Clinical Benefits of n-3 PUFA and ɤ-Linolenic Acid in Patients with Rheumatoid Arthritis (original) (raw)
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Lipids in Health and Disease, 2011
Background and aim Marine n-3 fatty acids and γ-linolenic acid both have anti-inflammatory effects and may be useful to help treat inflammatory diseases. The effects of these alone or combined were examined in patients with arthritis in a randomized controlled trial. Design Patients with rheumatoid arthritis or psoriatic arthritis were randomized into four groups in a double-blind, placebo-controlled parallel designed study. Patients received the respective capsules (1: 3.0 g n-3 LC-PUFA/d; 2: 3.2 g γ-linolenic acid/d; 3: 1.6 g n-3 LC-PUFA + 1.8 g γ-linolenic acid/d; 4: 3.0 g olive oil) for a twelve week period. Clinical status was evaluated and blood samples were taken at the beginning and at the end of the period. Differences before and after intervention were tested with paired t-test or with Wilcoxon test for non-normal data distribution. Results 60 patients (54 rheumatoid arthritis, 6 psoriatic arthritis) were randomised, 47 finished per protocol. In group 1, the ratio of arach...
The Journal of Nutritional Biochemistry, 2013
Background: Type 2 diabetes mellitus (T2DM) is accompanied by chronic low-grade inflammation, with an imbalance in the secretion of adipokines and, worsening insulin resistance. Supplementation with n-3 PUFA in T2DM decreases inflammatory markers, the purpose of the study was to investigate the effect of n-3 PUFA supplementation on adipokines, metabolic control, and lipid profile in T2DM Mexican adults. Methods: In a randomized, single-blind, placebo-controlled pilot study, 54 patients with T2DM received 520 mg of DHA + EPA-enriched fish-oil (FOG) or a placebo (PG) daily. Baseline and 24-week anthropometric and biochemical measurements included glucose, insulin, glycosylated hemoglobin (Hb1Ac), leptin, adiponectin, resistin, and lipid profile; n-3 PUFA intake was calculated in g/day. Results: Waist circumference and blood glucose showed significant reductions in the FOG group (p = 0.001 and p = 0.011, respectively). Hb1Ac (p = 0.009 and p = 0.004), leptin (p < 0.000 and p < 0.000), and leptin/adiponectin ratio (p < 0.000 and p < 0.000) decreased significantly in both groups after 24 weeks (FOG and PG respectively). Serum resistin (FOG p < 0.000 and PG p = 0.001), insulin (FOG p < 0.000 and PG p < 0.000), and HOMA-IR (FOG p = 0.000 and PG p < 0.000) increased significantly in both groups. FOG had an overall improvement in the lipid profile with a significant decrease in triacylgycerols (p = 0.002) and atherogenic index (p = 0.031); in contrast, the PG group had increased total cholesterol (p < 0.000), non-HDL cholesterol (p < 0.000), and atherogenic index (p = 0.017). Conclusions: We found a beneficial effect of n-3 PUFA supplementation on waist circumference, glucose, Hb1Ac, leptin, leptin/adiponectin ratio, and lipid profile, without significant changes in adiponectin, and increases in resistin, insulin, and HOMA-IR in both groups.
Polyunsaturated fatty acids and rheumatoid arthritis
Current Opinion in Clinical Nutrition and Metabolic Care, 2001
The n-3 polyunsaturated fatty (PUFA) acids and among them the n-3 PUFAs from fish oil -eicosapentaenoic acid and docosahexaenoic acid -own potent immunomodulatory potential. This can be beneficially utilized in cardiovascular disease or depression as well as in rheumatoid arthritis. A commonly accepted opinion about the minimum dosage to gain a therapeutic effect has not been formed yet. In order to achieve an amelioration of symptoms in RA the concluding recommendation is to consume dietary supplements containing three to six gram n-3 fatty acids daily for > 12 weeks. Following these suggestions patients taking dietary supplements of fish oil show improvements in clinical parameters including the number of tender joints, the duration of morning stiffness as well as the patient´s evaluation of global arthritis activity. Finally, the intake of n-3 PUFAs can only be recommended as an add-on therapy and must not replace the standard therapeutic regimes. A large research agenda remains to be worked on in order to be able to determine the role of therapeutic effects of n-3 PUFAs in RA.
