Orrego-González Eduardo, Londoño-Tobón Luisa, Ardila-González José, Polania-Tovar Diego, Valencia-Cárdenas Ana, Velez-Van Meerbeke Alberto
Research Group, Neurosciences (NEUROS), School of Medicine and Health Sciences, Universidad Del Rosario, Bogotá, Colombia.
Hospital Universitario Mayor (MEDERI), Bogotá, Colombia.
Evid Based Complement Alternat Med. 2020 Jul 20;2020:2371527. doi: 10.1155/2020/2371527. eCollection 2020.
Colorectal cancer represents a heavy burden for health systems worldwide, being the third most common cancer worldwide. Despite the breakthroughs in medicine, current chemotherapeutic options continue to have important side effects and may not be effective in preventing disease progression. Cannabinoids might be substances with possible therapeutic potential for cancer because they can attenuate the side effects of chemotherapy and have antiproliferative and antimetastatic effects. We aim to determine, through a systematic review of experimental studies performed on animal CRC models, if cannabinoids can reduce the formation of preneoplastic lesions (aberrant crypt foci), number, and volume of neoplastic lesions.
A systematic, qualitative review of the literature was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Embase, and Scopus databases were searched. We use the following Medical Subject Headings (MESH) terms in PubMed: "colorectal neoplasms," "colonic neoplasms," "colorectal cancer," "polyps," "rimonabant," "cannabidiol," "cannabinoids," "azoxymethane," "xenograft," and "mice." Only studies that met the eligibility criteria were included.
Eight experimental studies were included in the analysis after the full-text evaluation. Seven studies were azoxymethane (AOM) colorectal cancer models, and four studies were xenograft models. Cannabidiol botanical substance (CBD BS) and rimonabant achieved high aberrant crypt foci (ACF) reduction (86% and 75.4%, respectively). Cannabigerol, O-1602, and URB-602 demonstrated a high capacity for tumor volume reduction. Induction of apoptosis, interaction with cell survival, growth pathways, and angiogenesis inhibition were the mechanisms extracted from the studies that explain cannabinoids' actions on CRC.
Cannabinoids have incredible potential as antineoplastic agents as experimental models demonstrate that they can reduce tumor volume and ACF formation. It is crucial to conduct more experimental studies to understand the pharmacology of cannabinoids in CRC better.
结直肠癌是全球卫生系统的沉重负担，是全球第三大常见癌症。尽管医学上取得了突破，但目前的化疗方案仍有重要的副作用，且可能无法有效预防疾病进展。大麻素可能是具有潜在癌症治疗潜力的物质，因为它们可以减轻化疗的副作用，并具有抗增殖和抗转移作用。我们旨在通过对在动物结直肠癌模型上进行的实验研究进行系统评价，确定大麻素是否能减少癌前病变（异常隐窝灶）的形成、肿瘤病变的数量和体积。
根据系统评价和Meta分析的首选报告项目（PRISMA）指南，对文献进行了系统的定性评价。检索了PubMed、Embase和Scopus数据库。我们在PubMed中使用了以下医学主题词（MESH）：“结直肠肿瘤”、“结肠肿瘤”、“结直肠癌”、“息肉”、“利莫那班”、“大麻二酚”、“大麻素”、“氧化偶氮甲烷”、“异种移植”和“小鼠”。仅纳入符合纳入标准的研究。
全文评估后，八项实验研究纳入分析。七项研究为氧化偶氮甲烷（AOM）结直肠癌模型，四项研究为异种移植模型。大麻二酚植物提取物（CBD BS）和利莫那班实现了较高的异常隐窝灶（ACF）减少率（分别为86%和75.4%）。大麻萜酚、O-1602和URB-602显示出较高的肿瘤体积缩小能力。诱导凋亡、与细胞存活和生长途径的相互作用以及血管生成抑制是从研究中提取的解释大麻素对结直肠癌作用的机制。
大麻素作为抗肿瘤药物具有巨大潜力，因为实验模型表明它们可以减少肿瘤体积和ACF形成。开展更多实验研究以更好地了解大麻素在结直肠癌中的药理学至关重要。
