Endogenous cannabinoids: A new system involved in the homeostasis of arterial pressure in experimental cirrhosis in the rat

Ros, Josefa; Clària, Joan; To‐Figueras, Jordi; Planagumà, Anna; Cejudo–Martín, Pilar; Fernández‐Varo, Guillermo; Martı́n-Ruiz, Raúl; Arroyo, Vicente; Rivera, Francisca; Rodés, Juan; Jiménez, Wladimiro

doi:10.1053/gast.2002.30305

Cited by 219 publications

(159 citation statements)

References 19 publications

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“…Hot bathing leads to peripheral venodilation and shunts blood away from the splanchnic bed, resulting in symptom improvement [102,137] Very low validity of our findings is limited by the possibility of missing articles from our search strategy. We limited the search to English-language articles, so any relevant articles published in foreign languages were not included, and articles not indexed in MEDLINE, Embase, Web of Science, or the Cochrane Library would be missed.…”

Section: Limitationsmentioning

confidence: 91%

“…Animal studies lend some credibility to this theory; however, results are not consistently reproducible in human studies. Additionally, many inferential hypotheses were identified that attribute different aspects of CHS to a myriad of dysregulatory issues at CB-1 receptors throughout the body (brain, gastrointestinal tract, and vasculature) [97,98,102,105,133,[135][136][137]. The experimental evidence behind these inferences illustrates the complexity of the pathophysiology of CHS and raises many additional questions.…”

Section: Pathophysiology Of Chsmentioning

confidence: 99%

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Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatment—a Systematic Review

et al. 2016

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Cannabinoid hyperemesis syndrome (CHS) is a syndrome of cyclic vomiting associated with cannabis use. Our objective is to summarize the available evidence on CHS diagnosis, pathophysiology, and treatment. We performed a systematic review using MEDLINE, Ovid MEDLINE, Embase, Web of Science, and the Cochrane Library from January 2000 through September 24, 2015. Articles eligible for inclusion were evaluated using the G r a d i n g a n d R e c o m m e n d a t i o n s A s s e s s m e n t , Development, and Evaluation (GRADE) criteria. Data were abstracted from the articles and case reports and were combined in a cumulative synthesis. The frequency of identified diagnostic characteristics was calculated from the cumulative synthesis and evidence for pathophysiologic hypothesis as well as treatment options were evaluated using the GRADE criteria. The systematic search returned 2178 articles. After duplicates were removed, 1253 abstracts were reviewed and 183 were included. Fourteen diagnostic characteristics were identified, and the frequency of major characteristics was as follows: history of regular cannabis for any duration of time (100%), cyclic nausea and vomiting (100%), resolution of symptoms after stopping cannabis (96.8%), compulsive hot baths with symptom relief (92.3%), male predominance (72.9%), abdominal pain (85.1%), and at least weekly cannabis use (97.4%). The pathophysiology of CHS remains unclear with a dearth of research dedicated to investigating its underlying mechanism. Supportive care with intravenous fluids, dopamine antagonists, topical capsaicin cream, and avoidance of narcotic medications has shown some benefit in the acute setting. Cannabis cessation appears to be the best treatment. CHS is a cyclic vomiting syndrome, preceded by daily to weekly cannabis use, usually accompanied by symptom improvement with hot bathing, and resolution with cessation of cannabis. The pathophysiology underlying CHS is unclear. Cannabis cessation appears to be the best treatment

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Section: Limitationsmentioning

confidence: 91%

Section: Pathophysiology Of Chsmentioning

confidence: 99%

Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatment—a Systematic Review

et al. 2016

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“…Indeed, as demonstrated by several studies over the last decade macrophage-and platelet-derived endocannabinoids contribute to the hypotension associated with hemorrhagic (Wagner et al, 1997), endotoxic (Varga et al, 1998;Liu et al, 2003;Bátkai et al, 2004;Wang et al, 2001) and cardiogenic shock (Wagner et al, 2001a. Furthermore, a similar mechanism seems to be involved in the vasodilated state associated with advanced liver cirrhosis (Bátkai et al, 2001;Ros et al, 2002), which is possibly secondary to the endotoxemia frequently found in patients with latestage cirrhosis (Lumsden et al, 1988). Importantly, in all of the above-mentioned pathological conditions the hypotension could be reversed or inhibited by the CB 1 antagonist SR141716.…”

