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Emerging strategies for exploiting cannabinoid receptor agonists as medicines.

Abstract

Medicines that activate cannabinoid CB(1) and CB(2) receptor are already in the clinic. These are Cesamet (nabilone), Marinol (dronabinol; Delta(9)-tetrahydrocannabinol) and Sativex (Delta(9)-tetrahydrocannabinol with cannabidiol). The first two of these medicines can be prescribed to reduce chemotherapy-induced nausea and vomiting. Marinol can also be prescribed to stimulate appetite, while Sativex 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 CB(2) 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.

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  • Authors+Show Affiliations

    Institute of Medical Sciences, University of Aberdeen, Foresterhill, UK. rgp@abdn.ac.uk

    Source

    British journal of pharmacology 156:3 2009 Feb pg 397-411

    MeSH

    Blood-Brain Barrier
    Cannabidiol
    Dronabinol
    Drug Combinations
    Drug Interactions
    Humans
    Ligands
    Plant Extracts
    Receptor, Cannabinoid, CB1
    Receptor, Cannabinoid, CB2

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't
    Review

    Language

    eng

    PubMed ID

    19226257

    Citation

    Pertwee, Roger G.. "Emerging Strategies for Exploiting Cannabinoid Receptor Agonists as Medicines." British Journal of Pharmacology, vol. 156, no. 3, 2009, pp. 397-411.
    Pertwee RG. Emerging strategies for exploiting cannabinoid receptor agonists as medicines. Br J Pharmacol. 2009;156(3):397-411.
    Pertwee, R. G. (2009). Emerging strategies for exploiting cannabinoid receptor agonists as medicines. British Journal of Pharmacology, 156(3), pp. 397-411. doi:10.1111/j.1476-5381.2008.00048.x.
    Pertwee RG. Emerging Strategies for Exploiting Cannabinoid Receptor Agonists as Medicines. Br J Pharmacol. 2009;156(3):397-411. PubMed PMID: 19226257.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Emerging strategies for exploiting cannabinoid receptor agonists as medicines. A1 - Pertwee,Roger G, PY - 2009/2/20/entrez PY - 2009/2/20/pubmed PY - 2009/5/9/medline SP - 397 EP - 411 JF - British journal of pharmacology JO - Br. J. Pharmacol. VL - 156 IS - 3 N2 - Medicines that activate cannabinoid CB(1) and CB(2) receptor are already in the clinic. These are Cesamet (nabilone), Marinol (dronabinol; Delta(9)-tetrahydrocannabinol) and Sativex (Delta(9)-tetrahydrocannabinol with cannabidiol). The first two of these medicines can be prescribed to reduce chemotherapy-induced nausea and vomiting. Marinol can also be prescribed to stimulate appetite, while Sativex 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 CB(2) 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. SN - 1476-5381 UR - https://www.unboundmedicine.com/medline/citation/19226257/Emerging_strategies_for_exploiting_cannabinoid_receptor_agonists_as_medicines_ L2 - https://doi.org/10.1111/j.1476-5381.2008.00048.x DB - PRIME DP - Unbound Medicine ER -