Cannabidiol (CBD) is increasingly recognized for its role as an antiseizure medication, especially for the management of Drug-Resistant Epilepsy (DRE). This encompasses serious conditions like Dravet syndrome, Lennox-Gastaut syndrome, and Tuberous Sclerosis, where there is strong evidence supporting its effectiveness, as noted in approved medical guidelines. Beyond epilepsy, CBD’s therapeutic potential is being explored in various fields, including appetite regulation, lipid metabolism, immune system modulation, addiction, pain management, and oncology. However, the evidence supporting these applications is mixed, indicating a need for additional research.
CBD is known to interact with major CYP isoforms and less prominently with glucuronidation and excretion transport systems, factors that may influence the pharmacokinetics of antiseizure drugs. With regard to potential side effects, long-term use of CBD might lead to hepatotoxicity, as studies have shown elevated enzyme levels (ALT, AST, GGT) following daily CBD consumption over a span of just a few weeks. Additionally, CBD can encourage adipogenesis through PPARγ, impacting processes like lipogenesis, and potentially affecting anemia and fertility. It may also alter immune function, raising the risk of infections. Given these considerations, robust pharmacovigilance is essential to track long-term CBD use and its interactions with anticonvulsant medications to ensure patient safety.
The focus of this Research Topic is to explore CBD's mechanisms of action in drug-resistant epilepsy (DRE) and gather diverse perspectives to advance our understanding of this challenging condition. We seek studies that leverage modern technological advancements and span a variety of global regions. Both clinical and foundational research with a translational focus are welcome. The ultimate aim is to foster international research collaboration, which will lead to more balanced and actionable insights as we address the complex challenges posed by DRE.
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