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   Compounds containing a 20-carbon core

   Comprise:
    ◦ prostaglandins
    ◦ thromboxanes        prostanoids
    ◦ leukotrienes
    ◦ lipoxins
    ◦ hydroxyeicosatetraenoic acids (HETEs)
    ◦ hepoxilins
EICOSANOID BIOSYNTHESIS
   In polyunsaturated fatty acid metabolism, especially metabolism of linoleic
    and arachidonic acid:
   In humans, arachidonic acid is
    formed from linoleic acid:




   In humans, the double bonds cannot
    be introduced beyond the ∆9 position
    ⇒ linoleic and linolenic acids are
    essential: must be supplied in food
    (plant oils, peanut, soybean, corn)
food

   linoleic acid




dihomo-γ-linolenic acid
                                           arachidonic
(8,11,14-eicosatrienoic)                      acid




       linolenic
          acid
                     eicosapentaenoic
                           acid
          food                                           1…cyclooxygenase pathway
                      food – mainly fish oils            2…lipoxygenase pathway
   Endothelial cells
   Leukocytes
   Platelets
   Kidney

   Unlike histamine, eicosanoids are NOT synthesized in advance and
    stored in granules – when needed, they can be produced very quickly
    from arachidonate released from membranes
   1) Activation of phospholipase A2 (PLA2)


   2) Release of arachidonate from membrane phospholipids by PLA 2


   3) Eicosanoid synthesis: COX or LO pathway + subsequent cell-specific
    modifications by synthases / isomerases (conversion of the precursor
    PGH2 to another prostanoid, conversion of LTA4…)
   Ligand binding to a receptor induces phospholipase C (PLC) activation → PLC
    cleaves PIP2 to DAG and IP3 that opens the Ca2+ channels in the ER. PLA2, activated
    by Ca2+ and probably also by phosphorylation (MAPK), translocates to membranes of
    GA, ER, or nucleus from which it releases arachidonate for here residing COX/LO.




                                            plasma                 GA, ER, or nuclear
                                            membrane                  membrane


                                         NOS synthesis/

                                                              on
                                         activation
                                                                                   The ligand can be
                                                          ati
                                                       loc

                                                                                   i.a. ATP released
                                                                                   from dying cells
                                                     ns
                            activ




                                                  tra
                                 ation




                                                     Ca
   PLA 2 expression / activity is      PLA2 expression / activity is
    stimulated by:                       impaired by:

    ◦   interleukin-1                    ◦ dexamethasone (synthetic
                                           glucocorticoid)
    ◦   angiotensin II                   ◦ annexin 1 (lipocortin) –
    ◦   bradykinin                         glucocorticoid-inducible protein
    ◦   EGF                              ◦ caspase-3
    ◦   thrombin
    ◦   epinephrine…




                                                    dexamethasone
   From membrane phospholipids – mainly by the action of phospholipase A2:



                                                 Arachidonate release
                                                 from phospholipids
                                                 can be blocked by the
                                                 anti-inflammatory steroids!
   In almost all cell types (except for red blood cells)

   3 pathways:
    ◦ A) cyclooxygenase (COX) – produces prostaglandins and thromboxanes

    ◦ B) lipoxygenase (LO) – produces leukotrienes, lipoxins, 12- and 15-
      HETEs, and hepoxilins

    ◦ C) cytochrome P450s (monooxygenases) – produce the other HETEs
      (20-HETE); principal pathway in the proximal tubules
   Prostaglandin H synthase, present as two isoenzymes (PGHS-1/COX-1,
    PGHS-2/COX-2), each possessing two activities:
    ◦ cyclooxygenase – catalyzes addition of two molecules of O2 to the
      arachidonic acid molecule, forming PGG2
    ◦ hydroperoxidase – converts the hydroperoxy function of PGG2 to an OH
      group (of PGH2)

    The enzyme is also capable of self-catalyzed destruction!

