Endocannabinoid receptor blockade increases vascular endothelial growth factor and inflammatory markers in obese women with polycystic ovary syndrome

• Published in: Clinical endocrinology (Oxford) Vol. 86; no. 3; pp. 384 - 387
• Main Authors: Sathyapalan, Thozhukat, Javed, Zeeshan, Kilpatrick, Eric S., Coady, Anne‐Marie, Atkin, Stephen L.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.03.2017
• Subjects: Biomarkers; Cannabinoid Receptor Antagonists - administration & dosage; Cannabinoid Receptor Antagonists - pharmacology; Cytokines; Cytokines - biosynthesis; Cytokines - drug effects; Female; Humans; Hyperandrogenism; Inflammation - metabolism; Interleukin-8 - biosynthesis; Metformin - administration & dosage; Obesity; Piperidines - administration & dosage; Polycystic ovary syndrome; Polycystic Ovary Syndrome - drug therapy; Polycystic Ovary Syndrome - metabolism; Polycystic Ovary Syndrome - pathology; Pyrazoles - administration & dosage; Vascular endothelial growth factor; Vascular Endothelial Growth Factor A - biosynthesis; Vascular Endothelial Growth Factor A - drug effects; Weight Loss
• ISSN: 0300-0664; 1365-2265; 1365-2265
• DOI: 10.1111/cen.13239

Summary Context Animal studies suggest that cannabinoid receptor‐1 (CB‐1) blockade reduces inflammation and neovascularization by decreasing vascular endothelial growth factor (VEGF) levels associated with a reduction in inflammatory markers, thereby potentially reducing cardiovascular risk. Objective To determine the impact of CB1 antagonism by rimonabant on VEGF and inflammatory markers in obese PCOS women. Design Randomized, open‐labelled parallel study. Setting Endocrinology outpatient clinic in a referral centre. Subjects Twenty patients with PCOS (PCOS) and biochemical hyperandrogenaemia with a body mass index of ≥30 kg/m2 were recruited. Patients were randomized to 1·5 g daily of metformin or 20 mg daily of rimonabant. Main outcome measures Post hoc review to detect VEGF and pro‐inflammatory cytokines TNF‐α, IL‐1β, IL‐1ra, IL‐2, IL6, IL‐8, IL‐10 and MCP‐1 before and after 12 weeks of treatment. Results After 12 weeks of rimonabant treatment, there was a significant increase in VEGF (99·2 ± 17·6 vs 116·2 ± 15·8 pg/ml, P < 0·01) and IL‐8 (7·4 ± 11·0 vs 18·1 ± 13·2 pg/ml, P < 0·05) but not after metformin (VEGF P = 0·7; IL‐8 P = 0·9). There was no significant difference in the pro‐inflammatory cytokines TNF‐α, IL‐1β, IL‐1ra, IL‐2, IL6, IL‐8, IL‐10 and MCP‐1 following either treatment. Conclusion This study suggests that rimonabant CB‐I blockade paradoxically raised VEGF and the cytokine IL‐8 in obese women with PCOS that may have offset the potential benefit associated with weight loss.