This review focuses on the possible roles of phytocannabinoids, synthetic cannabinoids, endocannabinoids, and "transient receptor potential cation channel, subfamily V, member 1" (TRPV1) channel blockers in epilepsy treatment. The phytocannabinoids are compounds produced by the herb Cannabis sativa, from which Δ9-tetrahydrocannabinol (Δ9-THC) is the main active compound. The therapeutic applications of Δ9-THC are limited, whereas cannabidiol (CBD), another phytocannabinoid, induces antiepileptic effects in experimental animals and in patients with refractory epilepsies. Synthetic CB1 agonists induce mixed effects, which hamper their therapeutic applications. A more promising strategy focuses on compounds that increase the brain levels of anandamide, an endocannabinoid produced on-demand to counteract hyperexcitability. Thus, anandamide hydrolysis inhibitors might represent a future class of antiepileptic drugs. Finally, compounds that block the TRPV1 ("vanilloid") channel, a possible anandamide target in the brain, have also been investigated. In conclusion, the therapeutic use of phytocannabinoids (CBD) is already in practice, although its mechanisms of action remain unclear. Endocannabinoid and TRPV1 mechanisms warrant further basic studies to support their potential clinical applications. This article is part of the Special Issue "NEWroscience 2018".

中文翻译：

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利用大麻素和香草素机制治疗癫痫

本综述重点关注植物大麻素、合成大麻素、内源性大麻素和“瞬时受体电位阳离子通道，亚家族 V，成员 1”（TRPV1）通道阻滞剂在癫痫治疗中的可能作用。植物大麻素是由大麻植物产生的化合物，其中Δ9-四氢大麻酚（Δ9-THC）是主要活性化合物。Δ9-THC 的治疗应用是有限的，而另一种植物大麻素大麻二酚 (CBD) 在实验动物和难治性癫痫患者中诱导抗癫痫作用。合成的 CB1 激动剂会产生混合效应，这阻碍了它们的治疗应用。一个更有前景的策略侧重于增加大脑中 anandamide 水平的化合物，anandamide 是一种按需生产的内源性大麻素，以抵消过度兴奋。因此，anandamide 水解抑制剂可能代表未来一类抗癫痫药物。最后，还研究了阻断 TRPV1（“vanilloid”）通道（大脑中可能的 anandamide 靶点）的化合物。总之，植物大麻素（CBD）的治疗用途已经在实践中，尽管其作用机制尚不清楚。内源性大麻素和 TRPV1 机制需要进一步的基础研究来支持其潜在的临床应用。本文是特刊“NEWroscience 2018”的一部分。植物大麻素（CBD）的治疗用途已经在实践中，尽管其作用机制尚不清楚。内源性大麻素和 TRPV1 机制需要进一步的基础研究来支持其潜在的临床应用。本文是特刊“NEWroscience 2018”的一部分。植物大麻素（CBD）的治疗用途已经在实践中，尽管其作用机制尚不清楚。内源性大麻素和 TRPV1 机制需要进一步的基础研究来支持其潜在的临床应用。本文是特刊“NEWroscience 2018”的一部分。