[HTML][HTML] Cyclooxygenase-1–selective inhibition prolongs gestation in mice without adverse effects on the ductus arteriosus

CD Loftin, DB Trivedi… - The Journal of clinical …, 2002 - Am Soc Clin Investig
CD Loftin, DB Trivedi, R Langenbach
The Journal of clinical investigation, 2002Am Soc Clin Investig
Preterm delivery is the leading cause of neonatal mortality and contributes significantly to
infant morbidity. Classical cyclooxygenase (COX) inhibitors, such as indomethacin, which
inhibit both COX-1 and COX-2, are effective for delaying premature labor, but their use is
limited by serious complications to the fetus and neonate, including adverse effects on the
ductus arteriosus (DA). Using isoform-selective inhibitors, we characterized the roles of the
COX isoforms in the initiation of labor and the regulation of fetal and neonatal DA closure in …
Preterm delivery is the leading cause of neonatal mortality and contributes significantly to infant morbidity. Classical cyclooxygenase (COX) inhibitors, such as indomethacin, which inhibit both COX-1 and COX-2, are effective for delaying premature labor, but their use is limited by serious complications to the fetus and neonate, including adverse effects on the ductus arteriosus (DA). Using isoform-selective inhibitors, we characterized the roles of the COX isoforms in the initiation of labor and the regulation of fetal and neonatal DA closure in mice. Chronic inhibition of COX-2 during pregnancy (gestation days 15–18) significantly increased neonatal mortality by preventing closure of the DA after birth, whereas acute COX-2 inhibition near the end of term (gestation day 18) constricted the fetal DA. In contrast, the inhibition of COX-1 during pregnancy lacked these prenatal and postnatal adverse effects on the DA and effectively delayed the initiation of full-term labor and LPS-induced preterm labor. These findings suggest that premature fetal DA closure or neonatal patent DA observed following indomethacin tocolysis in women may result from the inhibition of COX-2. Therefore, COX-1–selective inhibitors may provide effective treatment to delay preterm labor with fewer adverse effects on fetal or neonatal health than nonselective or COX-2–selective inhibitors.
The Journal of Clinical Investigation