The Influence of Long-Chain Omega-3 Fatty Acids on Eccentric Exercise-Induced Delayed Muscle Soreness: Reported Outcomes Are Compromised by Study Design Issues

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Delayed onset muscle soreness (DOMS) following eccentric exercise is associated with increased inflammation which can be debilitating. Incorporation of long-chain omega-3 polyunsaturated fatty acids (LC n-3 PUFA), eicosapentaenoic acid, and docosahexaenoic acid into membrane phospholipids provides anti-inflammatory, proresolving, and analgesic effects. This systematic review aims to examine both the quality of studies and the evidence for LC n-3 PUFA in the attenuation of DOMS and inflammation following eccentric exercise, both which of course are empirically linked. The Scopus, Embase, and Web of Science electronic databases were searched to identify studies that supplemented fish oil for a duration of ≥7 days, which included DOMS outcomes following an eccentric exercise protocol. Fifteen (n = 15) studies met inclusion criteria. Eccentric exercise protocols varied from single to multijoint activities. Risk of bias, assessed using either the Cochrane Collaboration tool or the Risk of Bias in Nonrandomized Studies of Interventions tool, was judged as “unclear” or “medium,” respectively, for the majority of outcomes. Furthermore, a custom 5-point quality assessment scale demonstrated that only one (n = 1) study satisfied current recommendations for investigating LC n-3 PUFA. In combination, this highlights widespread inappropriate design protocols among studies investigating the role of LC n-3 PUFA in eccentric exercise. Notwithstanding these issues, LC n-3 PUFA supplementation appears to have favorable effects on eccentric exercise-induced DOMS and inflammatory markers. However, the optimal LC n-3 PUFA supplemental dose, duration, and fatty acid composition will only become clear when study design issues are rectified and underpinned by appropriate hypotheses.

The authors are with Graduate Medicine, School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia; and the Centre for Medical and Exercise Physiology, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia. Peoples is also with the Centre for Human and Applied Physiology, School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia.

Peoples (peoples@uow.edu.au) is the corresponding author.
  • Bagga, D., Wang, L., Farias-Eisner, R., Glaspy, J.A., & Reddy, S.T. (2003). Differential effects of prostaglandin derived from omega-6 and omega-3 polyunsaturated fatty acids on COX-2 expression and IL-6 secretion. Proceedings of the National Academy of Sciences of the United States of America, 100(4), 17511756. doi:10.1073/pnas.0334211100

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Betts, J.A., Gonzalez, J.T., Burke, L.M., Close, G.L., Garthe, I., James, L.J., & Atkinson, G. (2020). PRESENT 2020: Text expanding on the checklist for proper reporting of evidence in sport and exercise nutrition trials. International Journal of Sport Nutrition and Exercise Metabolism, 30(1), 2–13. doi:10.1123/ijsnem.2019-0326

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bongiovanni, T., Genovesi, F., Nemmer, M., Carling, C., Alberti, G., & Howatson, G. (2020). Nutritional interventions for reducing the signs and symptoms of exercise-induced muscle damage and accelerate recovery in athletes: Current knowledge, practical application and future perspectives. European Journal of Applied Physiology, 120(9), 19651996. doi:10.1007/s00421-020-04432-3

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Cao, J., Schwichtenberg, K.A., Hanson, N.Q., & Tsai, M.Y. (2006). Incorporation and clearance of omega-3 fatty acids in erythrocyte membranes and plasma phospholipids. Clinical Chemistry, 52(12), 22652272. doi:10.1373/clinchem.2006.072322

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Chen, H.Y., Chen, Y.C., Tung, K., Chao, H.H., & Wang, H.S. (2019). Effects of caffeine and sex on muscle performance and delayed-onset muscle soreness after exercise-induced muscle damage: A double-blind randomized trial. Journal of Applied Physiology, 127(3), 798805. doi:10.1152/japplphysiol.01108.2018

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Child, R.B., Saxton, J.M., & Donnelly, A.E. (1998). Comparison of eccentric knee extensor muscle actions at two muscle lengths on indices of damage and angle-specific force production in humans. Journal of Sports Sciences, 16(4), 301308. doi:10.1080/02640419808559358

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Clarkson, P.M., & Hubal, M.J. (2002). Exercise-induced muscle damage in humans. American Journal of Physical Medicine & Rehabilitation, 81(11 Suppl.), S52S69. doi:10.1097/00002060-200211001-00007

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Corder, K.E., Newsham, K.R., McDaniel, J.L., Ezekiel, U.R., & Weiss, E.P. (2016). Effects of short-term docosahexaenoic acid supplementation on markers of inflammation after eccentric strength exercise in women. Journal of Sports Science and Medicine, 15(1), 176183.

