Clinical Endocannabinoid Deficiency Reconsidered: Current Research Supports the Theory in Migraine, Fibromyalgia, Irritable Bowel, and Other Treatment-Resistant Syndromes.
Clinical Endocannabinoid Deficiency Reconsidered: Current Research Supports the Theory in Migraine, Fibromyalgia, Irritable Bowel, and Other Treatment-Resistant Syndromes.
复制标题
重新考虑的临床内源性大麻素缺乏症：当前的研究支持偏头痛，纤维肌痛，肠易激和其他耐药综合症的理论。
DOI：
10.1089/can.2016.0009
复制
发表时间：
2016
影响因子：
3.8
通讯作者：
Russo EB
中科院分区：
文献类型：
--
作者：
Russo EB
医学继续在其方法中挣扎许多常见的主观疼痛综合征，缺乏客观迹象，并保持治疗抵抗。其中最重要的是偏头痛，纤维肌痛和肠易激综合征，这些疾病可能在其受影响的人群中重叠，其患者都忍受了心身标签的耻辱，以及无休止的药物干预的失败，其效果低于标准。在这些条件下显示痛觉过敏和中枢致敏与可能共同的潜在病理生理学的共同性表明，临床内源性大麻素缺乏症可能是其起源的特征。它的基本假设是，所有人都有一个潜在的内源性大麻素音调，这是内源性大麻素，花生四烯酸乙醇酰胺（花生四烯酸乙醇酰胺）和2-花生四烯酸甘油水平的反映，它们的生产，代谢，以及大麻素受体的相对丰度和状态。它的理论是，在某些条件下，无论是先天性还是后天性，内源性大麻素紧张度变得缺乏，并产生病理生理综合征。当在2001年首次提出并随后提出时，这一理论是基于遗传重叠和共病，可以由内源性大麻素系统（ECS）介导的遗传学模式，以及外源性大麻素治疗经常提供症状益处的事实。然而，缺乏客观证据和正式的临床试验数据。然而，目前，在偏头痛患者中，脑脊液anandamide水平的统计学显着差异已被记录在案，先进的成像研究表明，创伤后应激障碍中ECS功能低下。其他研究为该理论提供了更坚实的基础，而临床数据也提供了证据，证明疼痛减轻，睡眠改善以及大麻素治疗和影响ECS的自主生活方式的其他益处。
Medicine continues to struggle in its approaches to numerous common subjective pain syndromes that lack objective signs and remain treatment resistant. Foremost among these are migraine, fibromyalgia, and irritable bowel syndrome, disorders that may overlap in their affected populations and whose sufferers have all endured the stigma of a psychosomatic label, as well as the failure of endless pharmacotherapeutic interventions with substandard benefit. The commonality in symptomatology in these conditions displaying hyperalgesia and central sensitization with possible common underlying pathophysiology suggests that a clinical endocannabinoid deficiency might characterize their origin. Its base hypothesis is that all humans have an underlying endocannabinoid tone that is a reflection of levels of the endocannabinoids, anandamide (arachidonylethanolamide), and 2-arachidonoylglycerol, their production, metabolism, and the relative abundance and state of cannabinoid receptors. Its theory is that in certain conditions, whether congenital or acquired, endocannabinoid tone becomes deficient and productive of pathophysiological syndromes. When first proposed in 2001 and subsequently, this theory was based on genetic overlap and comorbidity, patterns of symptomatology that could be mediated by the endocannabinoid system (ECS), and the fact that exogenous cannabinoid treatment frequently provided symptomatic benefit. However, objective proof and formal clinical trial data were lacking. Currently, however, statistically significant differences in cerebrospinal fluid anandamide levels have been documented in migraineurs, and advanced imaging studies have demonstrated ECS hypofunction in post-traumatic stress disorder. Additional studies have provided a firmer foundation for the theory, while clinical data have also produced evidence for decreased pain, improved sleep, and other benefits to cannabinoid treatment and adjunctive lifestyle approaches affecting the ECS.
登录
查看更多内容
影响因子：
3.7
作者：
Cluny NL;Keenan CM;Reimer RA;Le Foll B;Sharkey KA
通讯作者：
Sharkey KA
影响因子：
4.8
作者：
Baker, D;Pryce, G;Di Marzo, V
通讯作者：
Di Marzo, V
DOI：
10.1124/jpet.103.059808
发表时间：
2004-04-01
影响因子：
3.5
作者：
Akerman, S;Kaube, H;Goadsby, PJ
通讯作者：
Goadsby, PJ
影响因子：
11
作者：
Di Filippo, M.;Pini, L. A.;Sarchielli, P.
通讯作者：
Sarchielli, P.
DOI：
10.1152/ajpgi.00376.2012
发表时间：
2013-03-01
影响因子：
4.5
作者：
Camilleri, Michael;Kolar, Gururaj J.;Zinsmeister, Alan R.
通讯作者：
Zinsmeister, Alan R.