Meta-analysis of omega-3 polyunsaturated fatty acids on immune functions and nutritional status of patients with colorectal cancer

Abstract

This meta-analysis assessed the clinical significance of omega-3 polyunsaturated fatty acids (PUFAs) in the management of patients with colorectal cancer (CRC) after radical resection. We comprehensively searched electronic databases, such as EMBASE, PubMed, MEDLINE and Cochrane Library, China National Knowledge Infrastructure (CNKI), China Biomedical Database (CBM), Wanfang Electronic Database, and VIP Medical Information System (VIP) from inception to 10 April 2022. Randomized controlled trials (RCTs) of omega-3 PUFAs and conventional nutrition or blank treatments were selected. The following were evaluated in the pooled analysis: immune function-related indices (IgA, IgG, IgM, CD3+, CD4+, CD8+, and ratio of CD4+/CD8+), nutritional status-related indices [total protein (TP), albumin (ALB), and prealbumin (PA)], and their corresponding 95% confidence intervals (CIs). Next, we conducted heterogeneity detection, sensitivity analysis, contour-enhanced funnel plot to detect possible publication bias, and meta-regression analysis. In all, 20 studies, including 1,613 patients (809 in the omega-3 PUFAs group and 804 in the control group), were selected in the final analysis. The results of the pooled analysis showed that omega-3 PUFAs significantly increased the humoral immune function indices, including IgA [standardized mean difference (SMD) = 0.54, 95% CI 0.10–0.99], IgM (SMD = 0.52, 95% CI 0.05–0.99), IgG (SMD = 0.65, 95% CI 0.47–0.84); T cell immune function indices, including CD3+ (SMD = 0.73, 95% CI 0.54–0.92), CD4+ (SMD = 0.76, 95% CI 0.53–0.98), and ratio of CD4+/CD8+ (SMD = 0.66, 95% CI 0.39–0.92). However, CD8+ was markedly reduced after intervention of omega-3 PUFAs (SMD = –0.28, 95% CI –0.66–0.09). In addition, pooled analysis indicated that omega-3 PUFAs markedly improved the nutritional status indicators, including TP (SMD = 0.53, 95% CI 0.17–0.88), ALB (SMD = 0.43, 95% CI 0.15–0.70), and PA (SMD = 0.46, 95% CI 0.01–0.90). The meta-regression analysis revealed that the covariates of the small sample affected the robustness and credibility of the CD4+ results. Conclusively, this study suggested that omega-3 PUFAs have the potential to be used as a valid immunonutritional therapy/support for treating patients with CRC postoperatively. This meta-analysis protocol was registered in PROSPERO (no. CRD42021288487).Systematic review registration[https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021288487], identifier [CRD42021288487].

Effect of Fish Oil Parenteral Emulsion Supplementation on Inflammatory Parameters after Esophagectomy

“…Cancer-induced alterations in cellular immunity could be corrected in the ω3-supplemented group, but there were no significant differences between groups in IL8 levels [ 19 ]. Furthermore, a recent meta-analysis [ 25 ] evaluated the influence of ω3 on humoral and cellular immunity and nutritional status in colorectal cancer patients. It demonstrated the effectiveness of ω3 administered postoperatively as enriched PN or EN in improving humoral and cellular immunity.…”

Comparative Effects of Different Nutritional Supplements on Inflammation, Nutritional Status, and Clinical Outcomes in Colorectal Cancer Patients: A Systematic Review and Network Meta-Analysis

“…To date, multiple systematic reviews and meta-analyses have reported similar results in which nutritional supplements have been shown to improve inflammation, nutritional status, and clinical outcomes in CRC patients [ 8 , 25 , 26 ]. However, the comparative effects of different nutritional supplements in CRC patients have not been estimated.…”

“…Depending on the localization and progression of the tumor, these treatments can be used in combination [ 2 , 3 , 4 , 5 ]. Due to long-term tumor consumption, inadequate nutritional intake, as well as stress responses and metabolic disorders caused by surgical trauma, chemotherapy, or radiotherapy, patients are prone to chronic inflammation, malnutrition, and complications [ 6 , 7 , 8 , 9 ]. Inflammation is a driving factor contributing to cancer progression, invasion, metastasis, and adverse clinical characteristics, such as malnutrition, weight loss, and fever, which can severely affect patients’ prognosis [ 10 ].…”

“…Several clinical studies have demonstrated the potency of nutritional supplements, such as omega-3 fatty acids (omega-3), arginine, vitamin D, glutamine, and probiotics, as an effective intervention in decreasing inflammation and enhancing the nutritional status, as well as the overall clinical outcomes of CRC patients [ 8 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ]. For instance, glutamine supplementation was discovered to modulate the immunometabolic response of CRC patients and lower their susceptibility to infections [ 22 , 23 ].…”

“…Moreover, NMA can also rank interventions based on various outcomes, aiding health professionals and clinicians in evidence-based decision-making. Much prior research suggests that omega-3, arginine, vitamin D, glutamine, and probiotics are the most effective and widely studied nutritional supplements for reducing inflammation and improving nutritional status and clinical outcomes in CRC patients [ 8 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ]. Therefore, in this study, we selected these nutritional supplements, aiming to compare and rank the effects of these nutritional supplements on inflammation, nutritional status, and clinical outcomes in CRC patients, as well as provide evidence-based data on nutritional supplementation for CRC patients.…”