Cycloxygenase-2 Inhibition Research Articles

Inhaled Indomethacin-Loaded Liposomes as Potential Therapeutics against Non-Small Cell Lung Cancer (NSCLC).

Most lung cancer instances are non-small cell lung cancers (NSCLC). As stated by recent literature, cycloxygenase-2 (COX-2) is upregulated in lung adenocarcinomas. COX-2 relates to enhanced cell proliferation and reduced apoptosis; both of which are essential for an invasive tumor growth and metastasis. Thus, COX-2 inhibition forms an important checkpoint. Drug repurposing and nano drug delivery systems will enable the faster and more efficacious drug development. This study was designed to prepare, characterize, and establish superior effectiveness of indomethacin (IND), (a nonselective COX-2 inhibitor) as liposomes (IND-Lip). IND-Lip were made using thin film hydration method andphysicochemical properties were characterized. Cell viabilitywas performed on NSCLC cell lines (A549, H1299 and H460) Clonogenic, spheroidal, caspase and COX-2 assays were then carried out. IND-Lip were found to have optimum physicochemical properties. Based on IC50value of 38.4 ± 4.9µM, A549 cells were used for further assays. From clonogenic assay, % colonies were found to be 25.5 ± 9.5% at 200µM of IND-Lip. IND-Lip performed significantly better in ex-vivo tumor reduction in 3D spheroid assay at 200μM concentration, compared to plain IND by Day 15. Finally, a significant inhibition of COX-2 as well as induction of caspase in all IND treated groups was observed. It is of note that liposomes demonstrated a superior efficacy in all studies compared to the plain drug. IND through liposomal delivery system can be a potentiallybeneficial strategy for lung carcinoma. However, further clinical studies andin-vivoresearch are essential to comprehend the complete view of this approach.

Abstract 6198: Regulation of cycloxygenase-2 in the tumor micro-environment improves radiation and immunotherapy

Abstract In breast cancer (BC), the presence of tumor infiltrating lymphocytes is associated with improved survival. A recent study showed that increased CD8 cells and Th17 cells are specifically associated with triple negative breast cancer (TNBC) patients, a highly aggressive subclass of breast cancer. However, they undergo functional reprogramming in the tumor micro-environment(TME) evident from decreased IFN-γ;; and granzyme B. These immune escape mechanisms contribute to inability of the immune system to control tumor progression. Thus modulation of TME is necessary to effectively target the tumor. Radiation therapy (RT) is commonly used in more than 60% of cancer patients including BC. Focal radiation limits systemic side effects commonly associated with chemotherapy and acts as immune modulator. Eventually the tumor comes out of the growth delay and tends to show more aggressive phenotype. We found that RT induced inflammation associated biomarkers nitric oxide synthase2 (NOS2) and cycloxygenase2 (COX2) in the TME, specifically in the tumor cells.We previously showed that co-expression of pro-inflammatory enzymes NOS2 and COX2is a powerful prognostic indicator of poor outcome (HR=21) among ER-patients which in turn drive major oncogenic pathways. Immunotherapy, on the other hand, is being used as a standard of care in lung cancer. However, currently there is no approved immunotherapy available for BC patients, early data from several ongoing clinical trials show activity in various subclasses of BC including TNBC. It is reported that PD-L1 is high in 20% of TNBCs and COX2 may be involved in its regulation in tumor-infiltrating myeloid cells. This led us to hypothesize that modulation of inflammation associated biomarkers in the TME would increase the efficacy of RT and immunotherapy by amplifying anti-tumor immunity. We investigated the effect of NOS2 or COX2 inhibition using commercially available inhibitor on radiation and αPD-L1 induced tumor growth delay and lung metastases in murine model of TNBC using 4T1 cell line implanted in flank of Balbc mice. Change in immune cell populations in the TME was investigated using confocal microscopy, CO-Detection by indEXing (CODEX) technology and flow-cytometry. We also measured the levels of inflammation associated cytokines in serum. We demonstrated that co-treatment with COX2 inhibitor led to tumor growth delay and reduced metastases compared to conventional therapy by changing the TME to support tumor clearance. Citation Format: Debashree Basudhar, Veena Somasundaram, David A. Scheiblin, Noemi Kedei, Robert Y. Cheng, Lisa A. Ridnour, Daniel W. McVicar, Stephen Lockett, David A. Wink. Regulation of cycloxygenase-2 in the tumor micro-environment improves radiation and immunotherapy [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 6198.

