FRI0237 OMEGA-3 AND OMEGA-6 FATTY ACIDS IN SJöGREN’S SYNDROME: CLINICAL IMPLICATIONS AND THEIR ASSOCIATION WITH INFLAMMATION

Abstract

Background:Essential ω-3 and ω-6 fatty acids (FA) are natural modulators of inflammation activity; however, their role in primary Sjögren’s syndrome (pSS) is unknown.Objectives:To evaluate the intake and serum levels of ω-3 and ω-6 FA in patients with pSS, and to correlate them with ocular and oral signs and symptoms, disease activity as well as with the presence of a panel of inflammatory chemokines/cytokines in saliva and tears.Methods:We included 108 patients with pSS according to EULAR/ACG criteria. We excluded patients under ω-3 and ω-6 supplementation. Dietary information was obtained from a semiquantitative food frequency questionnaire of one-day reminder (applied by a trained interviewer), and processed using computerized nutritional analysis software. Fasting blood samples were collected. We measured the serum levels of ω-3 (α-linolenic acid [α-L], eicosapentaenoic acid [EPA], docosahexaenoic acid [DHA]) and ω-6 (linoleic acid [LA], arachidonic acid [AA]) using gas chromatography flame ionization. We assessed the ESSDAI score, ESPPRI, OSDI, tear film break-up time, Schirmer-I test and the SICCA Ocular Staining Score (OSS). In a subgroup of patients, we obtained tears and saliva samples that were frozen at -86°C until assayed. Once defrosted, the levels of CXCL8, CXCL10, CCL2, IL-22 and IL-21 in saliva and CXCL8, CXCL10, CCL2 and CXCL9 in tears were measured by Luminometry.Results:The median age was 56.12 ± 13.7 years, 94.4% women and median disease duration 10 years. The FA ω-3 and ω-6 intake was 0.43 g/day and 3 g/d, respectively. The levels of α-L were 6.6 μg/mL, DHA 26 μg/mL, total ω-3 (α-L +DHA) 25.4 μg/mL, LA 168.5 μg/mL, AA 34 μg/mL, and total ω-6 (LA+AA) 205 μg/mL. We did not find a correlation among serum levels and food intake. Thus, further analyses were focused on serum results. We found a negative correlation between α-L and the OSDI (ρ= -0.42, p= 0.01) and ESSDAI (ρ= -0.26, p=0.03) as well of DHA and ESSDAI (ρ= -0.30, p= 0.01). The rest of the variables were not associated. In tears, there was a positive correlation of AA and CXCL9 (ρ= 0.48, p= 0.04), whereas in saliva, we observed a negative correlation between α-L, DHA and total ω3 (α-L+DHA) with CCL2. We also observed a negative correlation between total ω6 (LA+AA) and IL-21, and the ω6/ω3 ratio with IL-22.Conclusion:Our pSS patients had deficient FA omega intake. We observed lower ocular symptoms, lower ESSDAI scores and salivary levels of CCL2 among patients with higher levels of FA ω-3. Our study suggest that low serum levels of ω-3 might be implicated in the perpetuation of chronic inflammation. Disclosure of Interests:None declared

The place of omega-3 and omega-6 acids in supplementary treatment of inflammatory joint diseases

“…The first randomised trials evaluating the effectiveness of implementing omega-3 and omega-6 supplementation in supplementary treatment of this disease have been conducted in the last several years. It has been shown that supplementing omega-3 acids for 3 months leads to a statistically significantly increased amount of produced saliva (without stimulation) when compared to a placebo group [49], whilst the use of omega-3 acids in combination with omega-6 acids caused decreased activity of the disease evaluated with the ESSDAI index (EULAR Sjögren's syndrome disease activity index), as well as improvement of ocular lesions assessed with the Sicca Ocular Staining Score index, and it also increased the amount of produced saliva [50].…”