Specialized pro-resolving mediators


Specialized pro-resolving mediators are a large and growing class of cell signaling molecules formed in cells by the metabolism of polyunsaturated fatty acids by one or a combination of lipoxygenase, cyclooxygenase, and cytochrome P450 monooxygenase enzymes. Pre-clinical studies, primarily in animal models and human tissues, implicate SPM in orchestrating the resolution of inflammation. Prominent members include the resolvins and protectins.
SPM join the long list of other physiological agents which tend to limit inflammation including glucocorticoids, interleukin 10, interleukin 1 receptor antagonist, annexin A1, and the gaseous resolvins, carbon monoxide, nitric oxide, and hydrogen sulfide.
The absolute as well as relative roles of the SPM along with other physiological anti-inflammatory agents in resolving human inflammatory responses remain to be defined precisely. However, studies suggest that synthetic SPM that are resistant to being metabolically inactivated hold promise of being clinically useful pharmacological tools for preventing and resolving a wide range of pathological inflammatory responses along with the tissue destruction and morbidity that these responses cause. Based on animal model studies, the inflammation-based diseases which may be treated by such metabolically resistant SPM analogs include not only pathological and tissue damaging responses to invading pathogens but also a wide array of pathological conditions in which inflammation is a contributing factor such as allergic inflammatory diseases, autoimmune diseases, psoriasis, atherosclerosis disease leading to heart attacks and strokes, type 1 and type 2 diabetes, the metabolic syndrome, and certain dementia syndromes.
Many of the SPM are metabolites of omega-3 fatty acids and have been proposed to be responsible for the anti-inflammatory actions that are attributed to omega-3 fatty acid-rich diets.

History

Through most of its early period of study, acute inflammatory responses were regarded as self-limiting innate immune system reactions to invading foreign organisms, tissue injuries, and other insults. These reactions were orchestrated by various soluble signaling agents such as a) foreign organism-derived N-formylated oligopeptide chemotactic factors complement components C5a and C3a which are chemotactic factors formed during the activation of the host's blood complement system by invading organisms or injured tissues; and c)''' host cell-derived pro-inflammatory cytokines, host-derived pro-inflammatory chemokines, platelet-activating factor, and PUFA metabolites including in particular leukotrienes, hydroxyeicosatetraenoic acids, the hydroxylated heptadecatreineoic acid, 12-HHT, and oxoeicosanoids. These agents functioned as pro-inflammatory signals by increasing the permeability of local blood vessels; activating tissue-bound pro-inflammatory cells such as mast cells, and macrophages; and attracting to nascent inflammatory sites and activating circulating neutrophils, monocytes, eosinophils, gamma delta T cells, and Natural killer T cells. The cited cells then proceeded to neutralize invading organisms, limit tissue injury, and initiate tissue repair. Hence, the classic inflammatory response was viewed as fully regulated by the soluble signaling agents. That is, the agents formed, orchestrated an inflammatory cell response, but then dissipated to allow resolution of the response. In 1974, however, Charles N. Serhan and his renowned colleagues, Mats Hamberg and Bengt Samuelsson, discovered that human neutrophils metabolize arachidonic acid to two novel products that contain 3 hydroxyl residues and 4 double bonds viz., 5,6,15-trihydroxy-7,9,11,13-icosatetraenoic acid and 5,14,15-trihydroxy-6,8,10,12-icosatetraenoic acid. These products are now termed lipoxin A4 and B4, respectively. While initially found to have in vitro activity suggesting that they might act as pro-inflammatory agents, Serhan and colleagues and other groups found that the lipoxins as well as a large number of newly discovered metabolites of other PUFA possess primarily if not exclusively anti-inflammatory activities and therefore may be crucial for causing the resolution of inflammation. In this view, inflammatory responses are not self-limiting but rather limited by the formation of a particular group of PUFA metabolites that counteract the actions of pro-inflammatory signals. Later, these PUFA metabolites were classified together and termed specialized pro-resolving mediators.

