The Development of Cannabinoids as Therapeutic Agents in the United States.

IF 19.3 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pharmacological Reviews Pub Date : 2024-08-15 DOI:10.1124/pharmrev.123.001121
Conor H Murray, Brenda M Gannon, Peter J Winsauer, Ziva D Cooper, Marcus S Delatte
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Abstract

Cannabis is one of the oldest and widely used substances in the world. Cannabinoids within the cannabis plant, known as phytocannabinoids, mediate cannabis' effects through interactions with the body's endogenous cannabinoid system. This endogenous system, the endocannabinoid system, has important roles in physical and mental health. These roles point to the potential to develop cannabinoids as therapeutic agents while underscoring the risks related to interfering with the endogenous system during nonmedical use. This scoping narrative review synthesizes the current evidence for both the therapeutic and adverse effects of the major (i.e., Δ9-tetrahydrocannabinol and cannabidiol) and lesser studied minor phytocannabinoids, from nonclinical to clinical research. We pay particular attention to the areas where evidence is well established, including analgesic effects after acute exposures and neurocognitive risks after acute and chronic use. In addition, drug development considerations for cannabinoids as therapeutic agents within the United States are reviewed. The proposed clinical study design considerations encourage methodological standards for greater scientific rigor and reproducibility to ultimately extend our knowledge of the risks and benefits of cannabinoids for patients and providers. SIGNIFICANCE STATEMENT: This work provides a review of prior research related to phytocannabinoids, including therapeutic potential and known risks in the context of drug development within the United States. We also provide study design considerations for future cannabinoid drug development.

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大麻素作为治疗药物在美国的发展。
大麻是世界上历史最悠久、使用最广泛的物质之一。大麻植物中的大麻素(称为植物大麻素)通过与人体的内源性大麻素系统相互作用来介导大麻的作用。这种内源性系统,即内源性大麻素系统,在身心健康方面发挥着重要作用。这些作用显示了将大麻素开发为治疗药物的潜力,同时也强调了在非医疗使用过程中干扰内源性系统的相关风险。本综述综述了从非临床研究到临床研究的主要植物大麻素(即Δ9-四氢大麻酚和大麻二酚)和研究较少的次要植物大麻素的治疗效果和不良反应的现有证据。我们特别关注证据确凿的领域,包括急性接触后的镇痛效果以及急性和慢性使用后的神经认知风险。此外,我们还回顾了在美国将大麻素作为治疗药物的药物开发注意事项。拟议的临床研究设计考虑因素鼓励制定方法标准,以提高科学严谨性和可重复性,最终扩大我们对大麻素对患者和提供者的风险和益处的了解。意义声明 本研究综述了之前与植物大麻素有关的研究,包括治疗潜力和美国药物开发过程中的已知风险。我们还提供了未来大麻素药物开发的研究设计注意事项。
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来源期刊
Pharmacological Reviews
Pharmacological Reviews 医学-药学
CiteScore
34.70
自引率
0.50%
发文量
40
期刊介绍: Pharmacological Reviews is a highly popular and well-received journal that has a long and rich history of success. It was first published in 1949 and is currently published bimonthly online by the American Society for Pharmacology and Experimental Therapeutics. The journal is indexed or abstracted by various databases, including Biological Abstracts, BIOSIS Previews Database, Biosciences Information Service, Current Contents/Life Sciences, EMBASE/Excerpta Medica, Index Medicus, Index to Scientific Reviews, Medical Documentation Service, Reference Update, Research Alerts, Science Citation Index, and SciSearch. Pharmacological Reviews offers comprehensive reviews of new pharmacological fields and is able to stay up-to-date with published content. Overall, it is highly regarded by scholars.
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