Abstract 1197: Role of NOS2-COX2 inhibition in radiation-induced tumor growth delay and immuno-modulation in the tumor micro-environment

Abstract Triple negative breast cancer (TNBC) is associated with lack of expression of human epidermal growth factor receptor 2 (HER2), estrogen receptor (ER) and progesterone receptor (PR), and do not respond to hormonal therapy. It is one of the most aggressive breast cancer phenotypes and remains a major health hazard among women with drug resistance being a limiting factor in treatment. Inflammation is a key driver of poor survival among TNBC patients through increase in metastasis and chemo-resistance. We recently demonstrated that co-expression of pro-inflammatory enzymes nitric oxide synthase2 (NOS2) and cycloxygenase2 (COX2) is a powerful prognostic marker of poor outcome (HR=21) among ER(-) patients where we showed that inflammatory loops involving these proteins globally drive major oncogenic pathways [1]. Apart from intramural signaling, the crosstalk of tumor cells with immune cells is a key driver of immuno-suppression. Tumor progression is associated with tumor infiltrating M2 macrophages and Th2 cells leading to immuno-suppression, aberrant activation of cytokines, chemokines and growth factors thus creating a conducive environment for tumor growth and metastasis. Our goal is to modulate the tumor micro-environment (TME) to increase efficacy of current radiation- and immunotherapy. Radiation therapy is a commonly used treatment option in different types of cancer including breast cancer. Focal radiation limits systemic side effects commonly associated with chemotherapy. It also activates the immune system. A key component of the immune system mediated tumor clearance is cytotoxic CD8 T cells. More recently a study found that increased CD8 cells and Th17 cells are specifically associated with TNBC patients [2]. However, they undergo functional reprogramming in the TME evident from decreased cytotoxic (IFN-γ) and proliferation marker (granzyme B). We used confocal microscopy and flow-cytometry techniques to investigate the role of NOS2 and COX2 in radiation induced tumor growth delay and metastasis. We also examined the ability of NOS2 and COX2 in regulation of the immune profile of the TME, thus emphasizing their importance in tumor growth and immune-surveillance. Lastly, we evaluated the role of COX2 and NOS2 inhibition using commercially available inhibitors on radiation induced tumor growth delay in murine models of ER- breast cancer. [1] Basudhar, D. et al, Proceedings of the National Academy of Sciences of the United States of America 2017, 114 (49), 13030-13035. [2] Gil Del Alcazar, et al., Cancer discovery 2017, 7 (10), 1098-1115. Note: This abstract was not presented at the meeting. Citation Format: Debashree Basudhar, Veena Somasundaram, David A. Scheiblin, Robert Y. Cheng, Stephen J. Lockett, David Wink, Lisa A. Ridnour. Role of NOS2-COX2 inhibition in radiation-induced tumor growth delay and immuno-modulation in the tumor micro-environment [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 1197.

Sevoflurane preconditioning ameliorates traumatic spinal cord injury through caveolin-3-dependent cyclooxygenase-2 inhibition.

Acute traumatic spinal cord injury (tSCI) results in a lifetime of paralysis associated with a host of medical complications. The developing secondary complications of tSCI may result in further chronic neurodegenerative diseases. Sevoflurane preconditioning (SF-PreCon) has shown guaranteed protective effects in myocardial or cerebral ischemic/reperfusion injury. However, the role of SF-PreCon in tSCI still remains to be elucidated. Here, we found that SF-PreCon ameliorated the developing secondary complications through reducing the apoptosis rate and the secretion of inflammatory cytokines in injured spinal cord tissues, and therefore enhancing the recovery after tSCI. Notably, we demonstrated that SF-PreCon ameliorates tSCI through inhibiting Cycloxygenase-2 (COX-2). Importantly, we verified that SF-PreCon inhibits the expression of COX-2 and reduces the apoptosis rate after tSCI via the induction of Caveolin-3 (Cav-3). Taken together, our results suggest that SF-PreCon ameliorates tSCI via Cav-3-dependent COX-2 inhibition and provide an economical and practical method against the secondary injury after tSCI.

