选择性COX-2抑制剂引起心血管风险的研究进展

非甾体抗炎药(non-steroid anti-inflammatory drugs,NSAIDs)是一种有效的、广泛使用的抗炎镇痛药物,其对环氧合酶(cyclo-oxygenase,COX)亚型(COX-1、COX-2)的抑制作用将引起不同的反应,选择性COX-2抑制剂将显著增加不良心血管事件的风险,随着此类药物使用的增加和临床循证证据的积累,其带来的心血管风险引起了越来越多学者的关注。笔者通过归纳分析最新发表文献对选择性COX-2抑制剂引起心血管风险的研究进行综述,以期辅助临床合理用药,减少不良反应,提高用药安全性。

PGE_(2)在环氧合酶-2抑制剂保护脓毒症肠屏障功能中的作用

目的探讨PGE_(2)在环氧合酶-2抑制剂保护脓毒症肠屏障功能中的作用及机制。方法按随机数字表法将大鼠分为六组,假手术组、帕瑞昔布钠对照组、脓毒症组、帕瑞昔布钠治疗组、COX-2抑制剂组和帕瑞昔布钠-COX-2抑制剂组,每组8只。采用盲肠结扎穿孔术(CLP)制备脓毒症模型,ELISA检测大鼠血清和肠组织中TNF-α、IL-6水平和抗炎细胞因子IL-10水平,蛋白质免疫印迹试验(Western Blot)检测前列腺素E_(2)(PGE_(2))、前列腺素合酶-1(mPGES-1)和前列腺素受体EP4的蛋白表达,于假手术或CLP术后24 h取四组大鼠肠组织,RT-PCR法检测PGE_(2)、mPGES-1、EP4的mRNA表达水平。结果与假手术组比较,脓毒症大鼠血清和肠组织中TNF-α、IL-6和IL-10增加(P<0.05),帕瑞昔布钠治疗后能够降低TNF-α、IL-6水平(P<0.05),IL-10水平增加(P<0.05);术后24 h时脓毒症组大鼠肠组织PGE_(2)、mPGES-1、EP4和EP2 mRNA表达水平比假手术组明显升高,差异有统计学意义(P<0.05);与脓毒症组比较,帕瑞昔布钠治疗脓毒症大鼠后,肠组织PGE_(2)、mPGES-1、EP4的mRNA水平明显降低,差异有统计学意义(P<0.05);大鼠肠组织前列腺素E_(2)(PGE_(2))、前列腺素合酶-1(mPGES-1)和前列腺素受体EP4的蛋白表达水平比假手术组明显升高,差异有统计学意义(P<0.05),帕瑞昔布钠治疗后,肠组织前列腺素E_(2)(PGE_(2))、前列腺素合酶-1(mPGES-1)和前列腺素受体EP4的蛋白表达水平明显降低,差异有统计学意义(P<0.05);术后24h时,与假手术组比较,脓毒症组、帕瑞昔布钠治疗组、COX-2抑制剂组及帕瑞昔布钠-COX-2抑制剂组肠组织TNF-α、IL-10和IL-6的水平明显升高,差异有统计学意义(P<0.05);与脓毒症组比较,帕瑞昔布钠治疗组、COX-2抑制剂组及帕瑞昔布钠-COX-2抑制剂组肠组织TNF-α、IL-6的水平明显降低,IL-10的水平明显升高,差异有统计学意义(P<0.05);与帕瑞昔布钠治疗组比较,COX-2抑制剂组及帕瑞昔布钠-COX-2抑制剂组肠组织TNF-α、IL-6的水平降低,IL-10的水平明显升高,差异有统计学意义(P<0.05)。结论帕瑞昔布钠可通过抑制炎症反应来减轻脓毒症时肠屏障功能的损伤,其机制可能通过COX-2-mPGES-1-PGE_(2)-EP4通路发挥抗炎的作用。

