title: Aspirin for cancer is no mere antiplatelet prototype. There is potential in its ancient roots.
abstract: Aspirin (ASA), increasingly accepted as predominantly a cyclooxygenase (COX)-1 inhibitor, is a prodrug for salicylic acid (SA) which has no such activity. SA is widespread in nature, vital in plants, and present in drug free serum from animals and man. Evolutionary conserved SA receptors are found in human tissues. Very low doses of ASA will, on repeat dosing, produce near maximal platelet COX-1 inhibition. Evidence for cancer prophylaxis is based on ASA doses of at least 75mg/day. Pleiotropic mechanisms underlie low dose ASA's undoubted efficacy in preventive medicine but the key barrier to its more widespread use is gastrointestinal toxicity. ASA/SA combination formulations may improve the current risk/benefit ratio of chemo-prophylactic preparations. There is well established methodology for, and should be few regulatory barriers to, their evaluation.
authors: From the Research and Development Support Unit, Dumfries and Galloway Royal Infirmary, Bankend Road, Dumfries DG1 4AP, Scotland, United Kingdom. Electronic address: Jim.lawrence@nhs.net.
authors: James R
authors: JR
authors: Lawrence
authors: From the Research and Development Support Unit, Dumfries and Galloway Royal Infirmary, Bankend Road, Dumfries DG1 4AP, Scotland, United Kingdom.
authors: Gwendoline J
authors: GJ
authors: Baxter
authors: From the Research and Development Support Unit, Dumfries and Galloway Royal Infirmary, Bankend Road, Dumfries DG1 4AP, Scotland, United Kingdom.
authors: John R
authors: JR
authors: Paterson
mesh_terms: D000818:Animals; D001241:Aspirin / Q000008:administration & dosage*; D001792:Blood Platelets / Q000187:drug effects; D015179:Colorectal Neoplasms / Q000517:prevention & control; D016861:Cyclooxygenase Inhibitors / Q000737:chemistry; D005767:Gastrointestinal Diseases / Q000139:chemically induced; D006801:Humans; D009369:Neoplasms / Q000517:prevention & control*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D011315:Preventive Medicine; D012306:Risk; D020156:Salicylic Acid / Q000737:chemistry; D014652:Vascular Diseases / Q000188:drug therapy
chemical_list: D016861:Cyclooxygenase Inhibitors; D010975:Platelet Aggregation Inhibitors; D020156:Salicylic Acid; D001241:Aspirin