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Ji XK, Madhurapantula SV, He G, Wang KY, Song CH, Zhang JY, Wang KJ. Genetic variant of cyclooxygenase-2 in gastric cancer: More inflammation and susceptibility. World J Gastroenterol 2021; 27:4653-4666. [PMID: 34366627 PMCID: PMC8326261 DOI: 10.3748/wjg.v27.i28.4653] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/17/2021] [Accepted: 07/02/2021] [Indexed: 02/06/2023] Open
Abstract
Gastric cancer accounts for the majority cancer-related deaths worldwide. Although various methods have considerably improved the screening, diagnosis, and treatment of gastric cancer, its incidence is still high in Asia, and the 5-year survival rate of advanced gastric cancer patients is only 10%-20%. Therefore, more effective drugs and better screening strategies are needed for reducing the incidence and mortality of gastric cancer. Cyclooxygenase-2 (COX-2) is considered to be the key inducible enzyme in prostaglandins (PGs) synthesis, which is involved in multiple pathways in the inflammatory response. For example, inflammatory cytokines stimulate innate immune responses via Toll-like receptors and nuclear factor-kappa B to induce COX-2/PGE2 pathway. In these processes, the production of an inflammatory microenvironment promotes the occurrence of gastric cancer. Epidemiological studies have also indicated that non-steroidal anti-inflammatory drugs can reduce the risk of malignant tumors of the digestive system by blocking the effect of COX-2. However, clinical use of COX-2 inhibitors to prevent or treat gastric cancer may be limited because of potential side effects, especially in the cardiovascular system. Given these side effects and low treatment efficacy, new therapeutic approaches and early screening strategies are urgently needed. Some studies have shown that genetic variation in COX-2 also play an important role in carcinogenesis. However, the genetic variation analysis in these studies is incomplete and isolated, pointing out only a few single nucleotide polymorphisms (SNPs) and the risk of gastric cancer, and no comprehensive study covering the whole gene region has been carried out. In addition, copy number variation (CNV) is not mentioned. In this review, we summarize the SNPs in the whole COX-2 gene sequence, including exons, introns, and both the 5' and 3' untranslated regions. Results suggest that COX-2 does not increase its expression through the CNV and the SNPs in COX-2 may serve as the potential marker to establish risk stratification in the general population. This review synthesizes emerging insights of COX-2 as a biomarker in multiple studies, summarizes the association between whole COX-2 sequence variation and susceptibility to gastric cancer, and discusses the future prospect of therapeutic intervention, which will be helpful for early screening and further research to find new approaches to gastric cancer treatment.
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Affiliation(s)
- Xuan-Ke Ji
- College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan Province, China
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan Province, China
- Key Laboratory of Tumor Epidemiology of Henan Province, Zhengzhou University, Zhengzhou 450001, Henan Province, China
- State Key Laboratory of Esophageal Cancer Prevention and Treatment, Zhengzhou University, Zhengzhou 450001, Henan Province, China
| | - Sailaja Vatsalya Madhurapantula
- College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan Province, China
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan Province, China
- Key Laboratory of Tumor Epidemiology of Henan Province, Zhengzhou University, Zhengzhou 450001, Henan Province, China
- State Key Laboratory of Esophageal Cancer Prevention and Treatment, Zhengzhou University, Zhengzhou 450001, Henan Province, China
| | - Gui He
- College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan Province, China
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan Province, China
- Key Laboratory of Tumor Epidemiology of Henan Province, Zhengzhou University, Zhengzhou 450001, Henan Province, China
- State Key Laboratory of Esophageal Cancer Prevention and Treatment, Zhengzhou University, Zhengzhou 450001, Henan Province, China
| | - Kun-Yan Wang
- College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan Province, China
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan Province, China
- Key Laboratory of Tumor Epidemiology of Henan Province, Zhengzhou University, Zhengzhou 450001, Henan Province, China
- State Key Laboratory of Esophageal Cancer Prevention and Treatment, Zhengzhou University, Zhengzhou 450001, Henan Province, China
| | - Chun-Hua Song
- College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan Province, China
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan Province, China
