Ortiz Yuma T, McMahon Lance R, Wilkerson Jenny L
Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, United States.
Department of Pharmaceutical Sciences, School of Pharmacy, Texas Tech University Health Sciences Center, Amarillo, TX, United States.
Front Pharmacol. 2022 Apr 21;13:881810. doi: 10.3389/fphar.2022.881810. eCollection 2022.
Cannabinoids, including those found in cannabis, have shown promise as potential therapeutics for numerous health issues, including pathological pain and diseases that produce an impact on neurological processing and function. Thus, cannabis use for medicinal purposes has become accepted by a growing majority. However, clinical trials yielding satisfactory endpoints and unequivocal proof that medicinal cannabis should be considered a frontline therapeutic for most examined central nervous system indications remains largely elusive. Although cannabis contains over 100 + compounds, most preclinical and clinical research with well-controlled dosing and delivery methods utilize the various formulations of Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD), the two most abundant compounds in cannabis. These controlled dosing and delivery methods are in stark contrast to most clinical studies using whole plant cannabis products, as few clinical studies using whole plant cannabis profile the exact composition, including percentages of all compounds present within the studied product. This review will examine both preclinical and clinical evidence that supports or refutes the therapeutic utility of medicinal cannabis for the treatment of pathological pain, neurodegeneration, substance use disorders, as well as anxiety-related disorders. We will predominately focus on purified THC and CBD, as well as other compounds isolated from cannabis for the aforementioned reasons but will also include discussion over those studies where whole plant cannabis has been used. In this review we also consider the current challenges associated with the advancement of medicinal cannabis and its derived potential therapeutics into clinical applications.
大麻素，包括在大麻中发现的那些，已显示出有望成为治疗多种健康问题的潜在疗法，这些问题包括病理性疼痛以及对神经加工和功能产生影响的疾病。因此，将大麻用于医疗目的已为越来越多的人所接受。然而，产生令人满意的终点结果以及明确证据表明药用大麻应被视为大多数已研究的中枢神经系统适应症的一线治疗方法的临床试验在很大程度上仍然难以捉摸。尽管大麻含有100多种化合物，但大多数采用严格控制剂量和给药方法的临床前和临床研究都使用了Δ9-四氢大麻酚（THC）和大麻二酚（CBD）的各种制剂，这两种是大麻中含量最丰富的化合物。这些控制剂量和给药方法与大多数使用全株大麻产品的临床研究形成鲜明对比，因为很少有使用全株大麻的临床研究能够准确描述其成分，包括所研究产品中所有化合物的百分比。本综述将研究支持或反驳药用大麻治疗病理性疼痛、神经退行性变、物质使用障碍以及焦虑相关障碍的治疗效用的临床前和临床证据。出于上述原因，我们将主要关注纯化的THC和CBD，以及从大麻中分离出的其他化合物，但也将包括对那些使用全株大麻的研究的讨论。在本综述中，我们还考虑了与将药用大麻及其衍生的潜在疗法推进到临床应用相关的当前挑战。
