Prostaglandins: Synthesis, Functions, and Clinical Roles

Introduction to Prostaglandins

Prostaglandins are a group of physiologically active lipid compounds that have diverse, hormone-like effects in animals. Unlike classical hormones, they are not secreted from a gland and do not travel to a distant site but are synthesized at the site where they are needed.

  • Discovered by: Ulf von Euler in 1935 in human semen, who thought they originated from the prostate gland (hence the name).

  • Classification: Prostaglandins belong to a broader group of bioactive lipids known as eicosanoids, which also includes thromboxanes and leukotrienes.


Chemical Structure

  • Prostaglandins are derived from 20-carbon essential fatty acids, primarily arachidonic acid.

  • Structure: All prostaglandins share a common skeleton of a 20-carbon fatty acid with a five-membered ring.

  • Various prostaglandins differ in:

    • The functional groups attached to the ring.

    • The degree of saturation of the side chains.


Biosynthesis of Prostaglandins

Step 1: Liberation of Arachidonic Acid

  • Arachidonic acid is released from membrane phospholipids by the action of the enzyme phospholipase A₂ (PLA₂).

Step 2: Conversion via the Cyclooxygenase Pathway

  • Enzyme: Cyclooxygenase (COX)

  • Two isoforms:

    • COX-1: Constitutively expressed; maintains normal physiological functions.

    • COX-2: An inducible enzyme; expressed during inflammation, injury, or infection.

Step 3: Formation of Prostaglandin Precursors

  • COX converts arachidonic acid to PGG₂ and then to PGH₂.

  • PGH₂ is the common precursor for various prostaglandins and thromboxanes.

Step 4: Conversion to Specific Prostaglandins

  • Tissue-specific synthases convert PGH₂ into:

    • PGE₂

    • PGI₂ (prostacyclin)

    • PGD₂

    • PGF₂α

    • TXA₂ (thromboxane A₂)


Major Types and Their Functions

ProstaglandinSite of ActionMajor Functions
PGE₂Most tissuesVasodilation, fever, pain sensitization, uterine contraction, gastric mucus secretion
PGI₂ (prostacyclin)EndotheliumInhibition of platelet aggregation, vasodilation
PGF₂αUterus, eyeUterine contraction, increased intraocular pressure
PGD₂CNS, mast cellsSleep regulation, bronchoconstriction, allergic responses
TXA₂PlateletsPromotion of platelet aggregation, vasoconstriction

Physiological Roles of Prostaglandins

Inflammation and Immunity

  • PGE₂ and PGI₂ are produced during inflammation.

  • They increase vascular permeability, attract leukocytes, and induce pain and fever.

  • They are the primary target of NSAIDs to reduce symptoms of inflammation.

Reproductive System

  • PGF₂α and PGE₂ cause uterine contractions during menstruation and labor.

  • They are involved in ovulation and cervical ripening.

Cardiovascular System

  • PGI₂: A vasodilator and anti-thrombotic agent.

  • TXA₂: A vasoconstrictor and pro-thrombotic agent.

  • These two maintain the balance between coagulation and anticoagulation.

Gastrointestinal System

  • PGE₂ promotes mucus and bicarbonate secretion in the stomach.

  • It inhibits gastric acid secretion.

  • It protects the gastric mucosa.

Renal System

  • Prostaglandins maintain renal blood flow and glomerular filtration rate.

  • They regulate salt and water excretion.

Nervous System

  • PGE₂ is involved in pain perception and fever.

  • It acts on the hypothalamus to raise body temperature.


Clinical Relevance

NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)

  • Examples: Aspirin, Ibuprofen, Naproxen.

  • Mechanism: Inhibit COX enzymes, which reduces prostaglandin synthesis.

  • Used to treat: Pain, inflammation, and fever.

COX-2 Inhibitors

  • Example: Celecoxib.

  • Mechanism: Selectively inhibit COX-2, resulting in less gastric irritation than non-selective NSAIDs.

Prostaglandin Analogues (Drugs)

DrugAnalogue ofUsed for
MisoprostolPGE₁Preventing NSAID-induced ulcers, inducing labor
DinoprostonePGE₂Cervical ripening, labor induction
LatanoprostPGF₂αTreating glaucoma (reduces intraocular pressure)
AlprostadilPGE₁Maintaining patent ductus arteriosus in neonates, treating erectile dysfunction

Role in Pathology

  • Dysmenorrhea: Excess PGF₂α causes painful uterine contractions.

  • Asthma: PGD₂ contributes to bronchoconstriction.

  • Cancer: Overexpression of COX-2 is linked with tumorigenesis (e.g., angiogenesis, inhibition of apoptosis).


Summary of Key Points

  • Prostaglandins are locally acting lipid mediators derived from arachidonic acid.

  • They regulate a wide array of physiological functions, including inflammation, reproduction, cardiovascular health, and renal function.

  • Their synthesis is inhibited by NSAIDs, making them key targets in the treatment of pain, fever, and inflammation.

  • Synthetic prostaglandins and their analogues are used therapeutically in obstetrics, ophthalmology, and gastroenterology.


Prostaglandin Synthesis Pathway

Membrane Phospholipids
        ↓ (PLA₂)
Arachidonic Acid
        ↓ (COX-1 / COX-2)
PGG₂ → PGH₂
        ↓
PGE₂, PGI₂, PGF₂α, PGD₂, TXA₂