Mackey AL. Does an NSAID a day keep satellite cells at bay? J Appl Physiol 115: 900-908, 2013. First published May 16, 2013 doi:10.1152/japplphysiol.00044.2013.-Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely consumed by athletes worldwide, despite growing evidence for a negative influence on the adaptation of skeletal muscle to exercise, at least in young healthy individuals. This review focuses on the potential of NSAIDs to alter the activity of satellite cells, the muscle stem cell responsible for repair and maintenance of skeletal muscle. The signaling pathways that are potentially modified by NSAID exposure are also considered. Growth factors as well as inflammatory cells and connective tissue appear to be key factors in the response of muscle under conditions where cyclooxygenase and prostaglandin activity are blocked through NSAID ingestion or infusion. Discrepancies in the literature regarding the response of young and old individuals are addressed, where it appears that the elderly may benefit from NSAID ingestion, although this clearly requires further study. The long-term implications for the muscle of the apparent inhibitory effect of NSAIDs on satellite cells in younger individuals are not clear, and it is possible these may first become apparent with chronic use in athletes training at a high level or with advancing age. Reports of the potential for NSAIDs to alter prostaglandin and growth factor signaling provide a basis for further study of the mechanism of NSAID action on satellite cells. exercise; growth factor; muscle adaptation; NSAIDs; satellite cells SATELLITE CELLS (see Figs. 1 and 2) are a population of cells resident in adult skeletal muscle and have been proven to be essential for muscle repair (33, 67). The cycle of satellite cell activity (see Fig. 3) has been most widely studied in models of muscle injury or overload where the satellite cells are awoken from their dormant state. Briefly, the main steps involved include 1) activation to enter the cell cycle, and 2) proliferation, after which the cells either 3) undergo differentiation and fuse with a myofiber, or 4) return to quiescence (24,50,68,95). With the capacity to perform these two functions, namely repairing damaged tissue and replenishing their own cell pool, satellite cells have been ascribed the status of the muscle stem cell. While it appears that satellite cells in the muscle of elderly individuals are not as easily activated as in younger individuals (11), triggering activation and proliferation in vivo appears to be relatively easy, and many factors are now recognized as being capable of this. For example, mechanical stimuli in the form of stretch or forceful contractions, damage to the muscle, pharmacological agents, and inflammatory conditions are strong activators of satellite cells. It appears from the literature that nonsteroidal anti-inflammatory drugs (NSAIDs) can influence satellite cell activity, both directly and indirectly. This minireview will consider how NSAIDs can influence satellite cells at an...