The effect of N-eicosapentaenoyl ethanolamine on the regulation of cytokine synthesis by blood cells of patients with bronchial asthma in vitro

Introduction. Bronchial asthma is characterized by heterogeneity, multiple phenotypes, and varying clinical manifestations. Cytokines play a crucial role in the inflammatory response in asthma. The quantity, as well as the ratio of certain cytokines, determines the mechanism and type of inflammatory response in asthma, upon which the effectiveness of treatment of this disease depends. That is why the development of new methods of treating patients with asthma, aimed at correcting cytokine imbalance, is required. One of the promising substances is N-eicosapentaenoyl-ethanolamine (NAE-EPA), which exhibits anti-inflammatory properties by affecting cytokines, but remains poorly studied.Aim. To study the dose-dependent effect of N-eicosapentaenoyl-ethanolamine on the production of cytokines by peripheral blood cells, in vitro, in subjects with asthma.Materials and methods. The object of the study was whole blood, diluted 1:5 with culture medium of 15 patients with mild to moderate controlled asthma and 16 healthy subjects. The in vitro experiment was carried out in lipopolysaccharide-stimulated (LPS) blood samples (incubation with LPS at 37°C for 30 minutes). Then, the experimental substance N-acylethanolamine eicosapentaenoic acid (NAE EPA) was added in concentrations of 1.0; 5.0, and 10.0 µM and incubated at 37°C for 6 hours with gentle mixing. Cytokine levels (IL-2, IL-4, IL-6, IL-10, IL17A, TNF-α, and INF-γ) were studied by enzyme-linked immunoassay.Results. Analysis of the level of cytokines in patients with asthma showed that an increase in the plasma levels of IL-2, TNF-α, IL-6, and IL-17A is accompanied by a decrease in the level of regulatory IL-10. When NAE EPA was added at a dosage of 1 µM, no statistically significant changes were detected. Exposure to the experimental substance at a dose of 5 µM contributed to a decrease in IL-6 in the blood cells of patients by 19% (p ˂ 0.05). Exposure to NAE EPA at 10 µM produced the greatest number of statistically significant changes in cytokine levels. There was a decrease in IL-17A by 15% (p ˂ 0.05), IL-2 by 14% (p ˂ 0.05), IL-6 by 50% (p ˂ 0.01), and TNF-α by 10% (p ˂ 0.05) relative to values before exposure.Conclusion. N-eicosapentaenoyl ethanolamine shows potential as a regulator of pro- and anti-inflammatory cytokine synthesis in bronchial asthma with a predominant Th-17 type of immune response. The results obtained may contribute to the development of new treatment strategies for patients with asthma.