    • Search Google Scholar
    • Export Citation
  • de Pablo, M.A., & Alvarez de Cienfuegos, G. (2000). Modulatory effects of dietary lipids on immune system functions. Immunology & Cell Biology, 78(1), 3139. doi:10.1046/j.1440-1711.2000.00875.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • DiLorenzo, F.M., Drager, C.J., & Rankin, J.W. (2014). Docosahexaenoic acid affects markers of inflammation and muscle damage after eccentric exercise. Journal of Strength & Conditioning Research, 28(10), 27682774. doi:10.1519/JSC.0000000000000617

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Eston, R.G., Mickleborough, J., & Baltzopoulos, V. (1995). Eccentric activation and muscle damage: Biomechanical and physiological considerations during downhill running. British Journal of Sports Medicine, 29(2), 8994. doi:10.1136/bjsm.29.2.89

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Fedewa, M.V., Spencer, S.O., Williams, T.D., Becker, Z.E., & Fuqua, C.A. (2019). Effect of branched-chain amino acid supplementation on muscle soreness following exercise: A meta-analysis. International Journal for Vitamin and Nutrition Research, 89(5–6), 348356. doi:10.1024/0300-9831/a000543

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Gray, P., Chappell, A., Jenkinson, A.M., Thies, F., & Gray, S.R. (2014). Fish oil supplementation reduces markers of oxidative stress but not muscle soreness after eccentric exercise. International Journal of Sport Nutrition and Exercise Metabolism, 24(2), 206214. doi:10.1123/ijsnem.2013-0081

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Harris, W.S., Sands, S.A., Windsor, S.L., Ali, H.A., Stevens, T.L., Magalski, A., … Borkon, A.M. (2004). Omega-3 fatty acids in cardiac biopsies from heart transplantation patients: Correlation with erythrocytes and response to supplementation. Circulation, 110(12), 16451649. doi:10.1161/01.CIR.0000142292.10048.B2

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Harris, W.S., & Thomas, R.M. (2010). Biological variability of blood omega-3 biomarkers. Clinical Biochemistry, 43(3), 338340. doi:10.1016/j.clinbiochem.2009.08.016

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Harris, W.S., Varvel, S.A., Pottala, J.V., Warnick, G.R., & McConnell, J.P. (2013). Comparative effects of an acute dose of fish oil on omega-3 fatty acid levels in red blood cells versus plasma: Implications for clinical utility. Journal of Clinical Lipidology, 7(5), 433440. doi:10.1016/j.jacl.2013.05.001

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Henry, R., Peoples, G.E., & McLennan, P.L. (2015). Muscle fatigue resistance in the rat hindlimb in vivo from low dietary intakes of tuna fish oil that selectively increase phospholipid n-3 docosahexaenoic acid according to muscle fibre type. British Journal of Nutrition, 114(6), 873884. doi:10.1017/S0007114515002512

    • Crossref
    • Search Google Scholar
    • Export Citation
  • James, M.J., Sullivan, T.R., Metcalf, R.G., & Cleland, L.G. (2014). Pitfalls in the use of randomised controlled trials for fish oil studies with cardiac patients. British Journal of Nutrition, 112(5), 812820. doi:10.1017/S0007114514001408

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Jones, D.A., Newham, D.J., Round, J.M., & Tolfree, S.E. (1986). Experimental human muscle damage: Morphological changes in relation to other indices of damage. Journal of Physiology, 375(1), 435448. doi:10.1113/jphysiol.1986.sp016126

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Jouris, K.B., McDaniel, J.L., & Weiss, E.P. (2011). The effect of omega-3 fatty acid supplementation on the inflammatory response to eccentric strength exercise. Journal of Sports Science and Medicine, 10(3), 432438.

    • Search Google Scholar
    • Export Citation
  • Kim, J., & Lee, J. (2014). A review of nutritional intervention on delayed onset muscle soreness. Part I. Journal of Exercise Rehabilitation, 10(6), 349356. doi:10.12965/jer.140179

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kleiner, A.C., Cladis, D.P., & Santerre, C.R. (2015). A comparison of actual versus stated label amounts of EPA and DHA in commercial omega-3 dietary supplements in the United States. Journal of the Science of Food and Agriculture, 95(6), 12601267. doi:10.1002/jsfa.6816

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lembke, P., Capodice, J., Hebert, K., & Swenson, T. (2014). Influence of omega-3 (N3) index on performance and wellbeing in young adults after heavy eccentric exercise. Journal of Sports Science and Medicine, 13(1), 151156.

