Cannabis nyob rau hauv Parkinson's Disease - Tus Neeg Mob Txoj Kev Pom Zoo Tshaj Tawm Txog Kev Kho Mob: Kev Tshawb Fawb Txog Kev Sau Ntawv Ntu 1

TSAB NTAWV

Cannabis thiab cannabinoids feem ntau xav txog hauv kev kho mob Parkinson's Disease (PD). Lub hom phiaj ntawm daim ntawv no yog ua kom muaj kev tshuaj xyuas zoo ntawm cov ntaub ntawv muaj nyob ntawm kev kho mob cannabis.

Parkinson's disease yog ib yam kab mob ntev uas cuam tshuam rau lub paj hlwb, feem ntau ua rau cov tsos mob xws li kev txav mus los thiab tshee. Txawm li cas los xij, ntxiv rau nws cov teebmeem ntawm lub cev muaj zog, Parkinson's disease kuj tseem tuaj yeem cuam tshuam rau peb lub cim xeeb. Txawm li cas los xij, thaum qhov txiaj ntsig no muaj tseeb, peb tsis tuaj yeem ua qhov tsis zoo vim tias muaj ntau txoj hauv kev los txhim kho peb lub cim xeeb thiab lub neej zoo.

Ua ntej, cia peb saib cov txiaj ntsig tshwj xeeb ntawm Parkinson tus kab mob ntawm kev nco. Txawm li cas los xij, feem ntau, tus kab mob Parkinson feem ntau cuam tshuam rau lub cev muaj zog. Txawm li cas los xij, lwm cov tsos mob ntawm lub paj hlwb xws li kev paub tsis meej, kev nyuaj siab, thiab qee zaum nco tsis tau. Cov tsos mob no yuav cuam tshuam rau tib neeg lub neej niaj hnub thiab muaj peev xwm ua haujlwm, tshwj xeeb tshaj yog cov laus. Txawm li cas los xij, lawv tsis tas yuav cuam tshuam rau txhua tus neeg mob, thiab lawv tsis pom tseeb txhua lub sijhawm.

Yog li, yuav ua li cas los daws qhov cuam tshuam ntawm Parkinson tus kab mob ntawm kev nco? Nov yog qee txoj hauv kev yooj yim:

Ua ntej, nyob zoo. Thaum koj lub cim xeeb yuav raug cuam tshuam, kev txhawj xeeb thiab kev nyuaj siab tsuas yog ua rau muaj kev cuam tshuam ntau dua. Kev tuav tus cwj pwm zoo tuaj yeem pab koj daws cov teeb meem thiab cov teeb meem hauv lub neej zoo dua.

Qhov thib ob, ua kom koj tus kheej noj qab nyob zoo. Kev noj qab nyob zoo tuaj yeem ncua kev kis tus kab mob, xws li tswj kev noj zaub mov kom zoo, qoj ib ce kom zoo, thiab ua neej nyob tsis tu ncua.

Thib peb, ua kom koj txoj kev cob qhia puas siab puas ntsws. Txoj kev no tuaj yeem qhib peb lub hlwb paj hlwb thiab pab peb ntxiv dag zog rau kev nco thiab kev txawj ntse. Xws li kev ua si sib tw ua si, tsis tu ncua kawm yam tshiab, tswj kev sib raug zoo, thiab lwm yam.

Thaum kawg, tsom ntsoov rau kev kho tus kab mob. Kev kuaj xyuas sai thiab kho tus kab mob Parkinson tuaj yeem txo cov tsos mob thiab txo qhov cuam tshuam ntawm kev nco.

