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Curr Opin Rheumatol. 1999 May;11(3):202-9.

Nitric oxide synthase and cyclooxygenases: distribution, regulation, and intervention in arthritis.

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Department of Rheumatology and Medicine, Hospital for Joint Diseases, NYU School of Medicine, New York, New York 10003, USA.


Nitric oxide (NO) and prostaglandin E2 (PGE2) are two pleiotropic inflammatory mediators overproduced in arthritis-affected joints. The inducible isoform of nitric oxide synthase (iNOS) and cyclooxygenase (COX-2) are found both in the synovial tissue and in the cartilage. Their expression is regulated by catabolic cytokines, such as interleukin-1beta and tumor necrosis factor-alpha. These inflammatory mediators play a profound role in the pathogenic processes that arise in the pannus of rheumatoid arthritis and also interfere with cartilage homeostasis in osteoarthritis. Several drugs, including nonsteroidal anti-inflammatory drugs, immunosuppressive agents, and tetracyclines, attenuate the activity of NO and PGE2. These pleiotropic mediators are targets for pharmacologic intervention and gene therapy.

[Indexed for MEDLINE]

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