针对肠易激综合征腹痛的内源性大麻素系统治疗。
Targeting the endocannabinoid system for the treatment of abdominal pain in irritable bowel syndrome.
机构信息
Visceral Pain Research Group, College of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, South Australia, Australia.
Hopwood Centre for Neurobiology, Lifelong Health, South Australian Health and Medical Research Institute, North Terrace, Adelaide, South Australia, Australia.
出版信息
Nat Rev Gastroenterol Hepatol. 2023 Jan;20(1):5-25. doi: 10.1038/s41575-022-00682-y. Epub 2022 Sep 27.
The management of visceral pain in patients with disorders of gut-brain interaction, notably irritable bowel syndrome, presents a considerable clinical challenge, with few available treatment options. Patients are increasingly using cannabis and cannabinoids to control abdominal pain. Cannabis acts on receptors of the endocannabinoid system, an endogenous system of lipid mediators that regulates gastrointestinal function and pain processing pathways in health and disease. The endocannabinoid system represents a logical molecular therapeutic target for the treatment of pain in irritable bowel syndrome. Here, we review the physiological and pathophysiological functions of the endocannabinoid system with a focus on the peripheral and central regulation of gastrointestinal function and visceral nociception. We address the use of cannabinoids in pain management, comparing them to other treatment modalities, including opioids and neuromodulators. Finally, we discuss emerging therapeutic candidates targeting the endocannabinoid system for the treatment of pain in irritable bowel syndrome.
肠-脑互动障碍患者（尤其是肠易激综合征）内脏疼痛的管理极具临床挑战性，治疗方法寥寥无几。越来越多的患者使用大麻和大麻素来控制腹痛。大麻作用于内源性大麻素系统的受体，内源性大麻素系统是一种脂质介质的内源性系统，调节胃肠道功能和健康与疾病中的疼痛处理途径。内源性大麻素系统是治疗肠易激综合征疼痛的合理分子治疗靶点。在此，我们重点探讨了内源性大麻素系统的生理和病理生理功能，包括其对胃肠道功能和内脏痛觉的外周和中枢调节。我们讨论了大麻素在疼痛管理中的应用，将其与其他治疗方式（包括阿片类药物和神经调节剂）进行了比较。最后，我们讨论了针对内源性大麻素系统的新兴治疗候选药物，用于治疗肠易激综合征的疼痛。
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