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Prostaglandin-endoperoxide synthase 1 (COX-1) and Prostaglandin-endoperoxide synthase 2 (COX-2) (COX-1 (PTGS1), COX-2 (PTGS2))

Target
COX-1 (PTGS1), COX-2 (PTGS2)
Molecular classification
Enzyme (specifically, heme peroxidase family), Homodimeric membrane-bound protein
01

Overview

Cyclooxygenase-1 and cyclooxygenase-2 are enzymes central to the conversion of arachidonic acid to prostaglandins and thromboxanes, key mediators of inflammation, pain, fever, and several physiological homeostatic functions. COX-1 is constitutively expressed in most tissues and supports physiological processes such as gastric protection and platelet aggregation; COX-2 is normally inducible in response to inflammation and other stimuli and is heavily implicated in pathological conditions, including cancer. Both are homodimeric proteins with highly similar structures, although their active sites differ sufficiently to allow selective drug targeting, which is the basis for the development of COX-2 selective inhibitors. Inhibition of these enzymes underlies both the therapeutic efficacy and notable toxicity profiles of nonsteroidal anti-inflammatory drugs.

Other names
COX-1PTGS1prostaglandin G/H synthase 1prostaglandin-endoperoxide synthetase 1COX-2PTGS2prostaglandin G/H synthase 2prostaglandin-endoperoxide synthetase 2
02

Mechanism of action

Inhibition of cyclooxygenase activity (prevents prostaglandin synthesis from arachidonic acid) NSAIDs: nonselective inhibition (both COX-1 and COX-2) COX-2 inhibitors: selective inhibition of COX-2

03

Biological functions

Prostaglandin biosynthesis (conversion of arachidonic acid to prostaglandin H2)Regulation of inflammation, pain, feverMaintenance of gastric mucosal integrity (COX-1)Regulation of platelet aggregation (COX-1 via thromboxane A2)Mediation of pathophysiological processes (COX-2–induced in inflammation and cancer)
04

Disease associations

PainInflammationFeverGastric ulcers (adverse effect via COX-1 inhibition)Cancer (COX-2 overexpression)Cardiovascular disease
05

Safety considerations

Gastrointestinal toxicity (ulcers, bleeding) via COX-1 inhibitionIncreased cardiovascular risk (thrombosis, myocardial infarction) with COX-2 selective inhibitorsRenal side effects (NSAIDs cause sodium retention, hypertension)
06

Interacting drugs

Aspirin

7 more in the full profile.

07

Biomarkers

COX-2 expression levels in tumors (prognostic and predictive in oncology)Prostaglandin E2 levels (biochemical indicator of COX activity)

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