Tolerance of neurite outgrowth to Rho kinase inhibitors decreased by cyclooxygenase-2 inhibitor

In this study, PC12 Adh cells and Neuro-2a cells were treated with Rho-associated kinase inhibitors （Y27632 and Fasudil）, a cyclooxygenase-1 selective inhibitor （SC560）, and a cyclooxygenase-2 inhibitor （NS398）. We found that these cells became tolerant to Rho-associated kinase inhibitors, as neurite outgrowth induced by these inhibitors diminished following more than 3 days of exposure in either cell line. The proteins cyclooxygenase-2 and cytosolic prostaglandin E synthetase were upregulated at day 3. NS398 decreased the tolerance to neurite outgrowth induction in both cell lines, whereas SC560 had almost no effect. These findings indicate that cells become tolerant to neurite outgrowth induced by Rho-associated kinase inhibitors, this is at least partly associated with upregulation of proteins involved in the cyclooxygenase-2 pathway, and cyclooxygenases-2 inhibition prevents this tolerance.

Design, Synthesis and in vitro Evaluation of Thiazole Derivatives of Ibuprofen as Cyclooxygenase-2 Inhibitors

A series of thiazole derivatives of ibuprofen, as cyclooxygenase-2 Inhibitors, were designed, synthesized and in vitro evaluated.

Opioid-sparing effect of selective cyclooxygenase-2 inhibitors on surgical outcomes after open colorectal surgery within an enhanced recovery after surgery protocol

AIM: To evaluate the opioid-sparing effect of selective cyclooxygenase-2(COX-2) inhibitors on short-term surgical outcomes after open colorectal surgery.METHODS: Patients undergoing open colorectal resection within an enhanced recovery after surgery protocol from 2011 to 2015 were reviewed. Patients with combined general anesthesia and epidural anesthesia, and those with acute colonic obstruction or perforation were excluded. Patients receiving selective COX-2 inhibitor were compared with well-matched individuals without such a drug. Outcome measures included numeric pain score and morphine milligram equivalent(MME) consumption on postoperative day(POD) 1-3, gastrointestinal recovery(time to tolerate solid diet and time to defecate), complications and length of postoperative stay.RESULTS: There were 75 patients in each group. Pain score on POD 1-3 was not significantly different between two groups. However, MME consumption and MME consumption per kilogram body weight on POD 1-3 was significantly less in patients receiving a selective COX-2 inhibitor(P < 0.001). Median MME consumption per kilogram body weight on POD 1-3 was 0.09, 0.06 and nil, respectively in patients receiving a selective COX-2 inhibitor and 0.22, 0.25 and 0.07, respectively in the comparative group(P < 0.001), representing at least 59% opioidreduction. Patients prescribing a selective COX-2 inhibitor had a shorter median time to resumption of solid diet [1(IQR 1-2) d vs 2(IQR 2-3) d; P < 0.001] and time to first defecation [2(IQR 2-3) d vs 3(IQR 3-4) d; P < 0.001]. There was no significant difference in overall postoperative complications between two groups. However, median postoperative stay was significantly 1-d shorter in patients prescribing a selective COX-2 inhibitor [4(IQR 3-5) d vs 5(IQR 4-6) d; P < 0.001]. CONCLUSION: Perioperative administration of oral selective COX-2 inhibitors significantly decreased intravenous opioid consumption, shortened time to gastrointestinal recovery and reduced hospital stay after open colorectal surgery.

Exacerbation of inflammatory bowel disease by nonsteroidal anti-inflammatory drugs and cyclooxygenase-2 inhibitors:Fact or fiction?

The existence of a possible link between inflammatory bowel disease （IBD） and nonsteroidal anti-inflammatory drugs （NSAIDs） has been repeatedly suggested. Recently, a few studies have addressed the issue of a possible, similar effect by selective cyclooxygenase-2 inhibitors （COXIBs）. The present article reviews the available scientific evidence for this controversial subject.

