PTGS2 and cancer: The pro-inflammatory role of CNF1 is also supported by the demonstration that the toxin strongly up-regulate the transcription of cyclooxygenase- 2 (COX-2) [76], an immediate-early gene induced in response to pro-inflammatory cytokines, tumor promoters, and growth factors and over-expressed in cancers of the lung, colon, stomach, and breast [77-79].