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      The endocannabinoidome as a substrate for noneuphoric phytocannabinoid action and gut microbiome dysfunction in neuropsychiatric disorders
 Translated title: El endocannabinoidoma como sustrato para la acción no euforizante de los fitocannabinoides y para la disfunción del microbioma intestinal en trastornos neuropsiquiátricos Translated title: L'endocannabinoïdome comme substrat de l'action non euphorisante des phytocannabinoïdes et du dysfonctionnement du microbiome intestinal dans les troubles neuropsychiatriques.

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          Abstract

          The endocannabinoid (eCB) system encompasses the eCBs anandamide and 2-arachidonoylglycerol, their anabolic/catabolic enzymes, and the cannabinoid CB 1 and CB 2 receptors. Its expansion to include several eCB-like lipid mediators, their metabolic enzymes, and their molecular targets, forms the endocannabinoidome (eCBome). This complex signaling system is deeply involved in the onset, progress, and symptoms of major neuropsychiatric disorders and provides a substrate for future therapeutic drugs against these diseases. Such drugs may include not only THC, the major psychotropic component of cannabis, but also other, noneuphoric plant cannabinoids. These compounds, unlike THC, possess a wide therapeutic window, possibly due to their capability of hitting several eCBome and non-eCBome receptors. This is particularly true for cannabidiol, which is one of the most studied cannabinoids and shows promise for the treatment of a wide range of mental and mood disorders. The eCBome plays a role also in the microbiota-gut-brain axis, which is emerging as an important actor in the control of affective and cognitive functions and in their pathological alterations.


          Translated abstract

          El sistema endocannabinoide (SeCB) incluía los eCB anandamida y 2-araquidonoilglicerol, sus enzimas anabólicas / catabólicas y los receptores cannabinoides CB1 y CB2. Su expansión para incluir algunos mediadores lipídicos similares al SeCB, sus enzimas metabólicas y sus dianas moleculares (Fig. 1), forma el endocannabinoidoma (eCBoma). Este complejo sistema de señalización está profundamente involucrado en la aparición, la progresión y los síntomas de los principales trastornos neuropsiquiátricos y proporciona un sustrato para futuros fármacos terapéuticos contra estas enfermedades. Tales drogas pueden incluir no solo THC, el principal componente psicotrópico de la cannabis, sino también otros cannabinoides vegetales no euforizantes. Estos compuestos, a diferencia del THC, poseen una amplia ventana terapéutica, posiblemente debido a su capacidad de actuar sobre varios receptores eCBoma y no eCBoma. Esto es particularmente cierto para el cannabidiol, que es uno de los cannabinoides más estudiados y que aparece prometedor para el tratamiento de una amplia gama de trastornos mentales y del estado de ánimo. El eCBoma también tiene un papel en el eje microbiota-intestino-cerebro, que se perfila como un actor importante en el control de las funciones afectivas y cognitivas y en sus alteraciones patológicas.

          Translated abstract

          Le système endocannabinoïde (eCB) comprend les récepteurs cannabinoïdes CB1 et CB2 et les endocannabinoϊdes endogènes l’anandamide et le 2-arachidonoylglycérol ainsi que leurs enzymes anaboliques/cataboliques. L'endocannabinoϊdome (eCBome) est formé de ce système eCB et de plusieurs médiateurs lipidiques de type eCB, leurs enzymes métaboliques et leurs cibles moléculaires (Fig. 1). Ce système de signalisation complexe est profondément impliqué dans l'apparition, la progression et les symptômes des principaux troubles neuropsychiatriques et offre une base pour le développement de futurs traitements contre ces maladies. Ces médicaments peuvent contenir du THC, le principal composant psychotrope du cannabis, et aussi d'autres cannabinoïdes végétaux non euphorisants dont la fenêtre thérapeutique est large, contrairement au THC, peut-être en raison de leur capacité à atteindre plusieurs récepteurs eCBome et non eCBome. C’est particulièrement vrai pour le cannabidiol, l'un des cannabinoïdes les plus étudiés qui s'avère prometteur pour traiter un large spectre de troubles mentaux et de l'humeur. L'eCBome joue également un rôle dans l'axe microbiote-intestin-cerveau, acteur important dans le contrôle des fonctions affectives et cognitives et des pathologies qui y sont liées.

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          Cannabinoids and the expanded endocannabinoid system in neurological disorders

          Anecdotal evidence that cannabis preparations have medical benefits together with the discovery of the psychotropic plant cannabinoid Δ9-tetrahydrocannabinol (THC) initiated efforts to develop cannabinoid-based therapeutics. These efforts have been marked by disappointment, especially in relation to the unwanted central effects that result from activation of cannabinoid receptor 1 (CB1), which have limited the therapeutic use of drugs that activate or inactivate this receptor. The discovery of CB2 and of endogenous cannabinoid receptor ligands (endocannabinoids) raised new possibilities for safe targeting of this endocannabinoid system. However, clinical success has been limited, complicated by the discovery of an expanded endocannabinoid system - known as the endocannabinoidome - that includes several mediators that are biochemically related to the endocannabinoids, and their receptors and metabolic enzymes. The approvals of nabiximols, a mixture of THC and the non-psychotropic cannabinoid cannabidiol, for the treatment of spasticity and neuropathic pain in multiple sclerosis, and of purified botanical cannabidiol for the treatment of otherwise untreatable forms of paediatric epilepsy, have brought the therapeutic use of cannabinoids and endocannabinoids in neurological diseases into the limelight. In this Review, we provide an overview of the endocannabinoid system and the endocannabinoidome before discussing their involvement in and clinical relevance to a variety of neurological disorders, including Parkinson disease, Alzheimer disease, Huntington disease, multiple sclerosis, amyotrophic lateral sclerosis, traumatic brain injury, stroke, epilepsy and glioblastoma.
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            Efficacy and safety of the weight-loss drug rimonabant: a meta-analysis of randomised trials.

