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Table 1 Bioactive lipids and cytokines measured in sepsis and other critically ill patients correlated with prognosis

From: n-3 fatty acids, γ-linolenic acid, and antioxidants in sepsis

Source of body fluid/tissue Bioactive lipids to be measured Time when measured in sepsis/critical illness Method of measurement Probable change
Plasma PUFAs: LA, GLA, DGLA, AA, ALA, EPA, DHA and their trans-fatty acids On admission, every 24 hours until discharge or death GC; LC-MS GLA, AA, EPA and DHA ↓ at admission; restored to normal if appropriate external supplementation is given; trans-fatty acids ↑ at admission, will decrease if inflammation is contained and indicates relatively good prognosis
Plasma Various PGs, LTs, TXs On admission, every 24 hours until discharge or death ELISA-HPLC ↑ in 2-series PGs and TXs, and 4-series LTs indicates inflammatory process is dominant; ↑ in 3-series PGs and TXs, and 5-series LTs indicates that the administered EPA is being converted to these products; to be correlated with levels of lipoxins, resolvins, protectins and maresins; ↓ in 2-series PGs and TXs, and 4-series LTs after GLA/EPA/DHA supplementation indicates decreasing tendency of inflammation
Plasma Lipoxins, resolvins, protectins, maresins On admission, every 24 hours until discharge or death LC-MS Lipoxins, resolvins, protectins, maresins ↓ at admission; restored to normal if patient is improving, remain low if prognosis is poor
Plasma Nitrolipids On admission, every 24 hours until discharge or death LC-MS/MS-MS Nitrolipids ↓ at admission; restored to normal if patient is improving, remain low if prognosis is poor
Plasma Isoprostanes On admission, every 24 hours until discharge or death LC-MS/MS-MS Isoprostanes ↑ at admission; restored to normal if patient is improving, remain high if prognosis is poor
Plasma Cytokines On admission, every 24 hours until discharge or death ELISA and/or flow cytometric-based immunofluorescence assays If proinflammatory cytokines ↑, inflammation is dominant; if anti-inflammatory cytokines ↑, recovery process is on the anvil; correlation needs to be made among cytokine profile, bioactive lipids and clinical picture
  1. Shown are bioactive lipids and cytokines that could be measured at various time points in patients with sepsis and other critical illnesses and correlated with prognosis. These bioactive lipids/cytokines and other compounds could also be measured in urine at different time points and correlated with their plasma levels and prognosis of the patient. Although not mentioned in the table, other measurements that could be performed include lipid peroxides, nitric oxide, antioxidants (such as superoxide dismutase, glutathione, catalase) and adipose-fatty acid binding protein. AA, arachidonic acid; ALA, α-linolenic acid; DGLA, dihomo-γ-linolenic acid; DHA, docosahexaenoic acid; ELISA, enzyme-linked immunosorbent assay; EPA, eicosapentaenoic acid; GC, gas chromatography; GLA, γ-linolenic acid; HPLC, high-performance liquid chromatography; LA, linoleic acid; LC-MS, liquid chromatography-mass spectrometry; LT, leukotriene; MS-MS, tandem mass spectrometry; PG, prostaglandin; PUFA, polyunsaturated fatty acid; TX, thromboxane.