- Key Laboratory of Tumor Epidemiology of Henan Province, Zhengzhou University, Zhengzhou 450001, Henan Province, China
- State Key Laboratory of Esophageal Cancer Prevention and Treatment, Zhengzhou University, Zhengzhou 450001, Henan Province, China
| | - Jian-Ying Zhang
- College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan Province, China
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan Province, China
- Key Laboratory of Tumor Epidemiology of Henan Province, Zhengzhou University, Zhengzhou 450001, Henan Province, China
- State Key Laboratory of Esophageal Cancer Prevention and Treatment, Zhengzhou University, Zhengzhou 450001, Henan Province, China
| | - Kai-Juan Wang
- College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan Province, China
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan Province, China
- Key Laboratory of Tumor Epidemiology of Henan Province, Zhengzhou University, Zhengzhou 450001, Henan Province, China
- State Key Laboratory of Esophageal Cancer Prevention and Treatment, Zhengzhou University, Zhengzhou 450001, Henan Province, China
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Li Q, Ma C, Zhang Z, Chen S, Zhi W, Zhang L, Zhang G, Shi L, Cao F, Ma T. Association between cyclooxygenase-2 (COX-2) 8473 T > C polymorphism and cancer risk: a meta-analysis and trial sequential analysis. BMC Cancer 2018; 18:847. [PMID: 30143023 PMCID: PMC6109290 DOI: 10.1186/s12885-018-4753-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Accepted: 08/14/2018] [Indexed: 12/23/2022] Open
Abstract
Background Numerous studies have investigated the relationship between COX-2 8473 T > C polymorphism and cancer susceptibility, however, the results remain controversial. Therefore, we carried out the present meta-analysis to obtain a more accurate assessment of this potential association. Methods In this meta-analysis, 79 case-control studies were included with a total of 38,634 cases and 55,206 controls. We searched all relevant articles published in PubMed, EMBASE, OVID, Web of Science, CNKI and Wanfang Data, till September 29, 2017. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were used to evaluate the strength of the association. We performed subgroup analysis according to ethnicity, source of controls, genotyping method and cancer type. Moreover, Trial sequential analysis (TSA) was implemented to decrease the risk of type I error and estimate whether the current evidence of the results was sufficient and conclusive. Results Overall, our results indicated that 8473 T > C polymorphism was not associated with cancer susceptibility. However, stratified analysis showed that the polymorphism was associated with a statistically significant decreased risk for nasopharyngeal cancer and bladder cancer, but an increased risk for esophageal cancer and skin cancer. Interestingly, TSA demonstrated that the evidence of the result was sufficient in this study. Conclusion No significant association between COX-2 8473 T > C polymorphism and cancer risk was detected. Electronic supplementary material The online version of this article (10.1186/s12885-018-4753-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Qiuping Li
- Department of Medical Oncology, Luohe Central Hospital, Luohe First People's Hospital, No. 56 People's East Road, Luohe City, 462000, Henan Province, China
| | - Chao Ma
- Department of Medical Oncology, Luohe Central Hospital, Luohe First People's Hospital, No. 56 People's East Road, Luohe City, 462000, Henan Province, China
| | - Zhihui Zhang
- Department of Medical Oncology, Luohe Central Hospital, Luohe First People's Hospital, No. 56 People's East Road, Luohe City, 462000, Henan Province, China
| | - Suhua Chen
- Department of Medical Oncology, Luohe Central Hospital, Luohe First People's Hospital, No. 56 People's East Road, Luohe City, 462000, Henan Province, China
| | - Weiguo Zhi
- Department of Medical Oncology, Luohe Central Hospital, Luohe First People's Hospital, No. 56 People's East Road, Luohe City, 462000, Henan Province, China
| | - Lei Zhang
- Department of Medical Oncology, Luohe Central Hospital, Luohe First People's Hospital, No. 56 People's East Road, Luohe City, 462000, Henan Province, China
| | - Guoyao Zhang
- Department of Medical Oncology, Luohe Central Hospital, Luohe First People's Hospital, No. 56 People's East Road, Luohe City, 462000, Henan Province, China
| | - Lei Shi
- Department of Medical Oncology, Luohe Central Hospital, Luohe First People's Hospital, No. 56 People's East Road, Luohe City, 462000, Henan Province, China
| | - Fei Cao
- Department of Medical Oncology, Luohe Central Hospital, Luohe First People's Hospital, No. 56 People's East Road, Luohe City, 462000, Henan Province, China
| | - Tianjiang Ma
- Department of Medical Oncology, Luohe Central Hospital, Luohe First People's Hospital, No. 56 People's East Road, Luohe City, 462000, Henan Province, China.
