Editing Cyclooxygenase (section)

=== Natural COX inhibition ===
Culinary mushrooms, like [[maitake]], may be able to partially inhibit COX-1 and COX-2.<ref name="pmid12475274">{{cite journal | vauthors = Zhang Y, Mills GL, Nair MG | title = Cyclooxygenase inhibitory and antioxidant compounds from the mycelia of the edible mushroom Grifola frondosa | journal = Journal of Agricultural and Food Chemistry | volume = 50 | issue = 26 | pages = 7581–5 | date = December 2002 | pmid = 12475274 | doi = 10.1021/jf0257648 }}</ref><ref name="pmid12834003">{{cite journal | vauthors = Zhang Y, Mills GL, Nair MG | title = Cyclooxygenase inhibitory and antioxidant compounds from the fruiting body of an edible mushroom, Agrocybe aegerita | journal = Phytomedicine | volume = 10 | issue = 5 | pages = 386–90 | year = 2003 | pmid = 12834003 | doi = 10.1078/0944-7113-00272 }}</ref>

A variety of [[flavonoid]]s have been found to inhibit COX-2.<ref name="pmid15225597">{{cite journal | vauthors = O'Leary KA, de Pascual-Teresa S, de Pascual-Tereasa S, Needs PW, Bao YP, O'Brien NM, Williamson G | title = Effect of flavonoids and vitamin E on cyclooxygenase-2 (COX-2) transcription | journal = Mutation Research | volume = 551 | issue = 1–2 | pages = 245–54 | date = July 2004 | pmid = 15225597 | doi = 10.1016/j.mrfmmm.2004.01.015 }}</ref>

[[Fish oils]] provide alternative fatty acids to arachidonic acid. These acids can be turned into some anti-inflammatory [[prostacyclins]] by COX instead of pro-inflammatory [[prostaglandins]].<ref name="fish_oils">{{cite journal | vauthors = Cleland LG, James MJ, Proudman SM | title = Fish oil: what the prescriber needs to know | journal = Arthritis Research & Therapy | volume = 8 | issue = 1 | pages = 202 | year = 2006 | pmid = 16542466 | pmc = 1526555 | doi = 10.1186/ar1876 | doi-access = free }}</ref>

[[Hyperforin]] has been shown to inhibit COX-1 around 3-18 times as much as aspirin.<ref>{{cite journal | vauthors = Albert D, Zündorf I, Dingermann T, Müller WE, Steinhilber D, Werz O | title = Hyperforin is a dual inhibitor of cyclooxygenase-1 and 5-lipoxygenase | journal = Biochemical Pharmacology | volume = 64 | issue = 12 | pages = 1767–75 | date = December 2002 | pmid = 12445866 | doi = 10.1016/s0006-2952(02)01387-4 }}</ref>

[[Calcitriol]] ([[vitamin D]]) significantly inhibits the expression of the COX-2 gene.<ref name="pmid16886660">{{cite journal | vauthors = Moreno J, Krishnan AV, Peehl DM, Feldman D | title = Mechanisms of vitamin D-mediated growth inhibition in prostate cancer cells: inhibition of the prostaglandin pathway | journal = Anticancer Research | volume = 26 | issue = 4A | pages = 2525–30 | date = July–August 2006 | pmid = 16886660 | url = http://ar.iiarjournals.org/content/26/4A/2525.abstract | access-date = 2013-03-12 | archive-date = 2017-04-25 | archive-url = https://web.archive.org/web/20170425063418/http://ar.iiarjournals.org/content/26/4A/2525.abstract | url-status = live }}</ref>

Caution should be exercised in combining low dose aspirin with COX-2 inhibitors due to potential increased damage to the gastric mucosa.  COX-2 is upregulated when COX-1 is suppressed with aspirin, which is thought to be important in enhancing mucosal defense mechanisms and lessening the erosion by aspirin.<ref>{{Cite journal |last=Wallace |first=John L. |date=October 2008 |title=Prostaglandins, NSAIDs, and gastric mucosal protection: why doesn't the stomach digest itself? |url=https://pubmed.ncbi.nlm.nih.gov/18923189/ |journal=Physiological Reviews |volume=88 |issue=4 |pages=1547–1565 |doi=10.1152/physrev.00004.2008 |issn=0031-9333 |pmid=18923189}}</ref>