   Mostly, a given cell type produces 1 type of prostanoids: platelets
    produce almost exclusively thromboxanes, vascular endothelial cells
    prostacyclins, heart muscle makes PGI2, PGE2, PGF2α
cyclic 9,11-endoperoxide, 15-hydroperoxide is formed




      PGH2 = precursor of all series 2 prosta-glandins
       and thromboxanes
   Platelets contain thromboxane synthase producing TXA2, TXB2
   Vascular endothelial cells contain prostacyclin synthase which converts PGH2 to
    prostacyclin PGI2
   Aspirin inhibits the COX activity of both
    PGHS-1 and PGHS-2 (by acetylation of
    a distinct Ser of the enzyme)

   Other nonsteroidal anti-inflammatory
    drugs (NSAIDs) also inhibit the COX
    activity (ibuprofen competes with
    arachidonate)

   Transcription of PGHS-2 can be blocked
    by anti-inflammatory corticosteroids
12-lipoxygenase                     15-lipoxygenase                    3 different lipoxy-
                                                                       
                                                                       genases insert
                                                                       oxygen into the 5,
                                                                       12, or 15 position of
      Hepoxilins   5-lipoxygenase
        (HXA3)                                                         arachidonate; the
                                                                       first product is the
                                                                       hydroperoxy-
                                                                       eicosatetraenoic
                                                         5-lipoxygenaseacid (HPETE)




                                                                           Only 5-lipoxygenase
                                             se                             produces leukotri-
                               15-lipoxygena                                enes; requires
                                                                            protein FLAP

Gly–Cys–Glu
                           Leukotriene D4             Leukotriene E4       peptidoleukotrienes
                    -Glu                     -Gly
Requires glutathione!!!
   Cytochrome P450s – monooxygenases:
    RH + O2 + NADPH + H+→ ROH + H2O + NADP+

   Two main classes of compounds are formed:
    ◦ epoxygenases catalyze the formation of epoxyeicosatrienoic acids
      (EETs) that are further metabolized by epoxide hydrolases to
      dihydroxyeicosatrienoic acids (DiHETEs) which are almost inactive:




    ◦ hydroxylases catalyze the formation of HETEs (20-HETE, 13-HETE…)
arachidonic acid

        CYP450s                 cyclooxygenases                    lipoxygenases


          19-, 20-, 8-,
 EETs                      prostacyclins   thromboxanes                       lipoxins
          9-, 10-, 11-,
          12-, 13-, 15-,
          16-, 17-,
DiHETEs   18-HETE                 prostaglandins
                                                    leukotrienes

                                                           hepoxilins



                                                                    5-, 8-, 12-,
                                                                    15-HETE
   Prostaglandins – cyclopentane ring

   Thromboxanes – six-membered oxygen-containing ring

   Leukotrienes – 3 conjugated double bonds + one more unconjugated

   Lipoxins – conjugated trihydroxytetraenes
   The three classes A, E, F (third letter) are distinguished on the basis of the
    functional groups about the cyclopentane ring
   The subscript numerals refer to the number of double bonds in the side
    chains
   The subscript α refers to the configuration of the 9–OH group (projects
    down from the plane of the ring)



                                                      PGE2

                                 E…β-hydroxyketone
                                 2 double bonds
BIOLOGICAL EFFECTS OF EICOSANOIDS
   Eicosanoids, like hormones, display profound effects at extremely low
    concentrations

   They have a very short half-life; thus, they act in an autocrine or
    paracrine manner (unlike hormones)

   Biological effects depend not only on the particular eicosanoid but also
    on the local availability of receptors that it can bind to
   inflammatory response, notably as it involves the joints (rheumatoid
    arthritis), skin (psoriasis), and eyes

   production of pain and fever

   regulation of blood pressure

   regulation of blood clotting

   regulation of renal function

   control of several reproductive functions, such as the induction of labor
   Via the G protein-coupled receptors:
    ◦ a) Gαs stimulate adenylate cyclase (AC)
    ◦ b) Gαi inhibit adenylate cyclase




                                                (e.g. PKA)
◦ c) Gq activates phospholipase C that cleaves phosphatidylinositol-4,5-
  bisphosphate (PIP2) to inositol-1,4,5-trisphosphate (IP3) and diacylgly-cerol
  (DAG); DAG together with Ca2+ activates protein kinase C, IP3 opens Ca2+
  channels of the ER




