Cannabidiol: pharmacology and therapeutic targets.
Cannabidiol: pharmacology and therapeutic targets.
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DOI：
10.1007/s00213-020-05712-8
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发表时间：
2021-01
影响因子：
3.4
通讯作者：
Walsh SL
中科院分区：
文献类型：
--
作者：
Britch SC;Babalonis S;Walsh SL
缺乏监管批准的大麻二酚（CBD）产品正被用于自我治疗各种疾病及其未经证实的健康益处。支持这些说法的科学证据主要不是来自对照临床试验，而是来自对CBD具有许多生物靶点的认识。然而，CBD通常被消费，并且通常在未经批准和成分未知的非处方产品中。Epidiolex®是唯一一种经过严格药代动力学评估和临床试验测试的产品;它被美国食品和药物管理局批准为非计划药物，用于治疗顽固性儿童发作癫痫发作。然而，研究CBD对其他医疗条件的影响的研究数量有限，并且往往缺乏得出临床有意义结论所需的科学严谨性，对照或样本量。虽然Epidiolex®对人类消费是安全的，但最近对市售CBD产品的监管变化导致了有限的质量控制和未知CBD生物利用度的产品上市。即使是科学严谨的研究也使用了不同来源的CBD和不同的悬浮载体进行管理，因此很难比较研究结果并解决混合结果。本文综述了CBD的分子靶点、药代动力学、安全性和滥用倾向;此外，还描述了其对神经系统疾病、疼痛、炎症、免疫功能相关疾病、精神疾病和物质使用的潜在治疗作用的现有证据。
Cannabidiol (CBD) products lacking regulatory approval are being used to self-treat a myriad of conditions and for its unsubstantiated health benefits. The scientific evidence supporting these claims largely arises not from controlled clinical trials, but from the recognition that CBD has numerous biological targets. Yet, CBD is commonly consumed and often in over-the-counter products that are unapproved and of unknown composition. Epidiolex® is the only product that has undergone rigorous pharmacokinetic assessment and testing in clinical trials; it was approved as a non-scheduled drug by the U.S. Food and Drug Administration for the treatment of intractable childhood-onset seizures. However, studies investigating CBD for other medical conditions are limited in number and often lack the scientific rigor, controls, or sample sizes required to draw clinically meaningful conclusions. Although Epidiolex® is safe for human consumption, recent changes in regulation of commercially available CBD products has resulted in limited quality control and products marketed with unknown CBD bioavailability. Even scientifically rigorous studies have used different sources of CBD and different suspension vehicles for administration, making it difficult to compare results among studies and resolve mixed outcomes. This paper reviews the molecular targets, pharmacokinetics, and safety and abuse liability of CBD; additionally, the extant evidence on its potential therapeutic effects for neurological disorders, pain, inflammation, conditions related to immune function, psychiatric disorders, and substance use are described.
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