Beyond Inflammation: Blocking COX-2 May Provide Therapy for Multiple Diseases

UPSTREAM, DOWNSTREAM: Biochemical activity upstream of cyclooxygenase is better understood than reactions downstream of the enzyme.

Cancer, Alzheimer's disease, and stroke represent disparate destinations. But the pathogenic road leading to each passes through one enzyme: cyclooxygenase-2 (COX-2). Because of that biochemical junction, a class of compounds called COX-2 inhibitors, originally designed as anti-inflammatory agents against arthritis, may have broader utility.

The relationship between anti-inflammatory drugs and other diseases appeared epidemiologically before COX-2 inhibitors were tested. When scientists at pharmaceutical companies tested their own COX-2 inhibitors as anti-inflammatory agents in clinical trials, those epidemiological links became stronger. Now, both companies are testing their compounds for efficacy against conditions other than arthritis. And scientists are now examining how one mechanism can affect many diseases. "Undoubtedly, there are many diseases that will share common pathways, be it inflammation, carcinogenesis, or neurodegenerative processes," notes Andrew J. Dannenberg, director of the Strang-Cornell Gastrointestinal Cancer...