                                                                +
   Mediate inflammation:
    ◦ cause vasodilation ⇒ redness, heat (PGE1, PGE2, PGD2, PGI2)
    ◦ increase vascular permeability ⇒ swelling (PGE2, PGD2, PGI2)
   Regulate pain and fever (PGE2)
   PGE2, PGF2 stimulate uterine muscle contractions during labor
   Prostaglandins of the PGE series inhibit gastric acid secretions (synthetic
    analogs are used to treat gastric ulcers)
   Regulate blood pressure: vasodilator prostaglandins PGE, PGA, and PGI 2
    lower systemic arterial pressure
   Regulate platelet aggregation: PGI2 = potent inhibitor of platelet aggregation
   PGE2 inhibits reabsorption of Na+ and water in the collecting duct.
    PGI2: vasodilatation and regulation of glomerular filtration rate.
   Thromboxanes are synthesized by platelets and, in general, cause
    vasoconstriction and platelet aggregation

   TXA2 is also produced in the kidney (by podocytes and other cells) where it
    causes vasoconstriction and mediates the response to ANGII

   Thus, both thromboxanes and prostaglandins (PGI2) regulate coagulation
    ◦ In Eskimos, higher intake of eicosapentaenoic acid and group 3 prosta-
      noids may be responsible for low incidence of heart diseases and
      prolonged clotting times since TXA3 is a weaker aggregator than TXA2 and
      both PG3 and TXA3 inhibit arachidonate release and TXA2 formation
   LTs are produced mainly in leukocytes that also express receptors for LTs
   Leukotrienes are very potent constrictors of the bronchial airway muscles:
    (LTC4, LTD4, and LTE4 = the slow-reacting substance of anaphylaxis)
   They increase vascular permeability
   They cause attraction (LTB4) and activation of leukocytes (primarily
    eosinophils and monocytes), promote diapedesis (increase expression of
    integrins on the leukocyte surface), enhance phagocytosis
   They regulate vasoconstriction




     they regulate inflammatory reactions, host defense against infections
                      as well as hyperreactivity (asthma…)
(induction of gene
                                   expression)         (receptors for LTs)




(activation of NADPH oxidase)
            (synthesis of iNOS)
     (release from neutrophils)
                                                        (LTs promote diapedesis,
                                                        delay apoptosis of leukocytes)
   Overproduction of LTB4 was demonstrated in:
    ◦   Crohn's disease
    ◦   rheumatoid arthritis
    ◦   psoriasis
    ◦   cystic fibrosis

   Leukotrienes are also suspected of participating in atherosclerosis
    development

   Excessive bronchoconstriction can be found in some forms of asthma
   Lipoxins are produced mainly by leukocytes and platelets stimulated by
    cytokines (IL-4, TGF-β):
    ◦ a) 5-lipoxygenase (5-LO) of neutrophils produces leukotriene LTA4
      which enters platelets where it is converted by 15-LO to LXA4 or LXB4
    ◦ b) 15-LO of epithelial cells and monocytes forms 15-HPETE which
      becomes a substrate of 5-LO and epoxid hydrolase of leukocytes
                             …transcellular biosynthesis

   Main products: LXA4, LXB4
   Unlike pro-inflammatory eicosanoids, lipoxins attenuate the inflammation and
    appear to facilitate the resolution of the acute inflammatory response

   Hypothesis: in the first phase of the inflammatory response, leukotrienes are
    produced (e.g. LTB4) → then, the level of PGs rises and PGs „switch“ the
    syntheses from leukotriene production to the pathway which, in the 2nd phase,
    produces lipoxins promoting the resolution of inflammation

   Therefore, potential therapeutic use of LXs in the treatment of inflammatory
    diseases (glomerulonephritis, asthma) is being extensively studied
   LXs inhibit chemotaxis of neutrophils and eosinophils and diapedesis
   Inhibit formation of ROS (neutrophils, lymphocytes) and ONOO -
    (neutrophils)
   Inhibit production of specific cytokines by leukocytes
   Stimulate non-inflammatory phagocytosis (of apoptotic neutrophils…)
   Antagonize LT receptors
   Affect not only the cells of the myeloid line:
    ◦ inhibit the contraction of the bronchial smooth muscle
    ◦ inhibit production of cytokines by the cells of colon, fibroblasts…
    ◦ inhibit the interaction between leukocytes and endothelial cells
   5-HETE participates in host defense against bacterial infection
    (chemotaxis and degranulation of neutrophils and eosinophils)

   20-HETE causes vasoconstriction (by its effect on the smooth muscle of
    vessels); in kidney, it regulates Na+ excretion, diuresis, and blood pressure

   12- a 15-HETE are produced in kidney and participate in the regulation of
    the renin-angiotensin system (probably mediate feed-back inhibition of
    renin; 12-HETE also mediates secretion of aldosteron induced by ANGII)
   HXA3 stimulates glucose-induced insulin secretion by pancreatic β cells

   Under oxidative stress, HXA3 formation is stimulated and HXA3 upregulates
    the expression of glutathione peroxidase…compensatory defense
    response to protect cell viability?

