Vnitr Lek 2016, 62(5):406-412

Can fish oil improve wound healing in surgery?

Jana Neuwirthová*, Břetislav Gál, Pavla Urbánková, Pavel Smilek
Klinika otorinolaryngologie a chirurgie hlavy a krku LF MU a FN u sv. Anny v Brně

A surgical insult induces both local and systemic inflammatory responses which, if inappropriate, could impair wound healing. According to many studies ω-3 polyunsaturated fatty acids from fish oil improve the process of wound healing by their immunomodulatory effect. In contrast to current anti-inflammatory drugs, which could alter immune defence and impair the resolution of inflammation, ω-3 fatty acids have a simultaneous anti-inflammatory pro-resolution effect which is not immunosuppressive. Besides that they improve cicatrix quality. With regard to this effect they prevent excessive or prolonged inflammation and wound complications.

Keywords: anti-inflammatory agent; cicatrix; fish oil; macrophage; ω-3 fatty acid; resolution of inflammation; Toll-like receptor; wound healing

Received: December 19, 2015; Accepted: March 4, 2016; Published: May 1, 2016  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Neuwirthová J, Gál B, Urbánková P, Smilek P. Can fish oil improve wound healing in surgery? Vnitr Lek. 2016;62(5):406-412.
Download citation

References

  1. Roy S, Das A, Ganesh K et al. Wound inflammation. In: Aggarwal BB, Krishnan S, Guha S (eds). Inflammation, Lifestyle and Chronic Diseases: The Silent Link. CRC Press 2011: 183-201. ISBN 9781439839898. Go to original source...
  2. Jirkovská A. Hojení kožních afekcí u syndromu diabetické nohy při hospitalizaci. Vnitř Lék 2006; 52(5): 459-464. Go to PubMed...
  3. Yehuda S, Rabinovitz S. The Role of Essential Fatty Acids in Anorexia Nervosa and in Obesity. Crit Rev Food Sci Nutr. Published online: 11 Jun 2015. Dostupné z DOI: <http://doi:10.1080/10408398.2013.809690>. Go to original source... Go to PubMed...
  4. Zadák Z, Tichá A, Hronek M et al. Pokroky v metabolizmu a výživě 2011 a cesta k personalizované léčbě. Vnitř Lék 2011; 57(11): 970-974. Go to PubMed...
  5. Wong SW, Kwon MJ, Choi AM et al. Fatty acids modulate Toll-like receptor 4 activation through regulation of receptor dimerization and recruitment into lipid rafts in a reactive oxygen species-dependent manner. J Biol Chem 2009; 284(40): 27384-27392. Go to original source... Go to PubMed...
  6. Novak TE, Babcock TA, Jho DH et al. NF-kappa B inhibition by omega-3 fatty acids modulates LPS-stimulated macrophage TNF-alpha transcription. Am J Physiol Lung Cell Mol Physiol 2003; 284(1): L84-L89. Go to original source... Go to PubMed...
  7. Lee JY, Sohn KH, Rhee SH et al. Saturated fatty acids, but not unsaturated fatty acids, induce the expression of cyclooxygenase-2 mediated through Toll-like receptor 4. J Biol Chem 2001; 276(20): 16683-16689. Go to original source... Go to PubMed...
  8. Lee JY, Zhao L, Youn HS et al. Saturated fatty acid activates but polyunsaturated fatty acid inhibits Toll-like receptor 2 dimerized with Toll-like receptor 6 or 1. J Biol Chem 2004; 279(17): 16971-16979. Go to original source... Go to PubMed...
  9. Oh DY, Talukdar S, Bae EJ et al. GPR120 is an omega-3 fatty acid receptor mediating potent anti-inflammatory and insulin-sensitizing effects. Cell 2010; 142(5): 687-698. Go to original source... Go to PubMed...
  10. Im DS. Omega-3 fatty acids in anti-inflammation (pro-resolution) and GPCRs. Prog Lipid Res 2012; 51(3): 232-237. Go to original source... Go to PubMed...