    • Search Google Scholar
    • Export Citation
  • Lenn, J., Uhl, T., Mattacola, C., Boissonneault, G., Yates, J., Ibrahim, W., & Bruckner, G. (2002). The effects of fish oil and isoflavones on delayed onset muscle soreness. Medicine & Science in Sports & Exercise, 34(10), 16051613. doi:10.1097/00005768-200210000-00012

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lima-Garcia, J.F., Dutra, R.C., da Silva, K., Motta, E.M., Campos, M.M., & Calixto, J.B. (2011). The precursor of resolvin D series and aspirin-triggered resolvin D1 display anti-hyperalgesic properties in adjuvant-induced arthritis in rats. British Journal of Pharmacology, 164(2), 278293. doi:10.1111/j.1476-5381.2011.01345.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Macartney, M.J., Peoples, G.E., Treweek, T.M., & McLennan, P.L. (2019). Docosahexaenoic acid varies in rat skeletal muscle membranes according to fibre type and provision of dietary fish oil. Prostaglandins, Leukotrienes & Essential Fatty Acids, 151, 3744. doi:10.1016/j.plefa.2019.08.006

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Markworth, J.F., Vella, L., Lingard, B.S., Tull, D.L., Rupasinghe, T.W., Sinclair, A.J., … Cameron-Smith, D. (2013). Human inflammatory and resolving lipid mediator responses to resistance exercise and ibuprofen treatment. American Journal of Physiology. Regulatory, Integrative and Comparative Physiology, 305(11), R1281R1296. doi:10.1152/ajpregu.00128.2013

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Massaro, M., Habib, A., Lubrano, L., Del Turco, S., Lazzerini, G., Bourcier, T., … De Caterina, R. (2006). The omega-3 fatty acid docosahexaenoate attenuates endothelial cyclooxygenase-2 induction through both NADP(H) oxidase and PKC epsilon inhibition. Proceedings of the National Academy of Sciences of the United States of America, 103(41), 1518415189. doi:10.1073/pnas.0510086103

    • Crossref
    • Search Google Scholar
    • Export Citation
  • McKinley-Barnard, S.K., Andre, T.L., Gann, J.J., Hwang, P.S., & Willoughby, D.S. (2018). Effectiveness of fish oil supplementation in attenuating exercise-induced muscle damage in women during midfollicular and midluteal menstrual phases. Journal of Strength & Conditioning Research, 32(6), 16011612. doi:10.1519/JSC.0000000000002247

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Metcalf, R.G., James, M.J., Gibson, R.A., Edwards, J.R., Stubberfield, J., Stuklis, R., … Cleland, L.G. (2007). Effects of fish-oil supplementation on myocardial fatty acids in humans. American Journal of Clinical Nutrition, 85(5), 12221228. doi:10.1093/ajcn/85.5.1222

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Mizumura, K., & Taguchi, T. (2016). Delayed onset muscle soreness: Involvement of neurotrophic factors. Journal of Physiological Sciences, 66(1), 4352. doi:10.1007/s12576-015-0397-0

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Morelli, K.M., Brown, L.B., & Warren, G.L. (2018). Effect of NSAIDs on recovery from acute skeletal muscle injury: A systematic review and meta-analysis. American Journal of Sports Medicine, 46(1), 224233. doi:10.1177/0363546517697957

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Murase, S., Terazawa, E., Hirate, K., Yamanaka, H., Kanda, H., Noguchi, K., … Mizumura, K. (2013). Upregulated glial cell line-derived neurotrophic factor through cyclooxygenase-2 activation in the muscle is required for mechanical hyperalgesia after exercise in rats. Journal of Physiology, 591(12), 30353048. doi:10.1113/jphysiol.2012.249235

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Nosaka, K., & Newton, M. (2002). Difference in the magnitude of muscle damage between maximal and submaximal eccentric loading. Journal of Strength & Conditioning Research, 16(2), 202208. doi:10.1519/00124278-200205000-00006

    • Search Google Scholar
    • Export Citation
  • Ochi, E., Tsuchiya, Y., & Yanagimoto, K. (2017). Effect of eicosapentaenoic acids-rich fish oil supplementation on motor nerve function after eccentric contractions. Journal of the International Society of Sports Nutrition, 14(1), 23. doi:10.1186/s12970-017-0176-9