Inflammation

The production and activities of the SPM suggest a new view of inflammation wherein the initial response to foreign organisms, tissue injury, or other insults involves numerous soluble cell signaling molecules that not only recruit various cell types to promote inflammation but concurrently cause these cells to produce SPM which feed back on their parent and other cells to dampen their pro-inflammatory activity and to promote repair. Resolution of an inflammatory response is thus an active rather than self-limiting process which is set into motion at least in part by the initiating pro-inflammatory mediators which instruct relevant cells to produce SPM and to assume a more anti-inflammatory phenotype. Resolution of the normal inflammatory response, then, may involve switching production of pro-inflammatory to anti-inflammatory PUFA metabolites. Excessive inflammatory responses to insult as well as many pathological inflammatory responses that contribute to diverse diseases such as atherosclerosis, diabetes, Alzheimer's disease, inflammatory bowel disease, etc. may reflect, in part, a failure in this class switching. Diseases caused or worsened by non-adaptive inflammatory responses may by amenable to treatment with SPM or synthetic SPM which, unlike natural SPM, resist in vivo metabolic inactivation. The SPM possess overlapping activities which work to resolve inflammation. SPMs have the following anti-inflammatory activities on the indicated cell types as defined in animal and human model studies:
SPMs also stimulate anti-inflammatory and tissue reparative types of responses in epithelium cells, endothelium cells, fibroblasts, smooth muscle cells, osteoclasts, osteoblasts, goblet cells, and kidney podocytes as well as activate the heme oxygenase system of cells thereby increasing the production of the tissue-protective gaso-transmitter, carbon monoxide, in inflamed tissues.

Biochemistry

SPM are metabolites of arachidonic acid, eicosapentaenoic acid, docosahexaenoic acid, or n-3 DPA ; these metabolites are termed lipoxins, resolvins, protectins , and maresins. EPA, DHA, and n-3 DPA are n-3 fatty acids; their conversions to SPM are proposed to be one mechanism by which n-3 fatty acids may ameliorate inflammatory diseases. SPM act, at least in part, by either activating or inhibiting cells through binding to and thereby activating or inhibiting the activation of specific cellular receptors.

Lipoxins

Human cells synthesize LxA4 and LxB4 by serially metabolizing arachidonic acid ALOX15 ALOX5 followed by ALOX15 ALOX5 followed by ALOX12. Cells and, indeed, humans treated with aspirin form the 15R-hydroxy Epimer lipoxins of these two 15S-lipoxins viz., 15-epi-LXA4 and 15-epi-LXB4, through a pathway that involves ALOX5 followed by aspirin-treated cyclooxygenase 2. Aspirin-treated COX-2, while inactive in metabolizing arachidonic acid to prostanoids, metabolizes this PUFA to 15R-hydroperoxy-eicosatetraenoic acid whereas the ALOX15 pathway metabolizes arachidonic acid to 15S-hydroperoxy-eicosatetraenoic acid. The two aspirin-triggered lipoxins' or epi-lipoxins differ structurally from LxA4 and LxB4 only in the S versus R chirality of their 15-hydroxyl residue. Numerous studies have found that these metabolites have potent anti-inflammatory activity in vitro and in animal models and in humans may stimulate cells by binding to certain Receptor s in or on these cells. The following table lists the structural formulae, major activities, cellular receptor targets, and Wikipedia pages giving further information on the activity and synthesis of the lipoxins.
Trivial nameFormulaActivitiesReceptorSee Wikipedia page
LxA45S,6R,15S-trihydroxy-7E,9E,11Z,13E-ETEAnti-inflammatory, blocks pain perceptionStimulates FPR2, AHRLipoxin,15-Hydroxyicosatetraenoic acid#15S-HETE
LxB45S,14R,15S-trihydroxy-6E,8Z,10E,12E-ETEAnti-inflammatory, blocks pain perception?Lipoxin,15-Hydroxyicosatetraenoic acid#15S-HETE
15-epi-LxA4 5S,6R,15R-trihydroxy-7E,9E,11Z,13E-eicosatetraenoic acidAnti-inflammatory, blocks pain perceptionstimulates FPR2Lipoxin, 15-Hydroxyicosatetraenoic acid#15R-HETE
15-epi-LxB4 5S,14R,15R-trihydroxy-6E,8Z,10E,12E''-eicosatrienoic acidAnti-inflammatory, blocks pain perception?Lipoxin, 15-Hydroxyicosatetraenoic acid#15R-HETE

  • The FPL2 receptor is expressed on human neutrophils, eosinophils, monocytes, macrophages, T cells, synovial fibroblasts, and intestinal and airway epithelium as well as on astrocytes in the spinal cord of mice; GPR32 is expressed on human neutrophils, lymphocytes, monocytes, macrophages, and vascular tissue. Both of these receptors are involved in regulating inflammation. The AHR is a ligand-activated transcription factor that regulates xenobiotic-metabolizing enzymes such as cytochrome P450 enzymes.

