Endocannabinoid system: An untold story in hypertensive nephropathy

Abstract

Prognosis of hypertension leads to organ damage by causing nephropathy, stroke, retinopathy and cardiomegaly. Kidney, retinopathy and blood pressure (BP) have been discussed in plenty in relation with catecholamines of autonomic nervous system (ANS) and angiotensin II of renin angiotensin aldosterone system but very little have been told about the role of endocannabinoid system (ECS) in the regulation of kidney function, retinopathy and BP. ECS is a unique system in the body, which can be considered as master regulator of body functions. It encompasses endogenous production of its cannabinoids, its degrading enzymes and functional receptors, which innervate and perform various functions in different organs of the body. Kidney, retinopathy and BP pathologies arise normally due to elevated catecholamine and ang II, which are vasoconstrictor in their biological nature. Question arise which system or agent counterbalances the vasoconstrictors effect of noradrenaline and ang II in normal individuals? This review will not only try to illustrate the significance of ECS in the kidney and BP regulation but also establish the connection of ECS with ANS and ang II. This review will also explain that ECS, which is vasodilator in its action either independently counteract the effect produced with the vasoconstriction of ANS and ang II or by blocking some of the common pathways shared by ECS, ANS, and ang II in the regulation of kidney and BP regulation. This article conclude that persistent control of BP and normal functions of kidney is maintained either by decreasing systemic catecholamine, ang II or by up regulation of ECS, which will result in the regression of nephropathy, stroke, retinopathy, and cardiomegaly induced by hypertension.