Palavras-chave
Desnutrição
Metabolismo
Canabidiol
Como Citar
Copyright © | Todos os direitos reservados.
A revista detém os direitos autorais exclusivos de publicação deste artigo nos termos da lei 9610/98.
Reprodução parcial
É livre o uso de partes do texto, figuras e questionário do artigo, sendo obrigatória a citação dos autores e revista.
Reprodução total
É expressamente proibida, devendo ser autorizada pela revista.
Resumo
Objetivo: Analisar a fisiologia e histologia do duodeno, os efeitos da desnutrição proteico-energética e as potencialidades e riscos terapêuticos do canabidiol. Revisão bibliográfica: A presente revisão aborda aspectos fisiológicos, histológicos e terapêuticos do duodeno, à nutrição e ao uso do canabidiol (CBD). Descreve a função do duodeno na digestão e absorção de nutrientes, destacando estruturas como as glândulas de Brunner, vilosidades e microvilosidades, essenciais para a proteção da mucosa e aumento de absorção. Também são discutidos os efeitos da desnutrição proteico-energética no desenvolvimento fetal como restrição de crescimento e maior suscetibilidade a doenças metabólicas na vida adulta. No que se refere ao CBD, são exploradas suas interações com o sistema endocanabinoide (CB1 e CB2), associadas a efeitos anti-inflamatórios, neuroprotetores e hepatoprotetores e sua influência na homeostase energética e resposta à deficiência nutricional. Considerações finais: O estudo integra conhecimentos fisiológicos e histológicos do duodeno, mostrando os efeitos da desnutrição proteico-energética e o potencial terapêutico do canabidiol, destacando o papel do sistema endocanabinoide na homeostase energética e na saúde digestiva. Ressalta-se a escassez de estudos clínicos conclusivos quanto à segurança e à toxicidade hepática do CBD em diferentes doses, o que restringe achados para a prática clínica.
Referências
ABRAHAMS JL, et al. Cannabidiol restores intestinal barrier function. Nutrients, 2021; 13: 3982.
ANAND U, et al. CBD inhibits and desensitizes neuronal TRPV1 signaling via inhibition of adenylyl cyclase and cAMP pathways: implications for pain modulation. J Pain Res., 2020; 13: 1251–63.
ALMEIDA RF, et al. Alterações morfológicas do duodeno. Rev Bras Cienc Vet., 2016; 23: 85–92.
BARKER DJP. Fetal origins of coronary heart disease. BMJ, 1995; 311: 171–4.
BARKER DJP. The origins of the developmental origins theory. J Intern Med., 2007; 261: 412–7.
CARVALHO RS, et al. Imunidade de mucosa e desnutrição proteica. J Bras Patol., 2020; 56: 134–41.
CANI PD, et al. Changes in gut endocannabinoid system tone. Diabetes, 2009; 58: 1718–26.
CRIPPA JAS, et al. Cannabidiol for the treatment of anxiety disorders. Neurotherapeutics, 2018; 15: 825–36.
CROZIER SJ, et al. Molecular mechanisms of pancreatic dysfunction induced by dietary protein deficiency. J Nutr Biochem., 2009; 20(9): 723–31.
COSTA B, et al. Vanilloid TRPV1 receptor mediates the antihyperalgesic effect of cannabidiol in a rat model of acute inflammation. Br J Pharmacol., 2004; 143(2): 247–50.
COSTA C, et al. Protein–energy malnutrition: mechanisms and clinical consequences in adults. J Nutr Intermediary Metab., 2021; 27: 100292.
CONFORTIM HD, et al. Maternal protein restriction during pregnancy and lactation affects the development of muscle fibers and neuromuscular junctions in rats. Muscle Nerve, 2017; 55(1): 109-115.
CORROON J e FELICE J. Consumer perceptions of cannabidiol. Cannabis Cannabinoid Res., 2019; 4: 152–9.
COUCH DG, et al. Cannabidiol ameliorates experimental colitis. Inflamm Bowel Dis., 2018; 24: 526–35.
DEVINSKY O, et al. Cannabidiol: pharmacology and therapeutic role. Epilepsia, 2014; 55: 791–802.
DESAI M, et al. Organ-selective growth in the offspring of protein-restricted mothers. Br J Nutr., 1996; 76(4): 591–603.
DI MARZO V, et al. Leptin-regulated endocannabinoids. Nature, 2001; 410: 822–5.
DUDELEA L, et al. Maternal protein restriction before pregnancy reduces offspring early body mass and affects glucose metabolism in C57BL/6JBom mice. J Dev Orig Health Dis., 2012; 3(5): 364–74.
ELANGO R e BALL RO. Protein and amino acid requirements during pregnancy. Adv Nutr., 2016; 7(5): 1006S–1012S.
ESPOSITO G, et al. Cannabidiol reduces intestinal inflammation through PPAR-γ. Mol Med., 2011; 17: 1–10.
FERNANDES ACS, et al. Cannabidiol: farmacologia e efeitos terapêuticos. Rev Bras Cienc Saúde, 2023; 19: 55–61.
GARIBOTTO G, et al. Muscle protein turnover and low-protein diets in patients with chronic kidney disease: mechanisms and adaptation. Nephrol Dial Transplant., 2020; 35(5): 741–8.
GENTON L, et al. Nutrition and gastrointestinal function. Clin Nutr., 2015; 34: 1–6.
GLUCKMAN PD e HANSON MA. Developmental origins of disease. N Engl J Med., 2008; 359: 61–73.
HASENOEHRL C, et al. Cannabinoids and gastrointestinal motility. Neurogastroenterol Motil., 2017; 29: e13149.
