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Lipoproteins in inflammation and sepsis. II. Clinical aspects

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Abstract

Background

Systemic inflammation and sepsis are accompanied by severe metabolic alterations, including insulin resistance together with increased levels of triglycerides (TGs) and decreases in high- and low-density lipoproteins. Clinical studies have clearly established a link between lipid metabolism and systemic inflammation. Lipoproteins were shown to neutralize LPS and to exert direct anti-inflammatory actions. High- and low-density lipoproteins are thus thought to be important regulators of the host immune response during endotoxemia, which may also have the potential of improving the care of patients with Gram-negative sepsis.

Discussion

Nutritional lipids supplied during critical illness have been shown to modulate the host response to inflammation. In particular, inclusion of ω-3 fatty acids seems to have beneficial effects on cellular immunity and helps to maintain the balance between pro- and anti-inflammatory cytokines thereby preventing hyperinflammatory complications. In addition to improvements in the profile of lipid mediators generated, ω-3 fatty acids act as activating ligands of peroxisome proliferator-activated receptors and directly inhibit nuclear factor κB mediated proinflammatory signaling. We present an overview on the alterations in the metabolism of serum lipoproteins during sepsis and present data from clinical studies and discuss the significance of nutritional lipids and their role in immunomodulation with special emphasis on ω-3 fatty acids.

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Authors and Affiliations

  1. Department of Anesthesiology and Critical Care Medicine, Carl Gustav Carus University Hospital, Fetscherstrasse 74, Dresden, Germany

    Martina Wendel, Rüdiger Paul & Axel R. Heller

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  1. Martina Wendel
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  2. Rüdiger Paul
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  3. Axel R. Heller
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Correspondence to Axel R. Heller.

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This article is discussed in the editorial available at: http://dx.doi.org/10.1007/s00134-006-0434-9.

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Wendel, M., Paul, R. & Heller, A.R. Lipoproteins in inflammation and sepsis. II. Clinical aspects. Intensive Care Med 33, 25–35 (2007). https://doi.org/10.1007/s00134-006-0433-x

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  • DOI: https://doi.org/10.1007/s00134-006-0433-x

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