1型大麻素受体在药物心脏毒性中作用的研究进展

doi:10.3969/j.issn.1674-8115.2025.12.016

摘要/Abstract

摘要：

药物的心脏毒性作为全球公共卫生的重要挑战，已造成显著的医疗资源与经济损失。近年研究发现，1型大麻素受体（cannabinoid type 1 receptor，CB1R）在多种药物诱导的心脏损伤中发挥重要作用。该文系统梳理了CB1R的分子特征及其在心血管生理与病理生理中的双重角色，并重点探讨其在抗精神病药、抗肿瘤药物、大麻及合成大麻素心脏毒性中的分子机制。CB1R作为内源性大麻素系统的关键组分，广泛分布于心肌细胞、内皮细胞及免疫细胞中，在正常生理条件下对心率、血压以及心血管收缩活动等发挥稳态调控的功能，并可通过调控离子通道活性、炎症因子释放以及氧化/硝化应激参与心脏电生理紊乱、炎症反应和心肌纤维化等病理过程，同时也参与了药物心脏毒性的发生机制。CB1R是多种药物心脏毒性中的共性通路，可能成为防治药物心脏毒性的重要靶点。未来研究需进一步解析CB1R在不同病理条件下的调节机制，并探索靶向CB1R的精准干预手段，以平衡药物治疗获益与心血管风险。

关键词: 心脏毒性, 大麻素受体, 抗精神病药, 抗肿瘤药物, 大麻, 合成大麻素

Abstract:

Drug-induced cardiotoxicity, as a major global public health challenge, has led to substantial consumption of medical resources and significant economic losses. Recent studies have revealed that the cannabinoid type 1 receptor (CB1R) plays an important role in various types of drug-induced cardiac injury. This article systematically reviews the molecular characteristics of CB1R and its dual roles in cardiovascular physiology and pathophysiology, with a focus on its molecular mechanisms in cardiotoxicity induced by antipsychotics, anticancer drugs, cannabis, and synthetic cannabinoids. As a key component of the endocannabinoid system, CB1R is widely distributed in cardiomyocytes, endothelial cells, and immune cells. Under normal physiological conditions, it contributes to the homeostatic regulation of heart rate, blood pressure, and cardiovascular contractile activity. It participates in pathological processes, including cardiac electrophysiological disturbances, inflammatory responses, and myocardial fibrosis, through modulation of ion channel activity, release of inflammatory factors, and oxidative/nitrative stress. It is also involved in the mechanisms underlying drug-induced cardiotoxicity. CB1R represents a common pathway in the cardiotoxicity of multiple drugs and may become an important target for the prevention and treatment of drug-induced cardiotoxicity. Future research needs to further elucidate the regulatory mechanisms of CB1R under different pathological conditions and explore precise interventions targeting CB1R to balance therapeutic benefits of drugs against cardiovascular risks.

Key words: cardiotoxicity, cannabinoid receptor, antipsychotic, anti-cancer drug, marijuana, synthetic cannabinoid

中图分类号:

薄一鸣, 崔庆桓, 李立亮. 1型大麻素受体在药物心脏毒性中作用的研究进展[J]. 上海交通大学学报（医学版）, 2025, 45(12): 1694-1700.

BO Yiming, CUI Qinghuan, LI Liliang. Advances in effects of cannabinoid receptor type 1 on drug-induced cardiotoxicity[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2025, 45(12): 1694-1700.

图/表 2

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