Section: Role Of the Endocannabinergic System In The Hypotension Assomentioning

confidence: 96%

“…Although several lines of evidence indicate that the cardiovascular depressive effects of cannabinoids are mediated by peripherally localized CB 1 receptors, recent studies also suggest the existence of as yet undefined endothelial and cardiac receptor(s) that mediate certain endocannabinoid-induced cardiovascular effects Járai et al, 1999;Ford et al, 2002;Ho and Hiley, 2003;Kunos et al, 2002;Offertáler et al, 2003;O'Sullivan et al, 2004), however, the discussion of the latter is beyond the main scope of this summary. It has been established that the endocannabinergic system plays a pivotal role in cardiovascular regulation under various pathophysiological conditions associated with hypotension including hemorrhagic (Wagner et al, 1997), endotoxic (Varga et al, 1998) and cardiogenic shock (Wagner et al, 2001a, and advanced liver cirrhosis (Bátkai et al, 2001;Ros et al, 2002). Additional evidence also implicates this system in the regulation of blood pressure (Lake et al, 1997b;Li et al, 2003;Bátkai et al, 2004a).…”

Section: Introductionmentioning

confidence: 99%

Blood pressure regulation by endocannabinoids and their receptors

2005

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Cannabinoids and their endogenous and synthetic analogs exert powerful hypotensive and cardiodepressor effects by complex mechanisms involving direct and indirect effects on myocardium and vasculature. On the one hand, endocannabinoids and cannabinoid receptors have been implicated in the hypotensive state associated with hemorrhagic, endotoxic and cardiogenic shock, and advanced liver cirrhosis. On the other hand, there is emerging evidence suggesting that the endocannabinergic system plays an important role in the cardiovascular regulation in hypertension. This review is aimed to discuss the in vivo hypotensive and cardiodepressant effects of cannabinoids mediated by cannabinoid and TRPV 1 receptors, and focuses on the novel therapeutical strategies offered by targeting the endocannabinoid system in the treatment of hypertension.

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“…Rimonabant was also found to inhibit the LPS-induced blood pressure lowering effect in pithed rats (Godlewski et al 2004). Finally, rimonabant was found to increase arterial pressure and peripheral resistance in rats with liver cirrhosis but not in control rats (Batkai et al 2001;Ros et al 2002). Rimonabant also exhibited beneficial effects in a rat model of doxorubicin-induced cardiomyopathy .…”

Section: Cardiovascular Effectsmentioning

confidence: 93%

Prejunctional and peripheral effects of the cannabinoid CB1 receptor inverse agonist rimonabant (SR 141716)

Diepen

Schlicker

Michel

2008

Naunyn-Schmied Arch Pharmacol

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Rimonabant is an inverse agonist specific for cannabinoid receptors and selective for their cannabinoid-1 (CB 1 ) subtype. Although CB 1 receptors are more abundant in the central nervous system, rimonabant has many effects in the periphery, most of which are related to prejunctional modulation of transmitter release from autonomic nerves. However, CB 1 receptors are also expressed in, e.g., adipocytes and endothelial cells. Rimonabant inhibits numerous cardiovascular cannabinoid effects, including the decrease of blood pressure by central and peripheral (cardiac and vascular) sites of action, with the latter often being endothelium dependent. Rimonabant may also antagonize cannabinoid effects in myocardial infarction and in hypotension associated with septic shock or liver cirrhosis. In the gastrointestinal tract, rimonabant counteracts the cannabinoid-induced inhibition of secretion and motility. Although not affecting most cannabinoid effects in the airways, rimonabant counteracts inhibition of smoothmuscle contraction by cannabinoids in urogenital tissues and may interfere with embryo attachment and outgrowth of blastocysts. It inhibits cannabinoid-induced decreases of intraocular pressure. Rimonabant can inhibit proliferation of, maturation of, and energy storage by adipocytes. Among the many cannabinoid effects on hormone secretion, only some are rimonabant sensitive. The effects of rimonabant on the immune system are not fully clear, and it may inhibit or stimulate proliferation in several types of cancer. We conclude that direct effects of rimonabant on adipocytes may contribute to its clinical role in treating obesity. Other peripheral effects, many of which occur prejunctionally, may also contribute to its overall clinical profile and lead to additional indications as well adverse events.

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Endogenous cannabinoids: A new system involved in the homeostasis of arterial pressure in experimental cirrhosis in the rat

Cited by 219 publications

References 19 publications

Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatment—a Systematic Review

Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatment—a Systematic Review

Blood pressure regulation by endocannabinoids and their receptors

Prejunctional and peripheral effects of the cannabinoid CB1 receptor inverse agonist rimonabant (SR 141716)

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