Caffeic Acid Reverses Nonsteroidal Anti-inflammatory Drugs-aspirin Interaction

Aspirin resistance remains an important clinical issue. Previous reports have confirmed that both ibuprofen and indomethacin could antagonize aspirin action at platelet COX-1 level. Such an interaction prevented the patients with arthritis from receving aspirin therapy. We observed the effects of caffeic acid on such an ibuprofen or indomethacin-aspirin interaction both in vitro and in vivo. Both ibuprofen and indomethacin showed weak inhibition on AA-induced platelet aggregation, but significantly antagonized aspirin action on platelet aggregation. In contrast, neither ibuprofen nor indomethacin had effect on caffeic acid action on platelet aggregation. Interestingly, the antagonism of ibuprofen and indomethacin on aspirin action was abolished by simultaneouse addition of caffeic acid, suggesting that caffeic acid could reverse ibuprofen or indomethacin-aspirin interaction. We also obtained the same results from in vivo study. Taken together, our results provides novel insight into aspirin resistance by NSAIDs and suggests that the NSAIDS treated patients might benefit from the supplement of caffeic acid, a widely distributed polyphenols, when receiving aspirin therapy.