Prostaglandin E2 (PGE2) biosynthesis. Arachidonic acid (AA) is a polyunsaturated fatty acid that constitutes the phospholipid domain of most cell membranes and is released from the cellular membranes by cytoplasmic phospholipases A2 (PLA2). Free AA can be metabolized to PGE2 through the cyclooxygenase (COX) pathway. In this pathway, the key step is the enzymatic conversion of AA to the intermediate prostaglandin G2 (PGG2), which is then reduced to the intermediate PGH2 by the peroxidase activity of COX. PGH2 is sequentially metabolized to PGE2 by specific PGE synthases (cytosolic PGE synthase (cPGES), microsomal PGE synthase-1 (mPGES1), and mPGES2). PGE2 exerts its effects through ligation with four G-protein-coupled receptors (GPCRs), EP1–EP4. Each E-type prostanoid (EP) receptor couples to distinct signaling pathways. This figure was created using Servier Medical Art templates, which are licensed under a Creative Commons Attribution 3.0 Unported License; https://smart.servier.com.