title: Proresolution lipid mediators in multiple sclerosis - differential, disease severity-dependent synthesis - a clinical pilot trial.
abstract: BACKGROUND
  The severity and longevity of inflammation is controlled by endogenous counter-regulatory signals. Among them are long-chain polyunsaturated fatty acid (PUFA)-derived lipid mediators, which promote the resolution of inflammation, an active process for returning to tissue homeostasis.
  
  
  OBJECTIVE
  To determine whether endogenous production of lipid-derived resolution agonists is regulated differentially in patients with highly active and less active multiple sclerosis (MS).
  
  
  METHODS
  Matched-pairs study in University hospital Neurology department.
  
  
  METHODS
  Based on clinical (relapse frequency) and paraclinical (MRI lesions, contrast enhancement) criteria, 10 pairs of age- and sex-matched patients with relapsing-remitting MS were assigned either to a group with highly active or less active MS. Lipid mediators were quantified in serum and cerebrospinal fluid using LC-MS/MS-based lipidomics.
  
  
  RESULTS
  Levels of the key arachidonic (ω-6) and docosahexaenoic acid (ω-6)-derived mediators prostaglandins (PG), leukotrienes, hydroxyeicosatetraenoic acids (HETE) and resolution agonists lipoxin A(4) (LXA(4)), resolvin D1 (RvD1) and neuroprotectin D1 (NPD1) were quantified. In the patient group with highly active MS, 15-HETE and PGE(2) were increased, which are products of the 15-lipoxygenase and cyclooxygenase pathways. The proresolution mediator RvD1 was significantly upregulated and NPD1 was detected in the highly active group only. LXA(4) levels were not increased in patients with highly active MS.
  
  
  CONCLUSIONS
  Lipid mediator pathways are regulated differentially in the cerebrospinal fluid of MS patients, depending on disease severity. Non-exhaustive or possibly 'delayed' resolution pathways may suggest a defective resolution program in patients with highly active MS. Longitudinal analyses are required to hetero-typify this differential resolution capacity, which may be associated with disease progression, longevity and eventual termination.
authors: Department of Neurology & Experimental Neurology, Charité University Medicine Berlin, Berlin, Germany.
authors: Harald
authors: H
authors: Prüss
authors: Berit
authors: B
authors: Rosche
authors: Aaron B
authors: AB
authors: Sullivan
authors: Benedikt
authors: B
authors: Brommer
authors: Oliver
authors: O
authors: Wengert
authors: Karsten
authors: K
authors: Gronert
authors: Jan M
authors: JM
authors: Schwab
mesh_terms: D000328:Adult; D005231:Fatty Acids, Unsaturated / Q000134:cerebrospinal fluid / Q000378:metabolism*; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000134:cerebrospinal fluid / Q000378:metabolism*; D050356:Lipid Metabolism; D008297:Male; D055432:Metabolomics; D009103:Multiple Sclerosis / Q000378:metabolism*; D010865:Pilot Projects; D012720:Severity of Illness Index; D053719:Tandem Mass Spectrometry
chemical_list: D005231:Fatty Acids, Unsaturated; D018836:Inflammation Mediators