Thesis (Ph.D.)--Boston University / Resolvins are endogenous anti-inflammatory I pro-resolving lipid mediators derived from omega-3 fatty acids. Resolvin E1 (RvE1) reverses periodontitis and promotes regeneration of alveolar bone in vivo. The goal of this project was to determine the mechanism of RvE1 impact on bone formation. RvE1 significantly enhanced bone formation relative to a vehicle control in a mouse craniotomy model of bone healing. Since RvE1 is reported to act through receptors expressed by cells of the innate immune system, the initial hypothesis tested was that RvE1 actions are mediated through bone macrophages. The hypothesis was rejected, as no impact of RvE1 on macrophage mediated bone formation was demonstrable. The alternative hypothesis was that RvE1 acts directly on osteoblasts. Using mouse neonatal osteoblasts, calcification of osteoblast cultures was demonstrated. Osteoblasts express the RvE1 receptor, ChemR23, at the mRNA and protein level. Examination of intracellular signaling by RvE1 demonstrated increased phosphorylation of rpS6 through the AKT-mTOR pathway. The specificity of RvE1 signaling through ChemR23 was demonstrated with ChemR23 specific blocking antibody that abrogated the phosphorylation of rpS6. Rapamycin, an inhibitor of mTOR, also blocked rpS6 phosphorylation. To examine the mechanism of RvE1 treated osteoblast enhanced bone formation, secretion of bone specific proteins by osteoblasts after pro-inflammatory stimulation (IL-6) was examined with a focus on the osteoprotegerin (OPG) and receptor activator of NF-κB ligand (RANKL) axis, which regulates osteoclast differentiation. Secretion of RANKL and OPG by mouse neonatal osteoblasts stimulated with IL-6 and treated with RvE1 was measured by ELISA. IL-6 stimulation did not impact RANKL levels but decreased OPG production, thereby changing the RANKL/OPG to favor osteoclast activation and bone resorption. RvE1 blocked OPG changes, however, maintaining a RANKL/OPG more favorable to bone formation. In conclusion, RvE1 has anabolic actions in a mouse model of bone healing mediated through RANKL/OPG. RvE1 signals the receptor ChemR23 on the osteoblast surface through the mTOR pathway and phosphorylation of rpS6. Functionally, RvE1 shifts the balance between OPG and RANKL to favor bone formation. Mediators of innate immunity thus also directly regulate bone cells.

The benefits of fish oil supplementation for inflammation based disorders has been well-documented,[1] prompting investigations into the pathways through which these benefits are achieved. This led Serhan et al. to the discovery of a new class of pro-resolution lipid mediators, termed resolvins .[2][3] There has subsequently been much research into their being a potential treatment for chronic inflammatory diseases such as asthma,[4] diabetes,[5] and arthritis.[6] The aim of this research was to study the bioactivity of resolvin E1 (RvE1) and its analogues; to do this a flexible and versatile route towards the chemical synthesis of RvE1 had to be developed, which would allow for easy modification of the stereochemistry of the C-C double bonds and hydroxyl groups, as well as producing fragments containing key functional groups. The first proposed route synthesised RvE1 from two key fragments termed the lactone and epoxide fragments. RvE1 contains three stereogenic hydroxyl groups, one with S configuration and two with R configuration. The epoxide fragment was to be converted into two adjacent sections of the RvE1 chain. The S-stereocentre was introduced via hydrolytic kinetic resolution using a Jacobsen s catalyst.[7] The two R-stereocentres were introduced via the chiral pool originating from 1,2:5,6-di-O-isopropylidene-D-mannitol. Unfortunately, problems were encountered late on in the synthesis of both fragments and therefore a new synthetic route had to be devised. The second proposed route synthesised RvE1 from two key fragments termed the alkyne and halide fragments. The S-stereocentre and one R-stereocentre were proposed to be introduced via asymmetric reduction of a ketone group. The other R-stereocentre was proposed to be synthesised with the use of chiral additives during an indium-mediated coupling reaction.[8] As work progressed on the halide fragment, the Lewis acid catalysed thermodynamic conversion of a branched chain homoallylic alcohol to its linear counterpart was trialled in order to obtain one of the conjugated diene system in RvE1. Using literature conditions for a similar system[9] this reaction was unsuccessful. The reaction mechanism was studied and a hypothesis was put forward that adding a catalytic amount of the aldehyde that the branched chain homoallylic alcohol was synthesised from to the reaction mixture would promote the thermodynamic conversion to the linear chain. These conditions were trialled on a number of different starting materials, leading to either an improvement in yield for the thermodynamic conversion, or the success of a previously unsuccessful conversion.

