The Emerging Role of the Endocannabinoid System in Endocrine Regulation and Energy Balance

Uberto Pagotto, Giovanni Marsicano, Daniela Cota, Beat Lutz, and Renato Pasquali

Endocrinology Unit, Department of Internal Medicine and Gastroenterology, and Center for Applied Biomedical Research
(U.P., R.P.), Sant’ Orsola-Malpighi Hospital, 40138 Bologna, Italy; Department of Physiological Chemistry (G.M., B.L.),
Johannes Gutenberg-University Mainz, 55099 Mainz, Germany; and University of Cincinnati, Department of Psychiatry,
Obesity Research Center, Genome Research Institute (D.C.), Cincinnati, Ohio 45237


During the last few years, the endocannabinoid system has emerged as a highly relevant topic in the scientific community. Many different regulatory actions have been attributed to endocannabinoids, and their involvement in several pathophysiological conditions is under intense scrutiny. Cannabinoid receptors, named CB1 receptor and CB2 receptor, first discovered as the molecular targets of the psychotropic component of the plant Cannabis sativa, participate in the physiological modulation of many central and peripheral functions. CB2 receptor is mainly expressed in immune cells, whereas CB1 receptor is the most abundant G protein-coupled receptor expressed in the brain. CB1 receptor is expressed in the hypothalamus and the pituitary gland, and its activation is known to modulate all the endocrine hypothalamic-peripheral endocrine axes. An increasing amount of data highlights the role of the system in the stress response by influencing the hypothalamic-pituitary-adrenal axis and in the control of reproduction by modifying gonadotropin release, fertility, and sexual behavior. The ability of the endocannabinoid system to control appetite, food intake, and energy balance has recently received great attention, particularly in the light of the different modes of action underlying these functions. The endocannabinoid system modulates rewarding properties of food by acting at specific mesolimbic areas in the brain. In the hypothalamus, CB1 receptor and endocannabinoids are integrated components of the networks controlling appetite and food intake. Interestingly, the endocannabinoid system was recently shown to control metabolic functions by acting on peripheral tissues, such as adipocytes, hepatocytes, the gastrointestinal tract, and, possibly, skeletal muscle. The relevance of the system is further strenghtened by the notion that drugs interfering with the activity of the endocannabinoid system are considered as promising candidates for the treatment of various diseases, including obesity. (Endocrine Reviews 27: 73–100, 2006)

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