    Resolvins

Resolvins are metabolites of omega-3 fatty acids, EPA, DHA, and 7Z,10Z,13Z,16Z,19Z-docosapentaenoic acid. All three of these omega-3 fatty acids are abundant in salt water fish, fish oils, and other seafood. n-3 DPA is to be distinguished from its n-6 DPA isomer, i.e. 4Z,7Z,10Z,13Z,16Z-docosapentaenoic acid, also termed osbond acid.

EPA-derived resolvins

Cells metabolize EPA by a cytochrome P450 monooxygenase or aspirin-treated cyclooxygenase-2 to 18R-hydroperoxy-EPA which is then reduced to 18R-hydroxy-EPA and further metabolized by ALOX5 to 5S-hydroperoxy-18R-hydroxy-EPA; the later product may be reduced to its 5,18-dihydroxy product, RvE2, or converted to its 5,6-epoxide and then acted on by an epoxide hydrolase to form a 5,12,18-trihydroxy derivative, RvE1. In vitro, ALOX5 can convert 18S-HETE to the 18S analog of RvE1 termed 18S-RvE1. 18R-HETE or 18S-HETE may also be metabolized by ALOX15 to its 17S-hydroperoxy and then reduced to its 17S-hydroxy product, Rv3. Rv3, as detected in in vitro studies, is a dihydroxy mixture of 18S-dihydroxy and 18R-dihydroxy isomers, both of which, similar to the other aforementioned metabolites possess potent SPM activity in in vitro and/or animal models. In vitro studies find that ALOX5 can convert 18S-hydroperoxy-EPA to the 18S-hydroxy analog of RvE2 termed 18S-RvE2. 18S-RvE2, however has little or no SPM activity and is therefore not considered to be a SPM here. The following table lists the structural formulae, major activities, cellular receptor targets, and Wikipedia pages giving further information on the activity and syntheses.
Trivial nameFormulaActivitiesReceptorSee Wikipedia page
RvE15S,12R,18R-trihydroxy-6Z,8E,10E,14Z,16E-EPAAnti-inflammatory, blocks pain perceptionstimulates CMKLR1, receptor antagonist of BLT, inhibits activation of TRPV1, TRPV3, NMDAR, and TNFR receptorsResolvin#E series resolvins
18S-RvE15S,12R,18S-trihydroxy-6Z,8E,10E,14Z,16E-EPAAnti-inflammatory, blocks pain perceptionstimulates CMKLR1, receptor antagonist of BLTResolvin#E series resolvins
RvE25S,18R-dihydroxy-6E,8Z,11Z,14Z,16E-EPAAnti-inflammatorypartial receptor agonist of CMKLR1, receptor antagonist of BLTResolvin#E series resolvins
RvE317R,18R/S-dihydroxy-5Z,8Z,11Z,13E,15E-EPAAnti-inflammatory?Resolvin#E series resolvins

  • CMKLR1, also termed the ChemR23 or E series resolvin receptor, is expressed on inflammation-regulating NK cells, macrophages, dendritic cells, and Innate lymphoid cells as well as on epithelial cells and in brain, kidney, cardiovascular, gastrointestinal, and myeloid tissues; BLT is the receptor for LTB4 along with certain other pro-inflammatory agents and is expressed on human neutrophils, eosinophils, monocytes, macrophages, T cells, mast cells, and dendritic cells as well as in vascular tissue; GPR32 is expressed on human inflammation-regulating neutrophils, lymphocytes, monocytes, macrophages, and vascular tissue. TRPV1 and TRPV3 are expressed on neurons and supporting cells, principally of the peripheral nervous system, that are involved in the sensory perception of pain; the NMDA receptor is a glutamate receptor and ion channel protein involved in controlling synaptic plasticity and memory.