No description available.

Inflammation is the body’s natural response to injury or infection by pathogens (73). Chronic inflammation is a hallmark of cancer and may act to exacerbate tumor growth and metastasis(116). The resolution of inflammation is now known to be an active process mediated by small lipid autacoid molecules termed specialized pro-resolving lipid mediators (SPMs)(73,90). Chronic inflammation can result in a vicious cycle of tissue injury, inflammation, and further tissue injury. We evaluated the SPM, resolvin E1 (RvE1), to stimulate the resolution of inflammation in multiple murine models of pancreatic cancer and metastasis. RvE1 mediated macrophage class switching in the tumor microenvironment, increased immune cell infiltration, and improved immune resistance(116). On the macroscopic scale, RvE1 treatment inhibited tumor growth and number of metastases. Notably, multiple studies showed that RvE1 improved anti-tumor activity of current frontline cancer treatments such as chemotherapy (e.g. cisplatin and gemcitabine) and immunotherapy (e.g. anti-PD1). There was no observed toxicity associated with RvE1 as both a monotherapy and in combination with other treatments. These results show the efficacy of RvE1 in enhancing the resolution of inflammation within the pancreatic cancer microenvironment and suppressing tumor growth. The current study provides a robust platform for conducting further pre-clinical investigations for SPMs in the treatment of different cancer types.

Acute Lung injury (ALI) and the more severe acute respiratory distress syndrome (ARDS) are respiratory maladies that present immense clinical challenges. ALI affects 200,000 individuals annually and features a 40% mortality rate. ALI can be initiated by both pathogenic and sterile insults originating locally in the lungs or systemically. While immense research has been poured into this disease in an effort to find a therapeutic strategy, the heterogeneously diffuse nature of the disease has not yielded a cure for the disease. Death from this disease is strongly attributed to reduced gas exchange from a severely compromised alveolar-capillary barrier. The only way currently to manage this disease is through enhanced ventilation and hyperoxic therapy. Hyperoxic therapy is a common treatment given to over 800,000 patients each year to treat respiratory maladies such as ALI. Prolonged exposure to oxygen at high concentrations results in the development of a condition known as hyperoxic acute lung injury (HALI). In this disease, the formation of reactive oxygen species damages healthy tissue and impairs gas exchange. Hyperoxia is also a well-documented murine sterile lung injury model that replicates the symptoms of ALI in lung injury patients. The ability of non-lethal dosages of hyperoxia to resolve without lung fibrosis also enables the study of molecules associated with ALI resolution and repair, a process not clearly understood. Inflammation in ALI is associated with disease progression, however pharmaceutical interventions aimed at targeting the inflammatory cascade have failed in clinical trials for ALI. Recent reports point to an aberrant injury resolution mechanisms that may be more strongly correlated with morbidity and mortality. There seems to be a homeostatic imbalance between endogenous inflammation progression and resolution initiation. This is especially the case with HALI, as significant ROS generation results in depletion of redox regulating antioxidants. Resolution mechanisms associated with ALI in the oxygen toxicity setting is poorly understood. Polyunsaturated fatty acids such eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are essential fatty acids that show immense antioxidant and anti-inflammatory action in cases of acute injury. The lung mucosa is rich in DHA and following inflammatory insult DHA is readily converted to resolution phase interaction products (resolvins), which have shown immense proresolutionary potential in recent reports of acute injury. In the presence of aspirin, more potent and longer-acting aspirin-triggered resolvins are formed. The effects of resolvins and their aspirin triggered epimers have not been studied in an oxygen toxicity setting and are the focus of this dissertation. For the first time, we show that one of these resolvin molecules, aspirin triggered resolvin d1 (AT-RvD1), can enhance resolution of hyperoxic acute lung injury. In vitro results reveals that AT-RvD1 treatment resulted in reduced interaction of two key players in the HALI inflammatory cascade, the macrophage and alveolar epithelium. AT-RvD1 was able to blunt macrophage cytokine secretion as well as inhibit epithelial cell cytokine secretion and adhesion molecule expression. More importantly, AT-RvD1 blunted cytokine mediated leukocyte-epithelial cell interaction in vitro. In a sublethal hyperoxic injury model, mice given AT-RvD1 following hyperoxia exposure displayed reduced HALI pathological severity. ATRvD1 treatment resulted in reduced alveolar-capillary permeability, tissue inflammation, proinflammatory mediator secretion, epithelial cell death, and leukocyte influx. Taken together these novel results demonstrate the therapeutic potential of resolvins in the oxygen toxicity setting. These results also arouse the idea that resolvins could be used to lessen the comorbidities associated with oxygen therapy and improve recovery times of ALI patients.