Selective Cyclooxygenase-2 Inhibitors: Design and Synthesis

The discovery of COX-2 provides a novel target developing more effective NSAIDs with fewer side effects. On the basis of results from the structure-activity relationships (SAR) of selective COX-2 inhibitors, we have designed and synthesized some promising compounds.

EFFECTS OF p53 GENE THERAPY COMBINED WITH CYCLOOXYGENASE-2 INHIBITOR ON CYCLOOXYGENASE-2 GENE EXPRESSION AND GROWTH INHIBITION OF HUMAN LUNG CANCER CELLS

Background Gene therapy by adenovirus-mediated wild-type p53 gene transfer has been shown to inhibit lung cancer growth in vitro,in animal models,and in human clinical trials.The antitumor effect of selective cyclooxygenase(COX)-2 inhibitors has been demonstrated in preclinical studies.However,no information is available on the effects of p53 gene therapy combined with selective COX-2 inhibitor on COX-2 gene expression and growth inhibition of human lung cancer cells.Methods We evaluated the effects of recombinant adenovirus-p53(Ad-p53) gene therapy combined with selective COX-2 inhibitor on the proliferation,apoptosis,cell cycle arrest of human lung adenocarcinoma A549 cell line,and the effects of tumor suppressor exogenous wild type p53 on COX-2 gene expression.ResultsAd-p53 gene therapy combined with selective COX-2 inhibitor celecoxib shows significant synergistic inhibition effects on the growth of human lung adenocarcinoma A549 cell line. Exogenous p53 gene can suppress COX-2 gene expression.ConclusionsSignificant synergistic inhibition effects of A549 cell line by the combined Ad-p53 and selective COX-2 inhibitor celecoxib may be achieved by enhancement of growth inhibition,apoptosis induction and suppression of COX-2 gene expression.This study provides first evidence that the administration of p53 gene therapy in combination with COX-2 inhibitors might be a new clinical strategy for the treatment or prevention of NSCLC.

环氧化酶2抑制剂parecoxib对C2C12骨骼肌细胞分化的影响及机制研究

目的:探讨环氧化酶2抑制剂帕瑞昔布(parecoxib)对C2C12小鼠骨骼肌细胞分化的影响及其分子机制。方法:CCK-8法检测不同浓度的parecoxib处理后C2C12细胞的活力;分化培养基诱导C2C12小鼠骨骼肌细胞48 h后,将细胞分为对照组(control组)和parecoxib组继续分化48 h。免疫荧光检测肌管细胞分化成熟的标志蛋白肌球蛋白重链(MyHC),qPCR和Western印迹分别检测My HC、肌原纤维Ⅰ型(Myh7)、Ⅱa型(Myh2)、Ⅱb型(Myh4)、Ⅱx型(Myh1)、肌生成决定因子(MyoD)、肌生成因子5(Myf5)、肌生成素(myogenin)的基因和蛋白表达。结果:0、100、150、200、250、300μmol/L的parecoxib均不影响细胞活力。与对照组相比,parecoxib组MyHC阳性肌纤维数量减少,肌管融合受损,分化程度降低,MyHC、MyHCⅡa、MyHCⅡb、MyHCⅡx、MyoG、MyoD和Myf5的mRNA水平降低(t=19.04、53.93、72.38、33.72、15.32、3.061、18,均P<0.05),MyHCⅠ的mRNA水平升高(t=17.12,P<0.01)。Western印迹结果显示,与对照组相比,parecoxib组MyHC、MyHCⅡa、MyHCⅡb、MyHCⅡx、MyoG和MyoD蛋白水平降低(t=7.297、7.852、11.43、227、80.14、11.76,均P<0.01),MyHCⅠ蛋白水平升高(t=5.891,P<0.01)。结论:Parecoxib可能通过下调MyoG、MyoD和Myf5的表达,抑制C2C12骨骼肌细胞的分化。

Role of cyclooxygenase-2 in the carcinogenesis of gastrointestinal tract cancers: A review and report of personal experience

