Instituto de Química Médica, Consejo Superior de Investigaciones Científicas , Madrid, Spain.
Expert Opin Drug Discov. 2020 Aug;15(8):917-930. doi: 10.1080/17460441.2020.1752178. Epub 2020 Apr 27.
The pathophysiological relevance of the endocannabinoid system has been widely demonstrated in a variety of diseases including cancer, neurological disorders, and metabolic issues. Therefore, targeting the receptors and the endogenous machinery involved in this system can provide a successful therapeutic outcome. Ligands targeting the canonical cannabinoid receptors, CB and CB, along with inhibitors of the endocannabinoid enzymes have been thoroughly studied in diverse disease models. In fact, phytocannabinoids such as cannabidiol or Δ-tetrahydrocannabinol are currently on the market for the management of neuropathic pain due to spasticity in multiple sclerosis or seizures in children epilepsy amongst others.
Challenges in the pharmacology of cannabinoids arise from its pharmacokinetics, off-target effects, and psychoactive effects. In this context, the current review outlines the novel molecular approaches emerging in the field discussing their clinical potential.
Even if orthosteric CB and CB ligands are on the forefront in cannabinoid clinical research, emerging strategies such as allosteric or biased modulation of these receptors along with controlled off-targets effects may increase the therapeutic potential of cannabinoids.
内源性大麻素系统的病理生理学相关性已在包括癌症、神经紊乱和代谢问题在内的多种疾病中得到广泛证实。因此,针对该系统中涉及的受体和内源性机制进行靶向治疗可能会产生成功的治疗效果。针对经典大麻素受体 CB 和 CB 的配体以及内源性大麻素酶的抑制剂已在多种疾病模型中进行了深入研究。事实上,由于多发性硬化症中的痉挛或儿童癫痫中的癫痫发作等原因,目前市场上有一些植物大麻素,如大麻二酚或Δ-四氢大麻酚,可用于治疗神经性疼痛。
大麻素药理学面临的挑战来自其药代动力学、非靶点效应和精神活性效应。在这方面,当前的综述概述了该领域新兴的分子方法,并讨论了它们的临床潜力。
尽管正构 CB 和 CB 配体是大麻素临床研究的前沿,但新兴策略,如这些受体的变构或偏向性调节以及控制非靶点效应,可能会增加大麻素的治疗潜力。