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Researchers continue to learn more about how aspirin works, which may lead to newer, safer treatments. Getty Images
  • Asprin is one of the oldest pain-relieving drugs currently in use, and researchers continue to learn more about how it works.
  • New research suggests aspirin’s mechanism of action in reducing inflammation and influencing immune response could pave the way for newer medications without the same side effects.
  • Millions of people take aspirin both for pain relief and to potentially improve their cardiovascular health despite inconclusive evidence of a benefit.

Researchers have gained new insights into how aspirin relieves pain, potentially paving the way for future pain-relieving, anti-inflammatory drugs.

Despite being one of the oldest commercial pain relievers used by millions daily, the ways these inflammation-reducing mechanisms work are still being explored, which is the subject of a new paper presented at the American Society for Biochemistry and Molecular Biology’s annual meeting on March 28th.

Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) like ibuprofen and naproxen. It partially reduces pain and inflammation by inhibiting the cyclooxygenase enzyme (COX), which tells the body to ramp up its inflammatory response.

In addition to this known mechanism of action, the researchers found that aspirin also influences immune response at the protein level, including reducing the breakdown of the essential amino acid tryptophan by inhibiting certain enzymes that are also targeted in cancer therapy.

Their findings led them to conclude that new anti-inflammatory drugs that work similarly to aspirin may be helpful in immunotherapy.

“It is a great finding and hypothesis, however, yet to be tested and approved,” Medhat Mikhael, MD, pain management specialist and medical director of the non-operative program at the Spine Health Center at MemorialCare Orange Coast Medical Center in Fountain Valley, Calif., told Healthline. “The clinical implications of the information is that modulation of the therapy to minimize risks could be a great addition to the other immune therapies used to treat cancer.”

Mikhael was not affiliated with the research.

Understanding how aspirin works is also essential for developing new drugs that work like aspirin but without its drawbacks.

“Aspirin is a magic drug, but long-term use of it can cause detrimental side effects such as internal bleeding and organ damage,” Subhrangsu Mandal, Ph.D., a professor of chemistry and biochemistry at the University of Texas at Arlington, said in a press release. “It’s important that we understand how it works so we can develop safer drugs with fewer side effects.”

This is especially critical because nearly 30 million Americans take aspirin daily out of the belief that it will aid their cardiovascular health, and 6.6 million of those are doing so outside of a healthcare professional’s recommendation, according to data from the National Institutes of Health.

Research suggests genuine potential benefits to taking daily aspirin, but not everyone should take it — especially without a doctor’s say-so.

“Patients at high risk of heart disease and stroke have been found to possibly benefit from using low dose Aspirin for prevention,” Mikhael said. “However, there is a major warning about taking aspirin on a regular basis if you have no risks, as you could be facing more serious side effects like gastric ulcers, GI bleeding, and kidney disease. Most studies conducted on patients with low or no risks taking regular aspirin daily are at much higher risks for side effects than benefits.”

In short, despite its high level of use, aspirin carries more risks than many other over-the-counter medications. Consumers should be aware of its shortcomings and benefits.

“Aspirin was in use before the Food and Drug Administration started approving drugs in the United States,” Thomas So, PharmD, senior manager of the Consumer Drug Information Group at healthcare information technology firm FDB told Healthline. “Aspirin would likely not have been approved due to the risk of bleeding. It might not have even made it past animal studies.”

And until a newer, safer aspirin is made, you can always ask your doctor.

“Consumers need to know that not all over counter medications are safe. Low-dose aspirin might be beneficial for high risk patients for heart attack or stroke; however, it is not to be used for patients on other blood thinners, patients with low or no risks for those diseases, as this will expose them to serious side effects,” Mikhael added. “Consumers should also know that they should consult their doctors before using any over-the-counter medications for prophylaxis or on a regular basis.”