COX-2 inhibition and the control of pain.

The discovery of the two isoenzymes of cyclooxygenase COX-1 and COX-2 and their separate functions, localization and regulation, has initiated the search for new and more selective inhibitors of prostaglandin biosynthesis. Selective COX-2 inhibitors were developed in order to improve an anti-inflammatory and analgesic specificity and potency. The role of inducible COX-2 at the peripheral site of inflammation is well known. The discovery of COX-2 in the spinal cord suggests that it is responsible for spinal prostaglandin release in nociceptive processes following a peripheral inflammatory stimulus. In the future, selective COX-2 inhibitors such as celecoxib (GD Searle & Co), rofecoxib (Merck & Co Inc) and the recently developed etoricoxib (Merck & Co Inc) may play an important role in the treatment of a wider range of pain conditions in addition to their present use as anti-inflammatory and analgesic drugs.