Selective cyclooxygenase （COX）-2 inhibitors （coxibs） were developed as one of the anti-inflammatory drugs to avoid the various side effects of non-steroidal anti-inflammatory drugs （NSAIDs）. However, coxibs also have an ability to inhibit tumor development of various kinds the same way that NSAIDs do. Many experimental studies using cell lines and animal models demonstrated an ability to prevent tumor proliferation of COX-2 inhibitors. After performing a randomized study for polyp chemoprevention study in patients with familial adenomatous polyposis （FAP）, which showed that the treatment with celecoxib, one of the coxibs, significantly reduced the number of colorectal polyps in 2000, the U.S. Food and Drug Administration （FDA） immediately approved the clinical use of celecoxib for FAP patients. However, some coxibs were recently reported to increase the risk of serious cardiovascular events including heart attack and stroke. In this article we review a role of COX-2 in carcinogenesis of gastrointestinal tract, such as the esophagus, stomach and colorectum, and also analyze the prospect of coxibs for chemoprevention of gastrointestinal tract tumors.

Selective COX-2 inhibitor,NS-398,suppresses cellular proliferation in human hepatocellular carcinoma cell lines via cell cycle arrest

AIM: To investigate the growth inhibitory mechanism of NS-398, a selective cyclooxygenase-2 (COX-2) inhibitor, in two hepatocellular carcinoma (HCC) cell lines (HepG2 and Huh7). METHODS: HepG2 and Huh7 cells were treated with NS-398. Its effects on cell viability, cell proliferation, cell cycles, and gene expression were respectively evaluated by water-soluble tetrazolium salt (WST-1) assay, 4’-6-diamidino-2-phenylindole (DAPI) staining, flow cytometer analysis, and Western blotting, with dimethyl sulfoxide (DMSO) as positive control. RESULTS: NS-398 showed dose- and time-dependent growth-inhibitory effects on the two cell lines. Proliferating cell nuclear antigen (PCNA) expressions in HepG2 and Huh7 cells, particularly in Huh7 cells were inhibited in a time- and dose-independent manner. NS-398 caused cell cycle arrest in the G1 phase with cell accumulation in the sub-G1 phase in HepG2 and Huh7 cell lines. No evidence of apoptosis was observed in two cell lines. CONCLUSION: NS-398 reduces cell proliferation by inducing cell cycle arrest in HepG2 and Huh7 cell lines, and COX-2 inhibitors may have potent chemoprevention effects on human hepatocellular carcinoma.

Relationship between expression and distribution of cyclooxygenase-2 and bcl-2 in human gastric adenocarcinoma

AIM: To explore expression and distribution features of COX-2 and bcl-2 in human gastric adenocarcinoma tissues and to study its biological significance.METHODS: Totally 36 human gastric carcinoma samples were enrolled in this study (cardiac adenocarcinoma 16 cases, distal gastric adenocarcinoma 20 cases). The expressions of COX-2 and bcl-2 in cancerous tissues and corresponding para-cancerous tissues were investigated by immunohistochemistry using COX-2 polyclonal antibody and bcl-2 monoclonal antibody. The normal gastric mucosa tissues were used as control.RESULTS: The expressions of COX-2 and bcl-2 in gastric carcinoma were significantly higher than that in the paracancerous tissues (77.8% vs 47.2%, P＜0.01, 80.56% vs 58.33%, P＜0.05). The expression of COX-2 in cardiac adenocarcinoma was remarkably higher than that in the distal gastric carcinoma (93.8% vs 65.0%, P＜0.01). The expression of COX-2 was mainly localized in the cytoplasm of tumor cells and partly in the nucleus. There is a transition of the COX-2 cytoplasmic positivity to nucleic in tumor cells with the increase of gastric carcinoma pathological grade. Interstitial macrophages, fibroblasts and vascular endothelial cells also expressed COX-2. The tissues with higher expression of COX-2 also expressed high level of bcl-2 protein.CONCLUSION: Abnormal expression pattern of COX-2within the tissues of human gastric cancer is correlated with tumor location and lymph node metastasis. COX-2may regulate expression of apoptosis suppressor gene (bcl-2) through interaction of tumor cells and stromal cells and play an important role in the generation and development of tumors, which will be of great help in developing new methods for antitumor therapy.

