Emerging strategies for exploiting cannabinoid receptor agonists as medicines

Research output: Contribution to journalLiterature review

311 Citations (Scopus)

Abstract

Medicines that activate cannabinoid CB1 and CB2 receptor are already in the clinic. These are Cesamet((R)) (nabilone), Marinol((R)) (dronabinol; Delta(9)-tetrahydrocannabinol) and Sativex((R)) (Delta(9)-tetrahydrocannabinol with cannabidiol). The first two of these medicines can be prescribed to reduce chemotherapy-induced nausea and vomiting. Marinol((R)) can also be prescribed to stimulate appetite, while Sativex((R)) is prescribed for the symptomatic relief of neuropathic pain in adults with multiple sclerosis and as an adjunctive analgesic treatment for adult patients with advanced cancer. One challenge now is to identify additional therapeutic targets for cannabinoid receptor agonists, and a number of potential clinical applications for such agonists are mentioned in this review. A second challenge is to develop strategies that will improve the efficacy and/or the benefit-to-risk ratio of a cannabinoid receptor agonist. This review focuses on five strategies that have the potential to meet either or both of these objectives. These are strategies that involve: (i) targeting cannabinoid receptors located outside the blood-brain barrier; (ii) targeting cannabinoid receptors expressed by a particular tissue; (iii) targeting up-regulated cannabinoid receptors; (iv) targeting cannabinoid CB2 receptors; or (v) 'multi-targeting'. Preclinical data that justify additional research directed at evaluating the clinical importance of each of these strategies are also discussed.

Original languageEnglish
Pages (from-to)397-411
Number of pages15
JournalBritish Journal of Pharmacology
Volume156
Issue number3
DOIs
Publication statusPublished - Feb 2009

Keywords

  • cannabis
  • Delta(9)-tetrahydrocannabinol
  • CB1 receptors
  • CB2 receptors
  • cannabinoid receptor agonism
  • clinical applications
  • clinical strategies
  • blood-brain barrier
  • synergistic interactions
  • endocannabinoid system
  • central-nervous-system
  • amyotrophic-lateral-sclerosis
  • chronic neurpathic pain
  • anxiety-like behavior
  • MU-opioid receptor
  • rat formalin test
  • CB2 receptor
  • multiple-sclerosis
  • inflammatory pain
  • liver-diseases

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