Omega-3 fatty acids, cardiovascular risk, and the resolution of inflammation
Omega-3 fatty acids, cardiovascular risk, and the resolution of inflammation
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DOI：
10.1096/fj.201802445r
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发表时间：
2019-02-01
期刊：
影响因子：
4.8
通讯作者：
Hansson, Goran K.
中科院分区：
文献类型：
--
作者：
Back, Magnus;Hansson, Goran K.
尽管大量摄入海洋食物被认为具有心脏保护作用，但 -3 脂肪酸的随机试验最初在补充 -3 脂肪酸在心血管预防中的作用方面产生了相互矛盾的结果。这项工作证明了最近 3 项 -3 脂肪酸临床试验的结果被置于介导其有益心血管作用的可能机制的背景下。特别是，通过 EPA 干预减少心血管事件随机试验 (REDUCE-IT) 表明，二十碳五烯乙酯（二十碳五烯酸 (EPA) 的乙酯形式 -3 脂肪酸）可显着减少心血管事件。重要的是，EPA 作为专门的促消退介质 resolvin E1 (RvE1) 形成的底物，可刺激炎症的消退。 RvE1 通过其特异性受体 ERV1/ChemR23 减少动脉粥样硬化和内膜增生。 -3 脂肪酸降低促炎和促动脉粥样硬化白三烯的水平可能进一步有助于有益的炎症平衡。因此，Rv/白三烯比率正在成为未解决的血管炎症的标志。最近的实验研究表明，源自-3脂肪酸的脂质介质的抗炎和促消退作用可抑制动脉粥样硬化，而与胆固醇和甘油三酯水平无关。最近 3 项补充 -3 脂肪酸的临床试验结果表明，补充 -3 的类型和剂量非常重要，并强调在选择补充 -3 的患者中进行风险分层的必要性，以预防心血管疾病的一级或二级预防。 Back, M., Hansson, G. K. Omega-3 脂肪酸、心血管风险和炎症的解决。
Although a high marine food intake is considered cardioprotective, randomized trials of -3 fatty acids initially generated conflicting results in terms of the role of -3 supplementation in cardiovascular prevention. This work demonstrates the results of the 3 most recent clinical trials with -3 fatty acids are put into the context of possible mechanisms mediating their beneficial cardiovascular effects. In particular, the randomized Reduction of Cardiovascular Events with EPA Intervention Trial (REDUCE-IT) showed that icosapent ethyl, which is the ethyl ester form of the -3 fatty acid eicosapentaenoic acid (EPA), induced a significant reduction of cardiovascular events. Importantly, EPA serves as a substrate for the formation of the specialized proresolving mediator resolvin E1 (RvE1), which stimulates the resolution of inflammation. RvE1 reduces atherosclerosis and intimal hyperplasia by means of its specific receptor ERV1/ChemR23. The decreased levels of proinflammatory and proatherosclerotic leukotrienes by -3 fatty acids may further contribute to a beneficial inflammatory balance. Consequently, the Rv/leukotriene ratio is emerging as a marker of nonresolving vascular inflammation. Recent experimental studies have shown that anti-inflammatory and proresolving effects of lipid mediators derived from -3 fatty acids inhibit atherosclerosis independently of cholesterol and triglyceride levels. The results of the 3 most recent clinical trials of -3 fatty acid supplementation indicate an importance of the type and dose of -3 supplementation and highlight the need for risk stratification in the patient selection for -3 supplementation for either primary or secondary prevention of cardiovascular disease.Back, M., Hansson, G. K. Omega-3 fatty acids, cardiovascular risk, and the resolution of inflammation.