    DHA-derived resolvins

Cells metabolize DHA by either ALOX15 or a cytochrome P450 monooxygenase 7S-hydroperoxy,17S-hydroxy-DHA which is then reduced to its 7S,17S-dihydroxy analog, RvD5; b) 4S-hydroperoxy,17S-hydroxy-DHA which is reduced to its 4S,17S-dihydroxy analog, RvD6; c) 7S,8S-epoxy-17S-DHA which is then hydrolyzed to 7,8,17-trihydroxy and 7,16,17-trihydorxy products, RvD1 and RvD2, respectively; and d)' 4S,5S-epoxy-17S-DHA which is then hydrolyzed to 4,11,17-trihydroxy and 4,5,17-trihydroxy products, RvD3 and RvD4, respectively. These six RvDs possess a 17S-hydroxy residue; however, if aspirin-treated cyclooxygenase-2 is the initiating enzyme, they contain a 17R-hydroxy residue and are termed 17R-RvDs, aspirin-triggered-RvDs, or AT-RvDs 1 thru 6. In certain cases, the final structures of these AT-RvDs is assumed by analogy to the structures of their RvD counterparts. Studies have found that most of these metabolites have potent anti-inflammatory activity in vitro and/or in animal models. The following table lists the structural formulae, major activities with citations, cellular receptor targets, and Wikipedia pages giving further information on the activity and synthesis of these D series resolvins.
Trivial nameFormulaActivitiesReceptorSee Wikipedia pages
RvD17S,8R,17S-trihydroxy-4Z,9E,11E,13Z,15E,19Z-DHAAnti-inflammatory, blocks pain perceptionstimulates GPR32, FPR2, inhibits activation of TRPV3, TRPV4, TRPA1Resolvin#D series resolvins
RvD27S,16R,17S-trihydroxy-4Z,8E,10Z,12E,14E,19Z-DHAAnti-inflammatory, blocks pain perception Increase survival after sepsisstimulates GPR32, GPR18, FPR2, inhibits activation of TRPV1 and TRPA1Resolvin#D series resolvins
RvD34S,11R,17S-trihydroxy-5Z,7E,9E,13Z,15E,19Z-DHAAnti-inflammatorystimulates GPR32Resolvin#D series resolvins
RvD44S,5R,17S-trihydroxy-6E,8E,10Z,13Z,15E,19Z-DHA??Resolvin#D series resolvins
RvD57S,17S-dihydroxy-4Z,8E,10Z,13Z,15E,19Z-DHAAnti-inflammatorystimulates GPR32Resolvin#D series resolvins
RvD64S,17S-dihydroxy-5E,7Z,10Z,13Z,15E,19Z-DHA??Resolvin#D series resolvins
17R-RvD1 7S,8R,17R-trihydroxy-4Z,9E,11E,13Z,15E,19Z-DHAAnti-inflammatory,blocks pain perceptionstimulates FPR2, GPR32, inhibits activation of TRPV3, TRPV4, and TNFRResolvin#Aspirin-triggered resolvin Ds
17R-RvD2 7S,16R,17R-trihydroxy-4Z,8E,10Z,12E,14E,19Z-DHA??Resolvin#Aspirin-triggered resolvin Ds
17R-RvD3 4S,11R,17R-trihydroxy-5Z,7E,9E,13Z,15E,19Z-DHAAnti-inflammatorystimulates GPR32Resolvin#Aspirin-triggered resolvin Ds
17R-RvD4 4S,5R,17R-trihydroxy-6E,8E,10Z,13Z,15E,19ZDHA??Resolvin#Aspirin-triggered resolvin Ds
17R-RvD5 7S,17R-dihydroxy-4Z,8E,10Z,13Z,15E,19Z-DHA??Resolvin#Aspirin-triggered resolvin Ds
17R-RvD6 4S,17R-dihydroxy-5E,7Z,10Z,13Z,15E,19Z-DHA??Resolvin#Aspirin-triggered resolvin Ds

  • The distribution and major functions of GPR32, FPR2, TRPV1, and TRPV3 are given in the above EPA-derived resolvins section; TRPA1 is a chemosensor ion channel located on the plasma membrane of many human cell types; TRPV4, also termed the vanilloid-receptor related osmotically activated channel and OSM9-like transient receptor potential channel member 4 2], is involved in multiple physiologic functions and dysfunctions. With respect to the SPMS, both receptors mediate the perception of various forms of inflammation-triggered pain.
  • The initial product of 15-lipoxygenase attack on DHA is 17S-hydroperoxy-4Z,7Z,10Z,13Z,15E,19Z-docosahexaenoic acid which may then be rapidly reduced by a cellular glutathione peroxidase to 17S-hydroxy-4Z,7Z,10Z,13Z,15E,19Z-docosahexaenoic acid. 17-HDHA has potent anti-inflammatory activity and has been classified as a SPM although not a resolvin. Similarly, 14S,20R-dihyrdoxy-4Z,7Z,10Z,12E,16Z,18E''-docosahexaenoic acid, while not yet assigned a RvD number, qualifies as a RvD-related SPM. It is a DHA metabolite made by mouse eosinophils, detected in the peritoneal fluid of mice undergoing experimental peritonitis, and possessing the ability to inhibit the influx of leukocytes into the peritoneum of mice undergoing experimental peritonitis. Finally, two resolvin sulfido-conjugates have been shown to be formed from their 7,17-dihydroxy precursor by cells in vitro, to accelerate regeneration of experimental injuries in planaria worms, and to have potent anti-inflammatory activity in various in vitro model systems.

