Recent trends in food consumption indicate an increase in the proportion of fats of the <*>-6 vs the <0-3 variety. Prior to the last half of the century, the ratio of co-6 to <*)-3 was 2:1; this ratio is now 20:1. Restoring the former balance between vegetable and fish oil would achieve a shift in eicosanoid synthesis, is more physiologic, and has an influence that goes hand in hand with the supply of fat as an energy source. That a move toward prostacyclin activity is desirable is reflected in the improved survival of critically ill patients with a high PGI to TXA ratio,” which may also explain some of the effects of fish oil on cardiovascular disease.
During immunologic activation, the membrane becomes a substrate for phospholipase A,, releasing phospholipid for eicosanoid synthesis. Although administered fish oil becomes incorporated in the plasma membrane of liver cells over the course of several weeks,23 this incorporation does not appear to be absolutely necessary to the biologic effect of fish oil. Extracellular uptake of AA and its use in eicosanoid synthesis occurs in the short term,*4 suggesting that infusions of fish oil could influence this process in an acute setting. Yamazald et al25 have shown rapid incorporation of a>-3 PUFA into the free fatty acid and organ phospholipid pool of rats within 24 h after a bolus injection of docosahexaenoic acid.
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