ABSTRACT
BACKGROUND: Bioactive lipid mediators play a crucial role during infection. Previously, we showed the expression level of FAAH mRNA in septic patients was lower than in healthy controls. CASE PRESENTATION: Four patients with a Sequential Organ Failure Assessment (SOFA) score of <7 recovered from sepsis. One patient with SOFA score of 12 on day 7 died on day 21. In the fatal case, eicosapentaenoic acid, docosahexaenoic acid, arachidonic acid, and linoleic acid-derived lipid mediators, including 9-hydroxyoctadecadienoic acid (9-HODE), 13-HODE, 9,10-dihydroxy-12-octadecenoic acid (9,10-DiHOME), and 12,13-DiHOME, were elevated on day 1. Increase in anti-inflammatory prostaglandin E1 ethanolamide together with persistently lower transcription level of FAAH mRNA was detected on day 7 in the fatal case. CONCLUSION: Lipidomic analysis on day 1 revealed elevated linoleic acid metabolites, whereas on day 7, elevated prostaglandin E1 ethanolamide and low level of FAAH mRNA transcription were observed in the fatal case of sepsis.