Department of Pharmacokinetics and Therapeutic Drug Monitoring, Pomeranian Medical University, Szczecin, Poland.
Department of Experimental and Clinical Pharmacology, Pomeranian Medical University, Szczecin, Poland.
Neurol Neurochir Pol. 2022;56(1):4-13. doi: 10.5603/PJNNS.a2022.0015. Epub 2022 Feb 8.
Cannabis (also known as marijuana) is the most frequently used psychoactive substance in the world. The role of cannabis in medicine is rapidly evolving, and advances in the understanding of its pharmacology have led to numerous proposed uses of these drugs.
Cannabis contains Δ9-tetrahydrocannabinol and cannabidiol as the primary constituents responsible for pharmacological activity. It is now known that there are at least two types of cannabinoid receptors. CB1 receptors are found mainly in the CNS, and their primary role is to inhibit the release of neurotransmitters. CB2 receptors' leading role is to modulate cytokine release and immune cell migration. Colocalisation of cannabinoid receptors with other types of nervous system receptors allows them to interact with many other transmitters such as dopamine, noradrenaline, acetylcholine, gamma-aminobutyric acid, serotonin, and glutamic and aspartic acids.
The rapidly expanding understanding regarding cannabinoids led to initial attempts to treat selected diseases with cannabinoid receptor agonists and antagonists. The most promising of these was the potential possibility of treating diseases for which current therapy is unsatisfactory, such as neurological diseases including multiple sclerosis, spastic muscular tension, extrapyramidal system diseases, neurodegenerative diseases and cerebral ischaemia. Attempts to treat psychiatric diseases (e.g. psychoses, neuroses, mood disorders, and alcohol dependence syndrome) with cannabinoids are much less advanced.
Cannabis and cannabinoids can be widely used to treat several diseases or alleviate symptoms, but their efficacy for specific indications is not always apparent. Further exploration is needed to understand whether the enhanced sensitivity to the cognitive effects of Δ9-THC depends on brain cannabinoid receptor dysfunction, and how these changes contribute to the cognitive deterioration and core pathophysiology symptoms associated with schizophrenia or other neurological and somatoform disorders.
大麻（又称 marijuana）是世界上使用最广泛的精神活性物质。大麻在医学中的作用正在迅速发展，对其药理学的认识进步导致了这些药物的许多新用途。
大麻含有 Δ9-四氢大麻酚和大麻二酚，是主要负责药理活性的成分。现在已经知道，至少有两种类型的大麻素受体。CB1 受体主要存在于中枢神经系统中，其主要作用是抑制神经递质的释放。CB2 受体的主要作用是调节细胞因子的释放和免疫细胞的迁移。大麻素受体与其他类型的神经系统受体的共定位使它们能够与许多其他递质相互作用，如多巴胺、去甲肾上腺素、乙酰胆碱、γ-氨基丁酸、血清素、谷氨酸和天冬氨酸。
对大麻素的认识迅速扩大，导致最初尝试使用大麻素受体激动剂和拮抗剂治疗选定的疾病。其中最有希望的是治疗目前治疗不满意的疾病的可能性，如神经系统疾病，包括多发性硬化症、痉挛性肌肉紧张、锥体外系统疾病、神经退行性疾病和脑缺血。用大麻素治疗精神病（如精神病、神经症、情绪障碍和酒精依赖综合征）的尝试进展要少得多。
大麻和大麻素可广泛用于治疗多种疾病或缓解症状，但它们对特定适应症的疗效并不总是明显。需要进一步探索，以了解对 Δ9-THC 的认知影响的敏感性增强是否取决于大脑大麻素受体功能障碍，以及这些变化如何导致与精神分裂症或其他神经和躯体形式障碍相关的认知恶化和核心病理生理学症状。
