Cannabidiol protects C2C12 myotubes against cisplatin-induced atrophy by regulating oxidative stress

Am J Physiol Cell Physiol. 2024 Apr 1;326(4):C1226-C1236. doi: 10.1152/ajpcell.00622.2023. Epub 2024 Feb 26.


Cancer and chemotherapy induce a severe loss of muscle mass (known as cachexia), which negatively impact cancer treatment and patient survival. The aim of the present study was to investigate whether cannabidiol (CBD) administration may potentially antagonize the effects of cisplatin in inducing muscle atrophy, using a model of myotubes in culture. Cisplatin treatment resulted in a reduction of myotube diameter (15.7 ± 0.3 vs. 22.2 ± 0.5 µm, P < 0.01) that was restored to control level with 5 µM CBD (20.1 ± 0.4 µM, P < 0.01). Protein homeostasis was severely altered with a ≈70% reduction in protein synthesis (P < 0.01) and a twofold increase in proteolysis (P < 0.05) in response to cisplatin. Both parameters were dose dependently restored by CBD cotreatment. Cisplatin treatment was associated with increased thiobarbituric acid reactive substances (TBARS) content (0.21 ± 0.03 to 0.48 ± 0.03 nmol/mg prot, P < 0.05), catalase activity (0.24 ± 0.01 vs. 0.13 ± 0.02 nmol/min/µg prot, P < 0.01), whereas CBD cotreatment normalized TBARS content to control values (0.22 ± 0.01 nmol/mg prot, P < 0.01) and reduced catalase activity (0.17 ± 0.01 nmol/min/µg prot, P < 0.05). These changes were associated with increased mRNA expression of GPX1, SOD1, SOD2, and CAT mRNA expression in response to cisplatin (P < 0.01), which was corrected by CBD cotreatment (P < 0.05). Finally, cisplatin treatment increased the mitochondrial protein content of NDUFB8, UQCRC2, COX4, and VDAC1 (involved in mitochondrial respiration and apoptosis), and CBD cotreatment restored their expression to control values. Altogether, our results demonstrated that CBD antagonize the cisplatin-induced C2C12 myotube atrophy and could be used as an adjuvant in the treatment of cancer cachexia to help maintain muscle mass and improve patient quality of life.NEW & NOTEWORTHY In an in vitro model, cisplatin treatment led to myotube atrophy associated with dysregulation of protein homeostasis and increased oxidative stress, resulting in increased apoptosis. Cotreatment with cannabidiol was able to prevent this phenotype by promoting protein homeostasis and reducing oxidative stress.

Keywords: cachexia; endocannabinoid system; mitochondrial function; oxidative stress; protein homeostasis.

MeSH terms

  • Cachexia / metabolism
  • Cannabidiol* / metabolism
  • Cannabidiol* / pharmacology
  • Cannabidiol* / therapeutic use
  • Catalase / metabolism
  • Cisplatin / toxicity
  • Humans
  • Muscle Fibers, Skeletal / metabolism
  • Muscular Atrophy / chemically induced
  • Muscular Atrophy / drug therapy
  • Muscular Atrophy / prevention & control
  • Neoplasms* / metabolism
  • Oxidative Stress
  • Quality of Life
  • RNA, Messenger / metabolism
  • Thiobarbituric Acid Reactive Substances / metabolism
  • Thiobarbituric Acid Reactive Substances / pharmacology


  • Cisplatin
  • Cannabidiol
  • Catalase
  • Thiobarbituric Acid Reactive Substances
  • RNA, Messenger