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Does cannabis hold the key to treating cardiometabolic disease?

Nature Clinical Practice Cardiovascular Medicine volume 3, pages 116–117 (2006)Cite this article

Obesity, particularly visceral adiposity, and its related metabolic and cardiovascular disorders, is a worldwide pandemic. The biological properties of one of the most widespread illicit drugs of abuse, marijuana, have been recruited for obesity management. By uncovering the cellular interactions of the cannabinoid Δ9-tetrahydrocannabinol (Δ9-THC)—the major active component of marijuana—researchers have identified new molecular pathways for treating cardiometabolic disease. Studies have demonstrated that modulation of the endocannabinoid system holds great therapeutic promise for the treatment of obesity, dyslipidemia, insulin resistance and atherosclerosis.1,2

The endocannabinoid system contributes to the regulation of food intake, energy balance, inflammation, and lipid and glucose metabolism, and might therefore play a fundamental role in the development of obesity and atherosclerosis.3 To date, two G-protein-coupled cannabinoid receptors that bind Δ9-THC with equal affinity have been identified: CB1 and CB2. The CB1 receptor, believed to mediate the psychotropic effects of cannabis and to participate in the modulation of food intake and adipogenesis, is expressed at high levels by brain cells and by several peripheral tissues including the gastrointestinal tract, the adrenal gland, the heart and adipose tissue. CB1 knockout mice exhibit a lean phenotype and appear to be resistant to diet-induced obesity and insulin resistance.4 By contrast, CB2 receptors are located primarily on blood cells and immune tissues, and stimulation of these receptors with Δ9-THC results in an immunosuppressive phenotype via the modulation of immune-cell cytokine production.5 This molecular system might have a role in the development of obesity, the metabolic syndrome and atherosclerosis, and its modulation might form the basis of new therapeutic strategies for these pathophysiologically linked conditions.

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Authors and Affiliations

  1. Division of General Internal Medicine,

    Paul E Szmitko & Subodh Verma

  2. Division of Cardiac Surgery, St Michael's Hospital, at the University of Toronto, Toronto, ON, Canada

    Paul E Szmitko & Subodh Verma

Authors
  1. Paul E Szmitko
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  2. Subodh Verma
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Correspondence to Subodh Verma.

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The authors declare no competing financial interests.

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Szmitko, P., Verma, S. Does cannabis hold the key to treating cardiometabolic disease?. Nat Rev Cardiol 3, 116–117 (2006). https://doi.org/10.1038/ncpcardio0504

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