Dietary fish oil supplementation inhibits formation of endometriosis-associated adhesions in a chimeric mouse model

Abstract

Objective To examine whether dietary fish oil supplementation reduces development of spontaneous endometriosis-associated adhesions using an established model. Design Laboratory-based study. Setting Medical center research laboratory. Patient(s)/Animal(s) Disease-free women of reproductive age and nude mice. Intervention(s) Women were not provided any intervention. Mice were randomized to receive fish oil supplementation or control diet. Main Outcome Measure(s) Experimental endometriosis was established in mice via injection of human endometrial tissue within 16 hours of ovariectomy. Mice were provided standard or menhaden fish oil–supplemented diets for ≥2 weeks before initiation of experimental endometriosis and until killing them 1 week later. At necropsy, mice were examined for the presence and extent of adhesions and endometriotic-like lesions. Tissues were excised and morphologically characterized. Result(s) Adhesions/lesions were reduced in mice provided with dietary fish oil compared with control animals. Leukocytes were more numerous within the adhesions/lesions of the mice maintained on the standard diet compared with animals provided with fish oil. As indicated by staining intensity, collagen deposition was greater at adhesion sites within control mice compared with fish oil–supplemented animals. Conclusion(s) Wound-healing associated with surgery created an inflammatory peritoneal microenvironment that promoted the development of both experimental endometriosis and adhesions in a murine model. Targeting excessive inflammation with fish oil may be an effective adjuvant therapy to reduce the development of postsurgical adhesions related to endometriosis.

Influence of diet on the risk of developing endometriosis

“…This finding comes from a 2016 study by Heard et al conducted in mice in which the experimental group was on the diet of 45% of fat and the control group was on a diet of 17% of fat [34]. Another study performed on animals in 2013 by Herington et al seems to confirm the positive influence of fish oils on decreasing the risk of developing endometriosis, demonstrating that supplementation with fish oil reduced the development of postoperative adhesions connected with endometriosis [35].…”

The role of Lipoxin A4 in endometrial biology and endometriosis

“…Interestingly, a recent paper demonstrated the protective effect of fish oil in endometriosis in a chimeric model where human endometrial tissue was injected into the peritoneum of nude mice. 163 Mice administered fish oil exhibited fewer leukocytes within lesions and less collagen deposition at adhesions indicating that dietary intervention may prevent postsurgical adhesion development. These effects may well be due to the formation of pro-resolving lipid mediators such as resolvins and protectins, metabolized from omega 3 fatty acids.…”

Diet and Risk of Endometriosis: A Systematic Review and Meta-Analysis Study

“…Harrington et al (2013) showed, in their study on mice, that fish oil can be used as an effective adjunctive therapy to reduce post-operative adhesion in endometriosis (10). All 3 studies included in the meta-analysis showed the effect of fish consumption on reducing the disease, however, none were statistically significant (9,11,12).…”