title: Aspirin in the 21st century-common mechanisms of disease and their modulation by aspirin: a report from the 2015 scientific conference of the international aspirin foundation, 28 August, London, UK.
abstract: Professor Peter Rothwell of Oxford University chaired the annual Scientific Conference of the International Aspirin Foundation in London on 28 August 2015. It took the form of four sessions. Aspirin has more than one action in its effects on disease. Its acetylation of cyclooxygenase 2 (COX-2) in platelets leads to the blockade of pro-inflammatory chemicals and generation of anti-inflammatory mediators and increase in nitrous oxide (NO) production, which helps to preserve arterial endothelium. But platelets are not its only target. There is now evidence that aspirin has a direct antitumour effect on intestinal mucosal cells that block their potential transformation into cancer cells. Randomised placebo-controlled trials (RCTs) in people with histories of colorectal neoplasia have shown that aspirin reduces the risk of recurrent adenomas and reduces long-term cancer incidence in patients with Lynch syndrome. Among women given aspirin for cardiovascular disease, there were fewer cancers than in those given placebo. Epidemiological evidence has suggested that aspirin treatment after cancer is diagnosed reduces the incidence of metastases and prolongs survival, and long-term studies of anticancer treatment with aspirin are under way to confirm this. Apart from cancer studies, aspirin use is now firmly established as treatment for antiphospholipid syndrome (Hughes syndrome) and is being used to prevent and treat the heightened risk of cardiovascular disease in diabetes mellitus and in patients with HIV.
authors.affiliation: The Croft, Pinwherry, Girvan, Ayrshire, Scotland KA26 0RU, UK.
authors.forename: Tom
authors.initials: T
authors.lastname: Smith
authors.affiliation: International Aspirin Foundation, 34 Bower Mount Road, Maidstone, Kent ME16 8AU, UK.
authors.forename: Pippa
authors.initials: P
authors.lastname: Hutchison
authors.affiliation: Institut für Pharmakologie und Klinische Pharmakologie, Heinrich-Heine-Universität, Düsseldorf, D-40225 Düsseldorf, Germany.
authors.forename: Karsten
authors.initials: K
authors.lastname: Schrör
authors.affiliation: Hospital Clínic-University of Barcelona, Barcelona, Catalonia 08036, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Clària
authors.affiliation: Service of Digestive Diseases, University Hospital, University of Zaragoza, IIS Aragon, CIBERehd, Zaragoza, Spain.
authors.forename: Angel
authors.initials: A
authors.lastname: Lanas
authors.affiliation: Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University, 66100 Chieti, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Patrignani
authors.affiliation: Clinical and Translational Epidemiology Unit and Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Andrew T
authors.initials: AT
authors.lastname: Chan
authors.affiliation: Institute of Genetics and Molecular Medicine, University of Edinburgh, UK.
authors.forename: Farhat
authors.initials: F
authors.lastname: Din
authors.affiliation: MRC Clinical Trials Unit, University College London, Institute of Clinical Trials & Methodology, London, UK.
authors.forename: Ruth
authors.initials: R
authors.lastname: Langley
authors.affiliation: Cochrane Institute, Dept. of Primary Care and Public Health, Cardiff University, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Elwood
authors.affiliation: Cardiff University School of Medicine, Heath Park, Cardiff CF14 4XN, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Freedman
authors.affiliation: Common Cold Centre, Cardiff University UK CF10 3AX, UK.
authors.forename: Ron
authors.initials: R
authors.lastname: Eccles
keywords: HIV; Hughes syndrome; Lynch syndrome; aspirin; cancer; diabetes