Cannabinoids for treating inflammatory bowel diseases: where are we and where do we go?


Experimental evidence gathered from preclinical IBD models and conducted in rodents point to a strong potential of the ECS components to serve as drug targets in inflammatory diseases of the intestine. Data suggest a homeostatic role of the ECS in the gut. Accordingly, it is believed that the enhancement of endocannabinoid signaling, as observed through the increased levels of endocannabinoids and their receptors, and the decrease in endocannabinoid degrading enzymes, is a response to disturbances of the homeostatic system and is aimed at restoring the balance. This is further supported by the finding that the manipulation of the ECS toward a further increase of endocannabinoid signaling is protective against IBD. On the other hand, analysis of biopsies from UC and CD patients paints a rather complex picture in terms of differential expression of ECS components. Most likely, owing to the small sample sizes in the studies, a conclusion on the meaning of this has not yet been reached. Most evidence points toward an involvement of CB1 and also CB2 receptors, especially with regard to immune cell recruitment. Further research in this direction, preferably on human IBD material, such as explants, cultured biopsies, etc. is highly warranted


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