Molfino Alessio, et al.
Oxidative medicine and cellular longevity, 2017
Abstract
Prognosis and outcomes of critically ill patients are strictly related with inflammatory status. Inflammation involves a multitude of interactions between different cell types and chemical mediators. Omega-3 polyunsaturated fatty acids (PUFAs), mainly represented by eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are able to inhibit different pathways including leukocyte chemotaxis, adhesion molecule expression and interactions, and production of inflammatory cytokines, through the action of specialized proresolving mediators (SPMs). SPMs from omega-6 fatty acids, such as lipoxins, and from omega-3 fatty acids such as resolvins, protectins, and maresins, act in reducing/resolving the inflammatory process in critical diseases, stimulating the phases of resolution of inflammation. In this light, the resolution of inflammation is nowadays considered as an active process, instead of a passive process. In critical illness, SPMs regulate the excessive posttrauma inflammatory response, protecting organs from damage. This review focuses on the role of omega-3 PUFAs as pharma nutrition agents in acute inflammatory conditions, highlighting their effects as anti-inflammatory or proresolving agents.
Figures
After a trauma or tissue injury, there is a vascular damage inducing the acute inflammatory response. The specialized lipid mediators (SPMs), derived from omega-6 and omega-3 fatty acid storage, act as proresolving mediators. The SPM class which initiates to resolve inflammation is represented by lipoxins that are able to limit neutrophil infiltration. Lipoxins and resolvins stimulate the recruitment of nonphlogistic monocytes. Resolvins and protectins stimulate the resolving macrophages to clear apoptotic neutrophils in the efferocytosis process. Signs of resolution include sequestration of proinflammatory cytokines and removal of inflammatory debris and microbial invaders. Maresins stimulate reepithelialization, wound healing, and tissue regeneration. Omega-3 fatty acid supplementation may enhance proresolving inflammatory responses via their capacity to regulate the expression of proinflammatory cytokines through the production of SPMs. PUFAs, polyunsaturated fatty acids.
| PMID: | 28694914 |
|---|---|
| DOI: | 10.1155/2017/5987082 |
| PMCID (Free PMC Article): | PMC5488236 |
| Category: | Immune |
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