Department of Medicine, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 21, 00128 Rome, Italy; European Center for Brain Research/IRCCS Santa Lucia Foundation, Via del Fosso di Fiorano 64, 00143 Rome, Italy.
Department of Molecular Physiology, Leiden University, Einsteinweg 55, 2333CC, Leiden, The Netherlands.
Prog Neurobiol. 2018 Jan;160:82-100. doi: 10.1016/j.pneurobio.2017.10.007. Epub 2017 Oct 31.
Multiple sclerosis is the most common inflammatory demyelinating disease of the central nervous system, caused by an autoimmune response against myelin that eventually leads to progressive neurodegeneration and disability. Although the knowledge on its underlying neurobiological mechanisms has considerably improved, there is a still unmet need for new treatment options, especially for the progressive forms of the disease. Both preclinical and clinical data suggest that cannabinoids, derived from the Cannabis sativa plant, may be used to control symptoms such as spasticity and chronic pain, whereas only preclinical data indicate that these compounds and their endogenous counterparts, i.e. the endocannabinoids, may also exert neuroprotective effects and slow down disease progression. Here, we review the preclinical and clinical studies that could explain the therapeutic action of cannabinoid-based medicines, as well as the medical potential of modulating endocannabinoid signaling in multiple sclerosis, with a link to other neuroinflammatory disorders that share common hallmarks and pathogenetic features.
多发性硬化症是最常见的中枢神经系统炎症性脱髓鞘疾病，由针对髓鞘的自身免疫反应引起，最终导致进行性神经退行性变和残疾。尽管对其潜在神经生物学机制的认识有了很大的提高，但仍需要新的治疗选择，特别是对于疾病的进行性形式。临床前和临床数据均表明，源自大麻植物的大麻素可用于控制痉挛和慢性疼痛等症状，而仅临床前数据表明，这些化合物及其内源性对应物，即内源性大麻素，也可能具有神经保护作用并减缓疾病进展。在这里，我们回顾了可以解释基于大麻素的药物治疗作用的临床前和临床研究，以及调节多发性硬化症中内源性大麻素信号的医学潜力，同时还探讨了与具有共同特征和发病特征的其他神经炎症性疾病的联系。