Hauv kev xaus, Parkinson tus kab mob tiag tiag cuam tshuam txog kev nco, tab sis qhov no tsis tau txhais hais tias peb yuav tsum raug khi los ntawm tus mob no. Nyob zoo, nyob noj qab nyob zoo, koom nrog kev cob qhia lub hlwb, thiab tsom mus rau kev kho mob yog txhua txoj hauv kev uas peb tuaj yeem txo qhov cuam tshuam no thiab txhim kho peb lub neej zoo. Nws tuaj yeem pom tias peb yuav tsum txhim kho kev nco, thiab Cistanche deserticola tuaj yeem txhim kho kev nco, vim Cistanche deserticola tseem tuaj yeem tswj hwm qhov sib npaug ntawm cov neurotransmitters, xws li nce qib ntawm acetylcholine thiab kev loj hlob. Cov khoom no tseem ceeb heev rau kev nco thiab kev kawm. Tsis tas li ntawd, Cistanche deserticola kuj tseem tuaj yeem txhim kho cov ntshav khiav thiab txhawb nqa cov pa oxygen, uas tuaj yeem ua kom lub hlwb tau txais cov as-ham txaus thiab lub zog, yog li txhim kho lub hlwb tseem ceeb thiab kev ua siab ntev.

Nyem paub ntxiv los txhim kho kev nco

Peb tsom mus soj ntsuam randomized sim nrog rau kev soj ntsuam ntawm cov neeg mob. Peb tau txheeb xyuas 569 cov ntaub ntawv ntawm PD thiab kev kho mob cannabinoid. Ntawm cov no, tsuas muaj xya daim ntawv qhia txog qhov kev sim siab ntawm qhov cuam tshuam ntawm cov cannabinoids sib txawv ntawm PD.

Cov txiaj ntsig ntawm cov kev sim no tsis txhawb kev ua tau zoo ntawm cannabinoids hauv kev kho mob ntawm lub cev muaj zog ntawm PD. Raws li cov ntaub ntawv muaj, peb txiav txim siab tias tam sim no muaj cov ntaub ntawv tsis txaus los txhawb kev tswj hwm ntawm cannabinoids rau cov neeg mob PD. Cov kev tshawb fawb loj dua, randomized ntawm kev siv cannabis hauv PD yuav tsum tau ua.

Keywords: Parkinson's Disease, cannabis, CBD, tshuaj maj, cov tsos mob tsis yog lub cev muaj zog.

Taw qhia

Parkinson's Disease (PD) yog tus kab mob thib ob feem ntau ntawm cov kab mob neurodegenerative, tom qab Alzheimer's Disease. Witha tsis muaj kev kho mob, feem ntau cov kev cuam tshuam yog qhia kom txo lub cev muaj zog thiab cov tsos mob tsis yog lub cev muaj zog ntawm tus kab mob.Cannabis (muab tshuaj maj) tau los ntawm cov nroj tsuag Cannabis.

Tetrahydrocannabinol (THC) yog qhov tseem ceeb ntawm kev puas siab puas ntsws ntawm cannabis, thaum cannabidiol (CBD) yog cov lus piav qhia ntau tshaj plaws hauv cov ntsiab lus ntawm kev kho mob paj hlwb. Thawj cov ntaub ntawv hais txog kev cuam tshuam ntawm cannabis ntawm kev txav mus los los ntawm kev tshawb fawb soj ntsuam. Consroe et al. [1] tau tshaj tawm xyoo 1986 tias CBD exacerbated Parkinsonian cov tsos mob hauv cov neeg mob nrog dystonia ntawm ntau hom (Meige's syndrome, torticollis).

Txoj kev tshawb no suav nrog tag nrho tsib tus neeg mob, ib tus nrog PD thiab dystonia ntxias los ntawm levodopa. Interestingly, koob tshuaj CBD siv nyob rau hauv txoj kev tshawb no yog heev siab, mus txog 600 mg / dA daim ntawv los ntawm Frankel li al. [2] piav qhia tsib tus neeg mob kho nrog tshuaj maj luam yeeb, nrog rau diazepam, levodopa, andapomorphine, txhua hnub sib law liag.

Cov kws sau ntawv tau tshaj tawm tsis muaj txiaj ntsig ntawm tshuaj maj ntawm PD tremor.Lub tswvyim tam sim no ntawm kev ua tau zoo ntawm cannabis hauv kev kho mob ntawm PD yog muab los ntawm kev tshawb pom ntawm endocannabinoid system (ECS). Endocannabinoid signaling yog alteredin feem ntau neurological ntshawv siab. Phytocannabinoids ua los ntawm thecannabinoid receptors 1 (CB-1R) thiab 2 (CB-2R).

