title: Cannabinoids therapeutic use: what is our current understanding following the introduction of THC, THC:CBD oromucosal spray and others?
abstract: The complexity of the endocannabinoid (eCB) system is becoming better understood and new drivers of eCB signaling are emerging. Modulation of the activities of the eCB system can be therapeutic in a number of diseases. Research into the eCB system has been paralleled by the development of agents that interact with cannabinoid receptors. In this regard it should be remembered that herbal cannabis contains a myriad of active ingredients, and the individual cannabinoids have quite distinct biological activities requiring independent studies. Areas covered: This article reviews the most important current data involving the eCB system in relation to human diseases, to reflect the present (based mainly on the most used prescription cannabinoid medicine, THC/CBD oromucosal spray) and potential future uses of cannabinoid-based therapy. Expert commentary: From the different therapeutic possibilities, THC/CBD oromucosal spray has been in clinical use for approximately five years in numerous countries world-wide for the management of multiple sclerosis (MS)-related moderate to severe resistant spasticity. Clinical trials have confirmed its efficacy and tolerability. Other diseases in which different cannabinoids are currently being investigated include various pain states, Alzheimer's disease, Parkinson's disease, Huntington's disease and epilepsy. The continued characterization of individual cannabinoids in different diseases remains important.
authors.affiliation: a Department of Medicine , Campus Bio-Medico University of Rome , Rome , Italy.|b Laboratory of Lipid Neurochemistry, European Center for Brain Research/IRCCS Santa Lucia Foundation , Rome , Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Maccarrone
authors.affiliation: c Laboratori de Neurofarmacologia, Departament de Ciències Experimentals i de la Salut (CEXS), Facultat de Ciències de la Salut i de la Vida , Universitat Pompeu Fabra , Barcelona , Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Maldonado
authors.affiliation: d Servicio de Psiquiatría , Hospital Universitari Vall d'Hebron , Barcelona , Spain.|e Departamento de Psiquiatría y Medicina Legal , Universitat Autònoma de Barcelona , Barcelona , Spain.|f CIBERSAM , Barcelona , Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Casas
authors.affiliation: g Passauer Wolf Reha-Zentrum Nittenau , Nittenau , Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Henze
authors.affiliation: h Multiple Sclerosis Clinical and Research Center, Tor Vergata University, Rome & Unit of Neurology , IRCCS Istituto Neurologico Mediterraneo Neuromed , Pozzilli , Italy.
authors.forename: Diego
authors.initials: D
authors.lastname: Centonze
mesh_terms: D000284:Administration, Oral; D000818:Animals; D002185:Cannabidiol; D063386:Cannabinoid Receptor Agonists / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use; D013759:Dronabinol; D004338:Drug Combinations; D015195:Drug Design; D063388:Endocannabinoids / Q000378:metabolism*; D006801:Humans; D010936:Plant Extracts / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use; D015398:Signal Transduction / Q000187:drug effects
chemical_list: D063386:Cannabinoid Receptor Agonists; D004338:Drug Combinations; D063388:Endocannabinoids; D010936:Plant Extracts; D002185:Cannabidiol; D013759:Dronabinol; C587251:nabiximols
keywords: Cannabidiol; cannabis; delta-9-tetrahydrocannabinol; endocannabinoid system; multiple sclerosis; spasticity