The interaction between the endocannabinoid system and the renin angiotensin system and its potential implication for COVID-19 infection

 Journal of Cannabis Research | Home“Coronavirus disease 2019 (COVID-19) is spreading fast all around the world with more than fourteen millions of detected infected cases and more than 600.000 deaths by 20th July 2020. While scientist are working to find a vaccine, current epidemiological data shows that the most common comorbidities for patients with the worst prognosis, hypertension and diabetes, are often treated with angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs).

Body: Both ACE inhibitors and ARBs induce overexpression of the angiotensin converting enzyme 2 (ACE-2) receptor, which has been identified as the main receptor used by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to enter into the alveolar cells of the lungs. While cannabinoids are known to reduce hypertension, the studies testing the hypotensive effects of cannabinoids never addressed their effects on ACE-2 receptors. However, some studies have linked the endocannabinoid system (ECS) with the renin angiotensin system (RAS), including a cross-modulation between the cannabinoid receptor 1 (CB1) and angiotensin II levels.

Conclusion: Since there are around 192 million people using cannabis worldwide, we believe that the mechanism underlying the hypotensive properties of cannabinoids should be urgently studied to understand if they can also lead to ACE-2 overexpression as other antihypertensive drugs do.”

https://pubmed.ncbi.nlm.nih.gov/32835160/

https://jcannabisresearch.biomedcentral.com/articles/10.1186/s42238-020-00030-4

Cannabinoid type 2 receptor agonist JWH133 decreases blood pressure of spontaneously hypertensive rats through relieving inflammation in the rostral ventrolateral medulla of the brain.

Journal of Hypertension | The International Society of Hypertension“Neuroinflammation in the rostral ventrolateral medulla (RVLM) has been reported to be associated with hypertension. The upregulation and activation of the cannabinoid type 2 (CB2) receptor may be part of the active process of limiting or downregulating the inflammatory process.

This study was designed to determine the role of the CB2 receptor in blood pressure (BP) through relieving neuroinflammation in the RVLM in spontaneously hypertensive rats (SHRs).

CONCLUSION:

Taken together, our results suggest that exciting the CB2 receptor relieves proinflammatory cytokine levels in the RVLM to decrease the BP, HR and RSNA in SHRs.”

https://www.ncbi.nlm.nih.gov/pubmed/32238784

https://journals.lww.com/jhypertension/Abstract/2020/05000/Cannabinoid_type_2_receptor_agonist_JWH133.15.aspx

Blood pressure regulation by endocannabinoids and their receptors

Logo of nihpa

“Cannabinoids and their endogenous and synthetic analogs exert powerful hypotensive and cardiodepressor effects by complex mechanisms involving direct and indirect effects on myocardium and vasculature.

On the one hand, endocannabinoids and cannabinoid receptors have been implicated in the hypotensive state associated with hemorrhagic, endotoxic and cardiogenic shock, and advanced liver cirrhosis.

On the other hand, there is emerging evidence suggesting that the endocannabinergic system plays an important role in the cardiovascular regulation in hypertension.

This review is aimed to discuss the in vivo hypotensive and cardiodepressant effects of cannabinoids mediated by cannabinoid and TRPV1 receptors, and focuses on the novel therapeutical strategies offered by targeting the endocannabinoid system in the treatment of hypertension.

The endocannabinergic system plays an important cardiovascular regulatory role not only in pathophysiological conditions associated with excessive hypotension but also in hypertension.

Thus, the pharmacological manipulation of this system may offer novel therapeutic approaches in a variety of cardiovascular disorders.”

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2225528/

Cannabinoids for treatment of glaucoma.

“The purpose of this article is to review the current status of cannabis in the treatment of glaucoma, including the greater availability of marijuana in the USA.

The pharmacology of marijuana and its effect on intraocular pressure has not changed since the research in the 1970s and 1980s.

Marijuana is an effective ocular hypotensive agent.

However, cardiovascular and neurological effects are observed at the same dose, and may theoretically reduce the beneficial effect of lowering intraocular pressure by reducing ocular blood flow. The clinician must be cognizant of this potential in diagnosis, prognosis, and therapy.”

http://www.ncbi.nlm.nih.gov/pubmed/26840343

Cannabis to lower blood pressure!

News Medical - Life Sciences & Medicine

“A new method for lowering blood pressure (hypertension) through use of a compound that synthesizes a cannabis (hashish) plant component has been developed by a pharmacology Ph.D. student at the Hebrew University of Jerusalem School of Pharmacy.

Cardiovascular disease (CVD) accounts for about one-third of all deaths in industrialized countries, and is the leading reason for visits there to physicians as well as for drug prescriptions. However, not all patients respond well to the drugs available. There is no “ideal’ hypotensive (blood pressure lowering) drug.

The cannabis plant – also known as hashish or marijuana – through its chemical compounds — cannabinoids — has been shown to have a beneficial, hypotensive effect.”

http://www.news-medical.net/news/2006/06/19/18517.aspx

Report shows relationship between sensation seeking, reward sensitivity and cannabis use

“Lowering Of Blood Pressure Achieved Through Use Of Hashish-like Drug”  http://www.sciencedaily.com/releases/2006/06/060620083025.htm

http://www.thctotalhealthcare.com/category/hypertension-high-blood-pressure/