   In vitro, stable analogs of HXA3 induce apoptosis of tumour cells and inhibit
    tumour growth

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Eicosanoids MUHAMAD MUSTANSAR

  • 1. z
  • 2. Compounds containing a 20-carbon core  Comprise: ◦ prostaglandins ◦ thromboxanes prostanoids ◦ leukotrienes ◦ lipoxins ◦ hydroxyeicosatetraenoic acids (HETEs) ◦ hepoxilins
  • 4. In polyunsaturated fatty acid metabolism, especially metabolism of linoleic and arachidonic acid:
  • 5. In humans, arachidonic acid is formed from linoleic acid:  In humans, the double bonds cannot be introduced beyond the ∆9 position ⇒ linoleic and linolenic acids are essential: must be supplied in food (plant oils, peanut, soybean, corn)
  • 6. food linoleic acid dihomo-γ-linolenic acid arachidonic (8,11,14-eicosatrienoic) acid linolenic acid eicosapentaenoic acid food 1…cyclooxygenase pathway food – mainly fish oils 2…lipoxygenase pathway
  • 7. Endothelial cells  Leukocytes  Platelets  Kidney  Unlike histamine, eicosanoids are NOT synthesized in advance and stored in granules – when needed, they can be produced very quickly from arachidonate released from membranes
  • 8. 1) Activation of phospholipase A2 (PLA2)  2) Release of arachidonate from membrane phospholipids by PLA 2  3) Eicosanoid synthesis: COX or LO pathway + subsequent cell-specific modifications by synthases / isomerases (conversion of the precursor PGH2 to another prostanoid, conversion of LTA4…)
  • 9. Ligand binding to a receptor induces phospholipase C (PLC) activation → PLC cleaves PIP2 to DAG and IP3 that opens the Ca2+ channels in the ER. PLA2, activated by Ca2+ and probably also by phosphorylation (MAPK), translocates to membranes of GA, ER, or nucleus from which it releases arachidonate for here residing COX/LO. plasma GA, ER, or nuclear membrane membrane NOS synthesis/ on activation The ligand can be ati loc i.a. ATP released from dying cells ns activ tra ation Ca
  • 10. PLA 2 expression / activity is  PLA2 expression / activity is stimulated by: impaired by: ◦ interleukin-1 ◦ dexamethasone (synthetic glucocorticoid) ◦ angiotensin II ◦ annexin 1 (lipocortin) – ◦ bradykinin glucocorticoid-inducible protein ◦ EGF ◦ caspase-3 ◦ thrombin ◦ epinephrine… dexamethasone
  • 11. From membrane phospholipids – mainly by the action of phospholipase A2: Arachidonate release from phospholipids can be blocked by the anti-inflammatory steroids!
  • 12. In almost all cell types (except for red blood cells)  3 pathways: ◦ A) cyclooxygenase (COX) – produces prostaglandins and thromboxanes ◦ B) lipoxygenase (LO) – produces leukotrienes, lipoxins, 12- and 15- HETEs, and hepoxilins ◦ C) cytochrome P450s (monooxygenases) – produce the other HETEs (20-HETE); principal pathway in the proximal tubules
  • 13. Prostaglandin H synthase, present as two isoenzymes (PGHS-1/COX-1, PGHS-2/COX-2), each possessing two activities: ◦ cyclooxygenase – catalyzes addition of two molecules of O2 to the arachidonic acid molecule, forming PGG2 ◦ hydroperoxidase – converts the hydroperoxy function of PGG2 to an OH group (of PGH2) The enzyme is also capable of self-catalyzed destruction!  Mostly, a given cell type produces 1 type of prostanoids: platelets produce almost exclusively thromboxanes, vascular endothelial cells prostacyclins, heart muscle makes PGI2, PGE2, PGF2α
  • 14. cyclic 9,11-endoperoxide, 15-hydroperoxide is formed  PGH2 = precursor of all series 2 prosta-glandins and thromboxanes
  • 15. Platelets contain thromboxane synthase producing TXA2, TXB2  Vascular endothelial cells contain prostacyclin synthase which converts PGH2 to prostacyclin PGI2
  • 16. Aspirin inhibits the COX activity of both PGHS-1 and PGHS-2 (by acetylation of a distinct Ser of the enzyme)  Other nonsteroidal anti-inflammatory drugs (NSAIDs) also inhibit the COX activity (ibuprofen competes with arachidonate)  Transcription of PGHS-2 can be blocked by anti-inflammatory corticosteroids
