Chronic Pain and the Endocannabinoid System: Smart Lipids – A Novel Therapeutic Option?

Walter Zieglgänsberger, Rudolf Brenneisen, Achim Berthele, Https, Carsten T. Wotjak, Borwin Bandelow, Thomas R. Tölle, Beat Lutz, Author Affiliations, Corresponding Author

There is evidence that also other non-CB1R and non-CB2R (GPR18, GPR119, and GPR55) are involved in the signaling of the ECS [18]. AEA and 2-AG can also activate other receptors, such as TRPV1 and GABA A receptors, respectively [33-35]. ECS signaling is terminated by cellular uptake processes, which likely involve transporter proteins. When THC was either smoked or applied together with CBD (ratios of 2:1, 1:1, and 1:2 of CBD to THC), patients highlight the more favorable therapeutic effects and less side effects compared to taking pure THC orally [98]. CBD inhalation increased THC plasma concentrations and diminished THC-induced analgesic effects, revealing a synergistic pharmacokinetic but antagonistic pharmacodynamic interaction of THC and CBD.

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