Taschler Ulrike, Hasenoehrl Carina, Storr Martin, Schicho Rudolf
Institute of Experimental and Clinical Pharmacology, Medical University of Graz, Graz, Austria.
Zentrum für Endoskopie, Starnberg, Germany.
Handb Exp Pharmacol. 2017;239:343-362. doi: 10.1007/164_2016_105.
Cannabinoid receptors are fundamentally involved in all aspects of intestinal physiology, such as motility, secretion, and epithelial barrier function. They are part of a broader entity, the so-called endocannabinoid system which also includes their endocannabinoid ligands and the ligands' synthesizing/degrading enzymes. The system has a strong impact on the pathophysiology of the gastrointestinal tract and is believed to maintain homeostasis in the gut by controlling hypercontractility and by promoting regeneration after injury. For instance, genetic knockout of cannabinoid receptor 1 leads to inflammation and cancer of the intestines. Derivatives of Δ-tetrahydrocannabinol, such as nabilone and dronabinol, activate cannabinoid receptors and have been introduced into the clinic to treat chemotherapy-induced emesis and loss of appetite; however, they may cause many psychotropic side effects. New drugs that interfere with endocannabinoid degradation to raise endocannabinoid levels circumvent this obstacle and could be used in the future to treat emesis, intestinal inflammation, and functional disorders associated with visceral hyperalgesia.
大麻素受体从根本上参与肠道生理的各个方面,如蠕动、分泌和上皮屏障功能。它们是一个更广泛实体的一部分,即所谓的内源性大麻素系统,该系统还包括其内源性大麻素配体以及配体的合成/降解酶。该系统对胃肠道的病理生理学有重大影响,并且被认为通过控制过度收缩和促进损伤后的再生来维持肠道内环境稳定。例如,大麻素受体1的基因敲除会导致肠道炎症和癌症。Δ-四氢大麻酚的衍生物,如那比隆和屈大麻酚,可激活大麻素受体,并已被引入临床用于治疗化疗引起的呕吐和食欲不振;然而,它们可能会引起许多精神方面的副作用。干扰内源性大麻素降解以提高内源性大麻素水平的新药可以规避这一障碍,未来可用于治疗呕吐、肠道炎症以及与内脏痛觉过敏相关的功能障碍。