EBioMedicine (Aug 2019)

Early increase of specialized pro-resolving lipid mediators in patients with ST-elevation myocardial infarctionResearch in context

  • Linn E. Fosshaug,
  • Romain A. Colas,
  • Anne K. Anstensrud,
  • Ida Gregersen,
  • Ståle Nymo,
  • Ellen L. Sagen,
  • Annika Michelsen,
  • Leif E. Vinge,
  • Erik Øie,
  • Lars Gullestad,
  • Bente Halvorsen,
  • Trond V. Hansen,
  • Pål Aukrust,
  • Jesmond Dalli,
  • Arne Yndestad

Journal volume & issue
Vol. 46
pp. 264 – 273

Abstract

Read online

Background: Termination of acute inflammation is an active process orchestrated by lipid mediators (LM) derived from polyunsaturated fatty acids, referred to as specialized pro-resolving mediators (SPM). These mediators also provide novel therapeutic opportunities for treating inflammatory disease. However, the regulation of these molecules following acute myocardial infarction (MI) remains of interest. Methods: In this prospective observational study we aimed to profile plasma levels of SPMs in ST-elevation MI (STEMI) patients during the first week following MI. Plasma LM concentrations were measured in patients with STEMI (n = 15) at three time points and compared with stable coronary artery disease (CAD; n = 10) and healthy controls (n = 10). Findings: Our main findings were: (i) Immediately after onset of MI and before peak troponin T levels, STEMI patients had markedly increased levels of SPMs as compared with healthy controls and stable CAD patients, with levels of these mediators declining during follow-up. (ii) The increase in SPMs primarily reflected an increase in docosapentaenoic acid- and docosahexaenoic acid-derived protectins. (iii) Several individual protectins were correlated with the rapid increase in neutrophil counts, but not with CRP. (iv) A shift in 5-LOX activity from the leukotriene B4 pathway to the pro-resolving RvTs was observed. Interpretation: The temporal regulation of SPMs indicates that resolution mechanisms are activated early during STEMI as part of an endogenous mechanism to initiate repair. Thus strategies to boost the activity and/or efficacy of these endogenous mechanisms may represent novel therapeutic opportunities for treatment of patients with MI. Fund: This work was supported by grants from the South-Eastern Norwegian regional health authority, the European Research Council under the European Union's Horizon 2020 research and innovation program, a Sir Henry Dale Fellowship jointly funded by the Wellcome Trust and the Royal Society, and the Barts Charity. Keywords: Myocardial infarction, Resolution, Inflammation, Specialized pro-resolving mediators, Polyunsaturated fatty acids