In the article Dreser compared aspirin with other salicylates in an effort to demonstrate that it was more beneficial and less toxic. This work was coupled with human trials whose results were published in in the journals Die Heilkunde and Therapeutische Monatshefte , showing that aspirin was indeed superior to other known salicylates. On 6 March the Bayer Company registered the product under the trade name Aspirin and then actively began to distribute the white powder to hospitals and clinics.
Although the company name Bayer has long been associated with aspirin, after World War I, Bayer lost the sole right to use the name aspirin. Medical reports highlighted the benefits of aspirin, and its popularity reflected the already significant use of salicylic compounds, coupled with the fact that this new drug was considerably safer and comparably less toxic.
In aspirin became available to the public without a prescription, making it arguably the first modern, synthetic, over-the-counter, mass-market medicine and a household name around the world. By providing an easy and inexpensive method to alleviate pain, aspirin began to change the experience and expectations of patients and doctors and ultimately the nature of modern medicine itself.
Before the mids Western physicians had considered pain an essential diagnostic tool, something that aspirin alleviated and thus disguised. Doctors would now have to look to other symptoms. It was not until that scientists began to understand how aspirin worked in the body as an anti-inflammatory agent—what is now referred to as a nonsteroidal anti-inflammatory drug NSAID.
John Robert Vane, a British pharmacologist, and his graduate student Priscilla Piper performed pioneering work on aspirin, exploring the effects of the drug on isolated lungs from guinea pigs and studying the effects of substances released from the lungs during severe allergic reactions to aspirin. During these studies the scientists identified two uncharacterized substances, one of which turned out to be a prostaglandin—a hormone-like compound involved in causing diverse effects in the body, including vasodilation, vasocontraction, and sending messages of pain and discomfort to the brain.
Piper and Vane later discovered that this prostaglandin had an effect similar to a known enzyme responsible for the contraction of nonvascular smooth muscle. Further studies demonstrated that aspirin minimized some effects of vasodilation response, ultimately leading Vane to consider that aspirin was inhibiting the synthesis of prostaglandins.
Samuelsson, received the Nobel Prize in Physiology or Medicine in But how does aspirin affect the production of prostaglandins? In researchers discovered a particular enzyme, cyclooxygenase, or COX, that is responsible for producing a number of biological mediators, including prostaglandins. Further research indicated that there was not one COX enzyme, but three, and that each played a different role in the human body.
While one COX enzyme is responsible for the synthesis of prostaglandins during inflammatory reactions, a second is involved in producing prostaglandins that help protect the stomach mucosa.
Aspirin affects both enzymes, providing analgesic effects as described, but at high doses sometimes results in stomach irritation. In an effort to separate the two effects pharmaceutical companies have worked hard to develop selective COX inhibitors, such as Celebrex, Vioxx, and Mobic, that reduce inflammation without damaging stomach mucosa. However, a number of issues have arisen with these products, most notably with Vioxx, which recent studies have shown to increase the risk for heart attacks.
Like all drugs, aspirin can be toxic at high doses greater than milligrams per kilogram body weight , but the benefits of aspirin clearly outweigh the risks. He named the yellow substance salicin , which is the Latin word for willow. Later chemists extracted salicylic acid from the bitter-tasting, needle-like crystals.
That's where Felix Hoffman comes in. His father suffered from rheumatism but salicylic acid caused him to vomit. Bayer applied for a German patent but was rejected, as acetylsalicylic acid had been synthesized earlier , first by a French chemist and later by a German chemist. Hoffman's version was an improvement, though, because his acetylsalicylic acid was stable. Also, in Physicians Health Study provided evidence that long term low dose aspirin resulted in a reduction in MI and a role for aspirin in the primary prevention ischemic heart disease In The Antiplatelets Trialist Collaboration confirmed that aspirin could prevent further cardiovascular events and death in people with established vascular disease Aspirin also has an important role in the immediate treatment of minor stroke in order to prevent recurrent stroke 15, Reviewing both its preventative effect for the two big killers cardiovascular disease and cancer the US Preventative Task Force 17 in recommend aspirin for primary disease prevention in certain groups.
A publication looking at the secondary prevention of cardiovascular disease has shown that aspirin is still one of the best options Other research has further supported this finding and a time dependent reduced incidence in colorectal cancer has been observed In , Sir John Burns 23 showed the role of aspirin in helping to prevent cancer in carriers of hereditary colorectal cancer. Further studies are ongoing to fully understand aspirins role in cancer prevention including the role of aspirin in reducing the risk of metastatic spread 24,25 in established cancer.
It is becoming apparent that an individualised approach is important as well as careful consideration of age and all risk factors. Individualised dosing regimens will be needed to fully exploit the potentially lifesaving benefits of this fascinating drug. A one size fits all approach is not appropriate and factors such as increased platelet turnover in certain disease conditions e. Ge Junbo, male, was born in Wulian, Shandong province on Nov.
He is the member of Chinese Academy of Sciences, professor and doctoral supervisor. He is also the designate chairman of the Cardiovascular Disease Branch of Chinese Medical Association, council member of the Cardiovascular Angiography and Interventions Association, international consultant of the American Heart Association. In Dec. Ge has been engaged in clinical and scientific research work of cardiovascular disease since , and his research area covers the pathogenesis of coronary heart disease, early diagnosis and treatment plan optimization.
Click here to find the press release. Discipline: Cardiology and Epidemiology. Neurology and Vascular Neurology. We would like to hear from you and have a chat, and maybe feature you on our podcast. Please fill in the form below and we will contact you with further information. The Aspirin Story. The story of Aspirin — a versatile medicine with a long history.
Aspirin in cardiovascular disease prevention In the s Laurence Craven, a general practitioner from California, published his work using aspirin to prevent vascular events. One hundred years of aspirin. The Lancet Elwood P. Aspirin yesterday, aspirin today, aspirin tomorrow: a history of prophylactic aspirin. Acetylsalicylic acid.
A Modern Herbal by M Grieve. Miner J. Inhibition of prostaglandin synthesis as a mechanism of action for aspirin-like drugs. Clinical pharmacology of platelet cyclooxygenase inhibition.
Circulation ; 72 6 Peto R. Editorial: Aspirin and myocardial infarction. Randomized trial of intravenous streptokinase, oral aspirin, both, or neither among 17, cases of suspected acute myocardial infarction: ISIS Collaborative overview of randomised trials of antiplatelet therapy Prevention of death, myocardial infarction and stroke by prolonged antiplatelet therapy in various categories of patients.
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