  • 17.
  • 18. 12-lipoxygenase 15-lipoxygenase 3 different lipoxy-  genases insert oxygen into the 5, 12, or 15 position of Hepoxilins 5-lipoxygenase (HXA3) arachidonate; the first product is the hydroperoxy- eicosatetraenoic 5-lipoxygenaseacid (HPETE)  Only 5-lipoxygenase se produces leukotri- 15-lipoxygena enes; requires protein FLAP Gly–Cys–Glu Leukotriene D4 Leukotriene E4 peptidoleukotrienes -Glu -Gly
  • 20. Cytochrome P450s – monooxygenases: RH + O2 + NADPH + H+→ ROH + H2O + NADP+  Two main classes of compounds are formed: ◦ epoxygenases catalyze the formation of epoxyeicosatrienoic acids (EETs) that are further metabolized by epoxide hydrolases to dihydroxyeicosatrienoic acids (DiHETEs) which are almost inactive: ◦ hydroxylases catalyze the formation of HETEs (20-HETE, 13-HETE…)
  • 21. arachidonic acid CYP450s cyclooxygenases lipoxygenases 19-, 20-, 8-, EETs prostacyclins thromboxanes lipoxins 9-, 10-, 11-, 12-, 13-, 15-, 16-, 17-, DiHETEs 18-HETE prostaglandins leukotrienes hepoxilins 5-, 8-, 12-, 15-HETE
  • 22. Prostaglandins – cyclopentane ring  Thromboxanes – six-membered oxygen-containing ring  Leukotrienes – 3 conjugated double bonds + one more unconjugated  Lipoxins – conjugated trihydroxytetraenes
  • 23. The three classes A, E, F (third letter) are distinguished on the basis of the functional groups about the cyclopentane ring  The subscript numerals refer to the number of double bonds in the side chains  The subscript α refers to the configuration of the 9–OH group (projects down from the plane of the ring) PGE2 E…β-hydroxyketone 2 double bonds
  • 24. BIOLOGICAL EFFECTS OF EICOSANOIDS
  • 25. Eicosanoids, like hormones, display profound effects at extremely low concentrations  They have a very short half-life; thus, they act in an autocrine or paracrine manner (unlike hormones)  Biological effects depend not only on the particular eicosanoid but also on the local availability of receptors that it can bind to
  • 26. inflammatory response, notably as it involves the joints (rheumatoid arthritis), skin (psoriasis), and eyes  production of pain and fever  regulation of blood pressure  regulation of blood clotting  regulation of renal function  control of several reproductive functions, such as the induction of labor
  • 27. Via the G protein-coupled receptors: ◦ a) Gαs stimulate adenylate cyclase (AC) ◦ b) Gαi inhibit adenylate cyclase (e.g. PKA)
  • 28. ◦ c) Gq activates phospholipase C that cleaves phosphatidylinositol-4,5- bisphosphate (PIP2) to inositol-1,4,5-trisphosphate (IP3) and diacylgly-cerol (DAG); DAG together with Ca2+ activates protein kinase C, IP3 opens Ca2+ channels of the ER +
  • 29. Mediate inflammation: ◦ cause vasodilation ⇒ redness, heat (PGE1, PGE2, PGD2, PGI2) ◦ increase vascular permeability ⇒ swelling (PGE2, PGD2, PGI2)  Regulate pain and fever (PGE2)  PGE2, PGF2 stimulate uterine muscle contractions during labor  Prostaglandins of the PGE series inhibit gastric acid secretions (synthetic analogs are used to treat gastric ulcers)  Regulate blood pressure: vasodilator prostaglandins PGE, PGA, and PGI 2 lower systemic arterial pressure  Regulate platelet aggregation: PGI2 = potent inhibitor of platelet aggregation  PGE2 inhibits reabsorption of Na+ and water in the collecting duct. PGI2: vasodilatation and regulation of glomerular filtration rate.
