What is the role of class III NSAIDs in the etiology of cyclooxygenase (COX) deficiency?

Updated: Feb 19, 2019
  • Author: George T Griffing, MD; Chief Editor: George T Griffing, MD  more...
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Class III NSAIDs include aspirin, salicylic acid, and valeryl salicylate and are defined as irreversible, competitive, time-dependent COX inhibitors. Although these agents are categorized together, only aspirin covalently modifies COX-1 and COX-2. This modification results after aspirin binds to the COX active site and transfers its acetyl group to a definitive serine residue. The acetylation of COX-1 specifically interferes with the endoperoxidase reaction that normally oxygenates and cyclizes arachidonic acid to form PGG2. Acetylation of COX-2 results in isoform modification that yields 15R-hydroxyeicosatetraenoic acid (15R-HETE) instead of PGG2. [40]

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