The process of inflammation is crucial in the body's fight against pathogenic invasion. Under certain circumstances however, inflammation can be lethal for example following sepsis. Sepsis occurs in 1-2% of hospital admissions and is secondary to the appearance of bacterial toxins in the circulation. The frequent progression of sepsis to septic shock results in hypotension and inadequate tissue perfusion. Septic shock carries a 45% risk of mortality making it the most common causes of death in intensive care units. In addition to acute inflammation, chronic and inappropriate inflammation occurs as a central component of autoimmune disease.

The American Autoimmune Related Disease Association lists over 50 different autoimmune diseases. Some of these are common such as multiple sclerosis, type 1 diabetes, Crohns disease and rheumatoid arthritis; some are very rare such as Stiff-man syndrome. The overproduction or inappropriate production of TNF-alpha has been implicated as having an important, often causative, role in both sepsis and autoimmune diseases. This has resulted in the development of pharmaceuticals able to reverse the overproduction of TNF-alpha, notably Infliximab and Etanercept which have been approved as treatments for Crohns disease and rheumatoid arthritis. In addition to these molecules, fish oil has been investigated in clinical trials as a natural regulator of TNF-alpha in the context of these diseases by a number of authors. The consensus opinion is that fish oil supplementation of the diet can be beneficial to sufferers of both IBD and rheumatoid arthritis. 

British researchers have extended our understanding of this field still further, demonstrating that single nucleotide polymorphisms in the TNF-alpha and beta genes can determine the effectiveness of fish oil as an anti-inflammatory agent. These researchers have patented the use of genotype testing to optimize the selection of patients that could benefit most from fish oil supplementation. The potential of such tests is immense given the safety of fish oil supplementation and it cost effectiveness compared to Infliximab and Etanercept. Partners are now being sought to develop the patent for clinical use.