Proposed model for CYP2S1-mediated modulation of prostanoids, including PGE2. Free AA is converted to PGG2 and PGH2 via COX enzymes. PGH2 is converted to prostanoids through thromboxane synthetase (TXA2), prostaglandin synthetases (PGD2, prostaglandin F2α, and PGE2), and prostacyclin synthetase (prostaglandin I2). In vitro metabolic studies indicate that CYP2S1 can metabolize PGG2 (Km = 270 nM) and PGH2 (Km = 11 μM) to numerous products including the following: 12-HHT, MDA, and TXA2 (Bui et al., 2011). This could potentially divert synthesis away from PGE2. Consistent with this proposed role for CYP2S1 in prostaglandin metabolism, CYP2S1 depletion may elevate PGG2 and PGH2 precursors, increasing their availability for synthesis of downstream prostanoids, including PGE2. Enzymes are represented by names enclosed in gray boxes. Open boxes contain either CYP2S1 metabolites (12-HHT, MDA, and TXA2) or PGE2.