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Kim JH, Lee MR, Hong YC. Modification of the association of bisphenol A with abnormal liver function by polymorphisms of oxidative stress-related genes. ENVIRONMENTAL RESEARCH 2016; 147:324-30. [PMID: 26922413 DOI: 10.1016/j.envres.2016.02.026] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 01/26/2016] [Accepted: 02/18/2016] [Indexed: 05/22/2023]
Abstract
Some studies suggested oxidative stress as a possible mechanism for the relation between exposure to bisphenol A (BPA) and liver damage. Therefore, we evaluated modification of genetic polymorphisms of cyclooxygenase 2 (COX2 or PTGS2), epoxide hydrolase 1 (EPHX1), catalase (CAT), and superoxide dismutase 2 (SOD2 or MnSOD), which are oxidative stress-related genes, on the relation between exposure to BPA and liver function in the elderly. We assessed the association of visit-to-visit variations in BPA exposure with abnormal liver function by each genotype or haplotype after controlling for age, sex, BMI, alcohol consumption, exercise, urinary cotinine levels, and low density lipoprotein cholesterol using a GLIMMIX model. A significant association of BPA with abnormal liver function was observed only in participants with COX2 GG genotype at rs5277 (odds ratio (OR)=3.04 and p=0.0231), CAT genotype at rs769218 (OR=4.16 and p=0.0356), CAT CT genotype at rs769217 (OR=4.19 and p=0.0348), SOD2 TT genotype at rs4880 (OR=2.59 and p=0.0438), or SOD2 GG genotype at rs2758331 (OR=2.57 and p=0.0457). Moreover, we also found higher OR values in participants with a pair of G-G haplotypes for COX2 (OR=2.81 and p=0.0384), G-C-A haplotype for EPHX1 (OR=4.63 and p=0.0654), A-T haplotype for CAT (OR=4.48 and p=0.0245), or T-G-A haplotype for SOD2 (OR=2.91 and p=0.0491) compared with those with the other pair of haplotypes for each gene. Furthermore, the risk score composed of 4 risky pair of haplotypes showed interactive effect with BPA on abnormal liver function (p=0.0057). Our study results suggest that genetic polymorphisms of COX2, EPHX1, CAT, and SOD2 modify the association of BPA with liver function.
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Affiliation(s)
- Jin Hee Kim
- Department of Environmental Health, Graduate School of Public Health, Seoul National University, Seoul 151-742, Republic of Korea; Department of Bioscience and Bioengineering, Sejong University, Seoul, 05006, Republic of Korea
| | - Mee-Ri Lee
- (c)Department of Preventive Medicine, Seoul National University College of Medicine, Seoul 110-799, Republic of Korea
| | - Yun-Chul Hong
- (c)Department of Preventive Medicine, Seoul National University College of Medicine, Seoul 110-799, Republic of Korea; (d)Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul 110-799, Republic of Korea.
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Applebaum E, Nackley AG, Bair E, Maixner W, Khan AA. Genetic Variants in Cyclooxygenase-2 Contribute to Post-treatment Pain among Endodontic Patients. J Endod 2015; 41:1214-8. [PMID: 26081267 DOI: 10.1016/j.joen.2015.04.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 04/21/2015] [Accepted: 04/28/2015] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Nonsteroidal anti-inflammatory drugs (NSAIDs) have a well-established analgesic efficacy for inflammatory pain. These drugs exert their effect by inhibiting the enzyme cyclooxygenase (COX) and are commonly used for the management of pain after endodontic treatment. There are 2 distinct isoforms of COX: COX-1, which is constitutively expressed, and COX-2, which is primarily induced by inflammation. Previous studies have shown that functional human genetic variants of the COX-2 gene may explain individual variations in acute pain. The present study extends this work by examining the potential contribution of the 2 COX isoforms to pain after endodontic treatment. METHODS Ninety-four patients treated by endodontic residents at the University of North Carolina School of Dentistry were enrolled into a prospective cohort study. Data on potential predictors of post-treatment pain were collected, and all patients submitted saliva samples for genetic analysis. Nonsurgical root canal therapy was performed, and participants recorded pain levels for 5 days after. RESULTS In this study, 63% of patients experienced at least mild pain after root canal therapy, and 24% experienced moderate to severe pain. The presence of pretreatment pain was correlated with higher post-treatment pain (P = .01). Elevated heart rate (P = .02) and higher diastolic blood pressure (P = .024) were also correlated with decreased post-treatment pain. Finally, we identified genetic variants in COX-2 (haplotype composed of rs2383515 G, rs5277 G, rs5275 T, and rs2206593 A) associated with post-treatment pain after endodontic treatment (P = .025). CONCLUSIONS Understanding the genetic basis of pain after endodontic treatment will advance its prevention and management.
