PTGS2 and cancer: Delphinidin may also prevent cancer by altering the expression of phase II antioxidant enzymes to achieve antioxidation via the nuclear-factor-E2-related factor 2/antioxidant response element (Nrf2/ARE) signaling system [26], as well as suppress inflammation by working on the PI3K/Akt and nuclear factor-kappa B (NF-κB) pathways to lower cyclooxygenase-2 (COX-2) and induce nitric oxide synthase (iNOS) synthesis.