by James J. Galligan, Ph.D., Associate Chair,
Department of Pharmacology and Toxicology

Aspirin is amongst the most commonly used drugs in the world.  It is well know for its pain and fever relieving effects and it is now widely used as a preventative treatment for heart attacks and strokes.  Aspirin is a derivative of salicylic acid which is found in the bark of willow trees.  Salicylic acid is very irritating so chemists at the German pharmaceutical giant Bayer modified the chemistry of salicylic acid to produce aspirin which is far less irritating.  Aspirin produces its beneficial effects by inhibiting two enzymes: cyclo-oxygenase 1 and cyclo-oxygenase 2 (COX-1 and COX-2).   COX-1 is present in the stomach lining and it is responsible for protecting the stomach lining against stomach acid.  This is why aspirin can cause an upset stomach or in more extreme cases, ulcers and bleeding.  COX-2 is responsible for producing inflammation and pain (more on COX-2 in a minute).  COX-2 is the target for drugs such as Celebrex which is claimed to produce the pain relieving effects of aspirin without the risk for an upset stomach or bleeding.

Despite the potential side effects (which in some people can be serious) of aspirin use, a new study published in the Journal of the American Medical Association indicates that aspirin may reduce the risk of death from colorectal cancer in patients previously diagnosed and treated for this disease.  Colorectal cancer is the second leading cause of cancer-related deaths in the United States so this finding has great life-saving potential.  An interesting finding in this study is that aspirin therapy was only beneficial in those patients who had tumors that expressed COX-2; no benefit was found in patients whose tumors did not express COX-2.  This is another example of the potential of “personalized medicine” where drug or other treatments for a disease can be tailored to the specific disease profile in a patient.  Personalized medicine could lead to higher success rates and also lower costs as ineffective treatments would not be used for patients that do not have a medical profile appropriate for that treatment.

While any drug treatments (including over-the-counter drugs) should be started only after consulting with your doctor, it seems that the simple aspirin tablet that can be found in everyone’s medicine cabinet is good for many things that might ail you.