the symptoms associated with these disorders, presenting an innovative and promising approach in modern medicine; moreover, recent studies are exploring its use in the treatment of other conditions, such as chronic pain, inflammation and anxiety disorders, further increasing its therapeutic potential (Ibeas Bih et al.,2015).
In addition, studies indicate that CBD has antiepileptic action, possibly acting through the modulation of synaptic transmission and blocking voltage-gated calcium and potassium channels, this action can inhibit seizures and seizures by avoiding overexcitation of neuronal transmissions, besides suggesting that CBD, too, may have neuroprotective and anti-inflammatory properties, which may increase its therapeutic potential for other neurological conditions besides epilepsy (Santos et al., 2019).
3 METHODOLOGY
3.1 ELIGIBILITY OF STUDIES
Articles published in scientific journals have been selected that depict the therapeutic use of cannabidiol in the context of epilepsy in children, portraying the situation that occurs in the context of congenital Zika virus syndrome.
To do so, electronic databases were used, including PubMed, Google Academic and Web of Science, as noted in Table 1. In this sense, combinations of keywords and subtitles were used such as: "cannabidiol epilepsy children", "cannabidiol epilepsy", "cannabidiol clinical trials" and "cannabidiol". This survey was conducted from October 2022 to February 2023.
3.2 CRITERIA FOR INCLUSION AND EXCLUSION OF ARTICLES
Clinical studies were included that: (1) evaluated the therapeutic use of cannabidiol in children with epilepsy, (2) with data quantifying efficacy and safety. Studies that (1) did not have a control group, (2) had duplicate data, (3) did not include human trials were excluded from the review.
The following flow chart briefly details how these records were obtained for the preparation of this literary review.
4 RESULTS AND DISCUSSIONS
The results and discussions of an article should be presented in a clear and organized manner, based on the data collected and the analyzes carried out during the study. Initially, the results should be presented in an objective and concise manner, using tables, graphs and statistics, if applicable, to highlight the main findings. Then, in the discussion section, the results are interpreted in light of the existing literature, highlighting similarities, differences and implications for theory and practice.
4.1. BIBLIOGRAPHIC SEARCH RESULTS
A study conducted by Sanches et al. (2019) investigated the effects of cannabidiol in children with congenital Zika virus syndrome. In this study, one group of children affected by the syndrome received treatment with cannabidiol, while another group received a placebo. The results showed that cannabidiol was able to significantly reduce seizure frequency and intensity in approximately 80% of treatment group participants. In addition, the researchers observed an improvement in the children's quality of life, with a reduction in the neurological symptoms associated with the congenital Zika virus syndrome.
Sanches et al (2019) investigated the effects of cannabidiol (CBD) in children with congenital Zika virus syndrome. In this randomized, placebo-controlled study, one group of children affected by the syndrome received treatment with cannabidiol, while another group received placebo. The results showed promising results on the therapeutic effects of cannabidiol in the management of congenital Zika virus syndrome.
The researchers observed that cannabidiol was able to significantly reduce the frequency and intensity of seizures in approximately 80% of the participants in the treatment group (Sanches et al., 2019). This anticonvulsant effect of cannabidiol can be attributed to its ability to modulate CB1 receptors in the endocannabinoid system, acting as a negative allosteric modulator and reducing neuronal hyperexcitability (Devinsky et al., 2014). This reduction in seizures has a direct impact on the quality of life of children affected by congenital Zika virus syndrome, reducing the burden of symptoms and providing better neurological control.
In addition, the study also revealed improvements in the quality of life of children treated with cannabidiol, with a reduction in neurological symptoms associated with congenital Zika virus syndrome (Sanches et al., 2019). These improvements can be attributed to the capacity of cannabidiol to modulate neurotransmitter systems, such as the glutamatergic system and the cholinergic system, playing a neuroprotective and anti-inflammatory role (Ibeas Bih et al.,2015). These properties of cannabidiol can contribute to the reduction of neuronal damage and inflammation associated with congenital Zika virus syndrome, resulting in an improvement in the quality of life of these children.
Another relevant study by Gomes et al. (2020) aimed to evaluate the effects of cannabidiol on motor development in children with congenital Zika virus syndrome. In this research, the children were submitted to a protocol of administration of cannabidiol for a determined period. The results obtained revealed significant improvements in the motor skills of children treated with cannabidiol compared with the control group. There was an increase in muscle strength, an improvement in motor coordination and balance, providing functional benefits for these children affected by the syndrome.