  11. Schwab JM, Chiang N, Arita M et al. Resolvin E1 and protectin D1 activate inflammation-resolution programmes. Nature 2007; 447(7146): 869-874. Go to original source... Go to PubMed...
  12. Gorjão R, Verlengia R, Lima TM et al. Effect of docosahexaenoic acid-rich fish oil supplementation on human leukocyte function. Clin Nutr 2006; 25(6): 923-938. Go to original source... Go to PubMed...
  13. Keeren K, Huang D, Smyl C et al. Effect of different omega-6/omega-3 polyunsaturated fatty acid ratios on the formation of monohydroxylated fatty acids in THP-1 derived macrophages. Biology (Basel) 2015; 4(2): 314-326. Go to original source... Go to PubMed...
  14. Khanna S, Biswas S, Shang Y et al. Macrophage dysfunction impairs resolution of inflammation in the wounds of diabetic mice. PLoS One 2010; 5(3): e9539. Dostupné z DOI: <http://dx.doi.org/10.1371/journal.pone.0009539>. Go to original source... Go to PubMed...
  15. Lee HN, Surh YJ. Therapeutic potential of resolvins in the prevention and treatment of inflammatory disorders. Biochem Pharmacol 2012; 84(10): 1340-1350. Go to original source... Go to PubMed...
  16. Sousa LP, Alessandri AL, Pinho V et al. Pharmacological strategies to resolve acute inflammation. Curr Opin Pharmacol 2013; 13(4): 625-631. Go to original source... Go to PubMed...
  17. Alessandri AL, Sousa LP, Lucas CD et al. Resolution of inflammation: mechanisms and opportunity for drug development. Pharmacol Ther 2013; 139(2): 189-212. Go to original source... Go to PubMed...
  18. Hübner G, Brauchle M, Smola H et al. Differential regulation of pro-inflammatory cytokines during wound healing in normal and glucocorticoid-treated mice. Cytokine 1996; 8(7): 548-556. Go to original source... Go to PubMed...
  19. Glaser R, Kiecolt-Glaser JK, Marucha PT et al. Stress-related changes in proinflammatory cytokine production in wounds. Arch Gen Psychiatry 1999; 56(5): 450-456. Go to original source... Go to PubMed...
  20. Head CC, Farrow MJ, Sheridan JF et al. Androstenediol reduces the anti-inflammatory effects of restraint stress during wound healing. Brain Behav Immun 2006; 20(6): 590-596. Go to original source... Go to PubMed...
  21. Jia Y, Turek JJ. Inducible nitric oxide synthase links NF-kappaB to PGE2 in polyunsaturated fatty acid altered fibroblast in-vitro wound healing. Lipi Health Dis 2005; 4: 14. Go to original source... Go to PubMed...
  22. Hardardottir I, Kinsella JE. Tumor necrosis factor production by murine resident peritoneal macrophages is enhanced by dietary n-3 polyunsaturated fatty acids. Biochim Biophys Acta 1991; 1095(3): 187-195. Go to original source... Go to PubMed...
  23. Petursdottir DH, Olafsdottir I, Hardardottir I. Dietary fish oil increases tumor necrosis factor secretion but decreases interleukin-10 secretion by murine peritoneal macrophages. J Nutr 2002; 132(12): 3740-3743. Go to original source... Go to PubMed...
  24. Hankenson KD, Watkins BA, Schoenlein IA et al. Omega-3 fatty acids enhance ligament fibroblast collagen formation in association with changes in interleukin-6 production. Proc Soc Exp Biol Med 2000; 223(1): 88-95. Go to original source... Go to PubMed...
  25. Jia Y, Turek JJ. Polyenoic fatty acid ratios alter fibroblast collagen production via PGE2 and PGE receptor subtype response. Exp Biol Med 2004; 229(7): 676-683. Go to original source... Go to PubMed...
  26. McDaniel JC, Massey K, Nicolaou A. Fish oil supplementation alters levels of lipid mediators of inflammation in microenvironment of acute human wounds. Wound Repair Regen 2011; 19(2): 189-200. Go to original source... Go to PubMed...