HOWLETT AC, et al. International Union of Pharmacology classification of cannabinoid receptors. Pharmacol Rev., 2002; 54: 161–202.
IFFLAND K e GROTENHERMEN F. Safety and side effects of cannabidiol. Cannabis Cannabinoid Res., 2017; 2: 139–54.
KEUSCH GT. The history of nutrition: malnutrition, infection and immunity. J Nutr., 2003; 133(1): 336S–40S.
KIRKHAM TC, et al. Endocannabinoids and feeding behaviour. Br J Pharmacol., 2002; 136: 550–7.
KOCH M, et al. Cannabinoid receptor signaling in central regulation of feeding behavior. Front Neurosci., 2017; 11: 293.
LANGLEY-EVANS SC. Nutritional programming of disease. Proc Nutr Soc., 2009; 68: 1–7.
LIMA APS, et al. Fitoterapia como estratégia complementar. Rev Saúde Coletiva, 2022; 32: 1–11.
LINARES IM, et al. Cannabidiol and neuroprotection. Neurochem Int., 2014; 75: 1–8.
LONG JZ, et al. Selective blockade of 2-arachidonoylglycerol hydrolysis produces cannabinoid behavioral effects. Nat Chem Biol., 2009; 5(1): 37–44.
LU HC e MACKIE K. An introduction to the endogenous cannabinoid system. Biol Psychiatry, 2020; 79: 516–25.
MALAFAIA G. A desnutrição proteico-calórica como agravante da saúde de pacientes hospitalizados. ABC&HS, 2009; 34(2): 117–22.
MENEZES RC, et al. Alterações intestinais na desnutrição. J Pediatr., 2019; 95: 1–8.
MECHOULAM R e SHVO Y. The structure of cannabidiol. Tetrahedron., 1963; 19: 2073–8.
MORICONI A, et al. TRPV1 receptors and inflammation. Cell Mol Life Sci., 2020; 77: 1–12.
MÜLLER C, et al. Cannabinoid ligands targeting transient receptor potential channels and related mechanisms. Front Mol Neurosci., 2018; 11: 487.
NEJATBAKHSH F, et al. Cannabidiol in gastrointestinal diseases. Front Pharmacol., 2021; 12: 719–28.
OLIVEIRA JF, et al. Prevalência de desnutrição e risco nutricional em pacientes. Com. Ciências Saúde, 2014; 25(2): 157-172.
OTA E, et al. Antenatal dietary education and supplementation to increase energy and protein intake during pregnancy. Cochrane Database Syst Rev., 2015; CD000032.
O’SULLIVAN SE, et al. The peripheral cannabinoid receptor type 1 (CB1) as a molecular target for modulating body weight in humans. Molecules, 2021; 26(20): 6178.
PACHER P, et al. The endocannabinoid system as a therapeutic target. Pharmacol Rev., 2020; 72: 606–43.
PERTWEE RG. Cannabinoid pharmacology. Br J Pharmacol., 2006; 147(Suppl 1): S163–71.
PERTWEE RG. The diverse CB1 and CB2 receptor pharmacology. Br J Pharm., 2008; 153: 199–215.
PERTWEE RG. Endocannabinoids and their pharmacological actions. Handb Exp Pharmacol., 2015; 231: 1–37.
ROSEBOOM TJ, et al. Effects of prenatal exposure to famine. Lancet, 2006; 368: 44–52.
ROKEY AC, et al. Cannabinoids and the placenta: receptors, signaling and outcomes. Placenta, 2023; 60: 1–13.
RUSSO EB, et al. Cannabidiol in gastrointestinal disorders. Front Pharmacol., 2019; 10: 1–12.
SABIN CA, et al. Gastrointestinal mucosal atrophy in protein-calorie malnutrition. Arch Dis Child., 2006; 91(3): 272–7.
SANTOS JÚNIOR PL, et al. Pancreatic exocrine dysfunction induced by protein-energy malnutrition in rats: morphological and biochemical alterations. J Gastroenterol Hepatol., 2018; 33(5): 937–45.
SIDO JM, et al. Role of Endocannabinoid Activation of Peripheral CB1 Receptors in the Regulation of Autoimmune Disease. Int Rev Immunol., 2015; 34(5): 403-14.
SILVA RS, et al. Duodenal alterations in protein-energy malnutrition. Arq Gastroenterol., 2013; 50: 1–7.
SIMOPOULOS AP. Omega-6 and omega-3 fatty acids: Endocannabinoids, genetics and obesity. OCL – Oilseeds and Fats, Crops and Lipids, 2020; 27(8): 7.
SOUZA LP, et al. Insegurança alimentar e gestação. Rev Saúde Pública, 2020; 54: 1–9.
SWENSON KS, et al. Fetal cannabidiol (CBD) exposure alters neurodevelopment and postnatal behavior in mice. J Neurosci Res., 2023; 101(11): 2345–59.
TORRES N, et al. Protein restriction during pregnancy affects maternal liver lipid metabolism and fetal brain lipid composition in the rat. Am J Physiol Endocrinol Metab., 2010; 298(2): E270–7.
VICTORA CG, et al. Maternal and child undernutrition. Lancet, 2008; 371: 340–57.
WATERLAND RA e MICHELS KB. Epigenetic epidemiology of the developmental origins hypothesis. Annu Rev Nutr., 2007; 27: 363–88.
WORLD HEALTH ORGANIZATION (WHO). Guidelines on the use of herbal medicines. Geneva: WHO; 2013.
WOLFF GL, et al. Epigenetic programming and metabolic disease. Endocrinology, 2018; 159: 1–10.
ZUARDI AW. Cannabidiol: from an inactive cannabinoid to a drug. Braz J Psychiatry, 2008; 30: 271–80.