Gamma-Terpinene Modulation of LPS-Stimulated Macrophages is Dependent on the PGE2/IL-10 Axis.

Gamma-terpinene is a monoterpene present in the essential oils of several plants, including those from the Eucalyptus genus. This molecule was recently described as anti-inflammatory and microbiocidal, but little is known about the mechanisms behind its effects. The aim of the present study was to investigate the effect of gamma-terpinene on the lipopolysaccharide-induced production of cytokines by murine peritoneal macrophages. Gamma-terpinene treatment was found to reduce the production of proinflammatory cytokines, such as interleukin-1β and interleukin-6, and enhance that of the anti-inflammatory cytokine interleukin-10. This was accompanied by increased levels of the enzyme cycloxygenase-2 and its product, the lipid mediator prostaglandin E2. Inhibition of cycloxygenase-2 with nimesulide abolished the potentiating effect of gamma-terpinene on interleukin-10 production. Moreover, nimesulide treatment also abrogated the inhibitory effect of gamma-terpinene on interleukin-1β and interleukin-6. Furthermore, in macrophages from mice deficient in the interleukin-10 gene, gamma-terpinene failed to inhibit interleukin-1β and interleukin-6 production. These results suggest that this monoterpene promotes the prostaglandin E2/interleukin-10 axis, which inhibits the production of these proinflammatory cytokines.

COX-2 mediates angiotensin II-induced (pro)renin receptor expression in the rat renal medulla.

(Pro)renin receptor (PRR) is predominantly expressed in the distal nephron where it is activated by angiotensin II (ANG II), resulting in increased renin activity in the renal medulla thereby amplifying the de novo generation and action of local ANG II. The goal of the present study was to test the role of cycloxygenase-2 (COX-2) in meditating ANG II-induced PRR expression in the renal medulla in vitro and in vivo. Exposure of primary rat inner medullary collecting duct cells to ANG II induced sequential increases in COX-2 and PRR protein expression. When the cells were pretreated with a COX-2 inhibitor NS-398, ANG II-induced upregulation of PRR protein expression was almost completely abolished, in parallel with the changes in medium active renin content. The inhibitory effect of NS-398 on the PRR expression was reversed by adding exogenous PGE2. A 14-day ANG II infusion elevated renal medullary PRR expression and active and total renin content in parallel with increased urinary renin, all of which were remarkably suppressed by the COX-2 inhibitor celecoxib. In contrast, plasma and renal cortical active and total renin content were suppressed by ANG II treatment, an effect that was unaffected by COX-2 inhibition. Systolic blood pressure was elevated with ANG II infusion, which was attenuated by the COX-2 inhibition. Overall, the results obtained from in vitro and in vivo studies established a crucial role of COX-2 in mediating upregulation of renal medullary PRR expression and renin content during ANG II hypertension.

Cycloxygenase-2 (COX-2) - A Potential Target for Screening of Small Molecules as Radiation Countermeasure Agents: An In Silico Study

Cyclooxygenase-2 (COX-2) is well established for its role in inflammation, cancer and has also been reported to play a significant role in radiation induced inflammation and bystander effect. It has already been reported to have a role in protection against radiation induced damage, suggesting it to be an important target for identifying novel radiation countermeasure agents. Present study aims at identifying novel small molecules from pharmacopeia using COX-2 as target in silico. Systematic search of the molecules that are reported to exhibit radiation protection revealed that around 30% (40 in 130) of them have a role in inflammation and a small percentage of these molecules (20%; 8 in 40) are reported to act as non-steroidal anti-inflammatory drugs (NSAIDS). Docking studies further clarified that antiinflammatory compounds exhibited higher binding energy (BE). Out of 15 top hits, 14 molecules are reported to have anti-inflammatory property, suggesting the significant role of COX-2 in radiation protection. Further, Johns Hopkins Clinical Compound Library (JHCCL), a collection of small molecule clinical compounds, was screened virtually for COX-2 inhibition by docking approach. Docking of around 1400 small molecules against COX-2, leads to identification of a number of previously unreported molecules, which are likely to act as radioprotectors.

