Cannabinoids and sepsis

There is growing evidence for an involvement of the cannabinoid system in the pathogenesis of sepsis. In vitro, immune cell activation increases endocannabinoid production and reduces metabolic breakdown. The net result of this increased endocannabinoid activity is likely to cause hypotension-often a characteristic of sepsis. In whole animals lacking the CB2 cannabinoid receptor (found on immune cells) there was an increased incidence of multi-organ failure in a caecal ligation and puncture model of sepsis. In humans there is limited evidence for reduced metabolic activity in immune cells of patients with systemic sepsis; polymixin B haemofiltration (reducing endocannabinoids) may be beneficial in sepsis. Collectively these data suggest that strategies to modulate the endocannabinoid response in sepsis might represent a novel adjunctive strategy.