Expression and significance of carcinoembryonic antigen, cancer antigen 153, and cyclooxygenase-2 in breast cancer

Objective This study aimed to evaluate serum and nipple discharge levels of carcinoembryonic antigen(CEA) and cancer antigen 153(CA153) and tissue cyclooxygenase-2(COX-2) expression in breast cancer cases and associations of these proteins with breast cancer metastasis.Methods The immunohistochemical Ultra Sensitive^(TM) S-P method was used to detect COX-2 expression in 77 cases of invasive breast carcinoma. Of these cases, 52 exhibited CEA and CA153 in both serum and nipple discharge(electrochemiluminescence method), and associations of these biomarkers with breast cancer prognosis were studied. Sixty cases of benign breast lesion were selected as a control group. Overall survival of breast carcinoma patients was evaluated. COX-2 expression was evaluated relative to clinicopathological features and CEA and CA153 levels, and its role in invasiveness was investigated.Results Among cases of invasive breast cancer, 72.7%(56/77) were COX-2 immunopositive, compared to 16.7% of benign lesions(χ2 = 66.745, P = 0.000) percentage of positive cells. COX-2 overexpression in breast cancer correlated positively with histological grade(II vs III; χ2 = 4.064, P = 0.043), lymph node metastasis(χ2 = 9.135, P = 0.003), and distant metastasis(χ2 = 8.021, P = 0.003). However, COX-2 expression did not correlate with age(≤ 50 vs 50 years) or tumor size(≤ 5 vs > 5 cm)(χ2 = 0.081, P = 0.776 and χ2 = 3.702, P = 0.054, respectively). Among breast cancer patients, COX-2 overexpression in tumors also correlated with shorter overall survival(P < 0.05). In brief, increased COX-2 expression correlates with worse prognosis and shorter overall survival. Malignant lesions were associated with significantly higher serum and nipple discharge levels of biomarkers, relative to benign lesions(P < 0.05). These biomarkers were present at significantly higher levels in nipple discharge than in serum(P < 0.05). Furthermore, significantly higher nipple discharge levels of CEA and CA153 were observed in COX-2-positive breast carcinoma patients, compared to COX-2-negative patients(P <0.05). Shorter overall survival in cancer patients group related to COX-2 overexpression in tumors(P < 0.05).Conclusion The study suggests that COX-2 overexpression correlates with poor clinicopathological parameters in breast cancers and might be an important biological marker of invasion and metastasis. The findings of the present study suggest that combined detection of COX-2 tissue expression and CEA and CA153 in serum and nipple discharge could facilitate clinical monitoring and diagnosis of metastasis in patients with breast cancer.

STUDY ON THE EXPRESSION OF CYCLOOXYGENASE-2 IN HEPATOCELLULAR CARCINOMA CELL LINES AND ON THE GROWTH INHIBITION EFFECT OF NS-398

Objective： To investigate the expression of cyclooxygenase -2 （COX-2） in hepatocellular carcinoma cell lines and to explore the effect of NS-398, a selective inhibitor for COX-2, on HepG-2 cell line. Methods： lmmunohistochemistry and RT-PCR were used to investigate COX-2 expression in 6 HCC cell lines. MTT and Flowcytometry were used to evaluate the effect of the selective inhibitor of COX-2, NS-398, on HepG-2 cell lines. Results： All six HCC cell lines showed COX-2 expression at protein level. Five out of 6 cell lines showed COX-2 expression at mRNA level. NS-398 could suppress the growth of HepG-2 cell line, in a time and dose dependant manner. Conclusion： NS-398, a selective inhibitor of COX-2, showed inhibition effect on HepG-2 HCC cell line. The efficacy of inhibition was time and dose dependent, providing a new evidence for chemoprovention of hepatocellular carcinorma with COX-2 selective inhibitors.

