Shaladi Ali Muftah, Crestani Francesco, Tartari Stefano, Piva Bruno
Servizio Terapia del Dolore e Cure Palliative, Rovigo-Trecenta.
Recenti Prog Med. 2008 Dec;99(12):616-24.
Hemp (Cannabis sativa L.) has been used since remotes ages as a herbal remedy. Only recently the medical community highlighted the pharmacological scientific bases of its effects. The most important active principle, Delta-9-tetrahydrocannabinol, was identified in the second half of the last century, and subsequently two receptors were identified and cloned: CB1 that is primarily present in the central nervous system, and CB2 that is present on the cells of the immune system. Endogenous ligands, called endocannabinoids, were characterized. The anandamide was the first one to be discovered. The effectiveness of the cannabinoids in the treatment of nausea and vomit due to anti-neoplastic chemotherapy and in the wasting-syndrome during AIDS is recognized. Moreover, the cannabinoids are analgesic, and their activity is comparable to the weak opioids. Furthermore, parallels exist between opioid and cannabinoid receptors, and evidence is accumulating that the two systems sometimes may operate synergistically. The interest of the pharmaceutical companies led to the production of various drugs, whether synthetic or natural derived. The good ratio between the polyunsatured fatty acids omega-3 and omega-6 of the oil of Cannabis seeds led to reduction of the phlogosis and an improvement of the pain symptoms in patients with chronic musculo-skeletal inflammation.
大麻(Cannabis sativa L.)自古以来就被用作草药。直到最近,医学界才强调了其作用的药理科学依据。最重要的活性成分Δ-9-四氢大麻酚是在上个世纪下半叶被鉴定出来的,随后又鉴定并克隆出了两种受体:主要存在于中枢神经系统的CB1和存在于免疫系统细胞上的CB2。内源性配体,即内源性大麻素,也得到了表征。花生四烯乙醇胺是第一个被发现的。大麻素在治疗抗肿瘤化疗引起的恶心和呕吐以及艾滋病期间的消瘦综合征方面的有效性已得到认可。此外,大麻素具有镇痛作用,其活性与弱阿片类药物相当。此外,阿片类受体和大麻素受体之间存在相似之处,并且越来越多的证据表明这两个系统有时可能协同作用。制药公司的兴趣促使人们生产了各种药物,无论是合成的还是天然衍生的。大麻籽中多不饱和脂肪酸ω-3和ω-6的良好比例可减轻慢性肌肉骨骼炎症患者的炎症并改善疼痛症状。