Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia.
Discipline of Pharmacology, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
Br J Pharmacol. 2020 Sep;177(18):4261-4274. doi: 10.1111/bph.15181. Epub 2020 Jul 27.
Extracts from the cannabis plant can dramatically improve the health of children suffering from refractory epilepsies such as Dravet syndrome. These extracts typically contain cannabidiol (CBD), a phytocannabinoid with well-documented anticonvulsant effects, but may also contain Δ -tetrahydrocannabinol (Δ -THC). It is unclear whether the presence of Δ -THC modulates the anticonvulsant efficacy of CBD. Here, we utilized the Scn1a mouse model of Dravet syndrome to examine this question.
Scn1a mice recapitulate core features of Dravet syndrome, including hyperthermia-induced seizures, early onset spontaneous seizures and sudden death. We assessed the effects on CBD and Δ -THC alone, and in combination on hyperthermia-induced seizures, spontaneous seizures and premature mortality.
Administered alone, CBD (100 mg·kg i.p.) was anticonvulsant against hyperthermia-induced seizures as were low (0.1 and 0.3 mg·kg i.p.) but not higher doses of Δ -THC. A subthreshold dose of CBD (12 mg·kg ) enhanced the anticonvulsant effects of Δ -THC (0.1 mg·kg ). Sub-chronic oral administration of Δ -THC or CBD alone did not affect spontaneous seizure frequency or mortality while, surprisingly, their co-administration increased the severity of spontaneous seizures and overall mortality.
Low doses of Δ -THC are anticonvulsant against hyperthermia-induced seizures in Scn1a mice, effects that are enhanced by a sub-anticonvulsant dose of CBD. However, proconvulsant effects and increased premature mortality are observed when CBD and Δ -THC are sub-chronically dosed in combination. The possible explanations and implications of this are discussed.
大麻植物提取物可显著改善患有难治性癫痫(如德拉维特综合征)的儿童的健康状况。这些提取物通常含有大麻二酚(CBD),这是一种具有良好抗惊厥作用的植物大麻素,但也可能含有 Δ -四氢大麻酚(Δ -THC)。目前尚不清楚 Δ -THC 的存在是否会调节 CBD 的抗惊厥作用。在这里,我们利用 Scn1a 小鼠模型来研究这个问题。
Scn1a 小鼠重现了德拉维特综合征的核心特征,包括发热诱导的癫痫发作、早期自发癫痫发作和突然死亡。我们评估了 CBD 和 Δ -THC 单独以及联合应用对发热诱导的癫痫发作、自发性癫痫发作和过早死亡的影响。
单独给予 CBD(100mg·kg 腹腔注射)可对抗发热诱导的癫痫发作,低剂量(0.1 和 0.3mg·kg 腹腔注射)但不是高剂量的 Δ -THC 也是如此。亚治疗剂量的 CBD(12mg·kg )增强了 Δ -THC(0.1mg·kg )的抗惊厥作用。亚慢性口服给予 Δ -THC 或 CBD 本身并不影响自发性癫痫发作的频率或死亡率,而令人惊讶的是,它们的联合给药增加了自发性癫痫发作的严重程度和总死亡率。
低剂量的 Δ -THC 对 Scn1a 小鼠发热诱导的癫痫发作具有抗惊厥作用,而 CBD 的亚抗惊厥剂量可增强其作用。然而,当 CBD 和 Δ -THC 亚慢性给药时,会观察到促惊厥作用和过早死亡增加。讨论了这种现象的可能解释和意义。