Research Question

Can cannabidiol (CBD) be used in the treatment of endometriosis by its anti-inflammatory, antioxidative, and anti-angiogenic effects?

Design

Endometrial implants were surgically induced in 36 female Wistar-Albino rats. After confirmation of endometriotic foci, the rats were randomized into four groups. In leuprolide acetate (LA) group, rats were given a single 1mg/kg subcutaneous LA injection. Other groups were 5 mg/kg CBD (CBD5), saline solution (SS), and 20 mg/kg CBD (CBD20) and daily intra-peritoneal injections were applied for seven days. After 21 days, the rats were sacrificed, and total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) measurements in blood and peritoneal fluid samples, and immunohistochemical staining for TNF-α, IL-6 and vascular endothelial growth factor (VEGF) of endometriotic tissues were evaluated.

Results

Significant reduction in the endometriotic implant surface area, serum TOS, OSI, IL-6, TNF-α and peritoneal fluid OSI, IL-6 and TNF-α levels were observed in CBD5 when compared to SS group (p < 0.05). Compared to SS group, increased TAS (p < 0.01) levels in serum and peritoneal fluid were found in CBD5 group. CBD5 and LA groups were similar regarding inflammatory and oxidative stress parameters of serum and peritoneal fluid samples. CBD5 group showed significantly lower mean intensity in both surface epithelium and stromal cells and only in surface epithelium cells for VEGF and IL-6, respectively, when compared to LA group (p=0,002 and p=0,001 respectively).

Conclusion

By its anti-inflammatory, anti-oxidative and anti-angiogenic effects, CBD might be a therapeutic agent candidate for endometriosis.