  27. Theilla M, Schwartz B, Cohen J et al. Impact of a nutritional formula enriched in fish oil and micronutrients on pressure ulcers in critical care patients. Am J Crit Care 2012; 21(4): e102-e109. Dostupné z DOI: <http://dx.doi.org/10.4037/ajcc2012187>. Go to original source... Go to PubMed...
  28. Qu X, Zhang X, Yao J et al. Resolvins E1 and D1 inhibit interstitial fibrosis in the obstructed kidney via inhibition of local fibroblast proliferation. J Pathol 2012; 228(4): 506-519. Go to original source... Go to PubMed...
  29. Bohr S, Patel SJ, Sarin D et al. Resolvin D2 prevents secondary thrombosis and necrosis in a mouse burn wound model. Wound Repair Regen 2013; 21(1): 35-43. Go to original source... Go to PubMed...
  30. Kalish BT, Kieran MW, Puder M et al. The growing role of eicosanoids in tissue regeneration, repair, and wound healing. Prostaglandins Other Lipid Mediat 2013; 104-105: 130-138. Go to original source... Go to PubMed...
  31. Hasturk H, Kantarci A, Goguet-Surmenian E et al. Resolvin E1 regulates inflammation at the cellular and tissue level and restores tissue homeostasis in vivo. J Immunol 2007; 179(10): 7021-7029. Go to original source... Go to PubMed...
  32. Herrera BS, Ohira T, Gao L et al. An endogenous regulator of inflammation, resolvin E1, modulates osteoclast differentiation and bone resorption. Br J Pharmacol 2008; 155(8): 1214-1223. Go to original source... Go to PubMed...
  33. Hasturk H, Kantarci A, Ohira T et al. RvE1 protects from local inflammation and osteoclast-mediated bone destruction in periodontitis. FASEB J 2006; 20(2): 401-403. Go to original source... Go to PubMed...
  34. Bannenberg G, Serhan CN. Specialized pro-resolving lipid mediators in the inflammatory response: an update. Biochem Biophys Acta 2010; 1801(12): 1260-1273. Go to original source... Go to PubMed...
  35. Gao L, Faibish D, Fredman G et al. Resolvin E1 and chemokine-like receptor 1 mediate bone preservation. J Immunol 2013; 190(2): 689-694. Go to original source... Go to PubMed...
  36. Ruthig DJ, Meckling-Gill KA. Both (n-3) and (n-6) fatty acids stimulate wound healing in the rat intestinal epithelial cell line, IEC-6. J Nutr 1999; 129(10): 1791-1798. Go to original source... Go to PubMed...
  37. Jacobi SK, Moeser AJ, Corl BA et al. Dietary long-chain PUFA enhance acute repair of ischemia-injured intestine of suckling pigs. J Nutr 2012; 142(7): 1266-1271. Go to original source... Go to PubMed...
  38. Kaliannan K, Wang B, Li XY et al. A host-microbiome interaction mediates the opposing effects of omega-6 and omega-3 fatty acids on metabolic endotoxemia. Sci Rep 2015; 5: 11276. Dostupné z DOI: <http://dx.doi.org/10.1038/srep11276>. Go to original source... Go to PubMed...
  39. Chiang N, Fredman G, Backhed F et al. Infection regulates pro-resolving mediators that lower antibiotic requirements. Nature 2012; 484(7395): 524-528. Go to original source... Go to PubMed...
  40. Serhan CN, Chiang N. Resolution phase lipid mediators of inflammation: agonists of resolution. Curr Opin Pharmacol 2013; 13(4): 632-640. Go to original source... Go to PubMed...
  41. Shapiro H. Could n-3 polyunsaturated fatty acids reduce pathological pain by direct actions on the nervous system? Prostaglandins Leukot Essent Fatty Acids 2003; 68(3): 219-224. Go to original source... Go to PubMed...
