Disease-Modifying Symptomatic Treatment (DMST) Potential of Cannabinoids in Patients with Multiple Sclerosis

被引:0
|
作者
Bruno, Antonio [1 ]
Annovazzi, Pietro [2 ]
Clerico, Marinella [3 ]
Cocco, Eleonora [4 ]
Conte, Antonella [1 ,5 ]
Marfia, Girolama Alessandra [6 ,7 ]
Salvetti, Marco [1 ,8 ]
Tomassini, Valentina [9 ]
Clerici, Valentina Torri [10 ]
Totaro, Rocco [11 ]
Dolcetti, Ettore [1 ]
Centonze, Diego [1 ,6 ]
机构
[1] IRCCS Neuromed, Neurol Unit, Pozzilli, IS, Italy
[2] Gallarate Hosp, Multiple Sclerosis Ctr ASST Valle Olona, Neuroimmunol Unit, Gallarate, VA, Italy
[3] Univ Torino, Clin & Biol Sci Dept, Cagliari, Italy
[4] Univ Cagliari, Ctr Sclerosi Multipla, Dept Med Sci & Publ Hlth, Cagliari, Italy
[5] Sapienza Univ Rome, Dept Human Neurosci, Rome, Italy
[6] Tor Vergata Univ, Dept Syst Med, Rome, Italy
[7] Tor Vergata Univ Hosp, Multiple Sclerosis Clin & Res Unit, Rome, Italy
[8] Sapienza Univ Rome, Ctr Expt Neurol Therapies CENTERS, Dept Neurosci Mental Hlth & Sensory Organs, Rome, Italy
[9] Univ G Annunzio Chieti Pescara, Inst Adv Biomed Technol ITAB, Dept Neurosci Imaging & Clin Sci, Chieti, Abruzzo, Italy
[10] IRCCS Ist Neurol C Besta, Neuroimmunol Unit, Milan, Italy
[11] San Salvatore Hosp, Demyelinating Dis Ctr, Dept Neurol, Laquila, Italy
关键词
Cannabinoid; spasticity plus syndrome; multiple sclerosis; disease modifying therapies; neuroprotective effects; symptomatic therapies; THC/CBD OROMUCOSAL SPRAY; ENDOCANNABINOID SYSTEM; NEUROPATHIC PAIN; DOUBLE-BLIND; SAFETY; COMBINATION; PLASTICITY; EFFICACY; SATIVEX; PHYTOCANNABINOIDS;
D O I
10.2174/011570159X329058240820070701
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
With the recent introduction of a number of highly effective disease-modifying treatments (DMTs) and the resulting almost complete prevention of acute relapses in many patients with multiple sclerosis (MS), the interest of MS clinicians has gradually shifted from relapse prevention to counteraction of disease progression and the treatment of residual symptoms. Targeting the cannabinoid system with nabiximols is an approved and effective strategy for the treatment of spasticity secondary to MS. Recently, the concept of spasticity plus syndrome (SPS) was introduced to account for the evidence that spasticity often appears in MS patients in clusters with other symptoms (such as pain, bladder dysfunction, sleep, and mood disorders), where cannabinoids can also be effective due to their broader action on many immune and neuronal functions. Interestingly, outside these symptomatic benefits, extensive pre-clinical and clinical research indicated how the modulation of the cannabinoid system results in significant anti-inflammatory and neuroprotective effects, all potentially relevant for MS disease control. This evidence makes nabiximols a potential disease modifying symptomatic treatment (DMST), a concept introduced in an attempt to overcome the often artificial distinction between DMTs and symptomatic therapies (STs).
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页数:8
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