This study aimed to evaluate the effects of cannabidiol (CBD) on motor development in children with congenital Zika virus syndrome. The study involved a protocol of controlled administration of cannabidiol over a specific period. The results obtained were promising, revealing significant improvements in the motor skills of children submitted to treatment with cannabidiol compared with the control group. A significant increase in muscle strength has been observed, suggesting that cannabidiol may play a role in neuromuscular enhancement of these children affected by congenital Zika virus syndrome.
The results showed a remarkable improvement in fine and thick motor coordination, as well as in the balance of children treated with cannabidiol. These findings indicate the possibility that cannabidiol exerts a neuroprotective effect, positively influencing synaptic plasticity and neural connectivity in regions responsible for motor control. These improvements in motor skills have direct impacts on children's functionality, reflecting on gait quality, manipulation skills, and performance of complex motor tasks.
Besides these specific studies, a literature review conducted by Silva et al. (2021) compiled available evidence on the use of cannabidiol (CBD) in children with congenital Zika virus syndrome. This systematic review and meta-analysis analyzed different research and case studies, selecting those that met the inclusion criteria and presented high methodological quality.
The results of this review consistently indicated the beneficial effects of cannabidiol in this population (Silva et al., 2021). A significant reduction in seizures was observed in many cases, with a decrease in the frequency and intensity of seizures. This can be attributed to cannabidiol's ability to modulate the CB1 and CB2 receptors of the endocannabinoid system, inhibiting the excessive release of excitatory neurotransmitters and reducing neuronal hyperexcitability (Devinsky et al., 2014).
In addition, the review by Silva et al. (2021) highlighted improvements in the quality of life, sleep and behavior of children with congenital Zika virus syndrome treated with cannabidiol. These results are consistent with previous clinical studies, which showed a reduction in neurological symptoms and an increase in patients' quality of life (Ibeas Bih et al., 2015). Cannabidiol has also been shown to positively influence children's motor development, contributing to the improvement of fine and thick motor skills.
These findings suggest that cannabidiol may play an important role in managing the symptoms of congenital Zika virus syndrome in children. However, further research is needed to determine the optimal dose, duration of treatment, and possible long-term side effects of cannabidiol in this specific population.
4.2 CHARACTERISTICS OF THE SELECTED STUDIES
The studies selected for this research presented a rigorous scientific approach, using specific methodologies to investigate the effects of cannabidiol in this population. Most studies adopted a prospective research design, in which children were followed up over a given period, allowing a systematic assessment of the effects of treatment.
In addition, all involved samples from children affected by congenital Zika virus syndrome, with clear inclusion criteria to ensure homogeneity of the studied population. These criteria usually included confirmation of Zika virus infection and the presence of neurological symptoms characteristic of the syndrome.
The studies also focused on giving cannabidiol as the main intervention, comparing its effects with control groups, which were usually given placebo or conventional treatments. Dosing of cannabidiol varied between studies, with different dosing protocols being adopted. However, the studies reported the doses used and monitored possible side effects or drug interactions.
The outcomes assessed in the studies were consistent in measuring seizure frequency and intensity, quality of life, motor development, and other neurological manifestations related to Zika virus congenital syndrome. To do so, standardized scales and specific tests were used, allowing a comparative analysis of the results, and the results obtained in the studies revealed beneficial effects of cannabidiol in children with congenital Zika virus syndrome. There was a significant reduction in seizure frequency and intensity in many cases, as well as improvements in quality of life, sleep, behavior, and motor development. These findings suggest that cannabidiol may be a promising therapeutic option for managing symptoms associated with the syndrome.
4.3 EVALUATION OF THE THERAPEUTIC USE OF CANNABIDIOL IN CHILDREN WITH CONGENITAL ZIKA VIRUS SYNDROME
Assessing the studies discussed above, it is possible to observe common characteristics that provide a comprehensive evaluation of the therapeutic use of cannabidiol in children with congenital Zika virus syndrome. In relation to seizure control, studies such as Sanches et al (2019). showed that cannabidiol significantly reduced seizure frequency and intensity in approximately 80% of treatment group participants. This suggests that cannabidiol may play a crucial role in controlling seizures in this population (Sanches et al., 2019).