In vitro and in vivo anti-inflammatory activities of columbin through the inhibition of cycloxygenase-2 and nitric oxide but not the suppression of NF-κB translocation

Columbin, a diterpenoid furanolactone, was isolated purely for the first time from the plant species Tinspora bakis. The anti-inflammatory effects of columbin were studied in vitro, in silico and in vivo. The effect of columbin on nitric oxide was examined on lipopolysaccharide–interferon-gamma (LPS/IFN) induced RAW264.7 macrophages. In vitro and in silico cyclooxygenase-1 and cyclooxygenase-2 inhibitory activities of columbin using biochemical kit and molecular docking, respectively, were investigated. Mechanism of columbin in suppressing NF-kappaB-translocation was tested using Cellomics®NF-κB activation assay and ArrayScan Reader in LPS-stimulated RAW264.7 cells. Moreover, effects of columbin in vivo that were done on carrageenan-induced mice paw-oedema were tested. Lastly, the in vitro and in vivo toxicities of columbin were examined on human liver cells and mice, respectively. Treatment with columbin or Nω-nitro-l-arginine methyl ester (l-NAME) inhibited LPS/IFN-γ-induced NO production without affecting the viability of RAW264.7. Pre-treatment of stimulated cells with columbin did not inhibit the translocation of NF-κB to the nucleus in LPS-stimulated cells. COX-1 and COX-2 inhibitory activities of columbin were 63.7±6.4% and 18.8±1.5% inhibition at 100μM, respectively. Molecular docking study further helped in supporting the observed COX-2 selectivity. Whereby, the interaction of columbin with Tyr385 and Arg120 signifies its higher activity in COX-2, as Tyr385 was reported to be involved in the abstraction of hydrogen from C-13 of arachidonate, and Arg120 is critical for high affinity arachidonate binding. Additionally, columbin inhibited oedema formation in mice paw. Lastly, the compound was observed to be safe in vitro and in vivo. This study presents columbin as a potential anti-inflammatory drug.

Clinical and Immunomodulatory Effects of Celecoxib Plus Interferon-Alpha in Metastatic Renal Cell Carcinoma Patients with COX-2 Tumor Immunostaining

Cycloxygenase-2 (COX-2) is an enzyme involved in prostaglandin E2 (PGE(2)) synthesis associated with higher renal cell carcinoma stage. COX-2 inhibition enhances interferon (IFN-α) anti-tumor immune effects in pre-clinical models. A phase II trial of celecoxib and IFN-α in a targeted population of metastatic renal cell carcinoma patients with maximal COX-2 expression was conducted. Cytokine-naive metastatic renal cell carcinoma patients with tumors expressing ≥10% maximal COX-2 staining by immunohistochemistry received IFN-α 5 million units daily and celecoxib 400 mg orally twice daily in an open-label, single-arm phase II trial. There were 3 partial responses among 17 patients (objective response rate 18%; 95% confidence interval, 4-43%). Time to progression was 5.6 months. Increased tumor staining 3+ for COX-2 was associated with increased baseline peripheral blood PGE(2) levels, and these patients demonstrated less PGE(2) decrease with therapy. Patients with more 3+ COX-2 staining had significantly more CD3(+) (p = 0.004) and CD4(+) (p = 0.002) IFN-γ T cells at baseline and a significantly greater decrease in these cells with therapy. Celecoxib plus IFN-α in renal cell carcinoma (RCC) patients with maximally staining COX-2 tumors does not significantly enhance overall response rates over IFN monotherapy. COX-2-expressing RCC demonstrates inherent immunosuppression. COX-2 inhibition with IFN results in minimal immunomodulation and no augmented clinical activity in RCC.

