There are two major inflammation pathways relevant to pain in osteoarthritis (OA). These are the cyclooxygenase pathways (COX-1 and COX-2) and the lipoxygenase pathway, which can be separated into 3-arms (15-LOX, 12-LOX and 5-LOX) of which the 5-LOX pathway is the best studied for OA.
COX and LOX pathways are inflammatory cascades that are initiated in ordinary cells from the lipid content that makes up the cellular membranes. Initiation and control of the inflammatory process are complex and governed by an array of biomolecular mechanisms. One important pro-inflammatory mechanism is associated closely with the cell-membrane-bound fatty acid arachidonic acid, which becomes converted into other compounds in the body that are potent pro-inflammatory substances. These pathways are shown in Figure 1.
The composition of the cellular fatty acids within cells is an area of particular interest when looking at the effects of dietary or supplemental fatty acids in the body (i.e. PCSO-524®). The composition can directly influence inflammatory processes in the body. In fact, research is now suggesting that fatty acids within the diet can alter OA risk and severity 15.

