Abstract
Introduction: The correct interaction between the elements of the endocannabinoid system plays an important role in the development of the central nervous system. Clinical and preclinical studies suggest that cannabidiol (CBD) may be useful for athletes due to its anti-inflammatory, analgesic, anxiolytic, and neuroprotective properties and its influence on the sleep-wake cycle. Furthermore, a series of implications for epigenetic processes were also proven, through changes in the expression of exosomes and microRNAs responsible for modulating the immune and inflammatory systems. Objective: It was to list the main clinical considerations of the nutritional modulation of cannabidiol in inflammatory and immunological processes in athletes through a systematic review. Methods: The PRISMA Platform systematic review rules were followed. The research was carried out from January to March 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and AMSTAR-2, and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 88 articles were found. A total of 36 articles were evaluated in full and 18 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 26 studies with a high risk of bias and 12 studies that did not meet GRADE and AMSTAR-2. CBD has been reported to exert a range of physiological, biochemical, and psychological effects with the potential to benefit human health. For example, there is preliminary supporting evidence for CBD's anti-inflammatory, neuroprotective, analgesic, and anxiolytic actions and the possibility that it may protect against gastrointestinal damage associated with inflammation and promote the healing of traumatic skeletal injuries. The combination of Δ9-THC and CBD can alter the activity of microRNAs responsible for increasing the biosynthesis of inflammatory mediators, leading to a reduction in the inflammatory profile. Despite these findings, there is still a lack of randomized and/or prospective controlled clinical studies with a robust sample size to better understand the safety and effectiveness of the use of cannabidiol by medium to high-performance athletes, as well as better understand the dosages for each type of sports performance.