Departments of Psychology and.
Integrative Physiology and Neuroscience, Washington State University, Pullman, WA, United States.
Pain. 2023 Sep 1;164(9):2036-2047. doi: 10.1097/j.pain.0000000000002902. Epub 2023 Apr 6.
Although preclinical studies generally report robust antinociceptive effects of cannabinoids in rodent persistent pain models, randomized controlled trials in chronic pain patients report limited pain relief from cannabis/cannabinoids. Differences between animal and human studies that may contribute to these discrepant findings include route of cannabis/cannabinoid administration, type of cannabis/cannabinoid, and how pain is measured. To address these factors, rats with complete Freund adjuvant (CFA)-induced hind paw inflammation were exposed acutely or repeatedly to vaporized cannabis extract that was either tetrahydrocannabinol (THC) or cannabidiol (CBD)dominant. One measure of evoked pain (mechanical threshold), 2 functional measures of pain (hind paw weight-bearing, and locomotor activity), and hind paw edema were assessed for up to 2 hours after vapor exposure. Acute exposure to vaporized THC-dominant extract (200 or 400 mg/mL) decreased mechanical allodynia and hind paw edema and increased hind paw weight-bearing and locomotor activity, with no sex differences. After repeated exposure to vaporized THC-dominant extract (twice daily for 3 days), only the antiallodynic effect was significant. Acute exposure to vaporized CBD-dominant cannabis extract (200 mg/mL) did not produce any effects in either sex; repeated exposure to this extract (100, 200, or 400 mg/mL) decreased mechanical allodynia in male rats only. Sex differences (or lack thereof) in the effects of vaporized cannabis extracts were not explained by sex differences in plasma levels of THC, CBD, or their major metabolites. These results suggest that although vaporized THC-dominant extract is likely to be modestly effective against inflammatory pain in both male and female rats, tolerance may develop, and the CBD-dominant extract may be effective only in male rats.
尽管临床前研究通常报告大麻素在啮齿动物持续性疼痛模型中具有强大的镇痛作用,但慢性疼痛患者的随机对照试验报告大麻/大麻素的止痛效果有限。导致这些不一致发现的动物和人类研究之间的差异包括大麻/大麻素的给药途径、大麻/大麻素的类型以及疼痛的测量方式。为了解决这些因素,用完全弗氏佐剂(CFA)诱导的后爪炎症的大鼠急性或反复暴露于四氢大麻酚(THC)或大麻二酚(CBD)为主的汽化大麻提取物。在暴露于汽化提取物后长达 2 小时,评估了诱发疼痛的一种测量方法(机械阈值)、2 种疼痛功能测量方法(后爪负重和运动活性)和后爪水肿。急性暴露于汽化的 THC 为主的提取物(200 或 400 mg/mL)可降低机械性痛觉过敏和后爪水肿,并增加后爪负重和运动活性,且无性别差异。反复暴露于汽化的 THC 为主的提取物(每天两次,持续 3 天),只有抗痛觉过敏作用显著。急性暴露于汽化的 CBD 为主的大麻提取物(200 mg/mL)在两性中均未产生任何作用;反复暴露于该提取物(100、200 或 400 mg/mL)仅降低雄性大鼠的机械性痛觉过敏。汽化大麻提取物作用的性别差异(或缺乏)不能用 THC、CBD 或它们的主要代谢物的血浆水平的性别差异来解释。这些结果表明,尽管汽化的 THC 为主的提取物可能对雄性和雌性大鼠的炎症性疼痛有一定的疗效,但可能会产生耐受性,而 CBD 为主的提取物可能仅对雄性大鼠有效。