Helping a patient resolve a chronic inflammatory condition is one of the biggest challenges a holistic practitioner faces. Even when patients are very compliant with dietary and lifestyle changes, and take all the recommended supplements and medications, inflammation can stubbornly persist.

We know now that resolving inflammation is not a passive process. Rather, it’s complex and highly active and can sometimes happen slowly or even stall. Inflammation can linger long after the acute phase of the injury or illness has passed.

Without resolution, the body never truly returns to homeostasis — inflammation becomes chronic.

A super-family of naturally occurring lipid mediators called specialized pro-resolving mediators (SPMs) plays a crucial role in switching off the inflammatory response.

SPMs don’t block the initial inflammation — inflammation is a desirable natural response to injury and illness. Instead, when the immune response has served its purpose, SPMs down-regulate the process to resolve the inflammation.

Produced in the tissues around the affected area, SPMs function as “resolution agonists” targeting the immune cells that mediate the inflammatory response. By binding to specific cellular receptors, particularly the types known as “G-protein coupled receptors,” SPMs modify cell behavior to promote resolution.

The SPMs mediators — lipoxins, resolvins, protectins, and maresins — are derived from arachidonic acid and omega-3 fatty acids.

Arachidonic acid is often seen as an undesirable pro-inflammatory metabolite of omega-6 fatty acid. But as in many other aspects of the immune system, push and pull both have their place.

SPMs in effect signal the immune system to stop actively responding and instead to accelerate the return to homeostasis.

SPMs play a unique role in helping the body finally shut down the immune response, inhibit additional inflammation, clear away the damaging byproducts of the inflammatory process, and aid tissue remodeling.

SPMs can facilitate the resolution even of prolonged or chronic inflammation. And once the SPMs have done their job, the body naturally breaks them down and eliminates them.

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