Lindner Theresa, Schmidl Doreen, Peschorn Laura, Pai Viktoria, Popa-Cherecheanu Alina, Chua Jacqueline, Schmetterer Leopold, Garhöfer Gerhard
Department of Clinical Pharmacology, Medical University Vienna, 1090 Vienna, Austria.
Department of Ophthalmology, Emergency University Hospital, 050098 Bucharest, Romania.
Pharmaceuticals (Basel). 2023 Aug 14;16(8):1149. doi: 10.3390/ph16081149.
Glaucoma is a leading cause of irreversible blindness worldwide. To date, intraocular pressure (IOP) is the only modifiable risk factor in glaucoma treatment, but even in treated patients, the disease can progress. Cannabinoids, which have been known to lower IOP since the 1970s, have been shown to have beneficial effects in glaucoma patients beyond their IOP-lowering properties. In addition to the classical cannabinoid receptors CB and CB, knowledge of non-classical cannabinoid receptors and the endocannabinoid system has increased in recent years. In particular, the CB receptor has been shown to mediate anti-inflammatory, anti-apoptotic, and neuroprotective properties, which may represent a promising therapeutic target for neuroprotection in glaucoma patients. Due to their vasodilatory effects, cannabinoids improve blood flow to the optic nerve head, which may suggest a vasoprotective potential and counteract the altered blood flow observed in glaucoma patients. The aim of this review was to assess the available evidence on the effects and therapeutic potential of cannabinoids in glaucoma patients. The pharmacological mechanisms underlying the effects of cannabinoids on IOP, neuroprotection, and ocular hemodynamics have been discussed.
青光眼是全球不可逆性失明的主要原因。迄今为止，眼压（IOP）是青光眼治疗中唯一可改变的风险因素，但即使在接受治疗的患者中，疾病仍可能进展。自20世纪70年代以来，人们就知道大麻素可降低眼压，并且已证明大麻素对青光眼患者除了具有降低眼压的特性外，还有其他有益作用。除了经典的大麻素受体CB1和CB2外，近年来对非经典大麻素受体和内源性大麻素系统的了解也有所增加。特别是，CB2受体已被证明可介导抗炎、抗凋亡和神经保护特性，这可能是青光眼患者神经保护的一个有前景的治疗靶点。由于大麻素具有血管舒张作用，它们可改善视神经乳头的血流，这可能表明其具有血管保护潜力，并可抵消青光眼患者中观察到的血流改变。本综述的目的是评估关于大麻素对青光眼患者的影响和治疗潜力的现有证据。已讨论了大麻素对眼压、神经保护和眼部血流动力学影响的药理学机制。
