title: Combination of aspirin with essential fatty acids is superior to aspirin alone to prevent or ameliorate sepsis or ARDS.
abstract: It has been suggested that aspirin may be of benefit in treating sepsis and ARDS in view of its ability to block cyclo-oxygenase-1 (COX-1) and COX-2 activities; inhibit nuclear factor kappa B (NF-κB); enhance the production of endothelial nitric oxide (eNO) and lipoxin A4 (LXA4). Our previous studies revealed that plasma phospholipid content of arachidonic acid (AA) and eicosapentaenoic acid (EPA) is low in patients with sepsis. This implies that beneficial actions of aspirin in sepsis and ARDS is unlikely to be obtained in view of deficiency of AA and EPA, the precursors of LXA4 and resolvins respectively that are potent anti-inflammatory compounds and enhancers of eNO generation. In view of this, I propose that a combination of aspirin and AA and EPA (and possibly, docosahexaenoic acid, DHA) is likely to be superior in the management of sepsis and ARDS compared to aspirin alone. This suggestion is supported by the recent observation that trauma patients with uncomplicated recoveries had higher resolvin pathway gene expression and lower gene expression ratios of leukotriene: resolvin pathways.
authors.affiliation: UND Life Sciences, 2020 S 360th St, # K-202, Federal Way, WA, 98003, USA. Undurti@hotmail.com.|BioScience Research Centre, GVP College of Engineering Campus and Department of Medicine, GVP Hospital, Madhurawada, Visakhapatnam, 530 048, India. Undurti@hotmail.com.
authors.forename: Undurti N
authors.initials: UN
authors.lastname: Das
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D016718:Arachidonic Acid / Q000627:therapeutic use*; D001241:Aspirin / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D015118:Eicosapentaenoic Acid / Q000627:therapeutic use*; D006801:Humans; D012128:Respiratory Distress Syndrome / Q000188:drug therapy / Q000517:prevention & control*; D018805:Sepsis / Q000188:drug therapy / Q000517:prevention & control*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D016718:Arachidonic Acid; D015118:Eicosapentaenoic Acid; D001241:Aspirin
keywords: Acute respiratory distress syndrome; Arachidonic acid; Aspirin; Cyclo-oxygenase; Docosahexaenoic acid; Eicosapentaenoic acid; Essential fatty acids; Lipoxin A4; Lipoxygenase; Nitric oxide; Protectins; Resolvin; Sepsis