Vitetta Luis, Nation Tamara, Oldfield Debbie, Thomsen Michael
Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia.
National Institute of Integrative Medicine, Melbourne 3122, Australia.
Pharmaceuticals (Basel). 2024 Dec 17;17(12):1702. doi: 10.3390/ph17121702.
Historically, the multiple uses of cannabis as a medicine, food, and for recreational purposes as a psychoactive drug span several centuries. The various components of the plant (i.e., seeds, roots, leaves and flowers) have been utilized to alleviate symptoms of inflammation and pain (e.g., osteoarthritis, rheumatoid arthritis), mood disorders such as anxiety, and intestinal problems such as nausea, vomiting, abdominal pain and diarrhea. It has been established that the intestinal microbiota progresses neurological, endocrine, and immunological network effects through the gut-microbiota-brain axis, serving as a bilateral communication pathway between the central and enteric nervous systems. An expanding body of clinical evidence emphasizes that the endocannabinoid system has a fundamental connection in regulating immune responses. This is exemplified by its pivotal role in intestinal metabolic and immunity equilibrium and intestinal barrier integrity. This neuromodulator system responds to internal and external environmental signals while also serving as a homeostatic effector system, participating in a reciprocal association with the intestinal microbiota. We advance an exogenous cannabinoid-intestinal microbiota-endocannabinoid system axis potentiated by the intestinal microbiome and medicinal cannabinoids supporting the mechanism of action of the endocannabinoid system. An integrative medicine model of patient care is advanced that may provide patients with beneficial health outcomes when prescribed medicinal cannabis.
从历史上看，大麻作为药物、食物以及作为具有精神活性的娱乐性药物的多种用途跨越了几个世纪。该植物的各个部分（即种子、根、叶和花）已被用于缓解炎症和疼痛症状（如骨关节炎、类风湿性关节炎）、焦虑等情绪障碍以及恶心、呕吐、腹痛和腹泻等肠道问题。已经证实，肠道微生物群通过肠-微生物群-脑轴产生神经、内分泌和免疫网络效应，作为中枢神经系统和肠神经系统之间的双向通信途径。越来越多的临床证据强调，内源性大麻素系统在调节免疫反应方面有着根本联系。这在其对肠道代谢和免疫平衡以及肠道屏障完整性的关键作用中得到了体现。这个神经调节系统对内部和外部环境信号做出反应，同时也作为一个稳态效应系统，与肠道微生物群相互关联。我们提出了一个由肠道微生物群和药用大麻素增强的外源性大麻素-肠道微生物群-内源性大麻素系统轴，支持内源性大麻素系统的作用机制。我们提出了一种综合医疗模式，当给患者开药用大麻时，可能会为患者带来有益的健康结果。
