Cannabinoid receptor 1 promotes hepatocellular carcinoma initiation and progression via multiple mechanisms.

Hepatocellular carcinoma (HCC) has high mortality and no adequate treatment. Endocannabinoids interact with hepatic CB1 receptors (CB1R) to promote hepatocyte proliferation in liver regeneration via inducing cell-cycle proteins involved in mitotic progression, including Forkhead Box M1 (FOXM1). Because FOXM1 is highly expressed in HCC and contributes to its genesis and progression, we analyzed the involvement of the endocannabinoid/CB1R system in murine and human HCC. Postnatal diethylnitrosamine (DEN) treatment induced HCC within 8 months in wild-type mice, but fewer and smaller tumors in CB1R-/- mice or in wild-type mice treated with the peripheral CB1R antagonist JD5037, as monitored in vivo by serial magnetic resonance imaging. Genome-wide transcriptome analysis revealed CB1R-dependent, tumor-induced upregulation of the hepatic expression of CB1R, its endogenous ligand anandamide, and a number of tumor promoting genes, including the GRB2 interactome as well as FOXM1 and its downstream target the tryptophan-catalyzing enzyme indoleamine 2,3-dioxygenase (IDO2). Increased IDO2 activity and consequent induction of immunosuppressive Treg cells in tumor tissue promote immune tolerance. Conclusion: The endocannabinoid/CB1R system is upregulated in chemically induced HCC resulting in the induction of various tumor promoting genes, including IDO2, and attenuation of these changes by blockade or genetic ablation of CB1R suppresses the growth of HCC and highlights the therapeutic potential of peripheral CB1R blockade. This article is protected by copyright. All rights reserved.
© 2015 by the American Association for the Study of Liver Diseases.