  • 30. Thromboxanes are synthesized by platelets and, in general, cause vasoconstriction and platelet aggregation  TXA2 is also produced in the kidney (by podocytes and other cells) where it causes vasoconstriction and mediates the response to ANGII  Thus, both thromboxanes and prostaglandins (PGI2) regulate coagulation ◦ In Eskimos, higher intake of eicosapentaenoic acid and group 3 prosta- noids may be responsible for low incidence of heart diseases and prolonged clotting times since TXA3 is a weaker aggregator than TXA2 and both PG3 and TXA3 inhibit arachidonate release and TXA2 formation
  • 31. LTs are produced mainly in leukocytes that also express receptors for LTs  Leukotrienes are very potent constrictors of the bronchial airway muscles: (LTC4, LTD4, and LTE4 = the slow-reacting substance of anaphylaxis)  They increase vascular permeability  They cause attraction (LTB4) and activation of leukocytes (primarily eosinophils and monocytes), promote diapedesis (increase expression of integrins on the leukocyte surface), enhance phagocytosis  They regulate vasoconstriction they regulate inflammatory reactions, host defense against infections as well as hyperreactivity (asthma…)
  • 32. (induction of gene expression) (receptors for LTs) (activation of NADPH oxidase) (synthesis of iNOS) (release from neutrophils) (LTs promote diapedesis, delay apoptosis of leukocytes)
  • 33. Overproduction of LTB4 was demonstrated in: ◦ Crohn's disease ◦ rheumatoid arthritis ◦ psoriasis ◦ cystic fibrosis  Leukotrienes are also suspected of participating in atherosclerosis development  Excessive bronchoconstriction can be found in some forms of asthma
  • 34. Lipoxins are produced mainly by leukocytes and platelets stimulated by cytokines (IL-4, TGF-β): ◦ a) 5-lipoxygenase (5-LO) of neutrophils produces leukotriene LTA4 which enters platelets where it is converted by 15-LO to LXA4 or LXB4 ◦ b) 15-LO of epithelial cells and monocytes forms 15-HPETE which becomes a substrate of 5-LO and epoxid hydrolase of leukocytes …transcellular biosynthesis  Main products: LXA4, LXB4
  • 35. Unlike pro-inflammatory eicosanoids, lipoxins attenuate the inflammation and appear to facilitate the resolution of the acute inflammatory response  Hypothesis: in the first phase of the inflammatory response, leukotrienes are produced (e.g. LTB4) → then, the level of PGs rises and PGs „switch“ the syntheses from leukotriene production to the pathway which, in the 2nd phase, produces lipoxins promoting the resolution of inflammation  Therefore, potential therapeutic use of LXs in the treatment of inflammatory diseases (glomerulonephritis, asthma) is being extensively studied
  • 36. LXs inhibit chemotaxis of neutrophils and eosinophils and diapedesis  Inhibit formation of ROS (neutrophils, lymphocytes) and ONOO - (neutrophils)  Inhibit production of specific cytokines by leukocytes  Stimulate non-inflammatory phagocytosis (of apoptotic neutrophils…)  Antagonize LT receptors  Affect not only the cells of the myeloid line: ◦ inhibit the contraction of the bronchial smooth muscle ◦ inhibit production of cytokines by the cells of colon, fibroblasts… ◦ inhibit the interaction between leukocytes and endothelial cells
  • 37.
  • 38. 5-HETE participates in host defense against bacterial infection (chemotaxis and degranulation of neutrophils and eosinophils)  20-HETE causes vasoconstriction (by its effect on the smooth muscle of vessels); in kidney, it regulates Na+ excretion, diuresis, and blood pressure  12- a 15-HETE are produced in kidney and participate in the regulation of the renin-angiotensin system (probably mediate feed-back inhibition of renin; 12-HETE also mediates secretion of aldosteron induced by ANGII)
  • 39. HXA3 stimulates glucose-induced insulin secretion by pancreatic β cells  Under oxidative stress, HXA3 formation is stimulated and HXA3 upregulates the expression of glutathione peroxidase…compensatory defense response to protect cell viability?  In vitro, stable analogs of HXA3 induce apoptosis of tumour cells and inhibit tumour growth