Les muscles squelettiques sont principalement composés de fibres musculaires, des longues cellules multinucléées. Ces fibres sont classifiées en fonction de leur phénotype métabolique et contractile en type I (fibres oxydatives lentes), IIA (fibres oxydatives rapides) ou IIX et IIB (fibres glycolytiques rapides). La détermination du phénotype musculaire dépend de plusieurs facteurs intrinsèques (ex. voies signalétiques, facteurs de transcription) et extrinsèques (ex. hormones, stress physique). Les cellules souches musculaires (cellules satellites) sont aussi impliquées dans ce processus. À la suite d'une lésion musculaire, les cellules satellites s'activent, prolifèrent, sortent du cycle cellulaire pour s’autorenouveler ou se différencier en myoblastes qui fusionnent ensemble et avec les fibres musculaires endommagées pour régénérer le muscle blessé. Récemment, nous avons démontré que les résolvines, des médiateurs lipidiques dérivés des omégas-3, favorisent la différenciation et la fusion des cellules satellites provenant d’un modèle de souris dystrophique. Toutefois, leur effet sur la détermination du phénotype musculaire demeure inconnu. Ce mémoire présente un travail de recherche visant à déterminer l’impact des médiateurs lipidiques sur le phénotype musculaire pendant la myogenèse. Pour répondre à cet objectif, in vitro, nous avons caractérisé l’impact des résolvines sur le phénotype des myotubes (quantification par immunofluorescence) et la signalisation cellulaire (analyse de RNAseq) lors de la myogenèse. In vivo, nous avons caractérisé l’impact des résolvines sur les propriétés contractiles (mesure de la force in situ) et le phénotype des fibres musculaires (quantification par immunofluorescence) lors de la régénération musculaire précoce et tardive. Un article a été rédigé et présente les différents résultats obtenus. In vitro, nous avons démontré que la résolvine D2 (RvD2), augmente la formation de myotube embryonnaire promouvant la myogenèse. La RvD2 favorise également le développement de myotubes lents. De plus, KD107, un agoniste du récepteur de la RvD2 (GPR18), induit l’activation des voies signalétiques AMPK, PPAR et mTOR reconnues pour favoriser le métabolisme oxydatif et la synthèse de protéines contractiles. In vivo, nos résultats démontrent qu’au cours de la régénération musculaire, l’administration locale de RvD2 améliore la force musculaire, promeut la formation du type de fibre caractéristique dans les muscles lents (type I) et rapides (type IIB), et augmente leur taille. L’administration systémique de RvD2 induit également un changement du type de fibre en faveur du type lent. La RvD2 présente un potentiel thérapeutique prometteur pour les maladies musculaires, car elle pourrait contribuer à prévenir la diminution des capacités myogéniques, la perte de force, les altérations du typage des fibres musculaires et/ou l'atrophie, qui sont des caractéristiques couramment observées dans de nombreuses myopathies. / Skeletal muscles are predominantly composed of long, multinucleated muscle fibers. These fibers are classified according to their metabolic and contractile phenotype as type I (oxidative slow fibers), IIA (oxidative fast fibers) or IIX and IIB (glycolytic fast fibers). The determination of fiber type is influenced by various intrinsic (e.g., signaling pathways and transcription factors) and extrinsic factors (e.g., hormones and physical stress). Muscle stem cells, also called satellite cells, have been suggested to play a role in this process of fiber type determination. Following an injury, satellite cells become activated, undergo proliferation, and exit cell cycle to self-renew or differentiate into myoblasts. These myoblasts can either fuse with each other or with damaged muscle fibersto regenerate the injured muscle. Our laboratory recently shows that resolvins, lipid mediators derived from omega-3 fatty acids, promote the differentiation and fusion of satellite cells from a dystrophic mouse model. Despite these findings, their impact on muscle phenotype