Cyclo Oxygenase2 COX and Prostaglandin E2 Synthase

Prostaglandin E2 (PGE2) has been identified as a bioactive compound stimulating cell proliferation, inhibiting apoptosis, modulating angiogenesis, participating in cell-to-cell signaling, and suppressing immune surveillance. The synthesis of PGE2 from arachidonic acid requires two enzymes that act in sequence. Cyclooxygenase (COX) catalyzes the synthesis of PGH2, which is converted, in turn, by microsomal prostaglandin E synthase (mPGES-1) to PGE2. There are two isoforms of COX designated COX-1 and COX-2, respectively. In general, COX-1 is constitutively expressed and COX-2 is only expressed following induction by cytokines, growth factors, oncogenes, and tumor promoters. Elevated levels of COX-2 and mPGES-1 have been detected in a small set of premalignant and malignant tissue of the penis.65

Given the small case series examined in each above-described study, the trustworthiness of findings is relatively low and meaningful conclusions on the prognostic value of the individual biomarkers are difficult to make. It would be useful to explore a potential cumulative role of the individual biomarkers in a combined approach. The role of a combined panel of biomarkers can potentially increase the predictability of disease progression. This combined approach should be evaluated in a well-structured large scale multicentre study.

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