Ob hom receptors yog qhia nyob rau hauv lub hauv nruab nrab lub paj hlwb, nrog ib tug predominance ntawm CB-1R. CB-1R yog qhia nyob rau hauv basalganglia, tshwj xeeb tshaj yog muaj siab concentrations nyob rau hauv nruab nrab ib feem ntawm lub internal pallidum [3]. CB-2R receptor qhia tau nce siab hauv microglial hlwb nyob rau hauv substantia nigra (SN) ntawm PDpatients, thiab ob qho tib si striatum thiab SN ntawm lipopolysaccharide (LPS)-lesioned nas.

Lub ntsiab endogenous ligands ntawm CB-1Rand CB-2R yog anandamide thiab 2-arachidonoylglycerol [4, 5].Slowing the progression of PD is the key target in its treatment. Cov ntaub ntawv pov thawj los ntawm cov kev tshawb fawb hauv vitro ntawm cov xov tooj ntawm tes qhia tau tias CBD tuaj yeem tiv thaiv cov hlwb los ntawm MPP+- ua rau muaj tshuaj lom [6] lossis txo cov amyloid-mediated neural toxicity [7]. Cov teebmeem neuroprotective ntawm CBD tau raug soj ntsuam hauv qee qhov kev tshawb fawb siv tsiaj cov qauv ntawm PD. Lastres-Becker et al. [8] tau qhia ob qho tib si hauv vivo thiab hauv vitro tias kev tswj hwm ntawm CBD tiv thaiv cov kab mob neurodegeneration tshwm sim los ntawm kev txhaj tshuaj ntawm 6-hydroxydopamine nyob rau hauv cov kab nruab nrab prosencephalic.

Cov kws sau ntawv xav tias qhov no tuaj yeem cuam tshuam txog kev tiv thaiv kab mob thiab / lossis cov tshuaj tiv thaiv oxidative ntawm cannabinoids. Garcia-Arencibia et al. [9] sim ntau cannabinoidcompounds tom qab qhov mob ntawm dopaminergic neuronsin SN.

Lawv xaus lus tias qhov kev tswj xyuas mob hnyav ntawm CBD zoo li muaj kev tiv thaiv neuroprotective; Txawm li cas los xij, kev tswj hwm ntawm CBD ib lub lis piam tom qab qhov txhab tsis muaj txiaj ntsig zoo. Qee tus kws sau ntawv kuj tau tshaj tawm txog qhov txo qis ntawm cov cim qhia txog kev ua kom muaj zog nuclear-κB, cyclooxygenase -2 kev ua, thiab phospho-ERK qib tom qab kho CBD [10].

Interestingly, nws tau raug tshaj tawm los ntawm qee tus kws sau ntawv tias cov txiaj ntsig neuroprotective ntawm CBD yuav tsis cuam tshuam rau tus neeg txais cannabinoid, vim CBD tsis muaj kev cuam tshuam ncaj qha rau CB-2R hauv lub cev muaj zog [11, 12].

Lwm tus tau qhia tias CB-2R yuav tsum yog lub hom phiaj tseem ceeb rau kev tshawb fawb txog cov teebmeem neuroprotective ntawm cannabinoids vim tias nws tau nthuav tawm hauv ob qho tib si reactive microglia thiab astrocytes, thiab yog li ntawd yuav txhawb nqa neuroinflammation [13].

Lub peev xwm los hloov kho qhov ua tsis taus basal ganglia kev ua si byphytocannabinoids tau tshawb xyuas ntau yam tsis ntev los no.Qhov no yog postulated kom ua tiav los ntawm lub peev xwm ntawm exogenouscannabinoids rau: a) cuam tshuam rau synaptic neurotransmission; b) cuam tshuam corticostriatal plasticity; thiab c) muaj neuroprotectiveand anti-inflammatory zog [11, 14].Lub hom phiaj ntawm qhov kev tshuaj xyuas no yog los soj ntsuam cov kev tshawb fawb txog kev kho mob ntawm kev kho mob ntawm lub cev muaj zog (tremor, bradykinesia, ntog, dyskinesia) thiab tsis yog lub cev muaj zog (kev ntxhov siab, mob. , pw tsaug zog tsis zoo) cov tsos mob nrog tshuaj maj thiab cannabinoids hauv cov neeg mob PD.