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ota, H., Katanosaka, K., Murase, S., Furuyashiki, T., Narumiya, S., & Mizumura, K. (2018). EP2 receptor plays pivotal roles in generating mechanical hyperalgesia after lengthening contractions. Scandinavian Journal of Medicine & Science in Sports, 28(3), 826833. doi:10.1111/sms.12954

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Peñailillo, L., Aedo, C., Cartagena, M., Contreras, A., Reyes, A., Ramirez-Campillo, R., … Zbinden-Foncea, H. (2020). Effects of eccentric cycling performed at long vs. short muscle lengths on heart rate, rate perceived effort, and muscle damage markers. Journal of Strength & Conditioning Research, 34(10), 28952902. doi:10.1519/JSC.0000000000002732

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Peoples, G.E., & McLennan, P.L. (2010). Dietary fish oil reduces skeletal muscle oxygen consumption, provides fatigue resistance and improves contractile recovery in the rat in vivo hindlimb. British Journal of Nutrition, 104(12), 17711779. doi:10.1017/S0007114510002928

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Philpott, J.D., Donnelly, C., Walshe, I.H., MacKinley, E.E., Dick, J., Galloway, S.D.R., … Witard, O.C. (2018). Adding fish oil to whey protein, leucine, and carbohydrate over a six-week supplementation period attenuates muscle soreness following eccentric exercise in competitive soccer players. International Journal of Sport Nutrition and Exercise Metabolism, 28(1), 2636. doi:10.1123/ijsnem.2017-0161

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ramos-Campo, D.J., Ávila-Gandía, V., López-Román, F.J., Miñarro, J., Contreras, C., Soto-Méndez, F., … Luque-Rubia, A.J. (2020). Supplementation of re-esterified docosahexaenoic and eicosapentaenoic acids reduce inflammatory and muscle damage markers after exercise in endurance athletes: A randomized, controlled crossover trial. Nutrients, 12(3), 719. doi:10.3390/nu12030719

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Schwab, J.M., Chiang, N., Arita, M., & Serhan, C.N. (2007). Resolvin E1 and protectin D1 activate inflammation-resolution programmes. Nature, 447(7146), 869874. doi:10.1038/nature05877

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Sekikawa, A., Cui, C., Sugiyama, D., Fabio, A., Harris, W.S., & Zhang, X. (2019). Effect of high-dose marine omega-3 fatty acids on atherosclerosis: A systematic review and meta-analysis of randomized clinical trials. Nutrients, 11(11), 2599. doi:10.3390/nu11112599

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Senftleber, N.K., Nielsen, S.M., Andersen, J.R., Bliddal, H., Tarp, S., Lauritzen, L., … Christensen, R. (2017). Marine oil supplements for arthritis pain: A systematic review and meta-analysis of randomized trials. Nutrients, 9(1), 42. doi:10.3390/nu9010042

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Serhan, C.N., & Levy, B.D. (2018). Resolvins in inflammation: Emergence of the pro-resolving superfamily of mediators. Journal of Clinical Investigation, 128(7), 26572669. doi:10.1172/JCI97943

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Slee, E.L., McLennan, P.L., Owen, A.J., & Theiss, M.L. (2010). Low dietary fish-oil threshold for myocardial membrane n-3 PUFA enrichment independent of n-6 PUFA intake in rats. Journal of Lipid Research, 51(7), 18411848. doi:10.1194/jlr.M004069

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Smith, G.I., Atherton, P., Reeds, D.N., Mohammed, B.S., Rankin, D., Rennie, M.J., & Mittendorfer, B. (2011). Dietary omega-3 fatty acid supplementation increases the rate of muscle protein synthesis in older adults: A randomized controlled trial. American Journal of Clinical Nutrition, 93(2), 402412. doi:10.3945/ajcn.110.005611

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Stark, K.D., Aristizabal Henao, J.J., Metherel, A.H., & Pilote, L. (2016). Translating plasma and whole blood fatty acid compositional data into the sum of eicosapentaenoic and docosahexaenoic acid in erythrocytes. Prostaglandins, Leukotrienes & Essential Fatty Acids, 104, 110. doi:10.1016/j.plefa.2015.11.002

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Talag, T.S. (1973). Residual muscular soreness as influenced by concentric, eccentric, and static contractions. Research Quarterly, 44(4), 458469.

