Eicosanoid-generating pathways

Eicosanoid-generating pathways comprise the enzymatic cascades that convert arachidonic acid and other polyunsaturated fatty acids into potent lipid mediators known as eicosanoids, including prostaglandins, thromboxanes, leukotrienes, and lipoxins (NCBI: PMC3155113). These pathways primarily involve three main branches: the cyclooxygenase (COX) pathway, the lipoxygenase (LOX) pathway, and the cytochrome P450 (CYP) pathway. Eicosanoids act as local hormones that regulate a wide array of physiological and pathological processes, such as inflammation, vascular tone, platelet aggregation, and immune responses. Dysregulation of these pathways is central to the pathogenesis of chronic inflammatory diseases, cardiovascular disorders, and certain cancers. Consequently, these pathways are major therapeutic targets; for instance, nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit COX enzymes to alleviate pain and inflammation, while leukotriene modifiers are used in asthma management (PubMed: 21849120). These pathways are critical for maintaining homeostasis, but their over-activation leads to tissue damage and chronic disease states.

Other names

Arachidonic acid cascadeEicosanoid metabolismProstanoid biosynthesisLeukotriene biosynthetic pathway

Inhibition of cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) enzymes to prevent prostaglandin and thromboxane synthesis; inhibition of 5-lipoxygenase (5-LOX) to prevent leukotriene synthesis; and antagonism of downstream eicosanoid receptors such as CysLT1 (StatPearls: NBK542314).