    n-3 DPA-derived resolvins

n-3 DPA -derived resolvins are recently identified SPM. In the model system used to identify them, human platelets pretreated with aspirin to form acetylated COX2 or the statin, atorvastatin, to form S-ntrosylated and thereby modify this enzyme's activity metabolize n-3 DPA to form a 13R-hydroperoxy-n-3 DPA intermediate which is passed over to nearby human neutrophils; these cell then metabolize the intermediate to four poly-hydroxyl metabolites termed resolvin T1, RvT2, RvT3, and RvT4. These T series resolvins also form in mice undergoing experimental inflammatory responses and have potent in vitro and in vivo anti-inflammatory activity; they are particularly effective in reducing the systemic inflammation as well as increasing the survival of mice injected with lethal doses of E. coli bacteria. Another set of newly described n-3 DPA resolvins, RvD1n-3, RvD2n-3, and RvD5n-3, have been named based on their presumed structural analogies to the DHS-derived resolvins RvD1, RvD2, and RvD5, respectively. These three n-3 DPA-derived resolvins have not been defined with respect to the chirality of their hydroxyl residues or the Cis–trans isomerism of their double bonds but do possess potent anti-inflammatory activity in animal models and human cells; they also have protective actions in increasing the survival of mice subjected to E. coli sepsis. The following table lists the structural formulae, major activities, cellular receptor targets, and Wikipedia pages giving further information on the activity and syntheses.
Trivial nameFormulaActivitiesReceptorSee Wikipedia pages
RvT17,13R,20-trihydroxy-8E,10Z,14E,16Z,18E-DPAAnti-inflammatory?Resolvin#T series resolvins
RvT27,8,13R-trihydroxy-9E,11E,14E,16Z,19Z-DPAAnti-inflammatory?Resolvin#T series resolvins
RvT37,12,13R-trihydroxy-8Z,10E,14E,16Z,19Z-DPAAnti-inflammatory?Resolvin#T series resolvins
RvT47,13R-dihydroxy-8E,10Z,14E,16Z,19Z-DPAAnti-inflammatory?Resolvin#T series resolvins
RvD1n-37,8,17-trihydroxy-8,10,13,15,19-DPAAnti-inflammatory?Resolvin#Resolvin Dn-3DPA
RvD2n-37,16,17-trihydroxy-8,10,12,14,19-DPAAnti-inflammatory?Resolvin#Resolvin Dn-3DPA
RvD5n-37,17-dihydroxy-8,10,13,15,19-DPAAnti-inflammatoryGPR101Resolvin#Resolvin Dn-3DPA

