Cannabinoids are chemicals that are found in the cannabis plant (cannabis sativa). Cannabidiol (CBD) is one of these chemicals and studies have shown it has anti inflammatory effects when induced on animal cells. People have smoked cannabis for thousands of years and it has said have an anti inflammatory role in the body. Tetrahydrocannabinol (THC) is another one of these chemicals and it is said it has psychoactive effects. Cannabinoid receptors (CB1 and CB2) are found in the endocannabinoid system and allow cannabinoids to thrive in the body. This paper describes the current knowledge on how endocannabinoids work in the body to have a therapeutic effect in alleviating pain conditions.
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Although cannabis has been used for pain management for thousand of years, very little approved cannabinoids are used for the treatment of pain relief and other medical symptoms. Cannabinoid therapy has gotten the attention back only after the finding of endocannabinoids and fatty acid amide hydrolase (FAAH) and monoacylglycerol lipase (MAGL), the enzymes acting in endocannabinoid metabolism. Recently, studies have focused on the inhibition of these degradative enzymes and the increasing of endocannabinoid levels in the brain. Special emphasis is given on multi-target analgesia chemicals, where one of the targets is the endocannabinoid degrading enzyme. Overall, the effects of cannabis could lead the long term effective treatment in reduced pain and inflammation. This systematic review suggests that cannabinoids could target immune cells to help alleviate neuropathic pain.
The discovery of CB1 and CB2 receptors, endocannabinoids, and the processes responsible for the biosynthesis, release, transport and metabolism of these chemicals were a massive help in understanding the job of endocannabinoids in various physiological and pathological situations, including pain modulation. Increasing endocannabinoid levels in the brain by the inhibition of endocannabinoid degrading enzymes, FAAH and MAGL, using pharmacological agents, and thereby decreasing the unwarranted side effects of cannabinoids, also made an additional contribution to this knowledge. Some of the most important future directions in this field are advancing peripherally restricted CB1 agonists, inventing new CB2 agonists, mixing cannabinoids with other analgesics, and increasing endocannabinoid levels using multi-target drugs such as FAAH/MAGL, FAAH (MAGL)/COX and FAAH (MAGL)/TRPV1 dual blockers. Clinical trials will demonstrate the value of these approaches.