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Distribution of constitutive (COX-1) and inducible (COX-2) cyclooxygenase in postviral human liver cirrhosis: a possible role for COX-2 in the pathogenesis of liver cirrhosis
  1. N A Mohammed1,
  2. S A El-Aleem2,
  3. H A El-Hafiz1,
  4. R F T McMahon3
  1. 1Departments of Tropical Medicine and General Medicine, Minia University, Minia, Egypt
  2. 2Department of Physiology, University of Bristol, University Walk, Bristol BS8 1TD, UK
  3. 3Laboratory Medicine Academic Group, University of Manchester, Stopford Building, Oxford Road, Manchester M13 9PT, UK
  1. Correspondence to:
 R F T McMahon
 Laboratory Medicine Academic Group, University of Manchester, Stopford Building, Oxford Road, Manchester M13 9PT, UK and Department of Histopathology, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL, UK; ray.mcmahonman.ac.uk

Abstract

Aims: Prostaglandins produced by the action of cyclooxygenases (COX) are important mediators of systemic vasodilatation and inflammation in liver cirrhosis. The aim of this study was to investigate the distribution of COX-1 and COX–2 in postviral cirrhosis.

Methods: The immunohistochemical expression of the constitutive (COX-1) and the inducible (COX-2) isoenzymes was investigated in 15 patients with cirrhosis after hepatitis B and C infection; three normal control livers were also analysed.

Results: COX-2 was absent from normal liver but was highly expressed in cirrhosis, mainly in the inflammatory, sinusoidal, vascular endothelial, and biliary epithelial cells. Low amounts of COX-1 were expressed in both normal and cirrhotic livers, exclusively in sinusoidal and vascular endothelial cells, with no differences seen between normal and cirrhotic livers.

Conclusions: COX-2 is overexpressed in liver cirrhosis, and possibly contributes to prostaglandin overproduction, which may be a major component of the inflammation and hyperdynamic circulation associated with cirrhosis. Because COX-2 is thought to contribute to tumour development, high COX-2 production could be a contributor to hepatocellular carcinoma development in cirrhosis. The finding of COX-2 and not COX-1 upregulation in cirrhosis could provide a possible new role for selective COX-2 inhibitors in reducing inflammation and minimising the occurrence of hepatocellular carcinoma in patients with cirrhosis.

  • liver cirrhosis
  • viral hepatitis
  • portal hypertension
  • prostaglandins
  • cyclooxygenase
  • COX, cyclooxygenases
  • HCC, hepatocellular carcinoma
  • NSAID, non-steroidal anti-inflammatory drug
  • PG, prostaglandin
  • TBS, Tris buffered saline
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  • Author Correction

    Please note that there is an error in the author listing. The correct list is shown here:

    NA Mohammed, SA Abd El-Aleem, HA El-Hafiz, and RFT McMahon

    Footnotes

    • This study was presented to the British Society of Gastroenterology at Birmingham in March 2002 and has been published in abstract form (Gut2002;suppl II:).

    • Sadly, Dr N A Mohammed has died since this paper was written.

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