Incorporation of n-3 PUFA and γ-linolenic acid in blood lipids and red blood cell lipids together with their influence on disease activity in patients with chronic inflammatory arthritis - a randomized controlled human intervention trial

Abstract

Background and aimMarine 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.DesignPatients 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.Results60 patients (54 rheumatoid arthritis, 6 psoriatic arthritis) were randomised, 47 finished per protocol. In group 1, the ratio of arachidonic acid (AA)/eicosapentaenoic acid (EPA) decreased from 6.5 ± 3.7 to 2.7 ± 2.1 in plasma lipids and from 25.1 ± 10.1 to 7.2 ± 4.7 in erythrocyte membranes (p ≤ 0.001). There was no significant influence on AA/EPA ratio due to interventions in group 2-4. In group 2, the intake of γ-linolenic acid resulted in a strong rise of γ-linolenic acid and dihomo-γ-linolenic acid concentrations in plasma lipids, cholesteryl esters, and erythrocyte membranes. The combination of n-3 LC-PUFA and γ-linolenic acid (group 3) led to an increase of γ-linolenic acid and dihomo-γ-linolenic acid concentrations in plasma lipids, cholesteryl esters, and erythrocyte mem-branes. This increase was only half of that in group 2.ConclusionsIncorporation of eicosanoid precursor FAs was influenced by an intake of n-3 LC-PUFA and γ-linolenic acid suggesting a possible benefit for therapy of chronic inflammatory diseases.Trial RegistrationClinicalTrials NCT01179971

Clinical Benefits of n-3 PUFA and ɤ-Linolenic Acid in Patients with Rheumatoid Arthritis

“…As well, intake of 3 g of n -3 PUFA markedly increases the AA/EPA ratio and EPA + DHA index, which are highly reliable predictors of sudden cardiac death [50,51,52]. This is an added value, since patients with RA have strongly elevated risk of cardiac death [53,54].…”

Effect of omega‐3 fatty acids on disease severity in patients with psoriasis: A systematic review

“…6 In a recent randomized controlled trial 23 involving 54 rheumatoid arthritis (RA) and six psoriatic arthritis patients who received 12 weeks treatment with n-3 PUFA, they analyzed the proportion of EPA and DHA being incorporated into the erythrocyte membranes. They have concluded that n-3 PUFA resulted in an increased incorporation of the eicosanoid precursor fatty acids (EPA, DHA) in plasma lipids and cell membranes, which had a positive correlation with a significant reduction of disease activity parameters (Disease Activity Score of 28 joints, VAS scale) in RA.…”

The Mediterranean Diet and Arthritis

“…The n À 3 long-chain PUFA and GLA were found to affect the incorporation of eicosanoid precursor fatty acids (EPA, DHA, DGLA) in plasma lipids and cell membranes, and there was an improvement in the patients' clinical status. In addition, n À 3 long-chain PUFA improved CV risk factors such as the AA/EPA ratio and the n À 3 fatty acid index [48]. The DAS28 composite activity index tended to fall in the group receiving 3 g olive oil/day.…”