Deficiency of anti-inflammatory system factors in the pathogenesis of sepsis and acute respiratory distress syndrome

Abstract

Sepsis and its complication in the form of acute respiratory distress syndrome (ARDS) are the main causes of death in hospital settings. The current review discusses the recent concepts of sepsis and ARDS pathogenesis, as well as the role of specialized proresolving mediators of inflammation in determining their course and outcomes. A special emphasis is placed on lipid anti-inflammatory factors (LAF) derived from long-chain polyunsaturated fatty acids. LAF include such substances as lipoxins, resolvins, maresins, protectins and their derivatives. Various animal models of sepsis and ARDS are discussed and the results of their treatment by LAF are interpreted. Attention is paid to survival of animals, clearance of bacteria, activity of the native immunity factors, synthesis of the proinflammatory mediators and permeability of the alveolar-blood barrier. A conclusion is drawn that LAF have a significant therapeutic potential but their efficiency depends on the phase of the inflammatory reaction at which they are employed.