Research regarding cannabis and its potential impact on cirrhosis and other chronic liver diseases is complex. The two major cannabinoids found in cannabis, tetrahydrocannabinol (THC) and cannabidiol (CBD) bind with or influence the cannabinoid receptors (CB1 and CB2) of the endocannabinoid system within the body. Previous studies had actually implicated action of CB1 in the progression of cirrhosis, fibrosis, and other liver diseases. However, CB2 receptor activation has shown beneficial effects on alcoholic fatty liver, hepatic inflammation, liver injury, regeneration and fibrosis and CBD has. Therefore, research suggests that using cannabis to selectively activate the CB2 receptor offers therapeutic potential for cirrhosis and other liver diseases (Mallat, et al., 2011). Studies suggest that CBD can help combat cirrhosis progression by assisting in the death of hepatic stellate cells (HSCs). When HSCs are activated, they proliferate and produce excess collagen, which causes the accumulation of scarring on the liver. CBD’s activation of the CB2 receptors, however, has been shown to be effective at inducing apoptosis (death) in these activated HSCs (Lim, Devi & Rozenfeld, 2011). Cannabidiol has also been shown to restore liver function in mice experiencing liver failure (Abraham, et al., 2011). Findings also support that CBD can serve as a protective strategy against ischemia reperfusion, the pivotal mechanism of tissue damage in cirrhosis, by reducing the force of key inflammatory pathways and oxidative/nitrative tissue injury. These effects of CBD are independent of their impact on the CB2 receptors (Mukhopadhyay, Rajesh & Pacher, 2011). CBD has also proven effective at protecting the liver from steatosis caused by alcohol drinking by preventing an increase in oxidative stress and the autophagy induced by alcohol, thus protecting the liver from progressive damage (Yang, et al., 2014).
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