Association of PI3-kinase and Wnt Signaling in Non-steroidal Anti-Inflammatory Drug-induced Apoptosis in Experimental Colon Cancer

In addition to having anti-inflammatory properties, non-steroidal anti-inflammatory drugs (NSAIDs) inhibit neoplastic cell proliferation by inducing apoptosis. Inhibition of cycloxygenase-2 (COX-2) seemed to be the principal target of NSAIDs, as it is overexpressed in several cancers and catalyzes the synthesis of prostaglandin E2 (PGE2), the critical proinflammatory molecule. A major role for phosphatidyl inositol 3kinase (PI3-kinase) pathway activation in human tumors has been more recently established. The present study explored the role of PI3-kinase and Wnt molecular pathways in NSAIDs’ chemopreventive effect in colon cancer. 1, 2-dimethylhydrazine was used for experimental colon cancer model and diclofenac as the chemopreventive agent. Protein expression of caspase-3 and 9 and fragmentation of DNA were checked in the colonic tissue. There was a decrease in all the three parameters, indicative of inhibition of apoptosis in the present experimental cancer model. Protein expression of PCNA and proliferation index as determined by both PCNA and BrdU immunostaining were also seen to be increased in the DMH treated animals. DMH upregulated the expression of PI3-kinase, Akt, Wnt and β-catenin, but reduced the GSK-3β levels. Coadministration with diclofenac, while decreasing PI3-kinase, Akt, Wnt and β-catenin, also increased the protein level of GSK-3β thus confirming that NSAIDs target PI3-kinase and Wnt signaling to exert the two important actions – induction of apoptosis and inhibition of cellular proliferation.

C003 Cycloxygenase-2 preserves flow-mediated remodeling in old obese zucker rats resistance arteries

Resistance arteries have a key role in the control of local blood flow. They are able to remodel in response to chronic increases in flow during growth, exercising or in ischemic diseases. Flow-mediated remodelling is governed by the endothelium. The incidence of metabolic syndrome increases with age and these 2 risk factors reduce endothelium integrity, because of an inflammatory process. We hypothesized that inflammation possibly through the induction of cycloxygenase-2 (COX2), might affect remodeling in old obese rats. In 12-month old obese and lean Zucker rats mesenteric resistance arteries were alternatively ligated in vivo so that one artery was submitted to high flow (HF), compare to normal flow (NF) vessels. After 21 days, outward hypertrophic remodelling in HF arteries occurred in obese rats (498±20 in HF arteries vs 443±18 μm in NF arteries, P<0.01), not in lean rats (454±17 vs 432±14, NS; n=12 per group). Endothelium-dependent (acetylcholine)-relaxation (AMR) was reduced in obese compare to lean rats. AMR was reduced by NO-synthesis blockade (L-NAME) in all groups and eNOS expression was higher in HF than in NF arteries without difference between lean and obese rats. Indomethacin further reduced AMR in HF from obese rats without significantly affecting arteries from lean animals. As COX2 immunostaining and expression level was evidenced in arteries from obese rats, COX2 inhibition (NS398) was tested on AMR. NS398 significantly reduced AMR in HF arteries in obese rats only. In obese rats chronically treated (3 weeks) with NS398 outward remodelling did not occurred in HF arteries. Thus, COX2 preserved arterial remodelling in response to a chronic rise in blood flow in old obese rats. This adaptation is in favor of a better tissue perfusion.

Peroxisome Proliferator-Activated Receptor-α Contributes to the Anti-Inflammatory Activity of Glucocorticoids

