New publication by our team: Cardiovascular Diseases and Marine Oils: A Focus on Omega-3 Polyunsaturated Fatty Acids and Polar Lipids

Introduction

Non-communicable diseases (NCD) are a significant burden on health care systems and society. Atherosclerotic cardiovascular diseases (ASCVD or CVD) are one of the main NCDs and are the leading cause of death worldwide. Previously considered a lipid storage disease, CVD is now thought to be far more complex, encompassing a significant pro-inflammatory state, dysregulated lipid metabolism, and oxidative stress [1]. Over half of the deaths related to cardiometabolic diseases are attributed to maladaptive diet [2,3]. Many diets and various dietary constituents have been strongly linked with beneficial effects against CVD [3]. One family of molecules of significant interest for their pro-inflammatory role in CVD and NCD is platelet-activating factor (PAF) and PAF-like lipids. Notably, these lipids have garnered significant attention for their potential modulation by pharmacological and dietary intervention [4,5]. The purpose of this paper is to highlight the role of inflammation in CVD, and considering that diet and lifestyle are modifiable risk factors for CVD prevention, we aim to explore the role that dietary polar lipids (PL) play against inflammation and the onset of CVD via the role of PAF.

Inflammation, Atherosclerosis, and Cardiovascular Diseases

Systemic inflammation is a biochemical phenomenon involving a plethora of immune cells and pathways as a result of tissue injury or in response to pathogenic insults. During the inflammatory response, our immune system activates various immune cells, such as leukocytes, which produce numerous agents that either promote or suppress inflammation. These agents include reactive oxygen species (ROS), cathepsins, elastases, proteinases, and lipid mediators, such as eicosanoids and platelet-activating factor (PAF). If inflammation is left unresolved, it can lead to the oxidative damage of plasma lipoproteins that results in the “inappropriate” recruitment of immune cells to the site of the inflammatory response, thus further exacerbating the response.

Atherosclerosis is the underlying cause of most CVD, which are chronic progressive vascular diseases driven by systemic and unresolving inflammation. Atherosclerosis develops via the induction of endothelial dysfunction and the infiltration of lipids and immune cells into the subendothelium, in which platelets play a significant role. Within the subendothelium, monocytes differentiate into macrophages that go on to engulf oxidized lipids, leading to the formation of foam cells and the characteristic fatty streaks and atherosclerotic plaques. The subsequent fissure, erosion, and potential rupture of the plaque can lead to major cardiovascular events, such as myocardial infarction. Various lipid mediators play a crucial role in the pro-inflammatory processes that occur in atherosclerosis. Eicosanoids are a group of structurally and stereochemically distinct lipid species that are generated and concentrated by inflammatory cells. Arachidonic acid (AA), which is an n-6 20-carbon polyunsaturated fatty acid (PUFA), and which also happens to be the most prominent PUFA present in cell membranes, is the main substrate for the biosynthesis of eicosanoid molecules implicated in both pro- and anti-inflammatory processes. These eicosanoids include leukotrienes, thromboxanes, prostaglandins, and various other oxidized derivatives. However, a less well-researched but important family of lipids that exhibit similar pro-inflammatory activities towards many of the eicosanoids are PAF and PAF-like lipids.

And the continuation of the story on omega-3 fatty acids and inflammation (our latest publication; in review : Marine Drugs)

Cardiovascular diseases (CVD) remain the leading cause of death across the globe, hence, establishing strategies to counteract CVD are imperative to reduce mortality and the burden on health systems. Dietary modification is an effective primary prevention strategy against CVD. Research regarding dietary supplementation has become increasingly popular.

This review focuses on the current in vivo, in vitro, and epidemiological studies associated with that of omega-3 polyunsaturated fatty acids (n-3 PUFA) and polar lipids (PLs) and how they play a role against CVD.

Furthermore, this review focuses on the results of several major clinical trials examining n-3 PUFA regarding both primary and secondary prevention of CVD. Notably, we place a lens on the REDUCE-IT and STRENGTH trials. Finally, supplementation of PLs has recently been suggested as a potential alternative avenue for the reduction of CVD incidence versus neutral forms of n-3 PUFA. However, the clinical evidence for this argument is currently rather limited.

Therefore, we draw on the current literature to suggest future clinical trials for PL supplementation. We conclude that despite conflicting evidence, future human trials must be completed to confirm whether PL supplementation may be more effective than n-3 PUFA supplementation to reduce cardiovascular risk.

Source: Cardiovascular Diseases and Marine Oils: A Focus on Omega-3 Polyunsaturated Fatty Acids and Polar Lipids