Protectins/neuroprotectins

DHA-derived protectins/neuroprotectins

Cells metabolize DHA by either ALOX15, by a bacterial or mammalian cytochrome P450 monooxygenase or by aspirin-treated cyclooxygenase-2 to 17S-hydroperoxy or 17R-hydroperoxy intermediates ; this intermediate is then converted to a 16S,17S-epoxide which is then hydrolyzed. PDX is formed by the metabolism of DHA by two serial lipoxygenases, probably a 15-lipoxygenase and ALOX12. 22-Hydroxy-PD1 is formed by the Omega oxidation of PD1 probably by an unidentified cytochrome P450 enzyme. While omega-oxidation products of most bioactive PUFA metabolites are far weaker than their precursors, 22-hydroxy-PD1 is as potent as PD1 in inflammatory assays. Aspirin-triggered-PD1 is the 17R-hydroxyl diastereomer of PD1 formed by the initial metabolism of DHA by aspirin-treated COX-2 or possibly a cytochrome P450 enzyme to 17R-hydroxy-DHA and its subsequent metabolism possibly in manner similar to that which forms PD1. 10-Epi-PD1, the 10S-hydroxy diastereomer of PD1, has been detected in small amounts in human neutrophils. While its in vivo synthetic pathway has not been defined, 10-epi-PD1 has anti-inflammatory activity. The following table lists the structural formulae, major activities, cellular receptor targets, and Wikipedia pages giving further information on the activity and syntheses.
Trivial nameFormulaActivitiesReceptorSee Wikipedia pages
PD1 10R,17S-dihydroxy-4Z,7Z,11E,13E,15Z,19Z-DHAanti-inflammatory, nerve protection/regeneration, blocks pain perceptioninhibits the activation of TRPV1Neuroprotectin D1
PDX10S,17S-dihydroxy-4Z,7Z,11E,13Z,15E,19Z-DHAanti-inflammatory, inhibits platelet activation?Neuroprotectin D1#Protectin DX and Dihydroxy-E,Z,E-PUFA
22-hydroxy-PD110R,17S,22-trihydroxy-4Z,7Z,11E,13E,15Z,19Z-DHAanti-inflammatory?Neuroprotectin D1#Protectin DX and Dihydroxy-E,Z,E-PUFA
17-epi-PD1 10R,17R-dihydroxy-4Z,7Z,11E,13E,15Z,19Z-DHAanti-inflammatory?Neuroprotectin D1#Aspirin-triggered PD1
10-epi-PD1 10S,17S-Dihydroxy-4Z,7Z,11E,13E,15Z,19Z-DHAanti-inflammatory?Neuroprotectin D1#10-epi-PD1

  • The TRPV1 receptor is discussed in the EPA-derived resolvin section.
  • While not yet given trivial names, certain isomers of the protectins also prove to have SPM activity: the 13Z cis-trans isomer of 10-epi-PD1, 10S,17S-dihydroxy-4Z,7Z,11E,13Z,15E,19Z-DHA, is a relatively abundant metabolite compared to PD1 detected in the peritoneal fluid from a mouse model of peritonitis and has moderately potent anti-inflammatory activity in this model; 10R,17S-dihydroxy-4Z,7Z,11E,13E,15E,19Z-DHA, is a prominent metabolite detected in stimulated leukocytes, not detected the mouse peritonitis model, and has modest anti-inflammatory activity in the latter model; and 10S,17S-dihydroxy-4Z,7Z,11E,13E,15Z,19Z-DHA, while not detected by in the mouse model of peritonitis or stimulated leukocytes, is more potent than even PD1 in inhibiting peritonitis in the mouse model. In addition to these compounds, two protectin sulfido-conjugates form in vitro, accelerate regeneration of injured planaria worms, and have potent anti-inflammatory activity in in vitro model systems.

    n-3 DPA-derived protectins/neuroprotectins

n-3 DPA-derived protectins with structural similarities to PD1 and PD2 have been described, determined to be formed in vitro and in animal models, and termed PD1n-3 and PD2n-3, respectively. These products are presumed to be formed in mammals by the metabolism of n-3 DPA by an unidentified 15-lipoxygenase activity to 16,17-epoxide intermediate and the subsequent conversion of this intermediate to the di-hydroxyl products PD1n-3 and PD2n-3. PD1n-3 has anti-inflammatory activity in a mouse model of peritonitis; PD2n-3 has anti-inflammatory activity in an in vitro model. The following table lists the structural formulae, major activities, cellular receptor targets, and Wikipedia pages giving further information on the activity and syntheses.
Trivial nameFormulaActivitiesReceptorSee Wikipedia pages
PD1n-310,17-dihydroxy-7,11,13,15,19-DPAanti-inflammatory?-
PD2n-316,17-dihydroxy-7,10,12,14,19-DPAanti-inflammatory?-

