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1 Attribution: University of Michigan Medical School, Department of Microbiology and Immunology License: Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Noncommercial Share Alike 3.0 License: We have reviewed this material in accordance with U.S. Copyright Law and have tried to maximize your ability to use, share, and adapt it. The citation key on the following slide provides information about how you may share and adapt this material. Copyright holders of content included in this material should contact with any questions, corrections, or clarification regarding the use of content. For more information about how to cite these materials visit Any medical information in this material is intended to inform and educate and is not a tool for self-diagnosis or a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional. Please speak to your physician if you have questions about your medical condition. Viewer discretion is advised: Some medical content is graphic and may not be suitable for all viewers.
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3 Arachadonic Acid Metabolism M1 Immunology Sequence Joseph Fantone, MD Winter 2009
4 How many take aspirin, ibuprofen, tylenol, naproxen? Why???
5 INFLAMMATORY MEDIATORS PLASMA DERIVED CELL-DERIVED COMPLEMENT CASCADE VASOACTIVE AMINES C3a, C5a histamine, serotonin COAGULATION CASCADE OXYGEN METABOLITES Thrombin, plasmin hydrogen peroxide (H ) superoxide anion (0 -) 2 hypochlorous acid (HOCl - ) ARACHIDONIC ACID METABOLITES cyclooxygenase-derived lipoxygenase-derived CYTOKINES Interleukins Chemokines Interferons Growth Factors Tumor Necrosis Factor
6 Intended Learning Outcomes To Understand The: Primary inflammatory mediators derived from the metabolism of arachidonic acid including their primary cellular source and biological activity. Effects of nonsteroidal anti-inflammatory compounds on blocking the production of arachidonic acid metabolites during disease Mechanism of aspirin therapy and diets rich in fish containing high levels of omega 3 fatty acids as potentially important in lowering the incidence of cardiovascular disease.
7 What is Arachidonic Acid? COOH J. Fantone
8 How And Where Is Arachidonic Acid Generated? chocolatebear (Wikispaces)
9 Lipid Mediators of Inflammation Stimulus + Phospholipase Cell membrane Phospholipids Arachidonic acid J. Fantone
10 Source Undetermined
11 What are the primary products derived from arachidonic acid? Cyclooxygenase (COX) Lipoxygenase (LO)
12 Acute inflammation: lipid mediators Stimulus + Phospholipase Cell membrane Phospholipids Arachidonic acid COX-1+2 COX-1 Lipooxygenases (5-LO) Prostaglandins Thromboxanes Leukotrienes Prostaglandin E 2 LTB 4 Prostacyclin PGI 2 TXB 2 LTC 4, LTD 4 J. Fantone
13 Source Undetermined
14 CELL SPECIFICITY OF ARACHIDONIC ACID-DERIVED PRODUCTS CELL PRODUCT Neutrophils Leukotrienes Macrophage/Monocyte Prostaglandins + Leukotrienes Platelets Thromboxane Endothelial Cells Prostacyclin
15 In Vivo Effects of Arachidonic Acid Derived Products: Regulates Thermostatic Set Point (Fever) Pain (Interacts with pain receptors) Blood Flow Leukocyte Activity Platelet Function
16 Biological Function of Arachidonic Acid Products Cyclooxygenase-derived Products: Prostaglandin E 2 /Prostacyclin Immunoregulatory Inhibits Immune cell activation Inhibits cytokine production Inhibits mast cell activation Blocks platelet aggregation Increases vasodilation Thromboxane Causes vasoconstriction Induces platelet aggregation
17 The Homeostatic Balance Endothelium PGI 2 Platelets TXA 2 Regents of the University of Michigan
18 Production of Fever Hypothalamus Thermoregulatory Area Endogenous pyrogens (Interleukins -1,-6) COX inhibitors (aspirin) Arachidonic acid X Prostaglandins Exogenous pyrogens (bacterial products) J. Fantone Increase temp set-point
19 Biological Function Lipoxygenase-derived Products: Leukotriene B 4 Neutrophil Activation - chemotaxis - degranulation Mast cell activation - degranulation Leukotriene C,D,E Smooth muscle contraction (SRS-A) Increase vascular permeability
20 Pharmacologic Regulation of Arachidonic Acid-Derived Products: Modulate Phospholipase activity: Suppress the release of arachidonic acid (no substrate available) Blocks both COX and LO-derived products Cyclooxygenase Activity: Blocks Cyclooxygenase-derived products COX-1 and COX-2 inhibitors Specific enzymes down-stream from COX: Thromboxane synthetase inhibitors Lipoxygenase activity: Block 5-lipoxygenase enzyme Small molecule receptor antagonists for cysteinyl leukotrienes
21 Non- Steroidal Anti-Inflammatory Compounds; NSAIDS Aspirin (acetysalicylic acid) Ibuprofen (propionic acid derivatives) Indomethacin (indole derivatives) Tylenol (acetominophen) COX-2 Inhibitors (Vioxx, celebrex, Bextra)
22 COX-2 Inhibitors CELEBREX (Celecoxib) Pfizer-(Pharmacia) BEXTRA (Valdecoxib) Pfizer VIOXX (Rofecoxib) Merck Osteoarthritis Rheumatoid arthritis Primary dysmenorrhea Pain management
23 Aspirin Irreversible inhibition of cyclooxygenase Acetylates active site of enzyme Decreased production of products (e.g. prostaglandins, prostacylcins & thromboxanes) Source Undetermined
