Cannabinoids as Treatment for Hemophilic Arthropathy: Hypothesized Molecular Pathways

Hemophilia is a recessive X linked hereditary disease which causes coagulation problems. In severe cases, one of the most common issues is hemophilic arthropathy (HA) leading to a range of problems such as joint pain, swelling, crippling and decreased range of motion. Regarding pathogenesis of this phenomenon, the main consequence is emerged as repeated episodes of bleeding leading to inflammation, angiogenesis and synovium hypertrophy. These pathways are triggered and directed by some cytokines and growth factors such as IL-1, IL-6, TNF-α, HIF-α, VEGF and MMP-9. Cannabinoids (CBNs) are active compounds of Cannabis Sativa known for their highly potent anti-angiogenic and anti-inflammatory activity. In molecular aspects, they are able to suppress all mentioned cytokines, growth factors and even more angiogenic regulators such as Ang-1 and Ang2. Here we suggested that CBNs could be valid candidates for targeting HA due to their anti-inflammatory and anti-angiogenic activity.