determination remains unknown. Therefore, the objective of our study was to investigate the influence of lipid mediators on muscle phenotype during myogenesis. In vitro experiments were conducted using immunofluorescence and RNAseq analysis to examine the effects of resolvins on the phenotype of myotubes and cell signaling during myogenesis. In vivo experiments involved measuring in situ strength and utilizing immunofluorescence techniques to evaluate the effects of resolvins on contractile properties and muscle fiber phenotype at both the early and late stages of muscle regeneration. We wrote a manuscript presenting all the results obtained. Our in vitro experiments demonstrated that resolvin-D2 (RvD2) enhances the formation of embryonic myotubes, thereby promoting the process of myogenesis. RvD2 also promotes the development of slow myotubes. Moreover, KD107, an agonist of the resolvin-D2 receptor GPR18, activates AMPK, PPAR and mTOR pathways which enhance the oxidative capacity and the synthesis of contractile protein. In vivo, our finding reveals that the local administration of RvD2 enhances muscle strength, facilitates the formation of the characteristic fiber type in slow (type I) and fast (type IIB) muscle, and increase their size. The systemic administration of RvD2 also promotes the fiber type switch in favor of the slow phenotype. Resolvin-D2 shows significant potential as a therapeutic intervention for muscle diseases. It could mitigate the loss of myogenic capacity, muscle strength, alterations in muscle fiber typing, and atrophy, which are frequently observed in numerous myopathies

Résumé : L’hypertension artérielle pulmonaire (HTAP) est une maladie rare dans laquelle les artères pulmonaires subissent un important remodelage et un recrutement de cellules proinflammatoires dans la paroi. Généralement les patients atteints sont diagnostiqués tardivement. Or, à son stade avancé, l’HTAP est irréversible. Aucun traitement actuel ne permet de soigner définitivement les patients. Nous émettons l’hypothèse que l’inflammation pourrait être à l’origine de plusieurs dysfonctions cellulaires et que sa résolution pourrait probablement prévenir l’HTAP. Deux modèles d’HTAP expérimentale ont été utilisés. Le premier met en jeu des artères pulmonaires humaines (APH) cultivées in vitro et rendues hyperréactives et sur lesquelles les effets des Résolvines D1 et E1 ainsi que leurs précurseurs respectifs ont été évalués. Le deuxième est un modèle in vivo bien connu de rats hypertendus à la monocrotaline (MCT) sur lesquels le rôle curatif du MAG-DHA (un monoacylglycéride de l’acide docosahexaénoïque) a été étudié quand l’HTAP est déjà installée. Les résultats démontrent que 24 h de prétraitement in vitro avec le TNFalpha, l’IL-6 ou l’ET-1 augmente la réactivité pharmaco-mécanique et la sensibilité au Ca2+ des APH stimulées avec 80 mM de KCl, 1 µM de 5-hydroxytryptamine (5-HT), 30 nM U-46619 et 1 µM de PDBu. En revanche, 300 nM de RvD1 ou de RvE1 ainsi que 1µM de MAG-DHA ou de MAG-EPA (monoacylglycéride de l’acide éicosapentaénoïque) renversent les effets induits par les traitements proinflammatoires et vasoconstricteurs. De plus, in vivo, il a été démontré que 7 jours de traitement avec le MAG-DHA peuvent permettre de résoudre le statut inflammatoire dans un modèle d’hypertension pulmonaire induite par la MCT chez le rat. Dans les deux modèles, l’expression de biomarqueurs inflammatoires (TNFalpha, COX-2, STAT3) et les niveaux de phosphorylation des activateurs nucléaires du remodelage tels que c-Fos, c-Jun, NFkB et MMP9 étaient augmentées par les traitements proinflammatoires. Cependant, les expériences d’immuno-buvardage montrent que la RvD1, la RvE1 et leurs précurseurs normalisaient les niveaux de détections de ces marqueurs de l’inflammation. En conclusion, l’ensemble des données montrent que les Résolvines D1 et E1 ainsi que leurs précurseurs sont des candidats efficaces pour résoudre l’inflammation induite pour prévenir l’hyperréactivité pharmacologique des artères pulmonaires. / Abstract : Pulmonary hypertension (PH) is rare disease characterized by an important remodelling and proinflammatory cells recruitement into the pulmonary artery wall. Because of the late diagnostic, the patient care is often performed when PH is at its irreversible and most severe stage. Unfortunatly, none of the actual treatments are able to cure the patients for the long term. We hypothesize that inflammation could be a major event at the origin of all the other cellular dysfunctions that characterise PH. Resolvins; metabolites from Oméga-3 could resolve inflammation and potentially prevent or reverse PH. In the present study, two models of PH have been used. The first one is an in vitro model involving cultured human pulmonary arteries (HPA) in which inflammatory or hyperreactive conditions have been induced to evaluate the effects of Resolvin D1 and E1 and their precursors. The second model is a well-known in vivo model of monocrotalineinduced PH in rats, treated with MAG-DHA (monoacylglyceride form of docosahexaenoic acid) to evaluate the curative ability of this compound to resolve the disease at its severe stage. Results show that 24-h pre-treatment with TNFα, IL-6 or ET-1 increased the reactivity and Ca2+ sensitivity of HPA as revealed by agonist challenges with: 80 mM KCl, 1 μM 5- hydroxytryptamine (5-HT), 30 nM U-46619 and 1 μM PDBu. However, 300 nM RvD1 or RvE1, as well as 1 μM MAG-DHA or MAG-EPA (monoacylglyceride form of eicosapentaenoic acid) strongly reversed the over responsiveness induced by proinflammatory and hyperreactive treatments.Moreover, a 7-day treatment with MAG-DHA is able to resolve the inflammatory status in a rat model of monocrotaline-induced pulmonary hypertension. In both models, the inflammatory status enhanced the expression of inflammatory biomarkers (TNF-α, COX-2, STAT-3) as well as the detection of MMP9 and phosphorylated nuclear factors such as P-c-Fos, P-c-Jun and P-NF-κB involved in the activation of wall remodeling. Hence, RvD1, RvE1 and their precursors normalized the expression of these inflammatory biomarkers. In conclusion, Resolvin D1 and E1 and their respective precursors MAG-DHA and MAGEPA could inhibit inflammation status to prevent and potentially cure pulmonary hypertension.

Résumé : Dans les maladies respiratoires chroniques, les propriétés biochimiques et mécaniques des muscles lisses des voies respiratoires (MLVR) ont été analysées, mais les modes d’action des médiateurs lipidiques endogènes dérivés des oméga-3 (époxy- ou polyhydroxy- éicosanoïdes) restent à clarifier. Mon travail de recherche a pour but de caractériser le rôle potentiel de monoacyglycéride de l’acide éicosapentaénoϊque (MAG-EPA) et de monoacylglycéride de l’acide docosahexaénoϊque (MAG-DHA) ainsi que leurs métabolites (acide 17,18-époxyéicosatétraénoϊque : 17,18-EpETE, résolvine D1 : RvD1), sur le statut inflammatoire et l’activité contractile des voies respiratoires mises en culture organoϊde avec des cytokines pro-inflammatoires. Sur des trachées de cobayes (TC) natives précontractées au U-46619 (agoniste du récepteur thromboxane prostanoϊde), le 17,18-EpETE relaxe les tissus de manière plus importante que son précurseur, le MAG-EPA. Dans les TC mises en culture pendant 3 jours, les niveaux de TNF-α ont augmenté dans les fractions microsomales par rapport aux trachées natives. Sur ces tissues cultivés et traités avec 0.3 µM 17,18-EpETE, une réduction de la sensibilité au Ca2+ a été démontrée. De plus, une diminution de niveaux de détection des P-p65-NFκB, c-fos et c-Jun a été quantifiée en présence de 17,18-EpETE et des inhibiteurs de PKC ou Rho kinase lorsque les TC sont préalablement traités par 10 ng/ml TNF-α. Les cytokines pro-inflammatoires (IL-13 et TNF-α, etc…) jouent un rôle majeur dans la physiopathologie de l’asthme. Le projet de bronchioles humaines évalue l’effet de la RvD1 et de ses précurseurs (MAG-DHA, MAG-DPA et 17(S)-HpDoHE) sur le statut inflammatoire et la bronchoréactivité, in vitro. Dans les bronchioles stimulées par l’IL-13 pendant 48 h, le