GW Pharmaceuticals plc, Sovereign House, Vision Park, Histon, Cambridge, CB24 9BZ, UK.
Endocannabinoid Research Group, Consiglio Nazionale delle Ricerche, Via Campi Flegrei 34, Comprensorio Olivetti, 80078, Pozzuoli (NA), Italy.
Trends Pharmacol Sci. 2015 Dec;36(12):802-821. doi: 10.1016/j.tips.2015.08.010. Epub 2015 Oct 1.
Chronic diseases are due to deviations of fundamental physiological systems, with different pathologies being characterised by similar malfunctioning biological networks. The ensuing compensatory mechanisms may weaken the body's dynamic ability to respond to further insults and reduce the efficacy of conventional single target treatments. The multitarget, systemic, and prohomeostatic actions emerging for plant cannabinoids exemplify what might be needed for future medicines. Indeed, two combined cannabis extracts were approved as a single medicine (Sativex(®)), while pure cannabidiol, a multitarget cannabinoid, is emerging as a treatment for paediatric drug-resistant epilepsy. Using emerging cannabinoid medicines as an example, we revisit the concept of polypharmacology and describe a new empirical model, the 'therapeutic handshake', to predict efficacy/safety of compound combinations of either natural or synthetic origin.
慢性疾病是由于基本生理系统的偏差引起的,不同的病理学特征是相似的生物网络功能障碍。随之而来的代偿机制可能会削弱身体对进一步损伤的动态反应能力,并降低传统单一靶点治疗的疗效。植物大麻素所表现出的多靶点、系统性和促进体内平衡的作用,为未来的药物提供了范例。事实上,两种联合的大麻提取物已被批准为一种药物(Sativex(®)),而纯大麻二酚,一种多靶点大麻素,正在成为治疗小儿耐药性癫痫的一种方法。我们以新兴的大麻素药物为例,重新审视多药理学的概念,并描述了一个新的经验模型,即“治疗握手”,以预测天然或合成来源的化合物组合的疗效/安全性。