Cannabis in liver disorders: a friend or a foe?

Authors:
Dr. Hemant Goyal, MD
Dr. Hemant Goyal, MD
Mercer University School of Medicine
Assistant Professor of Medicine
Macon, GA | United States
Abhilash Perisetti
Abhilash Perisetti
University of Arkansas for Medical Sciences
MD
LITTLE ROCK, AR | United States

Eur J Gastroenterol Hepatol 2018 11;30(11):1283-1290

Department of Gastroenterology, Saint Luke's Hospital, University of Missouri Kansas City (UMKC) School of Medicine, Kansas City, Missouri.

The recent legalization of recreational marijuana use in some parts of the world, the discovery of new indications for the clinical application of cannabis, and the acceptance of the use of cannabis in practice has been paralleled by extensive research on the active components of cannabis and the endocannabinoid system within the human body. In this review, we evaluate the available evidence on cannabis and its constituents and the application of this evidence in clinical practice, focusing particularly on the liver and liver diseases. Constituents of cannabis, such as cannabidiol and Δ-tetrahydrocannabinol, have shown anti-inflammatory, antioxidant, and hepatoprotective effects both in in vitro and clinical studies, and appear to have potential in the symptom management and treatment of various liver diseases that were previously considered difficult to manage conservatively. In addition, the manipulation of the inherent endocannabinoid response system has found favor in many clinical fields and has generated considerable research and clinical interest. Moreover, evidence with regard to the adverse effects of marijuana use in liver diseases is weak, which has led to raise a question on the prior rules, with regard to a denial of liver transplantation to marijuana users. All in all, the recent trends in research, clinical experiences, as well as the legislature, has opened up new avenues towards the widespread clinical application of cannabis and its derivatives as well as modifiers of the components of the endocannabinoid system. More research is required to fully exploit these new evidences.

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Source
http://dx.doi.org/10.1097/MEG.0000000000001256DOI Listing
November 2018
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