A comprehensive Nature Reviews Neurology article describes the expanded "endocannabinoidome" and its clinical relevance to neurological disorders from epilepsy and MS to Parkinson's and Alzheimer's disease.
Neurologists, neuroscience researchers, people interested in cannabinoid-based therapeutics
Two cannabinoid medicines approved: nabiximols for MS, purified CBD for epilepsy
What the researchers found
Beyond the classical CB1/CB2 system, an expanded "endocannabinoidome" includes biochemically related mediators with their own receptors and enzymes. Clinical success has come from nabiximols (THC+CBD) for MS spasticity/pain and purified CBD for pediatric epilepsy. The endocannabinoidome is involved in multiple neurological diseases.
Why it matters
This review from a leading neurology journal provides the most comprehensive framework for understanding how cannabinoid-based therapeutics interact with a system far more complex than originally understood.
The numbers in context
Two cannabinoid-based medicines approved: nabiximols (THC+CBD) for MS spasticity/pain, and purified CBD for Dravet and Lennox-Gastaut syndromes. The review covers Parkinson's, Alzheimer's, Huntington's, MS, ALS, TBI, stroke, epilepsy, and glioblastoma.
How the study worked
Comprehensive review published in Nature Reviews Neurology covering the endocannabinoid system and endocannabinoidome, their involvement in neurological disorders, and current/potential therapeutic applications.
What this study cannot tell us
Review of a broad field; many therapeutic applications remain preclinical; the complexity of the endocannabinoidome makes drug development challenging.
How to read the evidence
Comprehensive review in a top-tier neurology journal synthesizing extensive literature.
When this study was published
Published in 2020.
The bigger picture
The discovery that the endocannabinoid system is part of a much larger "endocannabinoidome" explains both the therapeutic potential and the complexity of targeting this system pharmacologically.
Questions still open
- Can targeting specific endocannabinoidome components yield more precise therapies? Will understanding this expanded system explain why cannabinoid treatments have had mixed clinical results?
Common questions
What is the endocannabinoidome?
Which cannabinoid-based medicines are currently approved?
Read the original research
Cannabinoids and the expanded endocannabinoid system in neurological disorders.
Nature reviews. Neurology, 16(1), 9-29
Citation
Cristino, Luigia; Bisogno, Tiziana; Di Marzo, Vincenzo. (2020). Cannabinoids and the expanded endocannabinoid system in neurological disorders.. Nature reviews. Neurology, 16(1), 9-29. https://doi.org/10.1038/s41582-019-0284-z
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