Cannabinoids—A New Perspective in Adjuvant Therapy for Pulmonary Hypertension

Abstract

Currently, no treatment can completely cure pulmonary hypertension (PH), which can lead to right ventricular failure and, consequently, death. Therefore, searching for new therapies remains important. Increased resistance in pulmonary circulation is mainly caused by the excessive contraction and proliferation of small pulmonary arteries. Cannabinoids, a group of lipophilic compounds that all interact with cannabinoid receptors, exert a pulmonary vasodilatory effect through several different mechanisms, including mechanisms that depend on vascular endothelium and/or receptor-based mechanisms, and may also have anti-proliferative and anti-inflammatory properties. The vasodilatory effect is important in regulating pulmonary resistance, which can improve patients' quality of life. Moreover, experimental studies on the effects of cannabidiol (plant-derived, non-psychoactive cannabinoid) in animal PH models have shown that cannabidiol reduces right ventricular systolic pressure and excessive remodelling and decreases pulmonary vascular hypertrophy and pulmonary vascular resistance. Due to the potentially beneficial effects of cannabinoids on pulmonary circulation and PH, in this work, we review whether cannabinoids can be used as an adjunctive therapy for PH. However, clinical trials are still needed to recommend the use of cannabinoids in the treatment of PH.

Cannabidiol Improves Antioxidant Capacity and Reduces Inflammation in the Lungs of Rats with Monocrotaline-Induced Pulmonary Hypertension

“…In our study, we have shown for the first time the overexpression of CB 1 -Rs and CB 2 -Rs in PH. Increased CB 2 -R density in lung tissue is probably associated with the presence of numerous inflammatory cells known to express CB 2 -Rs to a great extent [ 6 , 13 ]. Moreover, it has been suggested that TNFα and IL-1β can directly upregulate CB 1 -Rs and CB 2 -Rs in human blood [ 44 ].…”

“…The endocannabinoid system seems to play a role in PH, although it is not entirely clear how significant it is. In our previous work, [ 15 ] we have shown that N -arachidonoyl glycine (NAGLy) and palmitoleoyl ethanolamide (POEA) levels are reduced in the lung tissue of rats with MCT-induced PH, and NAGLy is an endocannabinoid with systemic vasodilating potential [ 13 ].…”

“…Cannabinoids, including CBD, have potentially beneficial effects in PH [ 13 ]. CBD has been suggested as an adjuvant therapy for the treatment of PH as a result of its relaxing effect in human pulmonary arteries [ 14 ].…”

Cannabidiol may prevent the development of congestive hepatopathy secondary to right ventricular hypertrophy associated with pulmonary hypertension in rats

“…Cannabidiol (CBD) is a non-intoxicative phytocannabinoid with many beneficial properties including antioxidant, anti-inflammatory, and anti-fibrotic [ 11 ]. It has been demonstrated that CBD, alleviates MCT-induced PH in rats [ 9 , 12 ] and Sugen + hypoxia-induced PH in mice by reducing RV systolic pressure (RVSP) [ 12 ].…”

Pharmacological aspects of cannabinoids

“…Южно-Российский журнал терапевтической практики South Russian Journal of Therapeutic Practice 2023;4(3):[27][28][29][30][31][32][33][34][35] …”