Cov ntaub ntawv thiab txoj kev

Kev tshawb nrhiav tau ua raws li PRISMAguidelines 2020 [15]. PubMed thiab Scopus databases tau tshawb nrhiav. Cov ntsiab lus "Parkinson" ntxiv rau "Marijuana", "Cannabis", "Nabilone", "Dronabinol" thiab "Nabiximols" tau siv.

Kev tshuaj xyuas ntawm cov ntaub ntawv thiab cov ntaub ntawv xov xwm tau raug cais tawm. Peb kuj suav nrog ib daim ntawv ntsuam xyuas, ntawm lwm cov tshuaj, cov nyhuv ntawmrimonaband, CB1 antagonist, ntawm cov neeg mob PD. Tsuas yog cov ntawv sau tag nrho luam tawm ua lus Askiv txij li xyoo 2000 txog rau 27 Lub Cuaj Hli 2021 tau suav nrog hauv kev tshuaj xyuas zaum kawg.

Cov txiaj ntsig

Nrhiav nrog cov ntsiab lus "Parkinson" THIAB "Marijuana" LOSSIS "Cannabis"; "nabilone"; "dronabinol"; "nabiximols" tau nthuav tawm 514 cov txiaj ntsig hauv Scopus database thiab 207 cov txiaj ntsig hauv PubMed database. Tom qab tsis siv neeg (EndNote) thiab phau ntawv (MF) tshem tawm cov duplicates, tag nrho ntawm 569 cov ntaub ntawv tau txheeb pom tias ua tau raws li cov txheej txheem tshawb nrhiav.In the next step, available abstracts are read to identify the original research papers on the effect of treatment onpatients with PD.

Peb tsis suav nrog cov ntaub ntawv qub txog kev paub txog cov neeg ua haujlwm kho mob lossis lawv tus cwj pwm rau kev kho mob cannabis. Daim duab PRISMA flow diagram ntawm cov txheej txheem tshawb nrhiav yog muaj raws li cov khoom siv ntxiv 1. Peb tau txheeb xyuas tag nrho ntawm 18 cov ntaub ntawv qub lossis cov ntaub ntawv series ntawm cov txiaj ntsig ntawm cannabis-raws li cov khoom ntawm cov tsos mob ntawm PD. Ntawm cov ntawd, muaj xya ob qhov muag tsis pom kev randomized sim muaj.

Peb ntawm cov no tau soj ntsuam cov txiaj ntsig ntawm CBD ntshiab ntawm cov tsos mob PD [16–18], ib txoj kev tshawb fawb koom nrog kev kho mob nrog THC thiab CBD hauv kev sib xyaw ua ke[19], thiab ob daim ntawv sau txog cov txiaj ntsig ntawm kev sim tshuaj ntsuam xyuas nrog nabilone [20, 21].

Table 1 qhia txog cov kev tshawb pom los ntawm cov kev tshawb fawb randomized. Muaj tsib qhov kev tshawb fawb qhib-daim ntawv sau npe / rooj plaub ntawm kev kho mob nrog CBD [22–24] lossis haus luam yeeb / vaporization ntawm cannabis [25, 26] hauv PD. Thaum kawg, xya ntawm cov ntawv sau tau sau tseg qhov kev tshawb pom los ntawm kev tshawb fawb hauv online lossis xov tooj ntawm cov neeg mob nrog PD ntawm cov teebmeem ntawm cov tshuaj maj (qee zaum ntxiv rau lwm yam kev kho mob) ntawm cov tsos mob PD [27–33].

Lub cev muaj zog cov cim ntawm PD

Muaj kev tshawb fawb tsawg heev uas tsom mus rau qhov cuam tshuam ntawm cannabis ntawm lub cev muaj zog ntawm PD. Rau cov ntsiab lus ntawm randomizedpapers ntawm kev kho mob cannabis hauv PD, thov mus saib hauv Table 1.

