The Efficacy of MAG-DHA for Correcting AA/DHA Imbalance of Cystic Fibrosis Patients

Abstract

Omega-3 polyunsaturated fatty acid (n-3 PUFA) supplementations are thought to improve essential fatty acid deficiency (EFAD) as well as reduce inflammation in Cystic Fibrosis (CF), but their effectiveness in clinical studies remains unknown. The aim of the study was to determine how the medical food containing docosahexaenoic acid monoglyceride (MAG-DHA) influenced erythrocyte fatty acid profiles and the expression levels of inflammatory circulating mediators. We conducted a randomized, double blind, pilot trial including fifteen outpatients with Cystic Fibrosis, ages 18–48. The patients were divided into 2 groups and received MAG-DHA or a placebo (sunflower oil) for 60 days. Patients took 8 × 625 mg MAG-DHA softgels or 8 × 625 mg placebo softgels every day at bedtime for 60 days. Lipid analyses revealed that MAG-DHA increased docosahexaenoic acid (DHA) levels and decrease arachidonic acid (AA) ratio (AA/DHA) in erythrocytes of CF patients following 1 month of daily supplementation. Data also revealed a reduction in plasma human leukocyte elastase (pHLE) complexes and interleukin-6 (IL-6) expression levels in blood samples of MAG-DHA supplemented CF patients. This pilot study indicates that MAG-DHA supplementation corrects erythrocyte AA/DHA imbalance and may exert anti-inflammatory properties through the reduction of pHLE complexes and IL6 in blood samples of CF patients. Trial registration: Pro-resolving Effect of MAG-DHA in Cystic Fibrosis (PREMDIC), NCT02518672.

Monoacylglycerol Form of Omega-3s Improves Its Bioavailability in Humans Compared to Other Forms

“…Significant EPA increments were observed after feeding subjects 2 g capsule of fish oil (3.2 g EPA and 2.2 DHA) daily for 6 weeks. In a 60-day trial, feeding MAG-DHA (8 × 625 mg MAG-DHA) daily showed an increased DHA levels and a decreased AA ratio (AA/DHA) in erythrocytes [39,55]. Feeding DHA from algal oils has also resulted in significant increments of DHA in plasma, erythrocytes, and rectal DHA levels [56,57].…”

“…Interestingly, OM3 was shown to be an effective substrate to MGAT enzyme and could be used as a pre-digested fat [37,38] with potentially improved bioavailability compared to ethyl ester or TAG. This lipase-independent MAG carrier may offer a clinical advantage to patients struggling with fat malabsorption/maldigestion problems, for instance, patients with cystic fibrosis [21,[37][38][39].…”

Cystic fibrosis related diabetes: Nutrition and growth considerations

“…Foods higher in omega-3 fatty acids may help improve the imbalance of omega-3 to omega-6 fatty acids and potentially improve inflammatory markers, but there is insufficient evidence to recommend supplements at this time. [30,31] A variety of high-fat foods are recommended, including polyunsaturated and monounsaturated fats. These can include butter, cheese, cream, olive oil, dressings, sauces, fatty fish, nuts and nut butters, seeds, and fatty vegetables (avocados).…”

Preparation of Fatty Acid and Monoglyceride from Vegetable Oil

“…Monoglycerides from omega-3 polyunsaturated fatty acid PUFA were also beneficial effects to some human disorder condition such as cancer and inflammation disease 26 . Monoglycerides from EPA and DHA are likewise very useful for human health base on their nutritive value 6 , role in there regulation of inflammation, cholesterol metabolism, and brain functions 27 , their influence to erythrocyte fatty acid profiles and the expression levels of inflammatory circulating mediators 28 . Long Chain Poly Unsaturated Fatty Acid LC-PUFA monoglycerides oil also increased LC-PUFA levels in erythrocytes, plasma, and chylomicrons 29 .…”