Polyunsaturated Fatty Acids and Cytokines: Their Relationship in Acute Lung Injury

  • Paolo Cotogni
  • Antonella Trombetta
  • Giuliana Muzio
  • Maria Felice Brizzi
  • Rosa Angela Canuto
Living reference work entry


Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are inflammatory diseases whose clinical severity depends on the grade of inflammatory response. Inflammatory cytokines are key elements in the pathogenesis of ALI/ARDS, and the occurrence of an imbalance between pro- and anti-inflammatory cytokines leads to additional non-pulmonary organ dysfunction which contributes to excess mortality rates.

Treatment of these patients includes nutrition support with lipids, usually soybean oil-based lipid emulsions, which are rich in omega (n)-6 polyunsaturated fatty acids (PUFAs) and deficient in n-3 PUFAs; however, too much n-6 PUFAs are detrimental due to their pro-inflammatory effects. Conversely, a large amount of experimental studies and some randomized clinical trials showed the benefits of the n-3 PUFA administration in the context of ALI because of their anti-inflammatory properties. Based on these data, several scientific societies recommended in their guidelines, with an A or B grade of recommendation, the use of n-3 PUFAs in ALI/ARDS patients. However, at present, the issue of lipid therapy in ALI/ARDS is still controversial due, at least in part, to inconclusive or contradicting results in several recent clinical trials using n-3 PUFAs.


A549 Cell Acute Lung Injury ARDSAcute Respiratory Distress Syndrome Enteral Nutrition Lipid Emulsion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

List of Abbreviations


Arachidonic acid


Acute lung injury


Acute respiratory distress syndrome


Bronchoalveolar lavage


Docosahexaenoic acid


Enteral nutrition


Eicosapentaenoic acid


Fatty acid


Fractional inspired oxygen


Intensive care unit




Length of stay








Arterial oxygen partial pressure




Parenteral nutrition


Polyunsaturated fatty acid


Randomized controlled trial


Tumor necrosis factor




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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Paolo Cotogni
    • 1
  • Antonella Trombetta
    • 2
  • Giuliana Muzio
    • 3
  • Maria Felice Brizzi
    • 2
  • Rosa Angela Canuto
    • 3
  1. 1.Department of Medicine, Anesthesiology and Intensive CareS. Giovanni Battista Hospital, University of TurinTurinItaly
  2. 2.Department of Medical SciencesUniversity of TurinTurinItaly
  3. 3.Department of Experimental Medicine and OncologyUniversity of TurinTurinItaly

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