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Pathway Description
Loxoprofen Action Pathway
Homo sapiens
Drug Action Pathway
Loxoprofen is a nonsteroidal anti-inflammatory agent used to treat pain and inflammation in musculoskeletal conditions and joint disorders. This drug is also an antipyretic and anti-inflammatory medication. Since loxoprofen is a prodrug, it is rapidly metabolized by the carbonyl reductase in the liver to its trans-alcohol form, which is a non-selective inhibitor of cyclooxygenase. This trans-alcohol form targets the prostaglandin G/H synthase-1 (COX-1) and prostaglandin G/H synthase-2 (COX-2) in the cyclooxygenase pathway. The cyclooxygenase pathway begins in the cytosol with phospholipids being converted into arachidonic acid by the action of phospholipase A2. The rest of the pathway occurs on the endoplasmic reticulum membrane, where prostaglandin G/H synthase 1 & 2 convert arachidonic acid into prostaglandin H2. Prostaglandin H2 can either be converted into thromboxane A2 via thromboxane A synthase, prostacyclin/prostaglandin I2 via prostacyclin synthase, or prostaglandin E2 via prostaglandin E synthase. COX-2 is an inducible enzyme, and during inflammation, it is responsible for prostaglandin synthesis. It leads to the formation of prostaglandin E2 which is responsible for contributing to the inflammatory response by activating immune cells and for increasing pain sensation by acting on pain fibers. Salsalate inhibits the action of COX-1 and COX-2 on the endoplasmic reticulum membrane. This reduces the formation of prostaglandin H2 and therefore, prostaglandin E2 (PGE2). The low concentration of prostaglandin E2 attenuates the effect it has on stimulating immune cells and pain fibers, consequently reducing inflammation and pain. Loxoprofen is administered as an oral tablet.
References
Loxoprofen Pathway References
Wishart DS, Feunang YD, Guo AC, Lo EJ, Marcu A, Grant JR, Sajed T, Johnson D, Li C, Sayeeda Z, Assempour N, Iynkkaran I, Liu Y, Maciejewski A, Gale N, Wilson A, Chin L, Cummings R, Le D, Pon A, Knox C, Wilson M: DrugBank 5.0: a major update to the DrugBank database for 2018. Nucleic Acids Res. 2018 Jan 4;46(D1):D1074-D1082. doi: 10.1093/nar/gkx1037.
Pubmed: 29126136
Shrestha R, Cho PJ, Paudel S, Shrestha A, Kang MJ, Jeong TC, Lee ES, Lee S: Exploring the Metabolism of Loxoprofen in Liver Microsomes: The Role of Cytochrome P450 and UDP-Glucuronosyltransferase in Its Biotransformation. Pharmaceutics. 2018 Aug 2;10(3):112. doi: 10.3390/pharmaceutics10030112.
Pubmed: 30072626
Quinones-Lombrana A, Li N, Del Solar V, Atilla-Gokcumen GE, Blanco JG: CBR1 rs9024 genotype status impacts the bioactivation of loxoprofen in human liver. Biopharm Drug Dispos. 2018 Jun;39(6):315-318. doi: 10.1002/bdd.2135.
Pubmed: 29851133
Riendeau D, Salem M, Styhler A, Ouellet M, Mancini JA, Li CS: Evaluation of loxoprofen and its alcohol metabolites for potency and selectivity of inhibition of cyclooxygenase-2. Bioorg Med Chem Lett. 2004 Mar 8;14(5):1201-3. doi: 10.1016/j.bmcl.2003.12.047.
Pubmed: 14980665
Sawamura R, Sakurai H, Wada N, Nishiya Y, Honda T, Kazui M, Kurihara A, Shinagawa A, Izumi T: Bioactivation of loxoprofen to a pharmacologically active metabolite and its disposition kinetics in human skin. Biopharm Drug Dispos. 2015 Sep;36(6):352-363. doi: 10.1002/bdd.1945. Epub 2015 Apr 21.
Pubmed: 25765700
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