Cadavid Angela P
Reproduction Group, Department of Microbiology and Parasitology, School of Medicine, University of Antioquia , Medellín , Colombia.
Front Immunol. 2017 Mar 15;8:261. doi: 10.3389/fimmu.2017.00261. eCollection 2017.
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.
阿司匹林是医学上最常用且最便宜的药物之一。它属于非甾体抗炎药，具有广泛的药理活性，包括镇痛、解热和抗血小板特性。目前，对于子痫前期（PE）高危孕妇，会开具低剂量阿司匹林，因为它能降低这种并发症的发生率。另一种推荐使用低剂量阿司匹林的妊娠相关病症是产科抗磷脂综合征（APS）。阿司匹林最广为人知的作用机制是抑制前列腺素的合成，但这本身并不能解释阿司匹林抗炎作用的全部。后来，又描述了另一种机制：通过环氧化酶 -2 的乙酰化作用，由花生四烯酸诱导产生阿司匹林触发的脂氧素（ATL）。ATL 稳定类似物的可得性推动了对该类似物用途的研究，并且发现，与内源性产生的脂氧素类似，ATL 可消除炎症，并具有抗氧化和免疫调节作用。如果我们认为在 PE 和产科 APS 中存在潜在的炎症过程，那么基于 ATL 的诱导作用，阿司匹林可能会被使用。本综述的目的是重新审视阿司匹林的新旧作用机制。特别是，鉴于其诱导抗炎和促解决脂质衍生介质的能力，旨在展示该药物预防某些妊娠并发症的其他潜在用途。