            Since the prevalence of obesity continues to increase, there is a demand for effective and safe anti-obesity agents that can produce and maintain weight loss and improve comorbidity. We did a meta-analysis of all published randomised controlled trials to assess the efficacy and safety of the newly approved anti-obesity agent rimonabant. We searched The Cochrane database and Controlled Trials Register, Medline via Pubmed, Embase via WebSpirs, Web of Science, Scopus, and reference lists up to July, 2007. We collected data from four double-blind, randomised controlled trials (including 4105 participants) that compared 20 mg per day rimonabant with placebo. Patients given rimonabant had a 4.7 kg (95% CI 4.1-5.3 kg; p<0.0001) greater weight reduction after 1 year than did those given placebo. Rimonabant caused significantly more adverse events than did placebo (OR=1.4; p=0.0007; number needed to harm=25 individuals [95% CI 17-58]), and 1.4 times more serious adverse events (OR=1.4; p=0.03; number needed to harm=59 [27-830]). Patients given rimonabant were 2.5 times more likely to discontinue the treatment because of depressive mood disorders than were those given placebo (OR=2.5; p=0.01; number needed to harm=49 [19-316]). Furthermore, anxiety caused more patients to discontinue treatment in rimonabant groups than in placebo groups (OR=3.0; p=0.03; number needed to harm=166 [47-3716]). Our findings suggest that 20 mg per day rimonabant increases the risk of psychiatric adverse events--ie, depressed mood disorders and anxiety-despite depressed mood being an exclusion criterion in these trials. Taken together with the recent US Food and Drug Administration finding of increased risk of suicide during treatment with rimonabant, we recommend increased alertness by physicians to these potentially severe psychiatric adverse reactions.
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              Cannabidiol enhances anandamide signaling and alleviates psychotic symptoms of schizophrenia

              Cannabidiol is a component of marijuana that does not activate cannabinoid receptors, but moderately inhibits the degradation of the endocannabinoid anandamide. We previously reported that an elevation of anandamide levels in cerebrospinal fluid inversely correlated to psychotic symptoms. Furthermore, enhanced anandamide signaling let to a lower transition rate from initial prodromal states into frank psychosis as well as postponed transition. In our translational approach, we performed a double-blind, randomized clinical trial of cannabidiol vs amisulpride, a potent antipsychotic, in acute schizophrenia to evaluate the clinical relevance of our initial findings. Either treatment was safe and led to significant clinical improvement, but cannabidiol displayed a markedly superior side-effect profile. Moreover, cannabidiol treatment was accompanied by a significant increase in serum anandamide levels, which was significantly associated with clinical improvement. The results suggest that inhibition of anandamide deactivation may contribute to the antipsychotic effects of cannabidiol potentially representing a completely new mechanism in the treatment of schizophrenia.
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                Author and article information

                Contributors
                Journal
                Dialogues Clin Neurosci
                Dialogues Clin Neurosci
                Dialogues Clin Neurosci
                Dialogues in Clinical Neuroscience
                Les Laboratoires Servier (France )
                1294-8322
                1958-5969
                September 2020
                September 2020
                : 22
                : 3
                : 259-269
                Affiliations
                Canada Excellence Research Chair on the Microbiome-Endocannabinoidome Axis in Metabolic Health, Université Laval, Canada; Joint International Unit between Université Laval and Consiglio Nazionale delle Ricerche of Italy on Chemical and Biomolecular Research on the Microbiome and its Impact on Metabolic Health and Nutrition, Istituto di Chimica Biomolecolare, CNR, Pozzuoli (NA), Italy
                Author notes
                Canada Excellence Research Chair on the Microbiome-Endocannabinoidome Axis in Metabolic Health, Université Laval, Pavillion des Services, 2440 Boulevard Hochelaga, Québec City, QC G1V 0A6, Canada; Joint International Unit between Université Laval and Consiglio Nazionale delle Ricerche of Italy on Chemical and Biomolecular Research on the Microbiome and its Impact on Metabolic Health and Nutrition, Istituto di Chimica Biomolecolare, CNR, Via Campi Flegrei 34, Comprensorio Olivetti, 80078, Pozzuoli (NA), Italy [* ] vincenzo.dimarzo@ 123456criucpq.ulaval.ca
                Article
                10.31887/DCNS.2020.22.3/vdimarzo
                7605024
                33162769
                989849c9-f5d0-4223-bfcb-524125c48880
                © 2020, AICHServier GroupCopyright © 2020 AICH Servier Group. All rights reserved

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by-nc-nd/3.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Original Article

                Neurosciences
                anxiety,autism,cannabinoid,depression,eating disorder,endocannabinoid,lipid mediator,schizophrenia

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