Omega-3 Polyunsaturated Fatty Acids in Critical Illness: Anti-Inflammatory, Proresolving, or Both?
Table 1
Key points: proresolving effects of omega-3 fatty acids in critical illness.
(i)Omega-3 fatty acids, principally present in dietary fish oils, are derived also from plants and are able to reduce or limit inflammation during disease, including acute and critical illness [4–6].
(ii)The biological effects of omega-3 fatty acids are mediated by the production of specialized proresolvin mediators (SPMs) [8, 9].
(iii)Gene expression of SPMs in human tissues correlates with outcomes in critically ill patients [10, 11, 17].
(iv)Lipoxins, resolvins, protectins, and maresins are SPMs produced in response to inflammation, able to accelerate resolution of inflammation rather than inhibiting inflammation [4, 7–9].
(v)Key biologic actions of SPMs are to limit neutrophil infiltration, promote efferocytosis of apoptotic cells, enhance microbial clearance, counter-regulate cytokines and chemokines, and downregulate prostanoids [10, 30, 33, 34].
(vi)Administration of omega-3 fatty acids in surgical and acutely ill patients may be associated with better outcome and reduced health costs.
