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Acute inflammation is a fundamental, protective response that orchestrates immune system to address harmful stimuli both from within and via invasion. New evidences indicate that the resolution of acute inflammation is not simply passive but active and highly regulated processes coordinated by new families of potent bioactive lipid mediators (LMs), coined specialized proresolving mediators (SPMs). These SPMs are biosynthesized from n-3 polyunsaturated fatty acids. Low concentrations of SPM (nM range) stimulate proresolving cellular processes, such as inhibition of neutrophil infiltration, enhancement of macrophage phagocytosis of bacteria and efferocytosis of cellular debris, and reduction of inflammatory pain through specific G-protein coupled receptors.Of the many bioactive mediators that regulate inflammation resolution, low-dose carbon monoxide (CO) functions as a tissue-protective gaso-transmitter that is endogenously produced by the heme oxygenase (HO) system. Specific SPMs activate the HO system, which in turn enhances endogenous CO production locally, thus establishing a protective feed-forward circuit between SPMs and CO. In addition, treatment with low-dose CO and SPMs exerts protective effects against ischemia/reperfusion injury by decreasing leukocyte-platelet interaction and proinflammatory LM levels.Recent studies reviewed herein assessed the impact of SPMs and low-dose inhaled CO on inflammatory diseases. LM metabololipidomics approach allows the assessment of the efficacy of novel treatments with SPMs and low-dose CO. Moreover, this approach indicates the regions where the action of individual LMs may be physiologically relevant and when these LMs are produced in vivo to serve their proresolving mediator functions that may also permit new directions for treating human diseases.

Novel Endogenous Proresolving Molecules:Essential Fatty Acid-Derived and Gaseous Mediators in the Resolution of Inflammation