The cyclooxygenase (COX) enzymes have elaborate roles in human physiology and pathology, spanning the cardiovascular, neuronal, renal, immune, gastrointestinal and reproductive systems.The cyclooxygenase isoenzymes, COX-1 and COX-2, catalyze the formation of prostaglandins, thromboxane, and levuloglandins.  COX enzymes are clinically important because they are inhibited by aspirin and numerous other non-steroidal anti-inflammatory drugs. COX-2 induction involves the orchestration of membrane-to-nucleus signaling processes such as tyrosine kinases, protein kinase C isoforms, peroxisome proliferator activated receptor, ras, NF-kB, and other transcription factors. Many of these converge on the mitogen activated protein kinase (MAPK) pathway involved in the transcriptional regulation of inflammatory genes. High expression of COX-2 in many tumors derives, in part, from somatic mutations that persistently activate signaling pathways for COX-2 expression.


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