Microvascular Effects of Endocannabinoid Signaling in Sepsis: A Mechanistic and Systematic Review

Abstract Microvascular dysfunction is a central determinant of organ failure in sepsis, reflecting early endothelial activation, increased permeability, and impaired capillary perfusion. Experimental evidence suggests that the endocannabinoid system (ECS) modulates these immunovascular processes, yet mechanistic insights remain dispersed across heterogeneous models. We conducted a PRISMA‐guided systematic review of experimental studies assessing pharmacological modulation of ECS components under sepsis or endotoxemia conditions. Eleven studies met inclusion criteria, encompassing in vivo microcirculatory preparations and in vitro endothelial or immune‐cell systems. Across