Abstract
Aspirin is one of the most frequently used and cheapest drugs in medicine. It belongs to the non-steroidal anti-inflammatory drugs with a wide range of pharmacological activities, including analgesic, antipyretic, and antiplatelet properties. Currently, it is accepted to prescribe a low dose of aspirin to pregnant women who are at high risk of preeclampsia (PE) because it reduces the onset of this complication. Another pregnancy alteration in which a low dose of aspirin is recommended is the obstetric antiphospholipid syndrome (APS). The most recognized mechanism of action of aspirin is to inhibit the synthesis of prostaglandins but this by itself does not explain the repertoire of anti-inflammatory effects of aspirin. Later, another mechanism was described: the induction of the production of aspirin-triggered lipoxins (ATLs) from arachidonic acid by acetylation of the enzyme cyclooxygenase-2. The availability of a stable analog of ATL has stimulated investigations on the use of this analog and it has been found that, similar to endogenously produced lipoxins, ATL resolves inflammation and acts as antioxidant and immunomodulator. If we consider that in PE and in the obstetric APS, there is an underlying inflammatory process, aspirin might be used based on the induction of ATL. The objective of this review is to revisit the old and new mechanisms of action of aspirin. In particular, it intends to show other potential uses of this drug to prevent certain pregnancy complications in the light of its ability to induce anti-inflammatory and pro-resolving lipid-derived mediators.
Highlights
Aspirin is the trade name for acetylsalicylic acid coined by the Bayer laboratories
We evaluated the effect of aspirin-triggered lipoxins (ATLs) on the inflammatory and oxidative response induced by plasma from preeclamptic women on endothelial cells
Besides the pharmacological effects that it shares with other non-steroidal anti-inflammatory drugs (NSAIDs), aspirin can induce other lipid-derived mediators with potent anti-inflammatory actions, and stimulation of the resolution of inflammation places aspirin in a privileged position in the therapeutic arsenal
Summary
Aspirin is the trade name for acetylsalicylic acid coined by the Bayer laboratories. In many countries, it remains a registered trademark of this company, whereas in others aspirin has become the generic name of this substance. Aspirin in low doses is the single most cost-effective medicine for the prevention of secondary events of thrombosis. Low doses of aspirin (LDA) are widely used in the prevention of diverse alterations of gestation such as preeclampsia (PE) and the obstetric antiphospholipid syndrome (APS). Controversy persists concerning the real efficiency and empirical use of this compound, its prescription is very common in high-risk pregnancies; its cost is low and it is relatively safe and accessible to all [1,2,3,4,5,6,7]
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