The 2008 ESPEN Sir David Cuthbertson Lecture: Fatty acids and inflammation - from the membrane to the nucleus and from the laboratory bench to the clinic

Calder, Philip C. (2010) The 2008 ESPEN Sir David Cuthbertson Lecture: Fatty acids and inflammation - from the membrane to the nucleus and from the laboratory bench to the clinic. Clinical Nutrition, 29 (1), 5-12. (doi:10.1016/j.clnu.2009.11.003). (PMID:19931231)

Abstract

Many chronic conditions involve excessive inflammation that is damaging to host tissues. Excessive or
inappropriate inflammation and immunosuppression are components of the response to surgery,
trauma, injury and infection in some individuals and these can lead, progressively, to sepsis and septic
shock. Hyperinflammation is characterised by the production of inflammatory cytokines, eicosanoids and
other inflammatory mediators, while the immunosuppression is characterised by impairment of antigen
presentation and of certain T cell responses. N-6 fatty acids may contribute to the hyperinflammed and
immunosuppressed states. N-3 fatty acids from fish oil decrease the production of inflammatory cytokines
and eicosanoids. They act both directly (by replacing arachidonic acid as an eicosanoid precursor)
and indirectly (by altering the expression of inflammatory genes through effects on transcription factor
activation). Thus, these fatty acids are potentially useful anti-inflammatory agents and may be of benefit
in patients with chronic inflammatory diseases or at risk of hyperinflammation and sepsis. An emerging
application of n-3 fatty acids is in surgical or critically ill patients where they may be added to parenteral
or enteral formulas. Studies to date are suggestive of clinical benefits from these approaches, although
more robust data are needed especially in critically ill patients.

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Contributors

Author: Philip C. Calder

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