Defining the role of COX-2 inhibitors in inflammatory and other diseases.

The well-established side effects of drug treatments for inflammatory disease, in particular those of the nonsteroidal antiinflammatory drugs (NSAIDs)--principally gastrointestinal (GI) toxicity--, have become an acute problem. There is now considerable experience with the COX-2 selective NSAIDs, which offer an improved GI side-effect profile. The William Harvey Research Conference held in Porto, Portugal, October 23, 2000, reviewed the history of the use of NSAIDs and discussed the pathological and physiological significance of the COX-2 enzyme while covering topics ranging from assays to measure the COX-2:COX-1 ratio, the structural basis for COX-2 selectivity, potential mechanisms of NSAID-induced gastrointestinal toxicity, preclinical studies, effects of COX-2 inhibitors on the kidney and vascular systems, to the latest clinical results, as well as the potential implication of COX-2 in cancer and Alzheimer's disease.