Aspirin and age-related macular degeneration: positives versus negatives

The anti-inflammatory, analgesic, antipyretic and antithrombotic activities of aspirin confer its wide therapeutic application. The three former activities require higher doses of aspirin, whereas the latter can be achieved through a lower, thus safer dose of the drug. Low-dose, long-term aspirin is used as an antithrombotic therapy to prevent cardiovascular disease. Such therapy is used by millions of people worldwide, including those suffering from age-related macular degeneration (AMD); thus, questions have arisen as to whether such treatment has any impact on the development and course of AMD. This editorial addresses the important issue of possible beneficial and adverse effects of long-term, low-dose aspirin treatment of AMD patients. Special emphasis is given to the ability of aspirin to acetylate cyclooxygenases (especially COX-2) and thus to initiate a biochemical pathway leading to the generation of anti-inflammatory pro-resolving mediators synthesized from both ω-3 and ω-6 long-chain polyunsaturated fatty acids. Such mediators (e.g., resolvins, lipoxins) may be of therapeutic value in retarding the development of dry form AMD.