Use of Medical Cannabis for Respiratory Diseases

Cannabis is a genus of flowering plant within the Cannabaceae family.
For thousands of years, the plant has been cultivated and used worldwide
for a variety of purposes; in small industries, in agriculture and livestock
farming, as a recreational drug as well as in medicine1. Currently, there is no consensus regarding its classification within the Cannabis genus2; some researchers have proposed a differentiation of at least two species – Cannabis Sativa and Cannabis Indica. Other taxonomists have suggested that the unique species Cannabis Sativa exists and the subtypes of this plant vary depending on the different proportions of cannabinoids and terpenoids that the plant may contain. At least 750 chemical substances were isolated from the cannabis plant, 104 of which are identified as cannabinoids (also known as phytocannabinoids). The most significant cannabinoids in relation to health effects are: Δ9–tetrahydrocannabinol (THC) and cannabidiol (CBD)3

The cannabinoids affect the function of the endocannabinoid system, which has three components: CB1 and CB2 cannabinoid receptors, endogenous endocannabinoids produced in the organism and enzymes that regulate endocannabinoid synthesis and metabolism4
THC is a partial agonist of CB1 and CB2 receptors. The CB1 receptors are primarily found in the central nervous system (brain and spinal cord), in the areas that regulate cognitive function, memory and emotions, appetite and nausea, pain and motor responses. The fact that it is located in the CNS explains the psychoactive effects of THC3. It should be noted that
CB receptors are not located in the respiratory center and do not directly affect the act of respiration5. Also, CB1 receptors are present in the peripheral nervous system, the gastrointestinal tract, liver and skeletal muscles. CB2 receptors, in contrast, are situated primarily in tissue macrophages and other immune cells, and are responsible for the immunomodulatory and anti-inflammatory effects of cannabis.
CBD has low affinity to CB1 and CB2 receptors and lacks psychoactivity.
CBD affects other receptors by utilizing many other mechanisms, modulating the activation of various enzymes and has potential analgesic, powerful anti-inflammatory, anticonvulsant, anti-psychotic and anxiolytic properties. Both cannabinoids mentioned above are believed to possess antioxidant effects.

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