Omega-3 Polyunsaturated Fatty Acids in Critical Illness: Anti-Inflammatory, Proresolving, or Both?

Figure 1

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.