A Convenient Synthesis of the Substituted 2,3-Diarylindole the Potent Selective COX-2 Inhibitors

Phenyl sulfone-containing 2, 3-diarylindole derivatives were designed and identified to be selective COX-2 inhibitors. A convenient synthetic route was also developed for the synthesis of the novel inhibitors.

Health Related Quality of Life among Osteoarthritis Patients: A Comparison of Traditional Non-Steroidal Anti-Inflammatory Drugs and Selective COX-2 Inhibitors in the United Arab Emirates Using the SF-36

Objectives: Osteoarthritis (OA) has a dramatic impact on patients’ health related quality of life (HRQoL). Chronic use of analgesics and anti-inflammatory medications for pain management may improve symptoms but on long term may affect HRQoL negatively. The objective of the present study was to compare the impact of two different classes of analgesics, traditional non-steroidal anti-inflammatory drugs (NSAIDs) and selective cyclo-oxygenase-2 (COX-2) inhibitors on HRQoL among osteoarthritis patients using the SF-36 questionnaire. Methods: Clinic based cross-sectional study conducted at Al-Qassimi Hospital, Sharjah, United Arab Emirates (UAE), over a period of six months. Ethical Approval was obtained from the ethics committee at Al-Qassimi Clinical Research Center. Total of 200 osteoarthritis patients fulfilling the inclusion and exclusion criteria were involved in the study. Patients’ demographics were collected from their medical records. The Medical Outcome Study Short-Form 36 (SF-36) questionnaire was used to measure patients’ HRQoL. SF-36 data were scored using health outcomes scoring software 4.5. Results: Mean age of the subjects was 62.19 ± 9.81 years with females constituting 151 (75.5%) of the patients. In general, females scored lower in most of the HRQoL domains compared to males and there was significant difference between the two groups in the mental health (p = 0.005) & mental component (p = 0.042) domains. Compared to selective COX-2 inhibitors, patients on NSAIDs scored higher on all domains of SF-36 except physical functioning. There was significant difference in mental health domain for patients treated with NSAIDs (p = 0.02). Celecoxib was only better than NSAIDs in osteoarthritis patients with more than one musculoskeletal disorders in the domain of bodily pain (p = 0.009). Conclusion: NSAIDs-treated patients did not differ significantly from celecoxib-treated patients in all domains of the SF-36 except for the mental health domain.

选择性COX-2抑制剂对胃癌细胞株BGC-823增殖和凋亡的影响

目的:观察塞来昔布对胃癌细胞株BGC-823细胞增殖和凋亡的影响,寻找安全有效的治疗胃癌的化疗药物。方法:常规培养胃癌细胞株BGC-823至80%融合,加入不同浓度塞来昔布继续培养,采用噻唑蓝(MTT)比色法观察其对胃癌BGC-823细胞生长的影响。流式细胞仪检测细胞周期和细胞凋亡情况。RT-PCR技术检测p21和Fas的表达。结果:MTT比色法显示体外不同浓度塞来昔布均能抑制胃癌BGC-823细胞生长,呈浓度和时间依赖性,各浓度组间比较有显著差异(P<0.05)。流式细胞仪检测发现在0～100μmol/L内,随浓度增加G1期细胞数增加,S期细胞数减少;RT-PCR显示塞来昔布干预后胃癌BGC-823细胞p21和Fas的表达增强且呈浓度依赖性,各浓度组间比较,差异有统计学意义(P<0.05)。结论:体外塞来昔布抑制胃癌BGC-823细胞增殖和促进其凋亡,可能与p21上调阻止细胞周期进展和促进Fas表达诱导细胞凋亡有关。

