Selective inhibitors of cyclooxygenase-2 (COX-2), such as rofecoxib (Vioxx), celecoxib (Celebrex), and valdecoxib (Bextra), have been developed for treating arthritis and other musculoskeletal complaints. Selective inhibition of COX-2 over COX-1 results in preferential decrease in prostacyclin production over thromboxane A2 production, thus leading to less gastric effects than those seen with nonselective COX inhibitors such as acetylsalicylic acid (aspirin). Here we show a novel effect of celecoxib via a mechanism that is independent of COX-2 inhibition. The drug inhibited the delayed rectifier (Kv2) potassium channels from Drosophila, rats, and humans and led to pronounced arrhythmia in Drosophila heart and arrhythmic beating of rat heart cells in culture. These effects occurred despite the genomic absence of cyclooxygenases in Drosophila and the failure of acetylsalicylic acid, a potent inhibitor of both COX-1 and COX-2, to inhibit rat Kv2.1 channels. A genetically null mutant of Drosophila Shab (Kv2) channels reproduced the cardiac effect of celecoxib, and the drug was unable to further enhance the effect of the mutation. These observations reveal an unanticipated effect of celecoxib on Drosophila hearts and on heart cells from rats, implicating the inhibition of Kv2 channels as the mechanism underlying this effect.Selective COX-2 2 inhibitors, or coxibs, were developed for use as nonsteroidal anti-inflammatory drugs without adverse gastric effects (1, 2). Gastric effects of nonselective cyclooxygenase inhibitors, such as acetylsalicylic acid (aspirin), arise in main part from inhibition of cyclooxygenase-1. A selective inhibition of COX-2 by coxibs helps avoid these effects (3, 4); however, adverse cardiovascular effects complicate the use of coxibs (5-7). These effects of coxibs have been attributed to a reduction in antithrombotic, COX-2-derived prostacyclin without a reduction in prothrombotic, COX-1-derived platelet thromboxane. This shifts the balance toward a prothrombotic state resulting in clot formation (7).The adverse effects of drugs like celecoxib arising from their selective inhibition of COX-2 is currently the topic of intense discussion (7,8). We now show that celecoxib can have additional, heretofore unanticipated effects on Drosophila hearts and rat heart cells via a pathway independent of cyclooxygenase inhibition. At low micromolar concentrations, celecoxib reduced heart rate and induced pronounced arrhythmia in Drosophila hearts. A similar effect was observed in rat cardiomyocytes in culture in which the drug reduced the beating rate in clusters of cells and made the beating arrhythmic. These effects were not mediated via cyclooxygenase inhibition but involved inhibition of the voltage-activated delayed rectifier K Ļ© channels (Kv2) by the drug. These observations reveal a new molecular mechanism underlying the effects of celecoxib that may operate in addition to its prothrombotic influence. The data also raise the possibility of effects on other tissues that express Kv2 channels.
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