Inhibition of SIRT1 deacetylase and p53 activation uncouples the anti-inflammatory and chemopreventive actions of NSAIDs

Giulia Dell’Omo, Daniela Crescenti, Cristina Vantaggiato, Chiara Parravicini, Aurora Paola Borroni, Nicoletta Rizzi, Mariangela Garofalo, Andrea Pinto, Camilla Recordati, Eugenio Scanziani, Fabio Domenico Bassi, Giancarlo Pruneri, Paola Conti, Ivano Eberini, Adriana Maggi, Paolo Ciana

Research output: Contribution to journalArticlepeer-review

39 Scopus citations


Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) have been proposed as chemopreventive agents for many tumours; however, the mechanism responsible for their anti-neoplastic activity remains elusive and the side effects due to cyclooxygenase (COX) inhibition prevent this clinical application. Methods: Molecular biology, in silico, cellular and in vivo tools, including innovative in vivo imaging and classical biochemical assays, were applied to identify and characterise the COX-independent anti-cancer mechanism of NSAIDs. Results: Here, we show that tumour-protective functions of NSAIDs and exisulind (a sulindac metabolite lacking anti-inflammatory activity) occur through a COX-independent mechanism. We demonstrate these NSAIDs counteract carcinogen-induced proliferation by inhibiting the sirtuin 1 (SIRT1) deacetylase activity, augmenting acetylation and activity of the tumour suppressor p53 and increasing the expression of the antiproliferative gene p21. These properties are shared by all NSAIDs except for ketoprofen lacking anti-cancer properties. The clinical interest of the mechanism identified is underlined by our finding that p53 is activated in mastectomy patients undergoing intraoperative ketorolac, a treatment associated with decreased relapse risk and increased survival. Conclusion: Our study, for the first-time, links NSAID chemopreventive activity with direct SIRT1 inhibition and activation of the p53/p21 anti-oncogenic pathway, suggesting a novel strategy for the design of tumour-protective drugs.

Original languageEnglish
Pages (from-to)537-546
Number of pages10
JournalBritish Journal of Cancer
Issue number5
StatePublished - 5 Mar 2019
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2019, The Author(s).


We thank L. Maravigna, M. Pandini, F. Cicala, M. Rebecchi, and C. Meda for technical assistance. This work was supported by Italian Association for Cancer Research IG Grants 11903 (to P.C.), CARIPLO Foundation Project 2009–2439 (to P.C.) and Frame Program 7 of European Union: INMiND-278850 (to A.M. and P.C.).

FundersFunder number
Italian Association for Cancer Research IG11903
Seventh Framework Programme278850
Fondazione Cariplo2009–2439
Seventh Framework Programme
Associazione Italiana per la Ricerca sul CancroIG Grants 11903


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