ABSTRACT
ABSTRACT BACKGROUND AND OBJECTIVES: Pain is "an unpleasant sensory and emotional experience associated or not with real or potential tissue damage" which, when exceeding its protective function, beyond three months, is considered chronic pain, which in the long term can have its own clinical course. Given the scientific advances on the therapeutic effects of cannabinoids, the article brings a proposal for reflection as the Brazilian public health system (SUS - Sistema Único de Saúde), through medical cannabis, could offer better therapies for the treatment of conditions such as chronic pain. CONTENTS: A narrative review was elaborated in databases such as Pubmed, Medline and Scielo. Considering the SUS Guidelines, the incorporation and access to medicinal cannabis can be understood as a strategy of social justice and reduction of inequities, because it is effective and safe in the treatment of chronic conditions, besides that the system already has strategies and policies aimed at regulating and distributing herbal medicines. Chronic pain is a prevalent condition, affects more than 2 billion people worldwide, and can be considered a global crisis. In Brazil, its prevalence varies between 23.02% and 76.17%, being higher in the elderly and female individuals. Despite this, in many cases, conventional treatments do not generate the analgesics effects expected, in addition to causing important adverse effects. CONCLUSION: Cannabis sativa L. has great potential to become one of the best alternatives for chronic pain to be incorporated into herbal access programs around the country, such as in the SUS' Farmácia Viva project.
RESUMO JUSTIFICATIVA E OBJETIVOS: A dor é "uma experiência sensitiva e emocional desagradável associada ou não a uma lesão tecidual real ou potencial" que ao exceder sua função de proteção, além de três meses, é considerada dor crônica, que à longo prazo pode ter seu próprio curso clínico. Diante dos avanços científicos acerca dos efeitos terapêuticos dos canabinoides, este artigo traz uma proposta de reflexão sobre como o Sistema Único de Saúde (SUS), por meio da medicina canábica, poderia ofertar melhores terapêuticas para o tratamento de condições que cursam com dor crônica. CONTEÚDO: Foi elaborada uma revisão narrativa em bancos de dados como Pubmed, Medline e Scielo. Considerando as diretrizes do SUS, a incorporação e acesso a cannabis medicinal pode ser entendida como estratégia de justiça social e redução de inequidades, por ser eficaz e segura no tratamento de condições crônicas, além de que o sistema já conta com estratégias e políticas voltadas para regulamentação e distribuição de fitoterápicos. Dor crônica é uma condição prevalente, afeta mais de 2 bilhões de pessoas em todo o mundo e pode ser considerada uma crise global. No Brasil, sua prevalência varia entre 23,02% e 76,17%, sendo maior em idosos e em pessoas do sexo feminino. Apesar disso, em muitos casos, os tratamentos convencionais não geram os efeitos analgésicos esperados, além de causarem efeitos adversos importantes. CONCLUSÃO: A Cannabis sativa L. tem um grande potencial de se tornar uma das melhores alternativas para dor crônica a ser incorporada nos programas de acesso a fitoterápicos no país, como no programa Farmácia Viva, do SUS.
ABSTRACT
Plants of the Asteraceae family have been traditionally used as medicinal plants. The species Achyrocline satureioides and Achyrocline alata present anti-inflammatory properties and great chemical similarity. However, no study has been performed to evaluate the influence of these plants on skin wound healing in vivo. Here, we have assessed the effect of these plants extracts on skin wound healing in mice. Mice were randomly arranged into three groups (n = 10), an injury was performed on the dorsal area of the animals, which received the following topical treatment: group 1, control (ointment base); group 2, A. satureioides extract; group 3, A. alata extract. The solution for treatment was prepared as 10% (w/w) concentration. The wound area was measured on days 1, 4, 9, 15 and 17 after treatment and tissues of local lesion were collected on the ninth day for histological analysis. A. alata was more effective since it induced earlier wound closure associated with decreasing initial inflammatory response, faster reepithelialization and collagen remodeling. A. satureioides improved the collagen renovation, but induced slower closure, which may be due to different concentrations of phenolic compounds among the plants here studied. Both plants did not alter the ultrastructural characteristics of cells in the healing process. In conclusion, our findings suggest the potent wound healing capacity of A. alata extracts, as demonstrated by more efficient and faster induction of wound closure. We believe this plant is a potential wound healing treatment for humans and further studies are necessary to assess its clinical practice.
