Stampanoni Bassi Mario, Sancesario Andrea, Morace Roberta, Centonze Diego, Iezzi Ennio
Neurology and Neurorehabilitation Units, IRCCS Istituto Neurologico Mediterraneo (INM) Neuromed, Pozzilli, Italy.
Department of Systems Medicine, Tor Vergata University, Rome, Italy.
Cannabis Cannabinoid Res. 2017 Feb 1;2(1):21-29. doi: 10.1089/can.2017.0002. eCollection 2017.
The endocannabinoid system plays a regulatory role in a number of physiological processes and has been found altered in different pathological conditions, including movement disorders. The interactions between cannabinoids and dopamine in the basal ganglia are remarkably complex and involve both the modulation of other neurotransmitters (γ-aminobutyric acid, glutamate, opioids, peptides) and the activation of different receptors subtypes (cannabinoid receptor type 1 and 2). In the last years, experimental studies contributed to enrich this scenario reporting interactions between cannabinoids and other receptor systems (transient receptor potential vanilloid type 1 cation channel, adenosine receptors, 5-hydroxytryptamine receptors). The improved knowledge, adding new interpretation on the biochemical interaction between cannabinoids and other signaling pathways, may contribute to develop new pharmacological strategies. A number of preclinical studies in different experimental Parkinson's disease (PD) models demonstrated that modulating the cannabinoid system may be useful to treat some motor symptoms. Despite new cannabinoid-based medicines have been proposed for motor and nonmotor symptoms of PD, so far, results from clinical studies are controversial and inconclusive. Further clinical studies involving larger samples of patients, appropriate molecular targets, and specific clinical outcome measures are needed to clarify the effectiveness of cannabinoid-based therapies.
内源性大麻素系统在许多生理过程中发挥调节作用，并且已发现在包括运动障碍在内的不同病理状况下会发生改变。大麻素与基底神经节中的多巴胺之间的相互作用非常复杂，涉及其他神经递质（γ-氨基丁酸、谷氨酸、阿片类物质、肽类）的调节以及不同受体亚型（1型和2型大麻素受体）的激活。在过去几年中，实验研究丰富了这一情况，报道了大麻素与其他受体系统（瞬时受体电位香草酸亚型1阳离子通道、腺苷受体、5-羟色胺受体）之间的相互作用。知识的进步，为大麻素与其他信号通路之间的生化相互作用增添了新的解释，可能有助于开发新的药理学策略。在不同的实验性帕金森病（PD）模型中进行的多项临床前研究表明，调节大麻素系统可能有助于治疗某些运动症状。尽管已经提出了一些基于大麻素的药物用于治疗PD的运动和非运动症状，但到目前为止，临床研究结果存在争议且尚无定论。需要进一步开展涉及更大患者样本、合适分子靶点和特定临床结局指标的临床研究，以阐明基于大麻素的疗法的有效性。
