Physiopathology and use of cannabinoids for fibrotic diseases

Fibrotic diseases represent a major cause of morbidity and mortality worldwide. Fibrosis can affect nearly all tissues, and it is characterized by an excessive deposition of collagen and other extracellular matrix proteins that alter normal organ architecture and function. Inflammation, mediated by the infiltration of cells of the natural and adaptive immune response in damaged tissues, is a common physiopathological event to most, if not all, fibrotic diseases. This inflammatory response precedes fibrosis, is maintained during the course of the disease, and modulates the degree of fibrosis. Nowadays, there is accumulating evidence indicating that the endocannabinoid system can play an important role in the pathophysiology of fibrotic diseases, and consequently, the pharmacological manipulation of this system with cannabinoids has opened new avenues for the treatment of these diseases. In this chapter, we summarize the published literature on cannabinoids on major fibrotic disease and discuss their potential therapeutic implications.