Gaseous mediator-based anti-inflammatory drugs

• There are significant adverse effects associated with use of current anti-inflammatory drugs.
• Key endogenous gaseous mediators are nitric oxide, hydrogen sulfide and carbon monoxide.
• The gaseous mediators can reduce ischemia, inflammation and pain, and promote tissue repair.
• Gaseous mediator-releasing anti-inflammatory drugs show considerable promise.

Among the most commonly used drugs, nonsteroidal anti-inflammatory drugs (NSAIDs) remain problematic because of their propensity to cause serious adverse events, principally affecting the gastrointestinal tract. In recent years, the discovery of potent anti-inflammatory and cytoprotective effects of endogenous gaseous mediators (nitric oxide, hydrogen sulfide, carbon monoxide) stimulated efforts to develop novel, combination NSAIDs that suppress prostaglandin synthesis (producing anti-inflammatory and analgesic effects) and release one or more of the cytoprotective gaseous mediators. Gaseous mediator-based anti-inflammatory drugs have reached the human clinical trial stage and show considerable promise as a safer option for treating chronic inflammatory diseases.