Maresins

DHA-derived maresins

Cells metabolize DHA by ALOX12, other lipoxygenase,, or an unidentified pathway to a 13S,14S-epoxide-4Z,7Z,9E,11E,16Z,19Z-DHA intermediate and then hydrolyze this intermediate by an epoxide hydrolase activity to MaR1 and MaR2. During this metabolism, cells also form 7-epi-Mar1, i.e. the 7S-12E isomer of Mar1, as well as the 14S-hydroxy and 14R-hydroxy metabolites of DHA. The latter hydroxy metabolites can be converted by an unidentified cytochrome P450 enzyme to maresin like-1 and Mar-L2 by omega oxidation; alternatively, DHA may be first metabolized to 22-hydroxy-DHA by CYP1A2, CYP2C8, CYP2C9, CYP2D6, CYP2E1, or CYP3A4 and then metabolized through the cited epoxide-forming pathways to Mar-L1 and MaR-L2. Studies have found that these metabolites have potent anti-inflammatory activity in vitro and in animal models. The following table lists the structural formulae, major activities, cellular receptor targets, and Wikipedia pages giving further information on the activity and syntheses.
Trivial nameFormulaActivitiesReceptorSee Wikipedia pages
MaR17R,14S-dihydroxy-4Z,8E,10E,12Z,16Z,19Z-DHAanti-inflammatory, tissue regeneration, blocks pain perceptionInhibits the activation of the vanilloid receptor TRPV1 and TRPA1Maresin
MaR213R,14S-dihydroxy-4Z,7Z,9E,11E,16Z,19Z-DHAanti-inflammatory?Maresin
7-epi-MaR17S,14S-dihydroxy-4Z,8E,10Z,12E,16Z,19Z-DHAanti-inflammatory?Maresin
MaR-L114S,22-dihydroxy-4Z,7Z,10Z,12E,16Z,19Z-DHAanti-inflammatory?-
MaR-L214R,22-dihydroxy-4Z,7Z,10Z,12E,16Z,19Z-DHAanti-inflammatory?-

n-3 DPA-derived maresins are presumed to be formed in mammals by metabolism of n-3 DPA by an undefined 12-lipoxygenase activity to a 14-hydroperoxy-DPA intermediated and the subsequent conversion of this intermediate to di-hydroxyl products which have been termed MaR1n-3, MaR2n-3, and MaR3n-3 based on their structural analogies to MaR1, MaR2, and MaR3, respectively. MaR1n-3 and MaRn-3 have been found to possess anti-inflammatory activity in in vitro assays of human neutrophil function. These n-3 DPA-derived maresins have not been defined with respect to the chirality of their hydroxyl residues or the cis–trans isomerism of their double bonds. The following table lists the structural formulae, major activities, cellular receptor targets, and Wikipedia pages giving further information on the activity and syntheses.
Trivial nameFormulaActivitiesReceptorSee Wikipedia pages
MaR1n-37S,14S-dihydroxy-8E,10E,12Z,16Z,19Z-DPAanti-inflammatory?-
MaR2n-313,14-dihydroxy-7,9,111,16,19-DPAanti-inflammatory?-
MaR3n-313,14-dihydroxy-7,9,111,16,19-DPA??-

Other PUFA metabolites with SPM-like activity

The following PUFA metabolites, while not yet formally classified as SPM, have been recently described and determined to have anti-inflammatory activity.

n-3 DPA metabolites

10R,17S-dihydroxy-7Z,11E,13E,15Z,19Z-docosapentaenoic acid has been found in inflamed exudates of animal models and possesses in vitro and in vivo anti-inflammatory activity almost as potently as PD1.

n-6-DPA metabolites

n-6 DPA is an isomer of n-3 DPA differing form the latter fatty acid only in the location of its 5 double bonds. Cells metabolize n-6 DPA to 7-hydroxy-DPAn-6, 10,17-dihydroxy-DPAn-6, and 7,17-dihydroxy-DPAn-3; the former two metabolites have been shown to possess anti-inflammatory activity in in vitro and in animal model studies.

oxo-DHA and oxo-DPA metabolites

Cells metabolize DHA and n-3 DPA by COX2 to 13-hydroxy-DHA and 13-hydroxy-DPAn-3 products and by aspirin-treated COX2 to 17-hydroxy-DHA and 17-hydroxy-DPAn-3 products and may then oxidize these products to there corresponding oxo derivatives, 13-oxo-DHA, 13-oxo-DPAn-3, 17-oxo-DHA, and 17-oxo-DPAn-3. These oxo metabolites directly activate the nuclear receptor Peroxisome proliferator-activated receptor gamma and possess anti-inflammatory activity as assesses in in vitro systems.

Docosahexaenoyl ethanolamide metabolites

DHA ethanolamide ester is metabolized to 10,17-dihydroxydocosahexaenoyl ethanolamide and/or 15-hydroxy-16-epoxy-docosapentaenoyl ethanolamide by mouse brain tissue and human neutrophils. Both compounds possess anti-inflammatory activity in vitro; 15-HEDPEA also has tissue-protective effects in mouse models of lung injury and tissue reperfusion. Like anandamide, both compounds activated the Cannabinoid receptor.

