Effect of intermittent versus continuous low dose aspirin on nasal epithelium gene expression in current smokers: A randomized, double-blinded trial.

A chemopreventive effect of aspirin (ASA) on lung cancer risk is supported by epidemiologic and preclinical studies. We conducted a randomized, double-blinded study in current heavy smokers comparing modulating effects of intermittent versus continuous low dose ASA on nasal epithelium gene expression and arachidonic acid (ARA) metabolism. Fifty-four participants were randomized to intermittent (ASA 81 mg daily for one week/placebo for one week) or continuous (ASA 81 mg daily) for 12 weeks. Low dose ASA suppressed urinary prostaglandin E2 metabolite (PGEM) (change of -4.55±11.52 from baseline 15.44 ±13.79 ng/mg creatinine for arms combined, p = 0.02), a surrogate of cyclooxygenase-mediated ARA metabolism, but had minimal effects on nasal gene expression of nasal or bronchial gene expression signatures associated with smoking, lung cancer and chronic obstructive pulmonary disease. Suppression of urinary PGEM correlated with favorable changes in a smoking associated gene signature (p