Immunonutrition with Omega-3-fatty acids. A new therapeutic strategy?

In the early phase of sepsis and SIRS an overwhelming activation of humoral and cellular mediator systems can alter vascular resistance and causes cap illary leakage increasing the risk of organ dysfunction. omega-6-arachidoni c acid is released from lipid pools of cellular membranes during inflammati on and is metabolized to pro-inflammatory prostaglandins and leukotriens, w hich are key mediators in the pathogenesis of organ dysfunction. omega-3-ei cosapentaenoic acid-derived lipid mediators present altered biologic effect s. Thus, omega-3- fatty acid application enables anti-inflammatory interven tion on the level of lipid mediators. The current article reviews experimen tal and clinical data on omega-3-fatty acids. Besides the decrease of pro-i nflammatory mediators, fish oil supplementation lowered post operative infe ction rates and showed a tendency to reduce hospital stay in surgical patie nts. It is believed that the decreased formation of LTB4 and TXA(2) during sepsis after administration of omega-3-fatty acids accounts for improved mi crocirculatory perfusion and declined lactate acidosis.