Acetaminophen selectively suppresses peripheral prostaglandin E2 release and increases COX-2 gene expression in a clinical model of acute inflammation.

Article Details

Citation

Lee YS, Kim H, Brahim JS, Rowan J, Lee G, Dionne RA

Acetaminophen selectively suppresses peripheral prostaglandin E2 release and increases COX-2 gene expression in a clinical model of acute inflammation.

Pain. 2007 Jun;129(3):279-86. Epub 2006 Dec 18.

PubMed ID
17175104 [ View in PubMed
]
Abstract

Acetaminophen is widely used for pain management as an alternative to NSAIDs and selective COX-2 inhibitors, but its action at a molecular level is still unclear. We evaluated acetaminophen's effect on PG release and the expression patterns of genes related to PG production in a clinical model of tissue injury and acute inflammation. Subjects (119 outpatients) received either 1000 mg acetaminophen, 50 mg rofecoxib (a selective COX-2 inhibitor), 30 mg ketorolac (a dual COX-1/COX-2 inhibitor), or placebo before the surgical removal of two impacted mandibular third molars. Microdialysis was used to collect inflammatory transudate from the surgical site for measurement of PGE2 and TXB2 levels at the site of injury. Biopsies were collected to investigate the expression patterns of genes related to PG production at baseline prior to surgery and at 3 or 24 h following surgery. PGE2 release was suppressed by ketorolac, rofecoxib and acetaminophen compared to placebo at 3 h coincident with increased COX-2 gene expression in biopsies collected from the surgical site. TXB2 release was suppressed only by ketorolac. COX-2 gene expression remained elevated at 24 h with continued ketorolac and acetaminophen treatment. COX-1 gene expression was significantly down-regulated at 24 h by ketorolac, rofecoxib and acetaminophen. Acetaminophen suppression of PGE2 without inhibiting TXB2 release, when COX-2 gene expression is up-regulated, suggests that acetaminophen is a selective COX-2 inhibitor in vivo. The up-regulation of COX-2 gene and down-regulation of COX-1 gene expression suggests that acetaminophen may result in changes in COX-derived prostanoids with repeated doses.

DrugBank Data that Cites this Article

Drug Targets
DrugTargetKindOrganismPharmacological ActionActions
AcetaminophenProstaglandin G/H synthase 2ProteinHumans
Yes
Inhibitor
Details
Pharmaco-transcriptomics
DrugDrug GroupsGeneGene IDChangeInteractionChromosome
AcetaminophenApprovedPTGS15742
downregulated
Acetaminophen results in decreased expression of PTGS1 mRNA9q33.2
AcetaminophenApprovedPTGS25743
upregulated
Acetaminophen results in increased expression of PTGS2 mRNA1q31.1
KetorolacApprovedPTGS15742
downregulated
Ketorolac results in decreased expression of PTGS1 mRNA9q33.2
KetorolacApprovedPTGS25743
upregulated
Ketorolac results in increased expression of PTGS2 mRNA1q31.1
RofecoxibApproved Investigational WithdrawnPTGIS5740
downregulated
rofecoxib results in decreased expression of PTGIS mRNA20q13.13
RofecoxibApproved Investigational WithdrawnPTGS15742
downregulated
rofecoxib results in decreased expression of PTGS1 mRNA9q33.2