Cannabinoids-A New Perspective in Adjuvant Therapy for Pulmonary Hypertension

Int J Mol Sci. 2021 Sep 17;22(18):10048. doi: 10.3390/ijms221810048.

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.

Keywords: cannabinoids; pulmonary hypertension; pulmonary vessels; vasoconstricion; vasorelaxation.

Publication types

  • Review

MeSH terms

  • Animals
  • Anti-Inflammatory Agents / pharmacology
  • Cannabidiol / pharmacology
  • Cannabinoids / metabolism*
  • Cell Proliferation
  • Disease Models, Animal
  • Endocannabinoids / metabolism
  • Heart Ventricles
  • Humans
  • Hypertension, Pulmonary / therapy*
  • In Vitro Techniques
  • Ligands
  • Lung / metabolism
  • Nitric Oxide
  • Pulmonary Circulation
  • Receptors, Cannabinoid / metabolism
  • Receptors, G-Protein-Coupled / metabolism
  • Systole
  • Vasoconstriction
  • Vasodilation
  • Ventricular Dysfunction, Right

Substances

  • Anti-Inflammatory Agents
  • Cannabinoids
  • Endocannabinoids
  • Ligands
  • Receptors, Cannabinoid
  • Receptors, G-Protein-Coupled
  • Cannabidiol
  • Nitric Oxide