Glucocorticoids (GCs) are effective anti-inflammatory agents widely used in the therapeutic approach to treatment of acute and chronic inflammatory diseases. Previous results suggest that peroxisome proliferator-activated receptor-alpha (PPAR-alpha), an intracellular transcription factor activated by fatty acids, plays a role in the control of inflammation. With the aim of characterizing the role of PPAR-alpha in GC-mediated anti-inflammatory activity, we tested the efficacy of dexamethasone (DEX), a synthetic GC specific for glucocorticoid receptor, in an experimental model of lung inflammation, carrageenan-induced pleurisy, comparing mice lacking PPAR-alpha (PPAR-alphaKO) with wild-type (WT) mice. We also tested the possible synergism of combined treatment with DEX and clofibrate, a PPAR-alpha agonist. Results indicate that DEX-mediated anti-inflammatory activity is weakened in PPAR-alphaKO mice compared with WT controls, and that is increased in WT mice when combined with PPAR-alpha agonist treatment. In particular, DEX was less effective in PPAR-alphaKO, compared with WT mice, as evaluated by inhibition of NF-kappaB, of TNF-alpha production, of cell migration, of cycloxygenase-2 (COX-2) and inducible nitric-oxide synthase activation. Interestingly enough, macrophages from PPAR-alphaKO were less susceptible to DEX-induced COX-2 inhibition in vitro compared with WT mice. However, PPAR-alpha transfection in PPAR-alphaKO macrophages, with consequent receptor expression, resulted in reconstitution of susceptibility to DEX-induced COX-2 inhibition to levels comparable with that obtained in WT macrophages. It is noteworthy that the DEX effect on macrophages in vitro was significantly increased in WT cells when combined with PPAR-alpha agonist treatment. These results indicate that PPAR-alpha can contribute to the anti-inflammatory activity of GCs.

The Cycloxygenase 2 (COX-2) Story: It's Time to Explain, Not Inflame

Despite initial promising reports that anti-inflammatory properties of cycloxygenase-2 (COX-2) inhibitors may confer anti-atherosclerosis effects and stabilize the atherosclerotic plaque, subsequent data from long-term clinical trials have shown that selective COX-2 inhibitors are associated with increased risk of cardiovascular events. The commonly cited explanation is that selective inhibition of COX-2 leads to depletion of prostacyclin, whereas the production of pro-thrombotic thromboxane by means of cycloxygenase-1 (COX-1) is unopposed. This hypothesis seems unlikely as the overall explanation, because low-dose aspirin does not decrease the increased risk associated with COX-2 inhibitors. Moreover, the risk associated with nonselective COX inhibitors may be similar to selective COX-2 inhibitors. Alternative hypotheses include (1) elevated blood pressure, (2) abnormal vascular remodeling, (3) inhibition of protective mechanisms against ischemia-reperfusion injury, and (4) inhibition of 15-epi-lipoxin production. Varying results in different experimental models may be related to the fact that COX-2 is involved in numerous cellular functions. Inhibiting COX-2 in inflammatory cells may have favorable effects, whereas in organs such as the heart and brain and/or blood vessels may have deleterious effects. Currently, the "selective COX-2 inhibitors" are not selective in the sense that they inhibit COX-2 in all tissues without predilection to inflammatory cells and, as a result, may summate to increase the risk of cardiovascular events.

Docosahexaenoic acid induces proteasome-dependent degradation of -catenin, down-regulation of survivin and apoptosis in human colorectal cancer cells not expressing COX-2

n-3 Polyunsaturated fatty acids have been shown to powerfully inhibit the growth of colon cancer cells, mainly acting as pro-apoptotic agents through inhibition of cycloxygenase-2 (COX-2) expression. Since dysregulation of beta-catenin expression is frequently found at early stage of colorectal carcinogenesis, we analyzed whether docosahexaenoic acid (DHA) may modify the expression of beta-catenin in colon cancer cells (SW480 and HCT116) over-expressing this protein, but lacking COX-2. Futhermore, we investigated if alterations in beta-catenin expression may be associated with apoptosis induction. Treatment of cells with increasing concentrations of DHA induced a dose- and time-dependent inhibition of beta-catenin protein expression which, however, was not accompanied by modifications in beta-catenin transcription. Conversely, the proteasomal inhibitors MG132 and lactacystin prevented DHA-induced beta-catenin decrease, suggesting that DHA may regulate the proteasomal degradation of beta-catenin. The reduced levels of beta-catenin were accompanied by decreased translocation of beta-catenin into the nucleus, where it acts as a transcription factor in concert with T-Cell Factor (TCF). DHA, at the same range of concentrations, was also able to induce apoptosis by a caspase-3-dependent mechanism and to cause a dose- and time-dependent decrease of survivin, an apoptosis inhibitor undetectable in normal tissues and expressed in colorectal cancer through TCF-beta-catenin stimulation. Several other proteins regulated by the TCF-beta-catenin pathway and involved in regulation of tumor growth were down-regulated by DHA, including peroxisome proliferator-activated receptor-delta, membrane type 1 (MT1)-matrix metalloproteinase (MMP), MMP-7 and vascular endothelial growth factor. The present study, thus, raises the possibility that DHA may exert pro-apoptotic and antitumoral effects through proteasomal regulation of beta-catenin levels and alterations in the expression of TCF-beta-catenin target genes.

