MEDICAL CANNABIS AND HEALTH: A PHARMACOLOGICAL REVIEW

Öz

Objective: Cannabis sativa L. is a plant that has been used for therapeutic purposes since ancient times. However, its use has been limited due to its content. Cannabis causes many changes at the gene level in the endocannabinoid system with the phytocannabinoids it contains. The aim of this study was to provide evidence that the endocannabinoid system could be a potential therapeutic target in many pathological conditions.

Result and Discussion: The change in the expression levels of receptors, endocannabinoids or enzymes in the endocannabinoid system may be associated with the pathologies of diseases such as Parkinson, Alzheimer, and Huntington. Besides, changes in the endocannabinoid system can affect the migration, proliferation of cancer cells. Also, cannabinoids, have been shown to play a role in the treatment of neuropathic pain. Today, some cannabis-based treatment preparations such as dronabilon and nabilon capsules used in the treatment of chemotherapy-induced nausea and vomiting have been approved and available in many countries. Preparations such as Δ9tetrahydrocannabinol/cannabidiol oromucosal spray are also among the preparations approved for use as analgesic in cancer patients or for the relief of muscle spasticity in multiple sclerosis patients. However, standardized preparations of cannabis and further research are needed for many other medical conditions.

Anahtar Kelimeler

• Cannabinoid
• Cannabis
• cancer
• neurodegenerative diseases

TIBBİ KENEVİR VE SAĞLIK: FARMAKOLOJİK BİR DERLEME

Öz

Amaç: Kenevir antik çağlardan bugüne dek tedavi amaçlı kullanılmakta olan bir bitkidir. Her ne kadar kullanımı içerdiği psikoaktif bileşenler dolayısıyla sınırlandırılmış olsa da, kenevirin tıbbi yönüne dair araştırmalar literatürde oldukça yoğundur. Cannabis sativa L., içerdiği fitokannabinoidler ile endokannabinoid sistemde gen düzeyinde pek çok değişikliğe sebep olabilmektedir. Endokannabinoid sistemin pek çok patolojik durumda potansiyel bir terapötik hedef olabileceğine dair kanıtların derlenmesi hedefiyle bu çalışma ortaya koyulmuştur.

Sonuç ve Tartışma: Endokannabinoid sistem içerisinde yer alan reseptörler, endokannabinoidler veya enzimlerin ekspresyon seviyelerinde meydana gelen değişiklikler, Parkinson, Alzheimer, Huntington gibi hastalıkların patolojileriyle ilişkili olabilmektedir. Aynı zamanda endokannabinoid sistemde meydana gelen değişikliklerin kanser hücrelerinin metastazı, yayılımı, proliferasyonunu etkileyebilmektedir. Buna ek olarak kannabinoidlerin, dolayısıyla kenevirin, nöropatik ağrının tedavisinde rol oynadığı gösterilmiştir. Günümüzde kemoterapiye bağlı bulantı ve kusma tedavisinde kullanılan dronabilon ve nabilon kapsülleri gibi bazı kenevir-temelli tedavi preparatları pek çok ülkede onaylanmış, kullanıma sunulmuştur. Δ9tetrahidrocannabinol/ cannabidiol oromukozal sprey gibi preparatlar da pek çok bölgede kanser hastalarında analjezik olarak ya da multiple skleroz hastalarının kas spastisitelerinin giderilmesinde kullanımı onaylanan preparatlardandır. Ancak endokannabinoid sistemin terapötik etkinlik üzerindeki önemi dikkate alındığında, daha pek çok tıbbi durum için kenevirin standardize edilmiş preparatlarına ve bu doğrultuda daha fazla araştırmaya ihtiyaç duyulmaktadır.

Anahtar Kelimeler

• Kannabinoid
• kanser
• kenevir
• nörodejeneretif hastalıklar

Kaynakça

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