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Affiliation(s)
- Elizabeth Applebaum
- Private Practice, School of Dentistry, University of North Carolina, Chapel Hill, North Carolina
| | - Andrea G Nackley
- Center for Pain Research and Innovation, School of Dentistry, University of North Carolina, Chapel Hill, North Carolina
| | - Eric Bair
- Center for Pain Research and Innovation, School of Dentistry, University of North Carolina, Chapel Hill, North Carolina
| | - William Maixner
- Center for Pain Research and Innovation, School of Dentistry, University of North Carolina, Chapel Hill, North Carolina
| | - Asma A Khan
- Center for Pain Research and Innovation, School of Dentistry, University of North Carolina, Chapel Hill, North Carolina.
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Agúndez JAG, Blanca M, Cornejo-García JA, García-Martín E. Pharmacogenomics of cyclooxygenases. Pharmacogenomics 2015; 16:501-22. [DOI: 10.2217/pgs.15.6] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Cyclooxygenases (COX-1 and COX-2) are key enzymes in several physiopathological processes. Many adverse drugs reactions to NSAIDs are attributable to COX-inhibition. The genes coding for these enzymes (PTGS1 and PTGS2) are highly variable, and variations in these genes may underlie the risk of developing, or the clinical evolution of, several diseases and adverse drug reactions. We analyze major variations in the PTGS1 and PTGS2 genes, allele frequencies, functional consequences and population genetics. The most salient clinical associations of PTGS gene variations are related to colorectal cancer and stroke. In many studies, the SNPs interact with NSAIDs use, dietary or environmental factors. We provide an up-to-date catalog of PTGS clinical associations based on case–control studies and genome-wide association studies, and future research suggestions.
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Affiliation(s)
- José AG Agúndez
- Department of Pharmacology, University of Extremadura, Cáceres, Spain
- Red de Investigación de Reacciones Adversas a Alergenos y Fármacos, Spain
| | - Miguel Blanca
- Red de Investigación de Reacciones Adversas a Alergenos y Fármacos, Spain
- Allergy Service, Carlos Haya Hospital, Málaga, Spain
| | - José A Cornejo-García
- Red de Investigación de Reacciones Adversas a Alergenos y Fármacos, Spain
- Allergy Service, Carlos Haya Hospital, Málaga, Spain
| | - Elena García-Martín
- Red de Investigación de Reacciones Adversas a Alergenos y Fármacos, Spain
- Department of Biochemistry & Molecular Biology, University of Extremadura, Cáceres, Spain
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Shalaby MA, Nounou HA, Ms A, O A, Azzam N, Saeed HM. Associations between single nucleotide polymorphisms of COX-2 and MMP-2 genes and colorectal cancer susceptibility in the Saudi population. Asian Pac J Cancer Prev 2015; 15:4989-94. [PMID: 24998576 DOI: 10.7314/apjcp.2014.15.12.4989] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It has been reported that COX-2 expression is associated with MMP-2 expression in thyroid and breast cancers, suggesting that MMPs are linked to COX-2-mediated carcinogenesis. Several polymorphisms within the MMP2 promoter region have been reported in cases with oncogenesis and tumor progression, especially in colorectal carcinogenesis. MATERIALS AND METHODS This research evaluated risk of association of the SNPs, including genes for COX-2 (A/G transition at +202) and MMP-2 (C/T transition at-1306), with colorectal cancer in 125 patients and 125 healthy controls. RESULTS AND CONCLUSIONS Our data confirmed that MMP2 C-1306 T mutations were significantly more common in colon cancer patients than in our control Saudi population; p=0.0121. On the other hand in our study, there was no significant association between genotype distribution of the COX2 polymorphism and colorectal cancer; p=0.847. An elevated frequency of the mutated genotype in the control group as compared to the patients subjects indeed suggested that this polymorphism could decrease risk in the Saudi population. Our study confirmed that the polymorphisms that could affect the expressions of MMP-2 and COX-2 the colon cancer patients were significantly higher than that in the COX-2 negative group. The frequency of individuals with MMP2 polymorphisms in colon cancer patients was higher than individuals with combination of COX2 and MMP2 polymorphisms. Our study confirmed that individuals who carried the polymorphisms that could affect the expressions of COX2 are more susceptible to colon cancer. MMP2 regulatory polymorphisms could be considered as protective; further studies need to confirm the results with more samples and healthy subjects.
