Lee John J W, Hamour Amr F, Wihlidal Jacob G J, Lee John M, Monteiro Eric, Poduch Ewa, Kotra Lakshmi, Vescan Allan D
Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, University of Toronto, Toronto, Canada.
Center for Molecular Design and Preformulations, Toronto General Hospital Research Institute, University of Toronto, Toronto, Canada.
Laryngoscope. 2025 Aug;135(8):2683-2690. doi: 10.1002/lary.32191. Epub 2025 Apr 22.
Recently, the endocannabinoid system (ECS) has emerged as a therapeutic target for various inflammatory diseases, including those of the respiratory tract. The objective of this scoping review is to explore the role of the ECS in the pathophysiology of CRS. Moreover, we sought to identify, appraise, and summarize the available evidence for cannabinoids as a potential treatment for CRS.
Six databases and four clinical trial registries were searched from inception to February 2025.
All identified studies investigating the role of the ECS in sinonasal inflammatory disease were included for review.
A total of 1534 studies were identified in the initial search. Following screening and full-text analysis by three authors, five studies were included in the final scoping review. Four of the studies were preclinical and in vitro in nature, examining the effects of ECS modulation through CB1 and/or CB2 receptors. The findings of each study support a common conclusion that the ECS is implicated in regulating cellular inflammatory pathways potentially involved in sinonasal disease. The final study investigated the effect of marijuana smoking on subjective and objective measures of CRS severity. There were no clinical studies identified investigating the use of cannabinoids for the treatment of sinonasal inflammatory conditions.
Current literature examining the role of ECS in sinonasal inflammatory disease is highly limited, though it indicates ECS may play a role in the complex pathophysiology of sinonasal inflammatory disease. Further work is warranted to assess ECS as a potential therapeutic target for CRS.
最近，内源性大麻素系统（ECS）已成为包括呼吸道疾病在内的各种炎症性疾病的治疗靶点。本范围综述的目的是探讨ECS在慢性鼻-鼻窦炎（CRS）病理生理学中的作用。此外，我们试图识别、评估和总结大麻素作为CRS潜在治疗方法的现有证据。
从开始到2025年2月，检索了六个数据库和四个临床试验注册库。
纳入所有确定的研究ECS在鼻窦炎性疾病中作用的研究进行综述。
在初步检索中总共识别出1534项研究。在三位作者进行筛选和全文分析后，五项研究被纳入最终的范围综述。其中四项研究本质上是临床前和体外研究，研究了通过CB1和/或CB2受体调节ECS的效果。每项研究的结果都支持一个共同的结论，即ECS参与调节可能与鼻窦疾病有关的细胞炎症途径。最后一项研究调查了吸食大麻对CRS严重程度主观和客观指标的影响。未发现有临床研究调查大麻素用于治疗鼻窦炎性疾病的情况。
目前研究ECS在鼻窦炎性疾病中作用的文献非常有限，尽管这表明ECS可能在鼻窦炎性疾病复杂的病理生理学中发挥作用。有必要进一步开展工作，以评估ECS作为CRS潜在治疗靶点的可能性。
