Prostaglandin-endoperoxide
synthase (PTGS), also known as
cyclooxygenase (COX), is the key enzyme in prostaglandin biosynthesis. It converts free arachidonic acid, released from membrane phospholipids at the sn-2 ester binding site by the enzymatic activity of phospholipase A2, to prostaglandin (PG) H2. The reaction involves both cyclooxygenase (
dioxygenase) and hydroperoxidase (
peroxidase) activity. The cyclooxygenase activity incorporates two oxygen molecules into arachidonic acid or alternate polyunsaturated fatty acid substrates, such as
linoleic acid and
eicosapentaenoic acid. Metabolism of
arachidonic acid forms a labile intermediate peroxide,
PGG2, which is reduced to the corresponding alcohol, PGH2, by the enzyme's hydroperoxidase activity. While metabolizing arachidonic acid primarily to PGG2, COX-1 also converts this fatty acid to small amounts of a racemic mixture of
15-Hydroxyicosatetraenoic acids (i.e., 15-HETEs) composed of ~22% 15(
R)-HETE and ~78% 15(
S)-HETE
stereoisomers as well as a small amount of 11(
R)-HETE. The two 15-HETE stereoisomers have intrinsic biological activities but, perhaps more importantly, can be further metabolized to a major class of anti-inflammatory agents, the
lipoxins. In addition, PGG2 and PGH2 rearrange non-enzymatically to a mixture of
12-Hydroxyheptadecatrienoic acids viz.,1 2-(S)-hydroxy-5Z,8E,10E-heptadecatrienoic acid (i.e. 12-HHT) and 12-(S)-hydroxy-5Z,8Z,10E-heptadecatrienoic acid plus
Malonyldialdehyde. and can be metabolized by
CYP2S1 to 12-HHT (see
12-Hydroxyheptadecatrienoic acid). These alternate metabolites of COX-1 may contribute to its activities. COX-1 promotes the production of the natural mucus lining that protects the inner stomach and contributes to reduced acid secretion and reduced pepsin content. COX-1 is normally present in a variety of areas of the body, including not only the stomach but any site of inflammation. == Clinical significance ==