Role of Inflammatory Cytokine-Induced Cycloxygenase 2 in the Ocular Immunopathologic Disease Herpetic Stromal Keratitis

Ocular infection with herpes simplex virus (HSV) results in a blinding immunoinflammatory stromal keratitis (SK) lesion. Early preclinical events include polymorphonuclear neutrophil (PMN) infiltration and neovascularization in the corneal stroma. We demonstrate here that HSV infection of the cornea results in the upregulation of the cyclooxygenase 2 (COX-2) enzyme. Early after infection, COX-2 was produced from uninfected stromal fibroblasts as an indirect effect of virus infection. Subsequently, COX-2 may also be produced from other inflammatory cells that infiltrate the cornea. The induction of COX-2 is a critical event, since inhibition of COX-2 with a selective inhibitor was shown to reduce corneal angiogenesis and SK severity. The administration of a COX-2 inhibitor resulted in compromised PMN infiltration into the cornea, as well as diminished corneal vascular endothelial growth factor levels, likely accounting for the reduced angiogenic response. COX-2 stimulation by HSV infection represents a critical early event accessible for therapy and the control of SK severity.

Intravascular Thrombosis After Hypoxia-Induced Pulmonary Hypertension

Background— Pulmonary hypertension induced by chronic hypoxia is characterized by thickening of pulmonary artery walls, elevated pulmonary vascular resistance, and right-heart failure. Prostacyclin analogues reduce pulmonary pressures in this condition; raising the possibility that cycloxygenase-2 (COX-2) modulates the response of the pulmonary vasculature to hypoxia. Methods and Results— Sprague-Dawley rats in which pulmonary hypertension was induced by hypobaric hypoxia for 14 days were treated concurrently with the selective COX-2 inhibitor SC236 or vehicle. Mean pulmonary arterial pressure (mPAP) was elevated after hypoxia (28.1±3.2 versus 17.2±3.1 mm Hg; n=8, P &lt;0.01), with thickening of small pulmonary arteries and increased COX-2 expression and prostacyclin formation. Selective inhibition of COX-2 aggravated the increase in mPAP (42.8±5.9 mm Hg; n=8, P &lt;0.05), an effect that was attenuated by the thromboxane (TX) A 2 /prostaglandin endoperoxide receptor antagonist ifetroban. Urinary TXB 2 increased during hypoxia (5.9±0.9 versus 1.2±0.2 ng/mg creatinine; n=6, P &lt;0.01) and was further increased by COX-2 inhibition (8.5±0.7 ng/mg creatinine; n=6, P &lt; 0.05). In contrast, urinary excretion of the prostacyclin metabolite 6-ketoprostaglandin F 1α decreased with COX-2 inhibition (8.6±3.0 versus 27.0±4.8 ng/mg creatinine; n=6, P &lt; 0.05). Platelet activation was enhanced after chronic hypoxia. COX-2 inhibition further reduced the PFA-100 closure time and enhanced platelet deposition in the smaller pulmonary arteries, effects that were attenuated by ifetroban. Mice with targeted disruption of the COX-2 gene exposed to chronic hypoxia had exacerbated right ventricular end-systolic pressure, whereas targeted disruption of COX-1 had no effect. Conclusions— COX-2 expression is increased and regulates platelet activity and intravascular thrombosis in hypoxia-induced pulmonary hypertension.