Dissecting the role of cannabinoids in vascular health and disease

• Published in: Journal of cellular physiology 2024-11, Vol.239 (11), p.e31373-n/a
• Main Authors: Guo, Yanan, Wei, Xiaoyun, Pei, Junyu, Yang, Haibo, Zheng, Xi‐Long
• Format: Article
• Language: English
• Subjects: Animals; Aorta; Aortic aneurysms; Arteriosclerosis; Arteritis; Atherosclerosis; Atherosclerosis - drug therapy; Atherosclerosis - metabolism; Cannabinoid receptors; Cannabinoids; Cannabinoids - pharmacology; Cannabinoids - therapeutic use; Cannabis; Clinical trials; Endocannabinoid system; Endocannabinoids - metabolism; Experimental research; Humans; Hypertension; Lung diseases; Marijuana; Monocrotaline; Observational studies; Pathogenesis; Receptors, Cannabinoid - metabolism; Recreational use; Vascular diseases; Vascular Diseases - drug therapy; Vascular Diseases - metabolism; Vasoconstriction; VSMCs
• ISSN: 0021-9541; 1097-4652; 1097-4652
• DOI: 10.1002/jcp.31373

Cannabis, often recognized as the most widely used illegal psychoactive substance globally, has seen a shift in its legal status in several countries and regions for both recreational and medicinal uses. This change has brought to light new evidence linking cannabis consumption to various vascular conditions. Specifically, there is an association between cannabis use and atherosclerosis, along with conditions such as arteritis, reversible vasospasm, and incidents of aortic aneurysm or dissection. Recent research has started to reveal the mechanisms connecting cannabinoid compounds to atherosclerosis development. It is well known that the primary biological roles of cannabinoids operate through the activation of cannabinoid receptor types 1 and 2. Manipulation of the endocannabinoid system, either genetically or pharmacologically, is emerging as a promising approach to address metabolic dysfunctions related to obesity. Additionally, numerous studies have demonstrated the vasorelaxant properties and potential atheroprotective benefits of cannabinoids. In preclinical trials, cannabidiol is being explored as a treatment option for monocrotaline‐induced pulmonary arterial hypertension. Although existing literature suggests a direct role of cannabinoids in the pathogenesis of atherosclerosis, the correlation between cannabinoids and other vascular diseases was only reported in some case series or observational studies, and its role and precise mechanisms remain unclear. Therefore, it is necessary to summarize and update previously published studies. This review article aims to summarize the latest clinical and experimental research findings on the relationship between cannabis use and vascular diseases. It also seeks to shed light on the potential mechanisms underlying these associations, offering a comprehensive view of current knowledge in this evolving field of study. Cannabinoid use is on the rise and is associated with vascular health and disease. Cannabinoids exert various biological effects on the vascular system mainly by binding to CB1 and CB2. CB1 has a “yin‐yang” relationship with CB2 structurally and functionally, and their agonists/antagonists are promising candidates for the management of multiple metabolic syndromes and vascular diseases.