Prostanoids are inflammatory compounds derived from essential fatty acids, playing a key role in communication within the central nervous system and control of immune and inflammatory processes. Omega-3 fatty acids found in oily fish can improve outcomes in patients with high blood pressure, high triglycerides, and heart disease, prevent rheumatoid arthritis and cardiovascular disease, and alleviate symptoms of mental illness and psychiatric disorders.
Prostanoids are biologically active pro-inflammatory compounds derived in the body from the chemical modification of three essential fatty acids. These compounds act as signaling substances, playing a key role in communication within the central nervous system and control of immune and inflammatory processes. The group of prostanoids consists of prostaglandins, prostacyclins, and thromboxanes. An enzyme, called cyclooxygenase (COX), causes the conversion of free fatty acids to prostanoids in a two-step process. Many drugs, such as aspirin, decrease inflammation in the body by blocking the synthesis of prostanoid molecules through cyclooxygenase inhibition.
The three 20-carbon fatty acids that make up prostanoids are eicosapentaenoic acid, arachidonic acid, and dihomo-gamma-linolenic acid. While eicosapentaenoic acid is an omega-3 fatty acid, the other two are omega-6 fatty acids. Omega-6 products cause more inflammation than omega-3 products, which explains the health benefits attributed to omega-3 fatty acids. The precise balance of the two forms of fatty acids in the diet influences blood pressure, arthritis, cardiovascular function, and many other processes or diseases in the body that have been linked to inflammation in the body.
Prostanoids are responsible for causing many of the local symptoms of inflammation, including pain, redness, swelling, and warmth. Anti-prostanoid drugs target one of two COX isoforms, either COX-1, which causes blood clotting, or COX-2, which causes pain and inflammation. However, some drugs mimic the action of prostanoids to treat erectile dysfunction, glaucoma, stomach ulcers, and pulmonary hypertension. In addition, obstetricians use two forms of prostanoid-mimicking drugs to induce labor.
Cells do not store prostanoids in the body, but synthesize them when required. Events that trigger prostanoid synthesis include injury to the cell, growth factors, or prostanoids released from a neighboring cell. A complex cascade culminates in the release of a free fatty acid from the cell membrane. The COX then binds two oxygen molecules to the fatty acid, forming a highly reactive and potentially harmful peroxide molecule. The release by peroxide of an oxygen atom produces prostaglandin H (PGH), the precursor of all prostanoids.
The US National Institutes of Health reports a high level of evidence that dietary modification to increase omega-3 fatty acids, found in oily fish, improves outcomes in patients with high blood pressure, high triglycerides and heart disease. There is also compelling evidence that omega-3 fatty acids can prevent rheumatoid arthritis and cardiovascular disease in susceptible patients. Additionally, omega-3 fatty acids can alleviate symptoms of mental illness and psychiatric disorders. The mechanisms by which omega-3 fatty acids protect tissues include displacement from omega-6 fatty acids and competition by COX enzymes.
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