Transcript
It’s a common misconception that inflammation is the root cause of a wide variety of chronic illnesses. It isn’t the root, though unchecked inflammation can certainly perpetuate a problem initiated by something else.
However, we’re learning now that resolution is actually built into the initial inflammatory cascade. Inflammatory prostaglandins (the same ones suppressed by NSAIDs) can actually serve as the foundation for some of the specialized pro-resolving mediators (SPMs) that will resolve the inflammation down the line (hence their name).
What Are Specialized Pro-Resolving Mediators (SPMs)?
SPMs are made from essential fatty acids, for the purpose of clearing out the metabolic waste left over from a cellular inflammatory conflict, so that resolution of the inflammation can occur.
Specifically, SPMs include lipoxins (produced from arachidonic acid, an omega-6), resolvins (the E-series is from EPA and the D-series is from DHA), protectins (from DHA), and maresins (from DHA).
While lipoxins are derived from the typically inflammatory arachidonic acid, the SPMs generally can switch from the pro-inflammatory state to encourage more SPM production, thus helping to achieve homeostasis, resolution of inflammation and of pain.
This is another very good reason not to overdo the NSAIDs: if you inhibit the COX-2 enzyme (which is what that drug class does), and thus prevent arachidonic acid production, you’ve also suppressed at least one of the very signals necessary to resolve the inflammation. The E-series resolvins also require the COX-2 pathway for production, even though they’re derived from EPA, rather than from arachidonic acid directly.
In fact, the lack of these SPM resolution signals can lead to neuropathic pain.
How SPMs Support Brain Health and Nervous System Function
SPMs are produced all over the body by the immune system, but also in neurons and glial cells. The microglia are the immune cells of the central nervous system, and these express receptors for all of the different types of SPMs.
So SPMs are an important part of repairing a disrupted blood brain barrier. DHA is already a building block for the BBB, but it’s also one of the most important substrates for SPM production as well.
Recommended EPA and DHA Dosage for Inflammation Resolution
In general, a healthy diet should contain about a 4:1 ratio of omega 6 to omega 3—so we shouldn’t need to supplement building blocks for arachidonic acid per se.
But EPA and especially DHA is very helpful, and since these are building blocks for SPMs, we’d want to do so at relatively high doses if we’re trying to resolve chronic inflammation (once the obstacle to cure has been addressed) or if we’re trying to repair the blood brain barrier.
Since DHA seems to be the winner here (and it’s usually lower in most EFA supplements than EPA), shooting for somewhere on the order of a couple of grams per day (this study used just over 2 grams), in divided doses and with food to avoid stomach upset is a good place to start.
SPMs are generally considered very safe. EFAs are associated with thinning the blood, so it’s worth watching for easy bruising with this, though studies haven’t really found a higher bleeding risk with higher dose EFAs.