MAG-DHA ainsi que ces métabolites diminuent l’activation de la voie TNF-α/NFκB et la sensibilité au Ca2+ des tissus prétraités avec l’IL-13 vers des niveaux proches des conditions contrôles. Dans les bronchioles prétraitées par le TNF-α, l’inflammation et l’hypersensibilité au Ca2+ sont abolies par 1 µM MAG-DPA. De plus, l’aspirine combinée au MAG-oméga-3 potentialise les effets inhibiteurs de ce dernier sur l’inflammation et l’hyperréactivité bronchique induite par les cytokines, tout en régulant à la hausse les niveaux de détection du GPR-32 (le récepteur de RvD1). En conclusion, les dérivés des oméga-3 à longue chaîne pourraient résoudre l’inflammation et contrer les causes de l’hyperréactivité bronchique (HRB). / Abstract : In chronic respiratory diseases, the biochemical and mechanical properties of airway smooth muscle were analyzed, but the mode of action of omega-3 derivatives (epoxy or polyhydroxy-eicosanoids) remains to be clarified. My research work aims to characterize the potential role of eicosapentaenoic acid monoacyglyceride (MAG-EPA) and docosahexaenoic acid monoacylglyceride (MAGDHA) and their bioactive metabolites (17,18-epoxyeicosatetraenoic acid: 17 18-EpETE, resolvin D1: RvD1) on the inflammatory status and the contractile activity of organcultured airway explants with pro-inflammatory cytokines. On 30 nM U-46619 (Thromboxane prostanoid receptor agonist) pre-contracted fresh guinea pig trachea, 17,18 EpETE displays a greater ability than its precursor, MAG-EPA to relax airways. In 72-h-cultured tracheal rings, TNF-α levels increase in the microsomal fractions when compared to native trachea. In cultured and pre-treated tracheal rings with 0.3 µM 17,18-EpETE, the Ca2+ hypersensitivity is alleviated in comparaison to 3 day cultured tracheal rings. In addition, the detection levels of P-NFκB, c-fos and c-Jun were abolished in the presence of 17,18-EpETE and PKC or Rho kinase inhibitors in short term-TNF-α- incubated tracheal rings. Pro-inflammatory cytokines (IL-13, TNF-α, etc…) play a major role in asthma pathophysiology. The human bronchi project evaluates the effect of RvD1 and its precursors (MAG-DHA, MAG-DPA and 17 (S)-HpDoHE) on the inflammatory status and bronchial reactivity, in vitro. In IL-13 stimulated human bronchi for 48 h, the MAG-DHA and its metabolites decrease the activation of TNF-α / NFκB pathway and blunt the Ca2+ hypersensitivity triggered by IL-13. In TNF-α-pretreated human bronchi, airway inflammation and Ca2+ hypersensitivity are reversed by 1 µM MAG-DPA. Hence, aspirin combined with MAG-omega-3 potentiate the inhibitory effects of MAG-DHA on inflammation and bronchial hyperrresponsiveness triggered by pro-inflammatory cytokines, while upregulating the GPR-32 detection levels (RvD1 receptor). In conclusion, omega-3 derivatives could counteract the causes of airway hyperrresponsiveness (AHR).

No / Bioactive lipid mediators derived from polyunsaturated fatty acids (PUFA) and exhibit a range of tissue and cell-specific activities in many physiological and pathological processes. Electrospray tandem mass spectrometry coupled to liquid chromatography (LC/ESI-MS/MS) is a sensitive, versatile analytical methodology for the qualitative and quantitative analysis of lipid mediators. Here we present an LC/ESI-MS/MS assay for the simultaneous analysis of twenty mono- and poly-hydroxy fatty acid derivatives of linoleic, arachidonic, eicosapentaenoic and docosahexaenoic acids. The assay was linear over the concentration range 1-100 pg/¿L, whilst the limits of detection and quantitation were 10-20 and 20-50 pg respectively. The recovery of the extraction methodology varied from 76-122% depending on the metabolite. This system is useful for profiling a range of biochemically-related potent mediators including the newly discovered resolvins and protectins, and their precursor hydroxy-eicosapentaenoic and hydroxy-docosahexaenoic acids, and, consequently, advance our understanding of the role of PUFA in health and disease. / Wellcome Trust, British Heart Foundation