选择性COX-2抑制剂塞来昔布对肝星状细胞增殖及活化的影响

目的通过观察选择性COX-2抑制剂塞来昔布对肝星状细胞增殖及活化的影响,以探讨COX-2在肝纤维化中的作用。方法用不同浓度的选择性COX-2抑制剂塞来昔布作用于体外培养的人肝星状细胞株LI-90,采用MTT法和半定量RT-PCR法检测塞来昔布对肝星状细胞增殖及活化的影响。结果塞来昔布可显著抑制体外培养的肝星状细胞LI-90的增殖和活化,随着药物剂量的增加和时间的延长,肝星状细胞LI-90的增殖和活化明显抑制,呈剂量和时间依赖性。结论塞来昔布对肝星状细胞增殖和活化的抑制作用是研究肝纤维化预防和治疗的重要方向之一。

塞来昔布对Lewis肺癌组织COX-2、VEGF、MVD、MMP-2表达的影响

目的探讨选择性环氧化酶(COX)-2抑制剂塞来(?)布对Lewis师癌移植瘤的抑制作用及其对肿瘤组织VEGF、MVD、MMP-2表达的影响。方法将C57BL/6小鼠随机分为药物组和对照组,药物组于接种Lewis肺癌细胞后第二天开始给予含1/1000塞来昔布的食物,连续24 d,计算抑瘤率。采用免疫组化的方法研究COX-2、VEGF、MVD、MMP-2的表达。并采用逆转录聚合酶链反应(RT-PCR)技术研究VEGF、MMP-2 mRNA的表达。结果含1/1 000塞来昔布食物饲养对Lewis肺癌移植瘤有明显抑制作用,抑瘤率为60.1%。免疫组化结果显示药物组肿瘤组织的COX-2积分平均值低于对照组,但无统计学差异(P>0.05)。药物组与对照组的VEGF积分为2.00±0.82和2.90±0.88(P<0.05),MVD平均值为16.70±7.77和23.15±4.58(P<0.05)。但药物组与对照组比较,MMP-2的表达无显著性差异。RT-PCR结果表明药物组VEGF mRNA 表达较对照组明显下调,而MMP-2 mRNA表达无明显改变。结论塞来昔布对Lewis肺癌移植瘤有明显抑制作用。其作用途径可能是通过抑制COX-2的活性,进而抑制VEGF的表达,减少新生血管形成。抑制肿瘤的生长。抑制肿瘤血管生长可能是塞来昔布肿瘤生长的又一机制。

选择性COX-2抑制剂对大鼠实验性肝癌早期干预的研究

目的:观察环氧化酶2(cyclooxygenase-2,COX-2)抑制剂对大鼠肝癌的发生及肿瘤血管生成的早期干预效果及作用机制。方法:将实验大鼠分为两组:单纯诱导组(12只)和药物干预组(40只),均给予二乙基亚硝胺(diethylnitrosamine,DEN)诱发大鼠实验性肝癌,药物干预组同时给选择性COX-2抑制剂罗非昔布(Rofecoxib)进行治疗,于第6周和第9周分批处死实验大鼠,观察病理变化;采用免疫组化法检测肝脏COX-2、肿瘤微血管密度(MVD)、抗凋亡基因Bcl-2和增殖细胞核抗原(proliferating cell nuclear an-tigen,PCNA)情况。结果:病理切片显示药物干预组大鼠肝脏的病变程度较单纯诱导组减轻;COX-2、Bcl-2在第6周及第9周、PCNA在第9周的表达干预组均低于诱导组(分别为P<0.01,P<0.05;P<0.05,P<0.01和P<0.05);MVD值两组间差异无统计学意义(P>0.05)。结论:COX-2抑制剂干扰和减缓了大鼠实验性肝癌的进程,其作用机制可能主要是通过诱导细胞凋亡及抑制细胞增殖而实现,对于肿瘤血管生成的抑制作用在诱癌早期未能显示。