Aspirin: A simplest yet most powerful molecule

Inflammation is essential for survival, yet it is also a primary cause of death.

Inflammation, a combination of pain, swelling, redness and fever, is bodies’ response to any injury. It is bodies’ survival strategy, without which, death would have caused by negligible bacterial infection or tiny wound.

Injured cells release molecular signals, activating immune system to generate inflammatory response. They release hormones, thromboxanes and prostaglandins, responsible for inflammation followed by a cascade of events, consisting of, constriction of blood vessels, aggregation of circulating platelets and finally converting the adjacent cells to survival mode. As a result bleeding stops after injury. Though it is essential for short term health, however recent studies show that in an aging body this clotting of blood may cause stroke or heart attack later in life.

Surprisingly, these events are very similar to cancer development. Tumours are everlasting wounds; cancerous cells flourish in inflammatory environment while neighbouring normal and healthy cells die. Prostaglandins and thromboxanes are specifically shown to promote cancer growth.

Thus all the evidences help to conclude that inflammation is a major contributor of the top 3 most fatal diseases in the world: heart disease, stroke, and cancer.

A simple drug, Aspirin or acetylsalicylic acid is known to inhibit inflammation. It irreversibly destroys an essential enzyme, Cyclooxygenase (COX), responsible for the synthesis of thromboxanes and prostaglandins, required for inflammation. Therefore keeping this in mind for last 30 years clinicians are regularly using Aspirin to reduce the chances of heart disease and stroke by controlling inflammation.  It also works as an excellent blood thinner by the same mechanism.

Retrospective studies on heart patients regularly using Aspirin showed its efficacy in lowering deaths also from cancer, the third most common cause of death. Aspirin is found to cut down the risk of colon cancer by 40%, demonstrated in 1991. Other evidences suggest that risk of several other cancer types such as Gastric, Biliary, Breast and Oesophageal is also reduced by 40% after long term Aspirin use. Furthermore, Aspirin is also found to reduce metastasis by 30%. Metastasis is responsible for 90% of deaths in cancer.

However, a US Preventive Task Force statement gave Aspirin a Grade D recommendation for managing cancer risk in 2007. This report also documented the negative side effects of Aspirin, such as, intestinal bleeding or kidney failure. However these negative side effects are observed only in small number of patients, particularly in aged and weak individuals.

Taken altogether, for an average person, the potential health benefits of Aspirin strongly overshadow the minimal adverse effects.  Thus this “One Cent Miracle Drug” is a life saviour of millions around the globe.

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Arunima Maiti

Arunima Maiti

Biomedical scientist with special interest in reproductive biology.

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