Prostaglandins and isoprostanes

PUFA derivatives containing a Cyclopentenone structure are chemically reactive and can form adducts with various tissue targets, particularly proteins. Certain of these PUFA-cyclopentenones
bind to the sulfur residues in the KEAP1 component of the KEAP1-NFE2L2 protein complex in the cytosol of cells. This negates KEAP1's ability to bind NFE2L2; in consequence, NFE2L2 becomes free to translocate to the nuclease and stimulate the transcription of genes that encode proteins active in detoxifying reactive oxygen species; this effect tends to reduce inflammatory reactions. PUFA-cyclopentenones may likewise react with the IKK2 component of the cytosolic IKK2-NFκB protein complex thereby inhibiting NFκB from stimulating the transcription of genes that encode various pro-inflammatory proteins. One or both of these mechanisms appears to contribute to the ability of certain highly reactive PUFA-cyclopenetenones to exhibit SPM activity. The PUFA-cyclopentenones include two prostaglandins, Δ12-PGJ2 and 15-deoxy-Δ12,14-PGJ2, and two isoprostanes, 5,6-epoxyisoprostane E2 and 5,6-epoxyisoprostane A2. Both PGJ2's are arachidonic acid-derived metabolites made by cyclooxygenases, primarily COX-2, which is induced in many cell types during inflammation. Both isoprostanes form non-enzymatically as a result the attack on the arachidonic acid bond to cellular phospholipids by reactive oxygen species; they are then release from the phospholipids to become free in attacking their target proteins. All four products have been shown to form and possess SPM activity in various in vitro studies of human and animal tissue as well as in in vivo studies of animal models of inflammation; they have been termed pro-resolving mediators of inflammation

Gene manipulation studies

Mice made deficient in their 12/15-lipoxygenase gene exhibit a prolonged inflammatory response along with various other aspects of a pathologically enhanced inflammatory response in experimental models of cornea injury, airway inflammation, and peritonitis. These mice also show an accelerated rate of progression of atherosclerosis whereas mice made to overexpress 12/15-lipoxygenase exhibit a delayed rate of atherosclerosis development. Alox15 overexpressing rabbits exhibited reduced tissue destruction and bone loss in a model of periodontitis. Similarly, Alox5 deficient mice exhibit a worsened inflammatory component, failure to resolve, and/or decrease in survival in experimental models of respiratory syncytial virus disease, Lyme disease, Toxoplasma gondii disease, and corneal injury. These studies indicate that the suppression of inflammation is a major function of 12/15-lipoxygenase and Alox5 along with the SPMs they make in at least certain rodent experimental inflammation models; although these rodent lipoxygenases differ from human ALOX15 and ALOX5 in the profile of the PUFA metabolites that they make as well as various other parameters, these genetic studies allow that human ALOX15, ALOX5, and the SPMs they make may play a similar anti-inflammatory functions in humans.
Concurrent knockout of the three members of the CYP1 family of Cytochrome P450 enzymes in mice, i.e. Cyp1a1, Cyp1a2, and Cyp1b1, caused an increase in the recruitment of neutrophils to the peritoneum in mice undergoing experimental peritonitis; these triple knockout mice also exhibited an increase in the peritoneal fluid LTB4 level and decreases in the levels of peritoneal fluid NPD1 as well as the precursors to various SPMS including 5-hydroxyeicosatetraenoic acid, 15-Hydroxyeicosatetraenoic acid, 18-hydroxyeicosapentaenoic acid, 17-hydroxydocosahexaenoic acid, and 14-hydroxydocosahexaenoic. These results support the notion that Cyp1 enzymes contribute to the production of certain SPMs and inflammatory responses in mice; CYP1 enzymes may therefore play a similar role in humans.

Clinical studies

In a randomized controlled trial, AT-LXA4 and a comparatively stable analog of LXB4, 15R/S-methyl-LXB4, reduced the severity of eczema in a study of 60 infants. A synthetic analog of ReV1 is in clinical phase III testing for the treatment of the inflammation-based dry eyesyndrome; along with this study, other clinical trials using an RvE1 analogue to treat various ocular conditions are underway. RvE1, Mar1, and NPD1 are in clinical development studies for the treatment of neurodegenerative diseases and hearing loss. And, in a single study, inhaled LXA4 decreased LTC4-initiated bronchoprovocation in patients with asthma.