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Entourage effect

The entourage effect is a proposed mechanism by which cannabis compounds act synergistically to modulate the overall psychoactive effects of the plant, primarily by the action of tetrahydrocannabinol (THC).[1][2] Cannabidiol (CBD) is under preliminary research for its potential to modify the effects of THC, possibly mitigating some of the negative, psychosis-like effects of THC. CBD is included in some medicinal formulations alongside THC.[1][3][4] Though the idea of the entourage effect has taken root in the cannabis industry and among consumers, the concept has no rigorous scientific evidence as of 2018.[1][3]

Background

The phrase entourage effect was introduced in 1999.[5][6] While originally identified as a novel method of endocannabinoid regulation by which multiple endogenous chemical species display a cooperative effect in eliciting a cellular response, the term has evolved to describe the polypharmacy effects of combined cannabis phytochemicals or whole plant extracts. The phrase now commonly refers to the compounds present in cannabis supposedly working in concert to create “the sum of all the parts that leads to the magic or power of cannabis”.[3] Other cannabinoids, terpenoids, and flavonoids may be part of an entourage effect.[6] The entourage effect is considered a possible cannabinoid system modulator and is achieved in pain management.[1][6][7]

Pharmacology

Endogenous 2-acyl-glycerols can increase 2-arachidonoylglycerol biological activity, which alone shows no significant activity. This entourage effect may represent a novel endogenous cannabinoid activity molecular regulation route.[5] Cannabinoid system modulators like N-palmitoylethanolamine may exhibit the entourage effect, increasing receptor affinity to enhance endogenous anandamide activity and/or reducing enzymatic anandamide degradation.[8]

Critisism

One study found that none of the six of the most common terpenoids in Cannabis directly activated CB1 or CB2, or modulated the signalling of the phytocannabinoid agonist Δ9-THC.[9]

References

  1. ^ a b c d Grof, Christopher P. L. (24 May 2018). "Cannabis, from plant to pill". British Journal of Clinical Pharmacology. 84 (11): 2463–2467. doi:10.1111/bcp.13618. ISSN 0306-5251. PMC 6177712. PMID 29701252.
  2. ^ Russo EB (August 2011). "Taming THC: potential cannabis synergy and phytocannabinoid-terpenoid entourage effects". British Journal of Pharmacology. 163 (7): 1344–64. doi:10.1111/j.1476-5381.2011.01238.x. PMC 3165946. PMID 21749363.
  3. ^ a b c Chen A (20 April 2017). "Some of the Parts: Is Marijuana's "Entourage Effect" Scientifically Valid?". Scientific American. Retrieved 2017-12-31.
  4. ^ Fine PG, Rosenfeld MJ (2013-10-29). "The endocannabinoid system, cannabinoids, and pain". Rambam Maimonides Medical Journal. 4 (4): e0022. doi:10.5041/RMMJ.10129. PMC 3820295. PMID 24228165.
  5. ^ a b Ben-Shabat S, Fride E, Sheskin T, Tamiri T, Rhee MH, Vogel Z, Bisogno T, De Petrocellis L, Di Marzo V, Mechoulam R (1998). "An entourage effect: inactive endogenous fatty acid glycerol esters enhance 2-arachidonoyl-glycerol cannabinoid activity". European Journal of Pharmacology. 353 (1): 23–31. doi:10.1016/S0014-2999(98)00392-6. PMID 9721036.
  6. ^ a b c Gupta S (11 March 2014). "Medical marijuana and 'the entourage effect'". CNN. Retrieved 31 December 2017.
  7. ^ Jerome, Bouaziz (April 1, 2017). "The Clinical Significance of Endocannabinoids in Endometriosis Pain Management". Cannabis and Cannabinoid Research. 2 (1). doi:10.1089/can.2016.0035. PMC 5436335. Retrieved 8 May 2017.
  8. ^ Bouaziz J, Bar On A, Seidman DS, Soriano D (April 1, 2017). "The Clinical Significance of Endocannabinoids in Endometriosis Pain Management". Cannabis and Cannabinoid Research. 2 (1): 72–80. doi:10.1089/can.2016.0035. PMC 5436335. PMID 28861506.
  9. ^ [www.biorxiv.org]