Nonsteroidal anti-inflammatory drugs (NSAIDs) comprise a heterogeneous group of pharmacological agents used for the symptomatic treatment of fever, pain, and inflammation. Although the main mechanism of action of NSAIDs consists of inhibiting prostaglandin synthesis by blocking the enzyme cyclooxygenase (COX), clinical, and experimental data strongly indicate the existence of additional mechanisms. Some of the COX-independent effects are related to the ability of NSAIDs to penetrate biological membranes and disrupt important molecular interactions necessary for a wide array of cellular functions, including cell adhesion. These effects, in particular those that interfere with L-selectin function in neutrophils during the inflammatory response, may contribute to the antiinflammatory properties that NSAIDs exert in vivo. Recent contributions in this field have shown that the anti-L-selectin effect of NSAIDs is related to the NADPH-oxidasedependent generation of superoxide anion at the plasma membrane. These findings might represent a novel approach for developing new and effective anti-inflammatory compounds with a better safety profile than the currently available NSAIDs.Keywords: L-selectin r Non-steroidal anti-inflammatory drugs r NADPH oxidase
IntroductionNonsteroidal anti-inflammatory drugs (NSAIDs) are a heterogeneous group of therapeutic agents widely used for the symptomatic treatment of rheumatic disorders. Since the early seventies of last century, it has been widely accepted that the main mechanism of action of these compounds, which is also responsible for the main side effect of gastric mucosal damage, is inhibition of cyclooxygenase (COX), a key enzyme in prostaglandin synthesis [1]. Prostaglandins are group of hormone-like lipid compounds with a wide variety of strong physiological effects, including regulation of inflammation, pain sensitization, and platelet aggregation, among many others. However, a growing body of evidence suggests that NSAIDs have additional anti-inflammatory properties (reviewed in [2]). Some of these effects appear to be related to the ability of NSAIDs to penetrate biological membranes, as evaluated in vitro using membrane mimetic models, cell cultures, Correspondence: Prof. Federico Díaz-González e-mail: federico.diaz.gonzalez@gmail.com and molecular dynamic simulation systems [3,4], where they disrupt normal signaling events and modify important processes necessary for cellular function, including cell adhesion [5,6].The ability of NSAIDs to interfere with either cell adhesion, for example, by cleavage of epithelial cell adhesion molecule protein on tumor cells [6], or with leukocyte adhesion pathways essential for the inflammatory response, such as causing L-selectin shedding on neutrophil [5], has been described. Interestingly, this antiadhesive effect of NSAIDs has also been shown to influence platelet adhesion, and it has been suggested that coagulation, hemostasis, and thrombus formation could be modulated by these compounds independently of the release of proinflammat...