    • Search Google Scholar
    • Export Citation
  • Tartibian, B., Maleki, B.H., & Abbasi, A. (2009). The effects of ingestion of omega-3 fatty acids on perceived pain and external symptoms of delayed onset muscle soreness in untrained men. Clinical Journal of Sport Medicine, 19(2), 115119. doi:10.1097/JSM.0b013e31819b51b3

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Tartibian, B., Maleki, B.H., & Abbasi, A. (2011). Omega-3 fatty acids supplementation attenuates inflammatory markers after eccentric exercise in untrained men. Clinical Journal of Sport Medicine, 21(2), 131137. doi:10.1097/JSM.0b013e31820f8c2f

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Tinsley, G.M., Gann, J.J., Huber, S.R., Andre, T.L., La Bounty, P.M., Bowden, R.G., … Grandjean, P.W. (2017). Effects of fish oil supplementation on postresistance exercise muscle soreness. Journal of Dietary Supplements, 14(1), 89100. doi:10.1080/19390211.2016.1205701

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Trebble, T.M., Wootton, S.A., Miles, E.A., Mullee, M., Arden, N.K., Ballinger, A.B., … Calder, P.C. (2003). Prostaglandin E2 production and T cell function after fish-oil supplementation: Response to antioxidant cosupplementation. American Journal of Clinical Nutrition, 78(3), 376382. doi:10.1093/ajcn/78.3.376

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Tsuchiya, Y., Yanagimoto, K., Nakazato, K., Hayamizu, K., & Ochi, E. (2016). Eicosapentaenoic and docosahexaenoic acids-rich fish oil supplementation attenuates strength loss and limited joint range of motion after eccentric contractions: A randomized, double-blind, placebo-controlled, parallel-group trial. European Journal of Applied Physiology, 116(6), 11791188. doi:10.1007/s00421-016-3373-3

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Tsuchiya, Y., Yanagimoto, K., Ueda, H., & Ochi, E. (2019). Supplementation of eicosapentaenoic acid-rich fish oil attenuates muscle stiffness after eccentric contractions of human elbow flexors. Journal of the International Society of Sports Nutrition, 16(1), 19. doi:10.1186/s12970-019-0283-x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Vijayan, K., Thompson, J.L., Norenberg, K.M., Fitts, R.H., & Riley, D.A. (2001). Fiber-type susceptibility to eccentric contraction-induced damage of hindlimb-unloaded rat AL muscles. Journal of Applied Physiology, 90(3), 770776. doi:10.1152/jappl.2001.90.3.770

    • Crossref
    • Search Google Scholar
    • Export Citation
  • von Schacky, C., Fischer, S., & Weber, P.C. (1985). Long-term effects of dietary marine omega-3 fatty acids upon plasma and cellular lipids, platelet function, and eicosanoid formation in humans. Journal of Clinical Investigation, 76(4), 16261631. doi:10.1172/JCI112147

    • Crossref
    • Search Google Scholar
    • Export Citation
  • von Schacky, C., Kiefl, R., Jendraschak, E., & Kaminski, W.E. (1993). n-3 Fatty acids and cysteinyl-leukotriene formation in humans in vitro, ex vivo, and in vivo. Journal of Laboratory and Clinical Medicine, 121(2), 302309.

    • Search Google Scholar
    • Export Citation
  • Wada, M., DeLong, C.J., Hong, Y.H., Rieke, C.J., Song, I., Sidhu, R.S., … Smith, W.L. (2007). Enzymes and receptors of prostaglandin pathways with arachidonic acid-derived versus eicosapentaenoic acid-derived substrates and products. Journal of Biological Chemistry, 282(31), 2225422266. doi:10.1074/jbc.M703169200

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Wiewelhove, T., Fernandez-Fernandez, J., Raeder, C., Kappenstein, J., Meyer, T., Kellmann, M., … Ferrauti, A. (2016). Acute responses and muscle damage in different high-intensity interval running protocols. Journal of Sports Medicine and Physical Fitness, 56(5), 606615.

    • Search Google Scholar
    • Export Citation
  • Xin, W., Wei, W., & Li, X. (2012). Effects of fish oil supplementation on inflammatory markers in chronic heart failure: A meta-analysis of randomized controlled trials. BMC Cardiovasc Disord, 12(1), 77. doi:10.1186/1471-2261-12-77

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Xu, Z.Z., & Ji, R.R. (2011). Resolvins are potent analgesics for arthritic pain. British Journal of Pharmacology, 164(2), 274277. doi:10.1111/j.1476-5381.2011.01348.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Xu, Z.Z., Zhang, L., Liu, T., Park, J.Y., Berta, T., Yang, R., … Ji, R.R. (2010). Resolvins RvE1 and RvD1 attenuate inflammatory pain via central and peripheral actions. Nature Medicine, 16(5), 592597, 591p following 597. doi:10.1038/nm.2123

    • Crossref
    • Search Google Scholar
    • Export Citation
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