Visual Overview
Abstract
The cannabis derivative marijuana is the most widely used recreational drug in the Western world and is consumed by an estimated 83 million individuals (∼3% of the world population). In recent years, there has been a marked transformation in society regarding the risk perception of cannabis, driven by its legalization and medical use in many states in the United States and worldwide. Compelling research evidence and the Food and Drug Administration cannabis-derived cannabidiol approval for severe childhood epilepsy have confirmed the large therapeutic potential of cannabidiol itself, Δ9-tetrahydrocannabinol and other plant-derived cannabinoids (phytocannabinoids). Of note, our body has a complex endocannabinoid system (ECS)—made of receptors, metabolic enzymes, and transporters—that is also regulated by phytocannabinoids. The first endocannabinoid to be discovered 30 years ago was anandamide (N-arachidonoyl-ethanolamine); since then, distinct elements of the ECS have been the target of drug design programs aimed at curing (or at least slowing down) a number of human diseases, both in the central nervous system and at the periphery. Here a critical review of our knowledge of the goods and bads of the ECS as a therapeutic target is presented to define the benefits of ECS-active phytocannabinoids and ECS-oriented synthetic drugs for human health.
Significance Statement The endocannabinoid system plays important roles virtually everywhere in our body and is either involved in mediating key processes of central and peripheral diseases or represents a therapeutic target for treatment. Therefore, understanding the structure, function, and pharmacology of the components of this complex system, and in particular of key receptors (like cannabinoid receptors 1 and 2) and metabolic enzymes (like fatty acid amide hydrolase and monoacylglycerol lipase), will advance our understanding of endocannabinoid signaling and activity at molecular, cellular, and system levels, providing new opportunities to treat patients.
Footnotes
- Received March 22, 2022.
- Revision received April 6, 2023.
- Accepted April 10, 2023.
All authors have contributed equally to this study.
For this investigation M.M. was partly supported by the Italian Ministry of Health through the competitive Ricerca Finalizzata 2018 [Grant RF-2018-12365391]. A.C.H. was supported by National Institutes of Health National Institute on Drug Abuse [Grant R01-DA042157]. A.M. was supported by the National Institute on Drug Abuse [Grant P01-DA009158] and by the National Institute on Alcohol Abuse and Alcoholism [Grant U01-AA028963].
No author has an actual or perceived conflict of interest with the contents of this article.
- Copyright © 2023 by The American Society for Pharmacology and Experimental Therapeutics
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