In addition, the induction of COX-2 by ACR occurs through activation of the protein kinase C (PKC), p38 mitogen-activated protein kinase (MAPK), and cAMP response element-binding protein (CREB) pathways; it has been suggested that ACR plays an important role in the progression of atherosclerosis via an inflammatory response involving COX-2 expression. This evidence concerns the gene PTGS2 and atherosclerosis.