Ian Barnett on the diverse uses of aspirin

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Acetylsalicylic acid – mean anything to you? Two pence per tablet at a well known, footwear related, high-street chemist; it is one of the most eminent commercial drugs available today. Traditionally used for the treatment of pain, inflammation and fever; its uses are rapidly growing as research yields new and diverse properties. It was discovered in the mid 19th century and was one of the most prolific drugs of the early 1900s, before the advent of paracetamol and ibuprofen. However, in recent years, its uses as an anticoagulant and anticancer drug have fuelled its revival. This impressive list of attributes belongs to the common aspirin.

Aspirin is synthesised from salicylic acid and acetic anhydride, releasing acetic acid (vinegar) for our chips along the way. Hippocrates documented the use of a white powder made from willow trees (which contain salicylic acid) around 400 BC. Hence, the use of salicylic acid as a painkiller is an ancient one, but is had side effects; most notably the ability to dissolve one’s stomach. To combat this problem, Charles Frédéric Gerhardt synthesised acetylsalicylic acid in 1853. Still an effective analgesic but one with less serious side effects, pure acetylsalicylic acid was first synthesised and sold by the German pharmaceutical company Bayer in 1899, under the familiar name ‘aspirin’.

As an anticoagulant, aspirin has been used to help prevent heart attacks and strokes over the past few decades. More recently, several research studies have revealed aspirin’s use for preventing cancer. One study in particular saw a 63% reduction in the incidence of bowel cancer amongst a group who each took a daily dose of 600 mg aspirin. The individuals who took part in this study had all been diagnosed with Lynch Syndrome; a hereditary condition which increases the risk of many forms of cancer, due to the suffers’ faulty DNA. Professor Sir John Burn, the research leader, said the idea behind the findings was that aspirin “knocks off the cells that are going to become a cancer”. Researchers at Oxford University have discovered that taking a much smaller dose, just 75mg of aspirin per day, reduces the incidence of all forms of cancer by 20%. Healthy individuals aged between forty and sixty gain the most from taking aspirin daily, as it takes between five and twenty years for the cancer prevention to take effect.

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However, Dutch researchers are not convinced that widespread, daily use of aspirin is advantageous, especially for middle-aged women. Bowel inflammation, stomach ulcers, bleeding and nausea are common side effects of prolonged aspirin use, therefore the long-term benefits are usually wiped out by these health problems. The study revealed that if 50 individuals were to take aspirin daily for 10 years, only one would feel any benefit. The incidence of heart attacks, strokes and death from heart disease is cut by only 0.2% to 2.2%, with the rate dropping the most amongst women over the age of 65. Another study revealed that 1,111 individuals would have to take daily doses of aspirin for just one life to be saved, hence an awful lot of people are taking aspiring needlessly.

Although aspirin enjoys only mixed reviews in the prevention of heart disease and strokes, it is clear that scientists are extremely interested in discovering the mechanism by which aspirin appears to reduce the risk of cancers. With the incidence of cancer rising by 20% in the UK over the last generation, a “wonder drug”, which could prevent or treat a multitude of cancers effectively, would be extremely lucrative; but is this drug already available for only pennies?

 

Ian Barnett

Image 1 – Sauligno

Image 2 credit – NEUROtiker