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Monoacylglycerol lipase inhibition as potential treatment for interstitial cystitis

Anu Chinnadurai1, Geraint Berger2, Ian Burkovskiy2

  • 1Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.

Medical Hypotheses
|August 25, 2019
PubMed

Insights

Interstitial cystitis (IC) treatment may be improved by targeting the endocannabinoid system. Inhibiting enzymes that break down natural cannabinoids could increase levels of beneficial compounds, reducing bladder inflammation.

Area of Science:

  • Urology
  • Immunology
  • Pharmacology

Background:

  • Interstitial cystitis (IC) is a chronic bladder inflammation with unknown causes and limited long-term treatments.
  • Current guidelines from EAU, AUA, and RCOG offer varied management strategies, including conservative, pharmacological, intravesical, and surgical options.
  • The endocannabinoid system presents a promising therapeutic target for IC.

Purpose of the Study:

  • To investigate the potential of targeting the endocannabinoid system for IC treatment.
  • To explore the role of cannabinoid receptor 2 (CBR2) agonists in mitigating bladder inflammation.
  • To hypothesize that inhibiting endogenous cannabinoid catabolism can enhance anti-inflammatory effects in the bladder.

Main Methods:

  • Identification of CBR2 in the detrusor and urothelial sensory nerves of human bladders.
  • Focus on inhibiting enzymes responsible for the breakdown of endogenous cannabinoids.
  • Hypothesizing increased local concentrations of CBR2 agonists, such as 2-arachidonyl glycerol.

Main Results:

  • Cannabinoid receptor 2 (CBR2) agonists have demonstrated the ability to reduce leukocyte migration.
  • Activation of CBR2 inhibits the release of pro-inflammatory cytokines at inflammatory sites.
  • The study hypothesizes that increased endogenous cannabinoid levels will lead to a reduced inflammatory response in the bladder.

Conclusions:

  • The endocannabinoid system, particularly CBR2, offers a potential therapeutic avenue for interstitial cystitis.
  • Modulating the endocannabinoid system by inhibiting catabolic enzymes may provide a novel treatment strategy for IC.
  • Further research into endogenous cannabinoid modulation could lead to improved management of chronic bladder inflammation.

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