Fullerton JN, O'Brien AJ, Gilroy DW. Lipid mediators in immune dysfunction after severe inflammation.
Trends Immunol 2013;
35:12-21. [PMID:
24268519 PMCID:
PMC3884129 DOI:
10.1016/j.it.2013.10.008]
[Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Revised: 09/16/2013] [Accepted: 10/22/2013] [Indexed: 12/21/2022]
Abstract
Aberrant LM levels contribute to immune dysfunction in CI.
Aberrance reflects dysregulation of inflammatory resolution pathways or their failure.
Targeted manipulation of LMs restores immune competence and outcomes in animal models.
Stratified resolution-based immunomodulatory strategies hold therapeutic potential.
Sepsis, trauma, burns, and major surgical procedures activate common systemic inflammatory pathways. Nosocomial infection, organ failure, and mortality in this patient population are associated with a quantitatively different reprioritization of the circulating leukocyte transcriptome to the initial inflammatory insult, greater in both magnitude and duration, and secondary to multiple observed defects in innate and adaptive immune function. Dysregulation of inflammatory resolution processes and associated bioactive lipid mediators (LMs) mechanistically contribute to this phenotype. Recent data indicate the potential efficacy of therapeutic interventions that either reduce immunosuppressive prostaglandins (PGs) or increase specialized proresolving LMs. Here, we reassess the potential for pharmacological manipulation of these LMs as therapeutic approaches for the treatment of critical illness (CI).
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