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脑震荡后的神经保护:大麻二酚的潜在作用。

Neuroprotection Following Concussion: The Potential Role for Cannabidiol.

机构信息

Faculty of Kinesiology & Health Studies, University of Regina, Regina, Saskatchewan, Canada.

出版信息

Can J Neurol Sci. 2020 May;47(3):289-300. doi: 10.1017/cjn.2020.23.

DOI:10.1017/cjn.2020.23
PMID:32029015
Abstract

Cannabidiol (CBD) has been generating increasing interest in medicine due to its therapeutic properties and an apparent lack of negative side effects. Research has suggested that high dosages of CBD can be taken acutely and chronically with little to no risk. This review focuses on the neuroprotective effects of a CBD, with an emphasis on its implications for recovering from a mild traumatic brain injury (TBI) or concussion. CBD has been shown to influence the endocannabinoid system, both by affecting cannabinoid receptors and other receptors involved in the endocannabinoid system such as vanilloid receptor 1, adenosine receptors, and 5-hydroxytryptamine via cannabinoid receptor-independent mechanisms. Concussions can result in many physiological consequences, potentially resulting in post-concussion syndrome. While impairments in cerebrovascular and cardiovascular physiology following concussion have been shown, there is unfortunately still no single treatment available to enhance recovery. CBD has been shown to influence the blood brain barrier, brain-derived neurotrophic factors, cognitive capacity, the cerebrovasculature, cardiovascular physiology, and neurogenesis, all of which have been shown to be altered by concussion. CBD can therefore potentially provide treatment to enhance neuroprotection by reducing inflammation, regulating cerebral blood flow, enhancing neurogenesis, and protecting the brain against reactive oxygen species. Double-blind randomized controlled trials are still required to validate the use of CBD as medication following mild TBIs, such as concussion.

摘要

大麻二酚(CBD)因其治疗特性和明显缺乏负面副作用而在医学领域引起了越来越多的关注。研究表明,大剂量的 CBD 可以急性和慢性服用,几乎没有风险。本综述重点介绍了 CBD 的神经保护作用,特别强调了其对轻度创伤性脑损伤(TBI)或脑震荡恢复的影响。CBD 已被证明可以通过影响内源性大麻素系统来影响内源性大麻素系统,包括通过影响大麻素受体和内源性大麻素系统中涉及的其他受体,如香草素受体 1、腺苷受体和 5-羟色胺通过非大麻素受体机制。脑震荡会导致许多生理后果,可能导致脑震荡后综合征。虽然已经表明脑震荡后会出现脑血管和心血管生理学的许多变化,但不幸的是,仍然没有单一的治疗方法可以增强恢复。CBD 已被证明可以影响血脑屏障、脑源性神经营养因子、认知能力、脑血管、心血管生理学和神经发生,所有这些都已被证明会因脑震荡而改变。因此,CBD 可以通过减少炎症、调节脑血流量、增强神经发生和保护大脑免受活性氧的侵害,从而为增强神经保护提供治疗。仍需要双盲随机对照试验来验证 CBD 在轻度 TBI(如脑震荡)后的药物使用。

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