title: Could heterotopic ossification be prevented by varying dietary n-3/n-6 polyunsaturated fatty acid ratio: a novel perspective to its treatment?
abstract: Heterotopic ossification (HO) is a common complication following with musculoskeletal trauma and surgical procedures. It usually decreases joint mobility and eventually causes loss of joint function. Despite nonsteroidal anti-inflammatory drugs (NSAIDs), the inhibitor of cyclooxygenase(COX), have been proven to prevent HO effectively via prostaglandin E2 synthesis regulation and modulation of tissue responsiveness to pro-inflammatory signaling, HO prevention is still a matter of debate for clinicians to avoid the side effect of NSAIDs. Interestingly, it is suggested that PGE2 production and pro-inflammatory microenvironment in body could be modified by varying the ratio of the precursor fatty acids in the diet. On account of the effect of dietary (n-6)/(n-3) PUFAs ratio on both COX metabolism and pro-inflammatory cytokines mediated biological responsiveness, we hypothesized lowering dietary (n-6)/(n-3) PUFAs ratio may not only directly reduce the substrate of COX-2 and COX-2 activity, but also partially ameliorate tissue inflammatory responsiveness to cytokines correlated with HO development,exerting an inhibitory effect on PGE2 synthesis to prevent HO formation. The negative role of lowering dietary (n-6)/(n-3) PUFAs ratio on angiogenesis, cytokines-induced apoptosis, inflammatory responsiveness and osteogenesis could also contribute to its action on HO development. If our hypothesis is proved to be corrected, it could be an innovative method to treat HO.
authors.affiliation: Department of Orthopaedic, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510665, Guangdong, PR China.
authors.forename: Liang
authors.initials: L
authors.lastname: Wang
authors.forename: Min-Jun
authors.initials: MJ
authors.lastname: Huang
authors.forename: Bin
authors.initials: B
authors.lastname: Liu
authors.forename: Zhong-Min
authors.initials: ZM
authors.lastname: Zhang
authors.forename: Xiao-Chen
authors.initials: XC
authors.lastname: Zheng
authors.forename: Bo
authors.initials: B
authors.lastname: Yan
authors.forename: Tian-Yu
authors.initials: TY
authors.lastname: Chen
authors.forename: Da-di
authors.initials: DD
authors.lastname: Jin
authors.forename: Xiao-Chun
authors.initials: XC
authors.lastname: Bai
mesh_terms: D017209:Apoptosis / Q000187:drug effects; D051546:Cyclooxygenase 2 / Q000378:metabolism; D004042:Dietary Fats, Unsaturated / Q000494:pharmacology*; D015232:Dinoprostone / Q000378:metabolism; D005231:Fatty Acids, Unsaturated / Q000032:analysis*; D006801:Humans; D008954:Models, Biological; D009389:Neovascularization, Pathologic / Q000378:metabolism; D009999:Ossification, Heterotopic / Q000517:prevention & control*; D010012:Osteogenesis / Q000187:drug effects
chemical_list: D004042:Dietary Fats, Unsaturated; D005231:Fatty Acids, Unsaturated; D051546:Cyclooxygenase 2; D015232:Dinoprostone