Cannabinoids Impact on Glucose Control and Hyperlipidemia But Not Obesity

Examining the effects of an endogenous cannabinoid uncovered a dual response in the pathways that regulate inflammatory response in the gut.

With Pramod K. Srivastava, PhD, and Caroline M. Apovian, MD

Given the growing demand for medical marijuana, more people will be consuming edible formulations that contain cannabinoids.1 This sparked interest from researchers at the University of Connecticut to understand the effects of cannabinoids on the gut and nervous system. Their findings on the cellular effects of cannabinoids, both an exogenous cannabinoid (capsaicin) and an endogenous cannabinoid (anandamide, one type of endocannabinoid) were published in the journal PNAS.

Across multiple studies,2 the researchers found that macrophages and cannabinoid receptors acted to control inflammatory response and related processes in the gut. In mice models, some using naive, nonobese mice with diabetes, the researchers found that endocannabinoids were involved in two mutually reinforcing regulatory pathways.

Cannabis compound may have impact on diabetes given its apparent role in gut inflammation.

Cannabinoids Play Important Role in Gut Microbiome

Study co-author Pramod K. Srivastava, PhD, MD,  professor of immunology and Director of the Center for Immunotherapy of Cancer and Infectious Diseases at the University of Connecticut, explained that food coming through the intestines is foreign material to the body.

Ordinarily, the body’s immune system attacks foreign bodies. The gut, however, needs to absorb nutrients. "This is extremely important because the gut is primarily a neurologically quiet area. Here we are showing that the fundamental and neurological role of the endocannabinoids is to cool down the gut," Dr. Srivastava told EndocrineWeb.

“We show [in this research] that if you have mice with a type 2 diabetes (T2D)-like condition, and you feed them anandamide, this seems to cure the disease. So, that's a clear point of interest for endocrinologists,”2 he said. "Greater understanding of the endocannabinoid system may lead to therapies for T2D, an autoimmune condition of gut inflammation in children."

Favorable Changes Imposed by Endocannabinoids 

“These findings suggest that the endocannabinoid system seems to regulate and keep immune cells and inflammation at bay in the gut,” Caroline M. Apovian, MD, FACP, FACN, director of the Nutrition and Weight Management Center at Boston Medical Center and professor of medicine and pediatrics at Boston University School of Medicine, told EndocrineWeb.

“We are now seeing a disconnect between the former research on endocannabinoid antagonists and obesity,” said Dr. Apovian, “This is saying something that you can construe to be the opposite—that endocannabinoids keep inflammation at bay. This is showing that the endocannabinoid increase can inhibit TH-27 cells, which are the bad guys.”

“Endocannabinoid antagonists were never approved for the treatment of obesity because of psychological side-effects,” she told EndocrineWeb. “This is just another link in the puzzle of the endocannabinoid system—the regulation of energy balance by the brain and the gut is heavily involved, so we need to keep doing this kind of research.”

Dr. Srivastava agreed that there’s still a lot that isn’t known about the cannabinoid system and its potential efficacy in glucose control, dyslipidemia, food intake and weight control.

“My study does not imply that we should all be eating pot brownies or candies with THC [delta-9-tetrahydrocannabinol]” Dr. Srivastava said, “Can we use this, for example, for treating inflammatory disease in the gut? Can we use this for understanding the onset of colitis? Are there other consequences of marijuana consumption for the gut? We don't know yet, as we have things to follow up on.” 

Endocannabinoid Activity Deserves More Attention

There are two key cannabinoid receptors subtypes: CB1 and CB2, which are part of a complex signaling system.  From earlier research, an obesity treatment was identified—a selective CB1 antagonist, rimonabant—which yielded a lower food intake in animal models.3,4 This effect appears to have an effect on leptin such that weight loss has been induced when CB1 receptors are blocked independent of food restriction.5,6

In addition, β-cells exposed to high glucose levels in the presence of cannabinoid receptor stimulation appeared to promote insulin release, an effect that was reversed by rimonabant but not CB2 receptor antagonists.7

The research findings advance our understanding of endocannabinoid signaling in adipocytes, and insulin production in mice that mimics a condition similar to that found in obese individuals, supporting the direct function of endocannabinoids on energy homeostasis.2,7  

All authors are free of any conflicts of interest.

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