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Das endogene Cannabinoidsystem

Therapeutische Implikationen der Cannabinoide bei neurologisch-psychiatrischen Erkrankungen

The endogenous cannabinoid system

Therapeutic implications for neurologic and psychiatric disorders

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Zusammenfassung

Seit ca. 5000 Jahren werden Medikamente auf Cannabisbasis genutzt. In den vergangenen Jahren ist ein starkes Interesse an der medizinischen Nutzung von Cannabinoiden entstanden. Grundlage dafür sind die Erkenntnisse, dass Cannabinoide über spezifische Rezeptoren (CB1 und CB2) wirken. Die CB1-Rezeptoren werden in spezifischen Hirnarealen (u. a. Zerebellum, Basalganglien und Hippokampus) und die CB2-Rezeptoren auf immunkompetenten Zellen exprimiert. Außerdem wurden körpereigene Liganden der Cannabinoidrezeptoren entdeckt (z. B. Anandamid). Eine Vielzahl physiologischer Prozesse wird u. a. über die Cannabinoidrezeptoren moduliert (Steuerung der Motorik, Gedächtnisfunktionen, Appetit, Schmerzen etc.). Aufgrund dieser neurobiologischen/pharmakologischen Erkenntnisse ergeben sich eine Reihe von möglichen Bereichen für die Anwendung von natürlichen und synthetischen Cannabinoiden. Bereits heutzutage werden Cannabinoide bei verschiedenen Erkrankungen eingesetzt, wobei die Datenlage unterschiedlich ist. Gesicherte Erkenntnisse liegen für die Behandlung von therapierefraktärer Übelkeit und Erbrechen bei Chemotherapie sowie beim HIV-wasting-Syndrom vor. Für die Wirksamkeit bei anderen Störungen wie Multiple Sklerose, bestimmten Formen der Bewegungsstörungen (Gilles-de-la-Tourette-Syndrom), Schmerzen etc. gibt es Hinweise. Die neuen Erkenntnisse über das Cannabinoidsystem und seine endogenen Liganden erklären auch die möglichen unerwünschten Wirkungen von Cannabinoiden.

Summary

For about 5,000 years, cannabis has been used as a therapeutic agent. There has been growing interest in the medical use of cannabinoids. This is based on the discovery that cannabinoids act with specific receptors (CB1 and CB2). CB1 receptors are located in specific brain areas (e.g. cerebellum, basal ganglia, and hippocampus) and CB2 receptors on cells of the immune system. Endogenous ligands of the cannabinoid receptors were also discovered (e.g. anandamids). Many physiologic processes are modulated by the two subtypes of cannabinoid receptor: motor functions, memory, appetite, and pain. These innovative neurobiologic/pharmacologic findings could possibly lead to the use of synthetic and natural cannabinoids as therapeutic agents in various areas. Until now, cannabinoids were used as antiemetic agents in chemotherapy-induced emesis and in patients with HIV-wasting syndrome. Evidence suggests that cannabinoids may prove useful in some other diseases, e.g. movement disorders such as Gilles de la Tourette’s syndrome, multiple sclerosis, and pain. These new findings also explain the acute adverse effects following cannabis use.

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Die Autoren widmen diese Arbeit Herrn Prof. Dr. Dr. H.M. Emrich zu seinem 60. Geburtstag.

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  1. Abt. Klinische Psychiatrie und Psychotherapie, Medizinische Hochschule Hannover

    U. Schneider, J. Seifert, J. Schlimme & K. R. Müller-Vahl

  2. Abt. für Anästhesiologie — Schmerzambulanz, Medizinische Hochschule Hannover

    M. Karst

  3. Praxis für Allgemeinmedizin, Hannover

    K. Cimander

  4. Cannabisforschungsgruppe, Abt. Klinische Psychiatrie und Psychotherapie, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625, Hannover, Deutschland

    U. Schneider

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Schneider, U., Seifert, J., Karst, M. et al. Das endogene Cannabinoidsystem . Nervenarzt 76, 1062–1076 (2005). https://doi.org/10.1007/s00115-005-1888-7

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