How does CBD reduce inflammation?

CBD reduces inflammation through multiple mechanisms: (1) inhibition of adenosine reuptake, increasing extracellular adenosine which suppresses inflammatory cytokines via A2A receptors; (2) activation of TRPV1 channels, which desensitizes pain and inflammatory signaling; (3) indirect modulation of CB2 receptors on immune cells, reducing macrophage and microglial activation; (4) inhibition of NF-κB signaling, a master regulator of inflammatory gene expression; and (5) activation of PPARγ, a nuclear receptor with broad anti-inflammatory effects. Unlike THC, CBD does not directly bind CB1 or CB2 receptors with high affinity, explaining its lack of psychoactivity while retaining anti-inflammatory properties. Most evidence comes from preclinical models; robust human RCT data for inflammatory conditions remain limited.