Izzo A A, Camilleri M
Department of Experimental Pharmacology, Endocannabinoid Research Group, University of Naples Federico II, via D Montesano 49, 80131, Naples, Italy.
Gut. 2008 Aug;57(8):1140-55. doi: 10.1136/gut.2008.148791. Epub 2008 Apr 8.
A multitude of physiological effects and putative pathophysiological roles have been proposed for the endogenous cannabinoid system in the gastrointestinal tract, liver and pancreas. These range from effects on epithelial growth and regeneration, immune function, motor function, appetite control, fibrogenesis and secretion. Cannabinoids have the potential for therapeutic application in gut and liver diseases. Two exciting therapeutic applications in the area of reversing hepatic fibrosis as well as antineoplastic effects may have a significant impact in these diseases. This review critically appraises the experimental and clinical evidence supporting the clinical application of cannabinoid receptor-based drugs in gastrointestinal, liver and pancreatic diseases. Application of modern pharmacological principles will most probably expand the selective modulation of the cannabinoid system peripherally in humans. We anticipate that, in addition to the approval in several countries of the CB(1) antagonist, rimonabant, for the treatment of obesity and associated metabolic dysfunctions, other cannabinoid modulators are likely to have an impact on human disease in the future, including hepatic fibrosis and neoplasia.
内源性大麻素系统在胃肠道、肝脏和胰腺中具有多种生理作用和假定的病理生理作用。这些作用范围包括对上皮生长和再生、免疫功能、运动功能、食欲控制、纤维生成和分泌的影响。大麻素在肠道和肝脏疾病中具有治疗应用潜力。在逆转肝纤维化以及抗肿瘤作用方面的两个令人兴奋的治疗应用可能会对这些疾病产生重大影响。本综述批判性地评估了支持基于大麻素受体的药物在胃肠道、肝脏和胰腺疾病中临床应用的实验和临床证据。应用现代药理学原理很可能会扩大对人类外周大麻素系统的选择性调节。我们预计，除了CB(1)拮抗剂利莫那班在几个国家被批准用于治疗肥胖症和相关代谢功能障碍外，其他大麻素调节剂未来可能会对人类疾病产生影响，包括肝纤维化和肿瘤形成。
