“Alcohol abuse, viral hepatitis and non-alcoholic fatty liver disease (NAFLD) represent the major causes of chronic liver injury, resulting in progressive accumulation of fibrosis within the liver parenchyma. Progression to cirrhosis exposes patients to life-threatening complications of portal hypertension liver failure and hepatic encephalopathy, and to a high risk of developing hepatocellular carcinoma. Overall, chronic liver diseases represent a major health problem with an estimated rate of death in the range of 1 400 000 per year worldwide. Recent findings have revealed a role of endocannabinoids and their receptors in the pathogenesis of several key steps of acute and chronic liver injury, therefore identifying pharmacological modulation of cannabinoid receptors as an attractive strategy for the management of morbidity related to liver injury .”

“Chronic liver diseases represent a major health problem due to cirrhosis and its complications. During the last decade, endocannabinoids and their receptors have emerged as major regulators of several pathophysiological aspects associated with chronic liver disease progression. Hence, hepatic cannabinoid receptor 2 (CB₂) receptors display beneficial effects on alcoholic fatty liver, hepatic inflammation, liver injury, regeneration and fibrosis. Cannabinoid receptor 1 (CB₁) receptors have been implicated in the pathogenesis of several lesions such as alcoholic and metabolic steatosis, liver fibrogenesis, or circulatory failure associated with cirrhosis. Although the development of CB₁ antagonists has recently been suspended due to the high incidence of central side effects, preliminary preclinical data obtained with peripherally restricted CB₁ antagonists give real hopes in the development of active CB₁ molecules devoid of central adverse effects. CB₂-selective molecules may also offer novel perspectives for the treatment of liver diseases, and their clinical development is clearly awaited. Whether combined treatment with a peripherally restricted CB₁ antagonist and a CB₂ agonist might result in an increased therapeutic potential will warrant further investigation.”

“Cannabis Sativa has a long-standing history of recreational and therapeutic use, starting over 200 years ago. Understanding of pathways involved in the pharmacological properties of cannabinoids has only emerged with the identification of an endocannabinoid system that comprises at least two specific G-protein coupled receptors [cannabinoid receptor 1 (CB₁) and cannabinoid receptor 2 (CB₂)], their endogenous lipidic ligands (endocannabinoids), and enzymes involved in endocannabinoid synthesis and degradation.”

“Over the past 10 years, the endocannabinoid system has emerged as a major player in the pathogenesis of liver diseases. CB₁ receptors have been implicated in the pathogenesis of several lesions such as liver fibrogenesis, alcoholic and metabolic steatosis, or circulatory failure associated with cirrhosis. In contrast, stimulation of hepatic CB₂ receptors is emerging as an overall protective pathway with antifibrogenic properties and beneficial effects on liver inflammation, alcoholic fatty liver and hepatocyte survival and regeneration. Exciting therapeutic developments expected with the availability of CB₁ receptor antagonists have been put to a hold, due to the high incidence of central side effects of first generation compounds. Fortunately, CB₁ antagonists devoid of brain penetrance are increasingly being synthetized and initial results suggest that they exhibit beneficial effects expected from previous studies. The clinical development of CB₂-selective agonists is also eagerly awaited.”

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3165953/