  42. Xu ZZ, Zhang L, Liu T et al. Resolvins RvE1 and RvD1 attenuate inflammatory pain via central and peripheral actions. Nat Med 2010; 16(5): 592-597. Go to original source... Go to PubMed...
  43. Huang L, Wang CF, Serhan CN et al. Enduring prevention and transient reduction of postoperative pain by intrathecal resolvin D1. Pain 2011; 152(3): 557-565. Go to original source... Go to PubMed...
  44. Xu ZZ, Berta T, Ji RR. Resolvin E1 inhibits neuropathic pain and spinal cord microglial activation following peripheral nerve injury. J Neuroimmune Pharmacol 2012; 8(1): 37-41. Go to original source... Go to PubMed...
  45. Escudero GE, Romañuk CB, Toledo ME et al. Analgesia enhancement and prevention of tolerance to morphine: beneficial effects of combined therapy with omega-3 fatty acids. J Pharm Pharmacol 2015; 67(9): 1251-1262. Go to original source... Go to PubMed...
  46. Fritsche KL. The Science of Fatty Acids and Inflammation. Adv Nutr 2015; 6(3): 293S-301S. Go to original source... Go to PubMed...
  47. Masson S, Latini R, Tacconi M et al. Incorporation and washout of n-3 polyunsaturated fatty acids after diet supplementation in clinical studies. J Cardiovasc Med (Hagerstown) 2007; 8(Suppl 1): S4-S10. Go to original source... Go to PubMed...
  48. Calder PC. Mechanisms of action of (n-3) fatty acids. J Nutr 2012; 142(3): S592-S599. Go to original source... Go to PubMed...
  49. Hosny M, Nahas R, Ali S et al. Impact of oral omega-3 fatty acids supplementation in early sepsis on clinical outcome and immunomodulation. Egyptian J Critical Care Med 2013; 1(3): 119-126. Go to original source...
  50. Heller AR, Rössler S, Litz RJ et al. Omega-3 fatty acids improve the diagnosis-related clinical outcome. Crit Care Med 2006; 34(4): 972-979. Go to original source... Go to PubMed...
  51. Lien EL. Toxicology and safety of DHA. Prostaglandins Leukot Essent Fatty Acids 2009; 81(2-3): 125-132. Go to original source... Go to PubMed...
  52. Nelson GJ, Schmidt PS, Bartolini GL et al. The effect of dietary docosahexaenoic acid on platelet function, platelet fatty acid composition, and blood coagulation in humans. Lipids 1997; 32(11): 1129-1136. Go to original source... Go to PubMed...
  53. Wang C, Harris WS, Chung M et al. N-3 Fatty acids from fish or fish-oil supplements, but not alpha-linolenic acid, benefit cardiovascular disease outcomes in primary- and secondary-prevention studies: a systematic review. Am J Clin Nutr 2006; 84(1): 5-17. Go to original source... Go to PubMed...
  54. Calder PC. Immunomodulation by omega-3 fatty acids. Prostaglandins Leukot Essent Fatty Acids 2007; 77(5-6): 327-335. Go to original source... Go to PubMed...
  55. Calder PC. Omega-3 polyunsaturated fatty acids and inflammatory processes: nutrition or pharmacology? Br J Clin Pharmacol 2013; 75(3): 645-662. Go to original source... Go to PubMed...
  56. Jirák R, Zeman M. Vliv omega-3 a omega-6 nenasycených mastných kyselin na psychické poruchy. Čes a Slov Psychiat 2007; 103(8): 420-426.
  57. Singer P, Shapiro H, Theilla M Anti-inflammatory properties of omega-3 fatty acids in critical illness: novel mechanisms and an integrative perspective. Intensive Care Med 2008; 34(9): 1580-1592. Go to original source... Go to PubMed...




Vnitřní lékařství

Madam, Sir,
please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

I declare:

  1. that I have met the above instruction
  2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited


No

Yes

If your statement is not true, please be aware
that brings the risk of danger to their health or the health of others.