Prostanoids with various physiological effects in the lung, have been shown to be one of the important factors in acute lung injury. However, in large scale clinical studies, beneficial effects of NSAIDs or PGE1 have not been demonstrated. On the other hand, with progress of basic research in prostaglandin metabolic pathway, receptor and synthase of each prostanoid have been clarified, and selective COX-2 blockers have been developed and are now available in Japan. We reviewed the relationship between prostanoids, acute lung injury and the effects of COX-2 selective blockers, and discussed the present status and future perspective in this field.
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