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Cannabinoids for gastrointestinal diseases: potential therapeutic applications
Giulia Di Carlo1, Angelo A Izzo
1Department of Experimental Pharmacology, University of Naples Federico II, via D. Montesano 49, 80131 Naples, Italy.
Expert Opinion on Investigational Drugs
|January 9, 2003
Summary
The endogenous cannabinoid system, including receptors and cannabinoids, impacts gut function. Modulating this system offers potential new treatments for various gastrointestinal diseases.
Area of Science:
- Gastroenterology
- Pharmacology
- Neuroscience
Background:
- Cannabinoid receptors (CB1 and CB2) are activated by marijuana's delta-9-Tetrahydrocannabinol and other cannabinoids.
- CB1 receptors are present on enteric nerves, influencing gastrointestinal functions like motility and secretion.
- The digestive tract possesses endogenous cannabinoids (endocannabinoids) and mechanisms for their inactivation, collectively forming the 'endogenous cannabinoid system'.
Purpose of the Study:
- To explore the role of the endogenous cannabinoid system in gastrointestinal function.
- To investigate the therapeutic potential of modulating the endogenous cannabinoid system for gastrointestinal disorders.
Main Methods:
- Review of pharmacological effects of cannabinoid receptor activation on the digestive tract.
- Examination of the components and functions of the endogenous cannabinoid system in the gut.
- Analysis of existing clinical applications of cannabinoids in treating gastrointestinal symptoms.
Main Results:
- Activation of CB1 receptors by cannabinoids can lead to gastroprotection and reduced gastric/intestinal motility and secretion.
- The endogenous cannabinoid system is present throughout the digestive tract, involving endocannabinoids and their inactivation pathways.
- Cannabinoids like nabilone and delta-9-Tetrahydrocannabinol are already clinically used as antiemetics.
Conclusions:
- Pharmacological modulation of the endogenous cannabinoid system presents a promising therapeutic strategy for gastrointestinal diseases.
- Potential applications include treating nausea, vomiting, gastric ulcers, irritable bowel syndrome, Crohn's disease, secretory diarrhea, paralytic ileus, and GERD.