tailieunhanh - Báo cáo y học: "Commentary Cyclooxygenase-2: where are we in 2003"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Commentary Cyclooxygenase-2: where are we in 2003? | Arthritis Research and Therapy Vol 5 No 1 Mukherjee and Topol Commentary Cyclooxygenase-2 where are we in 2003 Cardiovascular risk and COX-2 inhibitors Debabrata Mukherjee1 and Eric J Topol2 Division of Cardiology University of Michigan Ann Arbor Michigan USA 2Department of Cardiovascular Medicine The Cleveland Clinic Foundation Cleveland Ohio USA Corresponding author Eric J Topol e-mail topole@ Received 25 September 2002 Revisions received 3 October 2002 Accepted 4 October 2002 Published 28 October 2002 Arthritis Res Ther 2003 5 8-11 DOI ar609 2003 BioMed Central Ltd Print ISSN 1478-6354 Online ISSN 1478-6362 Abstract Selective cyclooxygenase-2 COX-2 inhibitors were developed to reduce the gastrointestinal toxicity of conventional nonsteroidal anti-inflammatory agents. However COX-2 inhibitors decrease prostacyclin production and may disrupt the normal homeostatic balance leading to a prothrombotic state and offsetting the potential gastrointestinal benefits. Available clinical data and basic biological studies raise significant concern about the potential prothrombotic effect of this class of drugs. Two recent studies with a newer more selective COX-2 inhibitor have added to the already existing concern about the cardiovascular safety of these agents. The widespread use of these agents mandates prospective randomized evaluation of the cardiovascular safety of COX-2 inhibitors. Keywords cardiovascular risk cyclooxygenase-2 inhibitors prothrombotic effects prostaglandins Introduction Aspirin and traditional nonsteroidal anti-inflammatory agents NSAIDs are effective analgesic and anti-inflammatory agents but they also have significant gastrointestinal toxicity. The gastrointestinal toxicity of NSAIDs is apparently related to inhibition of the cyclooxygenase-1 COX-1 isoform 1 . Following the discovery by Fu et al. of a novel COX protein in monocytes stimulated by interleukin 2 Kujubu et al. identified a gene with significant homology to COX-1 3 . .