What are Prostaglandins?

Pain Signal Influencers

Pain relievers
Pain relievers. Peter Dazeley/Photographer's Choice/Getty Images

What are Prostaglandins?

Prostaglandins are hormones that exert a lot of influence over key physiological processes in your body. They have both positive and negative effects on your health, as they facilitate homeostasis, but also promote disease processes. 

Prostaglandin Purposes

These short-lived substances are made from fatty acids, and play a role in many basic functions, for example: Vasodialation, vasoconstriction, (which are, respectively the automatic process of blood vessel opening and closing) bronchoconstriction (the constriction of air passageways,) blood clotting, uterine contractions, fever, and maintenance of tissues such as your stomach lining,

Along with the items in the list above, prostaglandins influence pain levels and regulate inflammation, two body processes that affect nearly every person who deals with a neck or back problem.

According to a 2003 editorial entitled "Painkillers and prostaglandins," published in Nature Structural Biology, there are about 24 different prostaglandins.

Medications that Target Prostaglandins

Because prostaglandins play an important role in creating (and possibly completing an episode of) inflammation, numerous drugs have been developed over the years to counter their action.  These drugs are deemed effective as well as relatively inexpensive; people around the world and down though the ages have regularly turned to them for relief. 

In ancient times, the willow bark was used to relieve pain and reduce fever, and these days many a holistic herbalist recommends this plant to their feverish clients.

 In the 1820s, the active ingredient of willow bark was determined to be salicylic acid.  But when patients experienced intense stomach problems (diarrhea and vomiting) as a result of taking salicylic acid, acetylsalicylic acid began to be used in its place.  In the 1890s, acetylsalicylic acid got its start in the market as aspirin - by a company known then and now as Bayer.

In the 1960's a class of drugs called phenylolkanoic acids was found to reduce inflammation and pain.  These acids are better known as COX inhibitors, due to their blocking action on the COX enzymes.  (COX enzymes tend to act early on in the generation of prostaglandins.)  The  "Painkillers and prostaglandins" article says that three COX enzymes have been discovered:  COX 1 which protects your GI tract, COX 2, which plays a role in inflammation, fever and pain, and COX 3 which is found mainly in the brain.  Well known COX inhibitors (that are currently on the market) for pain and inflammation - the type taken by people with neck or back pain - include aspirin and ibuprofen (Advil.) Aspirin and Advil inhibit both COX 1 and COX 2 enzymes.  Known side effects of these medications are ulcers and bleeding in the lining of the stomach. (Advil also comes with the risk for heart attack and stroke, unfortunately.)

You may remember Vioxx and Bextra, the once-promising pain relievers that were pulled from the market in 2004.

 The action of these drugs was to inhibit only the COX 2 enzyme; as such they were also known as COX 2 inhibitors.  Their benefit was that stomach related side effects were gone; the problem was that at the same time these drugs were enjoying blockbuster status in the market, it was determined that COX-2 inhibitors increased the risk of serious and even fatal heart attacks and stroke.  

In September of 2004, Merck voluntarily pulled Vioxx off the market. In April 2005, the FDA ordered drug maker Pfizer to pull Bextra off the market, but allowed Celebrex (Celecoxib) to remain, where it does to this day.

Sources:

Painkillers and prostaglandins. Nature Structural Biology 10, 233 (2003) doi:10.1038/nsb0403-233. Accessed Dec 2015.

Ricciotti, E., PhD, FitzGerald, Garret A., MD. Prostaglandins and Inflammation. Arterioscler Thromb Vasc Biol. 2011 May; 31(5): 986–1000. doi: 10.1161/ATVBAHA.110.207449. Accessed Dec 2015.

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