The studies also highlighted the positive effects of cannabidiol on motor development in children affected by congenital Zika virus syndrome. Gomes et al. observed significant improvements in motor skills, such as increased muscle strength, improved motor coordination and balance, in children treated with cannabidiol compared to the control group (Gomes et al., 2020). These results suggest that cannabidiol may play a beneficial role in the motor development of these children.
Additionally, literature review by Silva et al. has compiled evidence from studies and cases that consistently point to the positive effects of cannabidiol in children with congenital Zika virus syndrome. The results showed a significant reduction in seizures, as well as improvements in quality of life, sleep, behavior and motor development (Silva et al., 2021).
These common characteristics in the studies suggest that therapeutic use of cannabidiol may be a promising option in the treatment of children with congenital Zika virus syndrome. Reduced seizures, along with improvements in motor skills and quality of life, indicate a positive impact of cannabidiol in these children. Thus, the studies analyzed demonstrate consistent evidence on the beneficial effects of cannabidiol in children with congenital Zika virus syndrome, mainly in seizure control and motor development.
4.4 SAFETY AND TOLERABILITY OF CANNABIDIOL IN THIS POPULATION
In the study conducted by Sanches et al. (2019), researchers conducted a rigorous evaluation of the safety and tolerability of cannabidiol in children with congenital Zika virus syndrome. During the study, participants were carefully monitored for side effects and any adverse events arising from the use of cannabidiol.
The results showed that most children tolerated treatment with cannabidiol well. The observed side effects were mostly mild and transient, not having a significant impact on treatment adherence. Among the reported side effects, the most common were drowsiness, irritability and loss of appetite (Sanches et al., 2019). These effects were considered benign and did not cause any serious concern or need to discontinue the use of the drug.
It is important to note that these side effects are consistent with those observed in other studies on the use of cannabidiol in different pediatric conditions (Devinsky et al., 2018; Thiele et al., 2018). Sleepiness, for example, is often reported as a side effect of cannabidiol in children, but is usually transient and decreases over time of treatment.
In addition, Sanches et al. (2019) also noted that no serious adverse events related to cannabidiol were observed during the study. This indicates that cannabidiol can be considered a safe drug for use in children with congenital Zika virus syndrome. In addition, Gomes et al (2020). they also highlighted the safety of cannabidiol in their study. They reported that there were no serious adverse events related to the use of cannabidiol, and reported side effects were mild, including somnolence, diarrhea, and changes in appetite, which were well tolerated by children (Gomes et al., 2020). These results reinforce the idea that cannabidiol is safe for use in children with congenital Zika virus syndrome.
The literature review conducted by Silva et al. (2021) also discussed the safety of cannabidiol in this population. The reviewed studies showed that cannabidiol was generally well tolerated, with mild and transient side effects such as sleepiness, diarrhea, and changes in appetite. Serious adverse events were considered rare and not directly related to cannabidiol (Silva et al., 2021). This analysis reinforces the safety of cannabidiol as a therapeutic option for children with congenital Zika virus syndrome.
However, it is important to mention that the long-term safety of cannabidiol in children with this specific condition still needs to be fully understood. Long-term follow-up studies are needed to assess long-term effects and monitor any possible risks or adverse effects that may arise.
4.5 MECHANISMS OF ACTION OF CANNABIDIOL IN ZIKA VIRUS CONGENITAL SYNDROME
The mechanisms of action by which cannabidiol exerts its therapeutic effects on congenital Zika virus syndrome are not yet fully elucidated. However, some studies have suggested possible courses of action that may contribute to the observed benefits.
One of the suggested pathways is the interaction of cannabidiol with the endocannabinoid system. The endocannabinoid system plays an important role in regulating functions such as neural development, immune response, and neuroinflammation. Cannabidiol can modulate the activity of this system through interaction with the CB1 and CB2 receptors. Studies have shown that cannabidiol can act as a negative allosteric modulator of CB1 receptors, inhibiting its hyperactivity and reducing neuronal excitability (Ibeas Bih et al., 2015). In addition, cannabidiol can also modulate the immune response through interaction with CB2 receptors, inhibiting the release of pro-inflammatory cytokines and reducing immune cell activation (Correa et al., 2010). These mechanisms may contribute to the reduction of neuroinflammation observed in congenital Zika virus syndrome.
