Omega-3 Fatty Acid Supplementation Reduces Intervertebral Disc Degeneration - PubMed (original) (raw)

Omega-3 Fatty Acid Supplementation Reduces Intervertebral Disc Degeneration

Zachary NaPier et al. Med Sci Monit. 2019.

Abstract

BACKGROUND Intervertebral disc (IVD) degeneration is a common cause of lower back pain, which carries substantial morbidity and economic cost. Omega-3 fatty acids (n-3 FA) are known to reduce inflammatory processes with a relatively benign side effect profile. This study aimed to investigate the effect of n-3 FA supplementation on IVD degeneration. MATERIAL AND METHODS Two non-contiguous lumbar discs of 12 Sprague Dawley rats were needle-punctured to induce disc degeneration. Post-surgery, rats were randomly assigned to either a daily n-3 FA diet (530 mg/kg/day of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in a 2: 1 ratio, administered in sucrose solution) or control diet (sucrose solution only), which was given for the duration of the study. After 1 month, blood serum arachidonic acid/eicosapentaenoic acid (AA/EPA) ratios were analyzed. After 2 months, micro-MRI (magnetic resonance imaging) analysis and histological staining of disc explants were performed to analyze the IVD. RESULTS A reduction of blood AA/EPA ratios from 40 to 20 was demonstrated after 1 month of daily supplementation with n-3 FA. Micro-MRI analysis showed an injury-induced reduction of IVD hydration, which was attenuated in rats receiving n-3 FA. Histological evaluation demonstrated the destruction of nucleus pulposus tissue in response to needle puncture injury, which was less severe in the n-3 FA diet group. CONCLUSIONS The results of this study suggest that n-3 FA dietary supplementation reduces systemic inflammation by lowering AA/EPA ratios in blood serum and has potential protective effects on the progression of spinal disc degeneration, as demonstrated by reduced needle injury-induced dehydration of intervertebral discs and reduced histological signs of IVD degeneration.

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Figures

Figure 1

Figure 1

Study design. Left is a radiographic image of a rat lumbar spine. The red arrows indicate the sites of disc needle injury. Middle is anterior retroperitoneal approach to the lumbar spine with exposure of 3 consecutive discs with 18-gauge needle puncture of middle IVD. Right is post-surgery: rats were assigned to either the control (oral sucrose solution) group or n-3 FA diet group. Diet supplementation occurred daily for the duration of the experiment. AA/EPA blood and micro-MRI analyses were performed in vivo. Post-surgery, histological analysis was performed. Sac – day of sacrifice; IVD – intervertebral disc; n-3 FA – omega-3 fatty acids; AA/EPA – arachidonic acid/eicosapentaenoic acid; MRI – magnetic resonance imaging.

Figure 2

Figure 2

Reduction in serum AA/EPA ratio between pre-surgical and 4 weeks post-surgical rats receiving n-3 FA diet. Graphs show AA/EPA ratios tested in blood samples that were obtained pre-surgery, and after surgery in the n-3 FA diet group versus control diet group. n=4 per group. AA/EPA – arachidonic acid/eicosapentaenoic acid; n-3 FA – omega-3 fatty acids; MRI – magnetic resonance imaging.

Figure 3

Figure 3

Injury-induced reduction in disc hydration is attenuated in rats receiving n-3 FA diet. (A) Representative T2-weighted and proton density images of the n-3 FA diet and control diet groups pre- and 1-month post-surgery. (B) Shows relative high signal NP area values of T2-weighted images. Data were normalized to pre-surgery/pre-diet scans. n=≥6 per group. n-3 FA – omega-3 fatty acids; NP – nucleus pulposus.

Figure 4

Figure 4

Destruction of nucleus pulposus in response to needle puncture injury is decreased in the n-3 FA diet group compared to control diet group. Shown are H&E staining of injured and uninjured rat lumbar discs from both groups at 2 months post-surgery. n-3 FA – omega-3 fatty acids; H&E – hematoxylin and eosin.

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