Cov kev kho mob sib txawv tau siv. Lotan et al[26] tau tshaj tawm nyob rau hauv qhov kev sim tsis pom qhov txiaj ntsig zoo ntawm kev haus luam yeeb cannabis ntawm cov cim PD lub cev muaj zog xws li kev tshee, kev nruj, thiab bradykinesia, tau cuam tshuam hauv kev txo qis hauv UPDRS partIII cov qhab nia (33.1 ± 13.8 ntawm lub hauv paus rau 23.2 ± 10.5; p < 0.001) tom qab kho. Qhov no yog raws li qhov kev tshawb pom ntawm Shohetet al., uas cov kws sau ntawv tau tsom mus rau qhov kev hnov ​​​​mob, tab sis kuj tau tshaj tawm qis dua tag nrho UPDRS III cov qhab nia thaum kho (los ntawm 38.1 ± 18 txog 30.4 ± 15.6; p < 0.0001) [25].

Ob daim ntawv txheeb xyuas qhov cuam tshuam ncaj qha 30 feeb tom qab haus luam yeeb tshuaj maj. Cov txiaj ntsig zoo ntawm kev siv tshuaj maj tau tshaj tawm hauv cov kev tshawb fawb qhib tsis tau lees paub hauv kev sim randomizeddouble-dig muag. Chagas et al. [34] soj ntsuam cov neeg mob hauv "ON" xwm txheej ntawm UPDRS III nplai ua ntej thiab tom qab rau lub lis piam ntawm kev kho mob nrog CBD. Lawv tau tshaj tawm tsis muaj kev txhim kho txog lub cev muaj zog ntawm PD hauv pawg tau txais CBD 75 mg thiab 300 mg piv rau cov placebo.

Txawm li cas los xij, lawv tau tshaj tawm txog kev txhim kho tseem ceeb hauv tag nrho PDQ-39 cov qhab nia hauv pab pawg tau txais 300 mgCBD vs ib pab pawg placebo, nrog rau cov lus nug txog kev ua ub no ntawm kev ua neej nyob txhua hnub.

Levodopa-induced dyskinesia (LID) yog ib qho kev mob tshwm sim ntawm kev kho levodopa. Peb tau txheeb xyuas peb qhov kev sim tshuaj ntsuas qhov cuam tshuam ntawm cannabinoids ntawm LIDintensity. Txoj kev tshawb no los ntawm Carroll et al. [19] yog ib qho randomizedstudy nrog ib theem crossover. Nws suav nrog 19 tus neeg mob nrog PDand LID. Cov neeg mob tau txais kev sib xyaw ntawm THC 2.5 mg thiab CBD 1.25 mg ntsiav tshuaj.

Tag nrho cov koob tshuaj THC tau txwv rau 0.25 mg / kg / hnub, thiab feem ntau ntawm cov neeg mob tsis ncav cuag qhov txwv. Cov txiaj ntsig tau pom tias muaj kev nyab xeeb zoo, tab sis tsis muaj txiaj ntsig.Txawm tias cov kws sau ntawv tsis tau muab cov lus qhia ntxaws ntxaws ntawm tag nrho CBD ntau npaum li cas tau txais los ntawm txhua tus neeg mob, nws tau qis dua li cov koob tshuaj hauv lwm cov kev tshawb fawb ntawm CBD (txog 25 mg / kg / hnub) .

Ib qho me me (n=7) ob-dig muag crossover sim los ntawm Sieradzan li al. [20] tau pom qhov ua tau zoo ntawm nabilonein LID txo. Ib daim ntawv los ntawm Mesnage et al. [35] ntsuas qhov ua tau zoo ntawm peb yam tshuaj - neuropeptides neurokinin B, neurotensin, thiab anandamide. Ntawm cov no, anandamide actedas CB receptor antagonist. Cov neeg mob tau random muab rau ib qho ntawm peb cov tshuaj lossis cov placebo.

Cov kws sau ntawv tau tshaj tawm qhov tsis muaj kev txhim kho hauv lub sijhawm "ON" ncua sijhawm, lub sijhawm "ON" lub sijhawm, qhov feem pua ​​​​ntawm Parkinsonianmotor txhim kho (UPDRS III), lossis qhov hnyav ntawm LID.

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