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慢性疼痛与动物模型中的大麻二酚:行为药理学及未来展望。

Chronic Pain and Cannabidiol in Animal Models: Behavioral Pharmacology and Future Perspectives.

机构信息

Psychology Department, Faculty of Philosophy, Sciences, and Letters of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.

出版信息

Cannabis Cannabinoid Res. 2023 Apr;8(2):241-253. doi: 10.1089/can.2022.0096. Epub 2022 Nov 10.

Abstract

The incidence of chronic pain is around 8% in the general population, and its impact on quality of life, mood, and sleep exceeds the burden of its causal pathology. Chronic pain is a complex and multifaceted problem with few effective and safe treatment options. It can be associated with neurological diseases, peripheral injuries or central trauma, or some maladaptation to traumatic or emotional events. In this perspective, animal models are used to assess the manifestations of neuropathy, such as allodynia and hyperalgesia, through nociceptive tests, such as von Frey, Hargreaves, hot plate, tail-flick, Randall & Selitto, and others. Cannabidiol (CBD) has been considered a promising strategy for treating chronic pain and diseases that have pain as a consequence of neuropathy. However, despite the growing body of evidence linking the efficacy of CBD on pain management in clinical and basic research, there is a lack of reviews focusing on chronic pain assessments, especially when considering pre-clinical studies, which assess chronic pain as a disease by itself or as a consequence of trauma or peripheral or central disease. Therefore, this review focused only on studies that fit our inclusion criteria: (1) used treatment with CBD extract; (2) used tests to assess mechanical or thermal nociception in at least one of the following most commonly used tests (von Frey, hot plate, acetone, Hargreaves, tail-flick, Randall & Selitto, and others); and (3) studies that assessed pain sensitivity in chronic pain induction models. The current literature points out that CBD is a well-tolerated and safe natural compound that exerts analgesic effects, decreasing hyperalgesia, and mechanical/thermal allodynia in several animal models of pain and patients. In addition, CBD presents several molecular and cellular mechanisms of action involved in its positive effects on chronic pain. In conclusion, using CBD seems to be a promising strategy to overcome the lack of efficacy of conventional treatment for chronic pain.

摘要

慢性疼痛的发病率在普通人群中约为 8%,其对生活质量、情绪和睡眠的影响超过了其病因病理学的负担。慢性疼痛是一种复杂的、多方面的问题,有效的治疗方法很少,且安全性也得不到保障。它可能与神经疾病、外周损伤或中枢创伤有关,也可能与对创伤或情绪事件的某种适应不良有关。从这个角度来看,动物模型被用于通过伤害性测试(如 von Frey、Hargreaves、热板、尾巴闪烁、Randall & Selitto 等)来评估神经病的表现,如痛觉过敏和痛觉过敏。大麻二酚 (CBD) 被认为是治疗慢性疼痛和以神经病为后果的疾病的一种有前途的策略。然而,尽管越来越多的证据将 CBD 在临床和基础研究中对疼痛管理的疗效联系起来,但缺乏专门针对慢性疼痛评估的综述,特别是在考虑评估慢性疼痛本身或作为创伤或外周或中枢疾病后果的临床前研究时。因此,本综述仅关注符合我们纳入标准的研究:(1) 使用 CBD 提取物进行治疗;(2) 使用测试评估机械或热伤害感受,至少在以下最常用的测试之一中进行:von Frey、热板、丙酮、Hargreaves、尾巴闪烁、Randall & Selitto 等;(3) 评估慢性疼痛诱导模型中疼痛敏感性的研究。目前的文献表明,CBD 是一种耐受性良好且安全的天然化合物,在几种疼痛动物模型和患者中具有镇痛作用,可降低痛觉过敏和机械/热感觉过敏。此外,CBD 表现出几种分子和细胞作用机制,这些机制涉及到其对慢性疼痛的积极影响。总之,使用 CBD 似乎是克服慢性疼痛常规治疗效果不佳的一种有前途的策略。

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