Prostaglandin E2 synthase inhibition as a therapeutic target

Background: Most NSAIDs function by inhibiting biosynthesis of PGE2 by inhibition of COX-1 and/or COX-2. Since COX-1 has a protective function in the gastro-intestinal tract (GIT), non-selective inhibition of both cycloxy genases leads to moderate to severe gastro-intestinal intolerance. Attempts to identify selective inhibitors of COX-2, led to the identification of celecoxib and rofecoxib. However, long-term use of these drugs has serious adverse effects of sudden myocardial infarction and thrombosis. Drug-mediated imbalance in the levels of prostaglandin I2 (PGI2) and thromboxane A2 (TXA2) with a bias towards TXA2 may be the primary reason for these events. This resulted in the drugs being withdrawn from the market, leaving a need for an effective and safe anti-inflammatory drug. Methods: Recently, the focus of research has shifted to enzymes downstream of COX in the prosta glandin biosynthetic pathway such as prostaglandin E2 synthases. Microsomal prostaglandin E2 synthase-1 (mPGES-1) specifically iso...