Article

Effects of low-dose aspirin on acute inflammatory responses in humans

Division of Medicine, University College London, Centre for Clinical Pharmacology and Therapeutics, London, United Kingdom.
The Journal of Immunology (impact factor: 5.79). 09/2009; 183:2089-96. DOI:jimmunol.0900477 [pii] 10.4049/jimmunol.0900477 ISBN: 1550-6606 (Electronic) pp.2089-96

ABSTRACT Aspirin is a unique nonsteroidal anti-inflammatory drug; at high doses (aspirin(high), 1g), it is anti-inflammatory stemming from the inhibition of cyclooxygenase and proinflammatory signaling pathways including NF-kappaB, but is cardioprotective at lower doses (aspirin(low), 75 mg). The latter arises from the inhibition of thromboxane (Tx) B(2), a prothrombotic eicosanoid also implicated in polymorphonuclear leukocyte trafficking. As a result, aspirin(low) is widely used as a primary and secondary preventative against vascular disease. Despite this and its ability to synthesize proresolution 15-epi-lipoxin A(4) it is not known whether aspirin(low) is anti-inflammatory in humans. To address this, we generated skin blisters by topically applying cantharidin on the forearm of healthy male volunteers, causing an acute inflammatory response including dermal edema formation and leukocyte trafficking. Although not affecting blister fluid volume, aspirin(low) (75 mg, oral, once daily/10 days) reduced polymorphonuclear leukocyte and macrophage accumulation independent of NF-kappaB-regulated gene expression and inhibition of conventional prostanoids. However, aspirin(low) triggered 15-epi-lipoxin A(4) synthesis and up-regulated its receptor (FPRL1, ALX). From complimentary in vitro experiments, we propose that 15-epi-lipoxin A(4) exerts its protective effects by triggering antiadhesive NO, thereby dampening leukocyte/endothelial cell interaction and subsequent extravascular leukocyte migration. Since similar findings were obtained from murine zymosan-induced peritonitis, we suggest that aspirin(low) possesses the ability to inhibit mammalian innate immune-mediated responses. This highlights 15-epi-lipoxin A(4) as a novel anti-inflammatory working through a defined receptor and suggests that mimicking its mode of action represents a new approach to treating inflammation-driven diseases.

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Keywords

acute inflammatory response
 
blister fluid volume
 
dampening leukocyte/endothelial cell interaction
 
defined receptor
 
dermal edema formation
 
healthy male volunteers
 
highlights 15-epi-lipoxin A(4)
 
inflammation-driven diseases
 
leukocyte trafficking
 
macrophage accumulation independent
 
mammalian innate immune-mediated responses
 
murine zymosan-induced peritonitis
 
NF-kappaB-regulated gene expression
 
polymorphonuclear leukocyte
 
polymorphonuclear leukocyte trafficking
 
protective effects
 
secondary preventative
 
skin blisters
 
subsequent extravascular leukocyte migration
 
synthesize proresolution 15-epi-lipoxin A(4)