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The endocannabinoid system in advanced liver cirrhosis: pathophysiological implication and future perspectives
Maurizio Baldassarre1, Ferdinando A Giannone, Lucia Napoli
1Department of Medical and Surgical Sciences, Center for Applied Biomedical Research (C.R.B.A.), Alma Mater Studiorum University of Bologna, Bologna, Italy.
Summary
The endogenous cannabinoid system plays a key role in liver disease and its complications. Targeting this system offers promising therapeutic strategies for liver cirrhosis and related conditions.
Area of Science:
- Pharmacology
- Hepatology
- Endocrinology
Background:
- Endogenous cannabinoids (EC) are lipid signaling molecules affecting central and peripheral systems via CB1 and CB2 receptors.
- The EC system is upregulated in chronic liver disease, contributing to liver fibrosis and fatty liver.
- EC signaling is implicated in circulatory disturbances and complications of advanced cirrhosis.
Purpose of the Study:
- To review the role of the endogenous cannabinoid system in liver disease pathogenesis.
- To explore the therapeutic potential of targeting the EC system for liver cirrhosis and its complications.
Main Methods:
- Literature review of experimental and clinical studies on the EC system in liver disease.
- Analysis of pharmacological approaches targeting EC receptors and enzymes.
Main Results:
- The EC system is involved in liver fibrosis, obesity-related fatty liver, alcoholic liver disease, and hepatitis C.
- EC signaling contributes to portal hypertension, hyperdynamic circulation, and cirrhotic cardiomyopathy.
- The EC system is implicated in ascites, hepatic encephalopathy, and infection-related inflammation in cirrhosis.
Conclusions:
- The endogenous cannabinoid system is a significant factor in the pathogenesis of liver cirrhosis and its complications.
- Targeting peripheral CB1 receptors, CB2 receptors, or EC metabolism enzymes presents promising therapeutic avenues.
- Pharmacological modulation of the EC system holds potential for treating liver cirrhosis and associated conditions.
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