Development of New Anti Inflammatory Drugs

Approximately 50 NSAID preparations are listed in Monthly Index of Medical Specialties and, as a class, these are among the most commonly prescribed drugs. NSAIDs are sometimes known as the aspirin-like drugs because they have an activity profile that is broadly similar to that of aspirin that is, they all possess analgesic, anti-inflammatory and antipyretic properties to some degree, and produce characteristic side effects, including gastric intolerance and depression of blood clotting through inhibitory action on platelet function. Two closely related forms of the cyclooxygenase have been identified which are now known as COX-1 and COX-2. Both isoenzymes transform arachidonic acid to prostaglandins, but differ in their distribution and their physiological roles. Meanwhile, the responsible genes and their regulation have been clarified. COX-1, the pre-dominantly constitutive form of the enzyme, is expressed throughout the body and performs a number of homeostatic functions such as maintaining normal gastric mucosa and influencing renal blood flow. COX-1 and COX-2 at standard anti-inflammatory doses. Simmons also recently co-discovered COX-3 in 2002 and analyzed this new isozyme's relation to acetaminophen (paracetamol), arguably the most widely used analgesic drug in the world. The clinical ramifications and knowledge of COX isozymes are therefore rapidly expanding and could perhaps offer significant hope for future treatments of pain, inflammation and fever.