Current Pharmaceutical Design, 2009
Inflammation is part of the normal host response to infection and injury. However, inappropriate inflammation contributes to several diseases, including inflammatory bowel disease (IBD) and rheumatoid arthritis (RA). Both conditions are characterized by the excessive production of inflammatory cytokines, arachidonic acid (AA)-derived eicosanoids, and other inflammatory agents (e.g., reactive oxygen species, adhesion molecules). By virtue of their antiinflammatory action,-3 polyunsaturated fatty acids (PUFA) may be beneficial in inflammatory diseases. A large body of evidence supports a protective effect of-3 PUFA in experimental animal and ex-vivo models of Crohn's disease (CD), Ulcerative colitis (UC) and Rheumatoid arthritis (RA). Although fish oil supplementation in patients with IBD results in-3 PUFA incorporation into gut mucosal tissue and modification of inflammatory mediator profiles, the evidence of clinical benefits of-3 PUFA is weak. On the other hand, more convincing data support the efficacy of-3 PUFA in reducing pain, number of tender joints, duration of morning stiffness, use of non-steroidal anti-inflammatory drugs and improving physical performance in RA patients. In both IBD and RA further clinical trials with large sample size are needed to clarify the efficacy of-3 PUFA as a treatment.
Dietary fatty acids and arthritis
Prostaglandins, Leukotrienes and Essential Fatty Acids (PLEFA), 2010
Musculoskeletal complaints are the second most frequent reason for medical treatments. Within these diseases rheumatoid arthritis (RA) and, especially, osteoarthritis (OA) are common. Although the causes of arthritis are multifactorial and not fully understood, clinical trials have generally shown benefit from dietary n-3 polyunsaturated fatty acids. This has usually been attributed to their anti-inflammatory properties. Recently we have used in vitro model systems to study the molecular mechanism(s) by which n-3 PUFAs may act to alleviate the symptoms of arthritis. These experiments showed that n-3 PUFAs reduce expression of cartilage-degrading proteinases, cyclooxygenase-2 and inflammatory cytokines. Eicosapentaenoic acid (EPA) was more effective than docosahexaenoic acid (DHA) or alphalinolenic acid. The data provide a scientific rationale for the consumption of n-3 fatty acids as part of a healthy diet and perhaps in treating arthritis.
Marine n-3 polyunsaturated fatty acids: Efficacy on inflammatory-based disorders
Life Sciences, 2020
Inflammation is a physiological response to injury, stimulating tissue repair and regeneration. However, the presence of peculiar individual conditions can negatively perturb the resolution phase eventually leading to a state of low-grade systemic chronic inflammation, characterized by tissue and organ damages and increased susceptibility to non-communicable disease. Marine n-3 polyunsaturated fatty acids (n-3 PUFAs), mainly eicosapentaenoic (EPA) and docosahexaenoic acid (DHA), are able to influence many aspects of this process. Experiments performed in various animal models of obesity, Alzheimer's disease and multiple sclerosis have demonstrated that n-3 PUFAs can modulate the basic mechanisms as well as the disease progression. This review describes the available data from experimental studies to the clinical trials. 2. Omega-3 polyunsaturated fatty acids (n-3 PUFAs) Marine n-3 fatty acids include long-chain polyunsaturated fatty acids (n-3 PUFAs), i.e. EPA, docosapentaenoic acid (DPA), and DHA, mainly found in fish and other seafood. They can also be synthesized from the precursor molecule α-linolenic acid (ALA), but the rate of conversion is very low compared with the dietary source. It is well known that they exert various biological actions through three main
Journal of Medical Biochemistry, 2014
SummaryBackground: This study investigated the effects of a nutritionally relevant intake of eicosapentaenoic (EPA) and docosahexaenoic (DHA) fatty acids derived from oily fish or a fish oil supplement on selected cardiovascular risk factors in average middle-aged individuals.Methods: Thirty-three participants were randomized to receive salmon (oily fish) providing 274 mg EPA + 671 mg DHA/day or a commercial fish oil supplement providing 396 mg EPA + 250 mg DHA/day in a cross-over trial over an 8-week period separated by a 6-month washout period. Blood samples were collected before and after each intervention and lipids, inflammatory and oxidative stress parameters were determined.Results: Plasma levels of EPA, DHA and total n-3 fatty acids significantly increased after both interventions. A decreasing trend in triglycerides was more pronounced with salmon than with the fish oil supplement, but the changes noticed were not significant. Although there were no relevant changes in infl...
Low-grade systemic infl ammation is at the base of the most chronic non-communicable diseases, which are reaching epidemic proportions worldwide. Key players in the regulation of infl ammation are n-6 and n-3 polyunsaturated fatty acids (PUFAs), in particular arachidonic acid (n-6) and ei-cosapentaenoic acid (n-3). Th ey are precursors of eicosanoids-signaling molecules involved in modulating the intensity and duration of infl ammatory responses. Eicosanoids derived from n-6 PUFAs have proinfl ammatory actions, while those derived from n-3 PUFAs act anti-infl ammatory. Th erefore, dietary intake of n-6 and n-3 PUFAs, as well as their ratio, could markedly aff ect the pathogenesis and manifestation of many chronic diseases associated with low-grade infl amma-tion. Th is review will focus on the relationship between dietary PUFAs and infl ammation, with reference to PUFAs status in plasma phospholipids in Serbian population.