Cannabis Sativa Revisited—Crosstalk between microRNA Expression, Inflammation, Oxidative Stress, and Endocannabinoid Response System in Critically Ill Patients with Sepsis

Abstract

Critically ill patients with sepsis require a multidisciplinary approach, as this situation implies multiorgan distress, with most of the bodily biochemical and cellular systems being affected by the condition. Moreover, sepsis is characterized by a multitude of biochemical interactions and by dynamic changes of the immune system. At the moment, there is a gap in our understanding of the cellular, genetic, and molecular mechanisms involved in sepsis. One of the systems intensely studied in recent years is the endocannabinoid signaling pathway, as light was shed over a series of important interactions of cannabinoid receptors with biochemical pathways, specifically for sepsis. Furthermore, a series of important implications on inflammation and the immune system that are induced by the activity of cannabinoid receptors stimulated by the delta-9-tetrahydrocannabinol (Δ9-THC) and cannabidiol (CBD) have been noticed. One of the most important is their ability to reduce the biosynthesis of pro-inflammatory mediators and the modulation of immune mechanisms. Different studies have reported that cannabinoids can reduce oxidative stress at mitochondrial and cellular levels. The aim of this review paper was to present, in detail, the important mechanisms modulated by the endocannabinoid signaling pathway, as well as of the molecular and cellular links it has with sepsis. At the same time, we wish to present the possible implications of cannabinoids in the most important biological pathways involved in sepsis, such as inflammation, redox activity, immune system, and epigenetic expression.

The interaction between the endocannabinoid system and the renin angiotensin system and its potential implication for COVID-19 infection

“…Some media suggested cannabinoids could be used to treat the cytokine storm related to COVID-19 infection (Sexton 2020). There is actually preclinical evidence suggesting cannabinoids might protect against cytokine storm and they could improve prognosis in the case of sepsis (Dinu et al 2020). However, we believe such evidence is not enough to recommend the use of cannabinoids in these cases since there are already other drugs available that have been extensively tested to treat such disorders.…”

Impact of General Anesthesia Guided by State Entropy (SE) and Response Entropy (RE) on Perioperative Stability in Elective Laparoscopic Cholecystectomy Patients—A Prospective Observational Randomized Monocentric Study

“…Post-operative complication rate has been shown to vary between 20% and 42% [ 47 ]; they have an impact both on the clinical outcome of patients as well as on the OR management and patient outflow [ 48 ]. This is due to longer times of stay in the recovery room and a longer hospital length of stay [ 49 , 50 , 51 , 52 ]. Another important aspect that is directly connected to post-operative complications is the economical aspect of the medical system, with increased costs in such situations.…”

Multiparametric Monitoring of Hypnosis and Nociception-Antinociception Balance during General Anesthesia—A New Era in Patient Safety Standards and Healthcare Management

“…Under surgical stress, in the case of ischemia-reperfusion syndrome or hypotension, an excessive number of free radicals will be produced, as well as proinflammatory mediators. All these factors will also decrease the production capacity for antioxidant molecules [ 92 ].…”