Aspirin can induce gastric ulcers, largely because it inhibits the synthesis of gastroprotective prostaglandins. Co-administration of aspirin and a selective cyclooxygenase 2 inhibitor results in more gastric damage than that induced following administration of either drug alone. This is because aspirin triggers the cyclooxygenase-2-dependent synthesis of 15(R)-epi-lipoxin A4, a substance that acts to diminish injury to the stomach. Lipoxins can also be produced independently of the actions of aspirin on cyclooxygenase 2, and might enhance epithelial integrity in various mucosal tissues.
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