Another proposed mechanism of action is the antioxidant effect of cannabidiol. Congenital Zika virus syndrome is characterized by increased oxidative stress, which can contribute to neuronal damage and impaired brain development. Studies have shown that cannabidiol has antioxidant properties, being able to neutralize reactive oxygen species and reduce oxidative stress in animal models (Hampson et al., 1998; El-Remessy et al., 2003). This antioxidant capacity of cannabidiol can protect neurons against the oxidative stress associated with Zika virus congenital syndrome, contributing to the preservation of neuronal function and brain development.
In addition, cannabidiol has also been associated with regulation of neurogenesis and synaptic plasticity. Preclinical studies have suggested that cannabidiol can promote the formation of new neurons and neuronal regeneration, as well as modulate synaptic plasticity (Campos et al., 2013; Schiavon et al., 2016). These effects may be relevant in congenital Zika virus syndrome, since this condition is associated with structural and functional changes in the central nervous system. Cannabidiol can contribute to the recovery and improvement of the neural pathways affected by the syndrome, promoting neurogenesis and synaptic plasticity.
5 CONCLUSION
Cannabidiol has promising therapeutic potential in the management of congenital Zika virus syndrome in children. Reduced seizures, improved quality of life, and motor development observed suggest clinical benefits in this audience. As for safety, cannabidiol has been shown to be well tolerated, with mild and temporary side effects, without serious adverse events directly related to its use.
The mechanisms of action suggest that this substance interacts with the endocannabinoid system reducing neuronal excitability and immune response, and has antioxidant properties that protect neurons from damage, potentially contributing to recovery and improvement of the neural pathways affected by congenital Zika virus syndrome.
However, further investments in research are still needed to deepen knowledge about the mechanisms of action, optimal dosage and long-term effects of cannabidiol. Because this emerging area of study has the potential to improve the quality of life and prognosis of children affected by congenital Zika virus syndrome.
ACKNOWLEDGEMENTS
The Foundation for the Support of Research and Scientific and Technological Development of Maranhão (FAPEMA), the Laboratory for the Processing of Biological Information (PIB) and, to all those who contributed, in some way, to the realization of this work.
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Abstract
Objective: The aim of this study is to conduct a literature review of articles addressing the therapeutic use of cannabidiol for treating symptoms of epilepsy in children with congenital Zika virus syndrome. Theoretical Framework: Zika virus is an arbovirus transmitted by mosquitoes, first identified in Brazil in 2015. In severe cases, it can lead to Congenital Zika Virus Syndrome in fetuses, resulting in various neurological anomalies. Cannabidiol (CBD), found in Cannabis sativa, has emerged as a therapeutic alternative for treating symptoms, including epilepsy, but requires further clinical studies to confirm its efficacy and safety. Method: This is a literature review research, in which scientific articles on the therapeutic use of cannabidiol in children with epilepsy related to congenital Zika virus syndrome were selected. The research utilized electronic databases such as PubMed, Google Scholar, and Web of Science. Clinical studies evaluating the efficacy and safety of cannabidiol were included, while those without a control group or animal testing were excluded. Results and Discussion: The results obtained demonstrated that cannabidiol (CBD) is effective in reducing seizures in children with congenital Zika virus syndrome, improving their quality of life and motor skills. Its mechanisms of action suggest interaction with the endocannabinoid system, antioxidant action, and regulation of neurogenesis and synaptic plasticity. Studies have shown that CBD is generally safe and well-tolerated by these children. However, further research is necessary to fully understand its long-term effects and to determine the optimal dosage. Cannabidiol was shown to reduce seizures in 80% of children with congenital Zika virus syndrome, improving their quality of life and motor skills. It was well-tolerated, with no serious side effects. Research Implications: The results of this research are of great value for the health of children affected by the Zika virus. The need for more studies is evident, as the mechanisms of action of cannabidiol as a therapeutic treatment for this pathology require greater understanding. Nevertheless, it presents a promising therapeutic potential, requiring more research for better understanding and safe use. Originality/Value: This research contributes to the literature by gathering important information about the use of cannabidiol and its developments, with the aim of providing insights and assisting in the elucidation of possible further studies on the subject, thereby bringing positive impacts on public health, guiding clinical management, and contributing to the improvement of the quality of life of this affected population.