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Affiliation(s)
- Manal Ali Shalaby
- Genetic Engineering and Biotechnology Research Institute (GEBRI), City for Scientific Research and Technology Applications, Egypt E-mail : ,
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Prognostic significance of cyclooxygenase-2 protein in pancreatic cancer: a meta-analysis. Tumour Biol 2014; 35:10301-7. [PMID: 25034525 DOI: 10.1007/s13277-014-2260-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 06/18/2014] [Indexed: 02/06/2023] Open
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Markkula A, Simonsson M, Rosendahl AH, Gaber A, Ingvar C, Rose C, Jernström H. Impact of COX2 genotype, ER status and body constitution on risk of early events in different treatment groups of breast cancer patients. Int J Cancer 2014; 135:1898-910. [PMID: 24599585 PMCID: PMC4225481 DOI: 10.1002/ijc.28831] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Accepted: 02/20/2014] [Indexed: 12/15/2022]
Abstract
The COX2 rs5277 (306G>C) polymorphism has been associated with inflammation-associated cancers. In breast cancer, tumor COX-2 expression has been associated with increased estrogen levels in estrogen receptor (ER)-positive and activated Akt-pathway in ER-negative tumors. Our study investigated the impact of COX2 genotypes on early breast cancer events and treatment response in relation to tumor ER status and body constitution. In Sweden, between 2002 and 2008, 634 primary breast cancer patients, aged 25–99 years, were included. Disease-free survival was assessed for 570 rs5277-genotyped patients. Body measurements and questionnaires were obtained preoperatively. Clinical data, patient- and tumor-characteristics were obtained from questionnaires, patients' charts, population registries and pathology reports. Minor allele(C) frequency was 16.1%. Genotype was not linked to COX-2 tumor expression. Median follow-up was 5.1 years. G/G genotype was not associated with early events in patients with ER-positive tumors, adjusted HR 0.77 (0.46–1.29), but conferred an over 4-fold increased risk in patients with ER-negative tumors, adjusted HR 4.41 (1.21–16.02)(pinteraction = 0.015). Chemotherapy-treated G/G-carriers with a breast volume ≥850 ml had an increased risk of early events irrespective of ER status, adjusted HR 8.99 (1.14–70.89). Endocrine-treated C-allele carriers with ER-positive tumors and a breast volume ≥850 ml had increased risk of early events, adjusted HR 2.30 (1.12–4.75). COX2 genotype, body constitution and ER status had a combined effect on the risk of early events and treatment response. The high risk for early events in certain subgroups of patients suggests that COX2 genotype in combination with body measurements may identify patients in need of more personalized treatment.
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Affiliation(s)
- Andrea Markkula
- Division of Oncology and Pathology, Department of Clinical Sciences, Lund University, Lund, Sweden
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Li P, Liu JW, Xu YH, Zhu SP, Guo F, Dong X. Parecoxib inhibits cell proliferation and induces apoptosis in human pancreatic cancer cell lines BxPC-3 and AsPC-1. Shijie Huaren Xiaohua Zazhi 2012; 20:675-679. [DOI: 10.11569/wcjd.v20.i8.675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the effect of parecoxib on cell proliferation and apoptosis in human pancreatic cancer cell lines BxPC-3 and AsPC-1 and to explore possible mechanisms involved.
METHODS: After BxPC-3 and AsPC-1 cells were incubated with different concentrations of parecoxib, cell viability was measured by MTT assay to calculate the half maximal inhibitory concentration (IC50); cell apoptosis was evaluated by TUNEL assay; and the expression of COX-2 was detected RT-PCR.
RESULTS: Cell viability was apparently inhibited by parecoxib in both cell types, and the inhibitory effect was time- and dose-dependent. The IC50 values in the two cell lines were 400.98 μmol/L ± 10.78 μmol/L and 256.3 μmol/L ± 2.98 μmol/L, respectively. Treatment with parecoxib increased apoptosis rate and down-regulated COX-2 expression in both cell lines.
CONCLUSION: Parecoxib potently inhibits cell proliferation and induces apoptosis in human pancreatic cancer cell lines BxPC-3 and AsPC-1 possibly by suppressing the expression of COX-2.
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