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大麻二酚医学用途的神经学方面

Neurological Aspects of Medical Use of Cannabidiol.

作者信息

Mannucci Carmen, Navarra Michele, Calapai Fabrizio, Spagnolo Elvira V, Busardò Francesco P, Cas Roberto D, Ippolito Francesca M, Calapai Gioacchino

机构信息

Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.

Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy.

出版信息

CNS Neurol Disord Drug Targets. 2017;16(5):541-553. doi: 10.2174/1871527316666170413114210.

Abstract

BACKGROUND

Cannabidiol (CBD) is among the major secondary metabolites of Cannabis devoid of the delta-9-tetra-hydrocannabinol psychoactive effects. It is a resorcinol-based compound with a broad spectrum of potential therapeutic properties, including neuroprotective effects in numerous pathological conditions. CBD neuroprotection is due to its antioxidant and antiinflammatory activities and the modulation of a large number of brain biological targets (receptors, channels) involved in the development and maintenance of neurodegenerative diseases.

OBJECTIVE

The aim of the present review was to describe the state of art about the pre-clinical research, the potential use and, when existing, the clinical evidence related to CBD in the neurological field.

METHOD

Collection of all the pre-clinical and clinical findings carried out investigating the effects of CBD alone, not in combination with other substances, in the neurological arena with the exclusion of studies on neuropsychiatric disorders.

RESULTS

Laboratory and clinical studies on the potential role of CBD in Parkinson's disease (PD), Alzheimer's disease (AD), multiple sclerosis (MS), Huntington's disease (HD), amyotrophic lateral sclerosis ALS), cerebral ischemia, were examined.

CONCLUSION

Pre-clinical evidence largely shows that CBD can produce beneficial effects in AD, PD and MS patients, but its employment for these disorders needs further confirmation from well designed clinical studies. CBD pre-clinical demonstration of antiepileptic activity is supported by recent clinical studies in human epileptic subjects resistant to standard antiepileptic drugs showing its potential use in children and young adults affected by refractory epilepsy. Evidence for use of CBD in PD is still not supported by sufficient data whereas only a few studies including a small number of patients are available.

摘要

背景

大麻二酚(CBD)是大麻的主要次生代谢产物之一,不具有δ-9-四氢大麻酚的精神活性作用。它是一种基于间苯二酚的化合物,具有广泛的潜在治疗特性,包括在多种病理状况下的神经保护作用。CBD的神经保护作用归因于其抗氧化和抗炎活性以及对大量参与神经退行性疾病发生和维持的脑生物学靶点(受体、通道)的调节作用。

目的

本综述的目的是描述关于CBD在神经领域的临床前研究、潜在用途以及现有相关临床证据的最新情况。

方法

收集所有在神经领域单独研究CBD(不与其他物质联合)作用的临床前和临床研究结果,排除关于神经精神疾病的研究。

结果

对CBD在帕金森病(PD)、阿尔茨海默病(AD)、多发性硬化症(MS)、亨廷顿舞蹈病(HD)、肌萎缩侧索硬化症(ALS)、脑缺血中的潜在作用的实验室和临床研究进行了审查。

结论

临床前证据在很大程度上表明,CBD可对AD、PD和MS患者产生有益影响,但其在这些疾病中的应用需要精心设计的临床研究进一步证实。CBD抗癫痫活性的临床前证据得到了近期对标准抗癫痫药物耐药的人类癫痫患者临床研究的支持,这些研究表明其在难治性癫痫患儿和青年患者中具有潜在用途。关于CBD在PD中应用的证据仍缺乏充分数据支持,仅有少数包含少量患者的研究。

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