What are all the things that aspirin does?

doi:10.1136/bmj.327.7415.572

BMJ 2003;327:572-573 (13 September), doi:10.1136/bmj.327.7415.572

Editorial

What are all the things that aspirin does?

This fascinating but simple and cheap drug has an assured future

The first 150 words of the full text of this article appear below.

Ask any medical student and he or she will tell you that aspirinreduces fever, pain, and inflammation but may cause ulcers.Students may also recollect that it prolongs bleeding, and mayprevent strokes and heart attacks, but would be unlikely toknow of its use in cancer or Alzheimer's disease.

A defining point in the history of aspirin was the discoverythat it inhibited the prostaglandin forming cyclooxygenase.¹Prostaglandins cause inflammation, fever, and pain; have gastriccytoprotective actions; and are implicated in platelet aggregation,so this discovery provided a unified explanation for the effectsof aspirin (and most other non-steroidal anti-inflammatory drugs).However, events took an even more interesting turn when a furtherisoform of cyclo-oxygenase, cyclooxygenase-2, was discovered.²While similar in many ways to the original enzyme (COX 1) therewere important differences, including the fact that COX 2 wasinduced in cells by inflammatory insults. COX 2 . . . [Full text of this article]

Rod Flower, professor of biochemical pharmacology

William Harvey Research Institute, London EC1M 6BQ

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COX II selective agents not that safe: Brendon J Smith
bmj.com, 12 Sep 2003 [Full text]
Unifying hypothesis for human diseases: Richard G Fiddian-Green
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