24 Source Undetermined NSAIDS: Inhibit cyclooxygenase: reversible binding to active site of enzyme
25 AN ASPIRIN A DAY Regents of the University of Michigan
26 Regents of the University of Michigan
27 Aspirin Anti-thrombogenic Activity Inhibits platelet aggregation; blocks platelet-derived thromoboxane production Blocks platelet cyclooxygenase for the life of the platelet; no new protein synthesis Blocks endothelial cell-derived prostacyclin Suppression of endothelial cell-derived prostacyclin is short lived as endothelial cells can generation new cyclooxygenase enzyme Platelet activity is blocked more than endothelial cell activity
28 Acute inflammation: lipid mediators An important role in vascular homeostasis Endothelium Platelets Prostacyclin PGI 2 TXB2 Anti-thrombotic Pro-thrombotic J. Fantone
29 Acute inflammation: lipid mediators Therapeutic targets Endothelium Platelets Aspirin inhibits COX-2 irreversibly X All cells but the platelet can resynthesize the enzymes X Aspirin inhibits COX-1 irreversibly Prostacyclin PGI 2 TXB2 J. Fantone Anti-thrombotic Pro-thrombotic
30 Acute inflammation: lipid mediators Therapeutic targets Endothelium Platelets COX-2 COX-1 Prostacyclin PGI 2 TXB2 Anti-thrombotic Pro-thrombotic NSAIDs inhibit both COX-1 and COX-2; COXIBs inhibit COX-2 J. Fantone
31 Acute inflammation: lipid mediators Therapeutic targets Endothelium Platelets COX-2 X Ibuprofen* X COX-1 Prostacyclin PGI 2 TXB2 Anti-thrombotic Pro-thrombotic * Classical NSAID, it inhibits both COX enzymes J. Fantone
32 COX-2 inhibitors work by blocking COX-2 enzyme which is involved ingastrointestinal toxicity is reduced the inflammation pathway. By sparing COX-1 Source Undetermined
33 Acute inflammation: lipid mediators Therapeutic targets Endothelium Platelets COX-2 X Vioxx COX-1 Prostacyclin PGI 2 TXB2 Anti-thrombotic Pro-thrombotic J. Fantone
34 Fish Oil: Protective Effects Eicosapentanoic Acid Omega-3 Arachidonic Acid Omega-6 Source Undetermined Source Undetermined
35 Acute inflammation: lipid mediators Stimulus + Phospholipase Cell membrane Phospholipids Arachidonic acid COX-1+2 COX-1 Lipooxigenases (5-LO) Prostaglandins Thromboxanes Leukotrienes Prostaglandin E 2 LTB 4 Prostacyclin PGI 2 TXB 2 LTC 4, LTD 4 Vasodilation. Increase vascular permeability. Control platelet aggregation. Chemotaxis. Pain. Fever J. Fantone
36 Thank You
37 Additional Source Information for more information see: Slide 7: J. Fantone Slide 8: chocolatebear, Wikispaces, Slide 9: J. Fantone Slide 10: Source Undetermined Slide 12: J. Fantone Slide 13: Source Undetermined Slide 17: Regents of the University of Michigan Slide 18: J. Fantone Slide 23: Source Undetermined Slide 24: Source Undetermined Slide 25: Regents of the University of Michigan Slide 26: Regents of the University of Michigan Slide 28: J. Fantone Slide 29: J. Fantone Slide 30: J. Fantone Slide 31: J. Fantone Slide 32: Source Undetermined Slide 33: J. Fantone Slide 34: Source Undetermined; Source Undetermined Slide 35: J. Fantone
Attribution: University of Michigan Medical School, Department of Microbiology and Immunology
Attribution: University of Michigan Medical School, Department of Microbiology and Immunology License: Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution
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Author: Michael Jibson, M.D., Ph.D., 2009 License: Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike 3.0 License: http://creativecommons.org/licenses/by-sa/3.0/
Attribution: University of Michigan Medical School, Department of Microbiology and Immunology
Attribution: University of Michigan Medical School, Department of Microbiology and Immunology License: Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution
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Author: Michael Jibson, M.D., Ph.D., 2009 License: Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike 3.0 License: http://creativecommons.org/licenses/by-sa/3.0/
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Attribution: University of Michigan Medical School, Department of Microbiology and Immunology
Attribution: University of Michigan Medical School, Department of Microbiology and Immunology License: Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution
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Author: John Williams, M.D., Ph.D., 2009 License: Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Non-commercial Share Alike 3.0 License: http://creativecommons.org/licenses/by-nc-sa/3.0/
Attribution: University of Michigan Medical School, Department of Microbiology and Immunology
Attribution: University of Michigan Medical School, Department of Microbiology and Immunology License: Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution
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Author(s): Louis D Alecy, 2009 License: Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Non-commercial Share Alike 3.0 License: http://creativecommons.org/licenses/by-nc-sa/3.0/
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