The absorption and effect of dietary supplementation with omega-3 fatty acids on serum leukotriene B4 in patients with cystic fibrosis.
The substitution of omega-3 (n-3) fatty acids for omega-6 (n-6) fatty acids generates eicosanoids with diminished inflammatory effects. As the lungs of patients with cystic fibrosis (CF) are in a state of chronic inflammation in which increased amounts of eicosanoids are found, n-3 supplementation may reduce this level of inflammation and result in clinical improvement. The absorption and clinical effects of n-3 vs. n-6 fatty acids in CF were measured in a prospective, randomized, double-blind, crossover study in which 14 patients with CF (age: 6-16 years, mean 10.5 years; baseline Shwachman-Brasfield scores: 41-88, mean 76.7) received 6 weeks of n-3 ethyl ester concentrate from menhaden oil (100-131 mg/kg/day, mean 112.8) or n-6 fatty acids from safflower oil (102-132 mg/kg/day, mean 113.3), followed by a washout period of 6 weeks, and then 6 weeks of the other supplement. Analysis by gas chromatography showed that n-3 supplementation resulted in increased eicosapentaenoic acid (20:5n-3) in platelet phospholipids, from 0.14 to 2.16%, P < 0.05 and in increased docosahexaenoic acid (22:6n-3), from 1.33 to 3.72%, P < 0.05. Clinical effects were evaluated at weeks 0, 6, 12, and 18, and analyzed for differences among the n-3, n-6, and washout periods. No adverse effects were reported or observed. No statistically significant differences were found (ANOVA, P > 0.05) in Shwachman-Brasfield scores, sweat test, weight change, or forced expiratory volume and flow (FEV1, FEF25-75%, and FVC) percentiles. Tumor necrosis factor was not measurable in any serum sample. Serum leukotriene B4 (LTB4) levels were significantly reduced by n-3 fatty acids, mean reduction (-177 pg/mL) compared to n-6 fatty acids (+63 pg/mL) P < 0.05. These results show that both n-3 fatty acids are absorbed and incorporated into platelet phospholipids in patients with CF and reduced serum LTB4. No significant clinical differences or adverse effects were found.
Kurlandsky
L E
LE
Division of Pediatric Pulmonology, DeVos Children's Hospital at Butterworth Hospital, Grand Rapids, MI 49503.
Bennink
M R
MR
Webb
P M
PM
Ulrich
P J
PJ
Baer
L J
LJ
D000042:Absorption; D000293:Adolescent; D000704:Analysis of Variance; D001792:Blood Platelets / Q000378:metabolism; D002648:Child; D018592:Cross-Over Studies; D003550:Cystic Fibrosis / Q000097:blood / Q000178:diet therapy*; D004042:Dietary Fats, Unsaturated / Q000494:pharmacology / Q000627:therapeutic use*; D004281:Docosahexaenoic Acids / Q000097:blood; D004311:Double-Blind Method; D015118:Eicosapentaenoic Acid / Q000097:blood; D015525:Fatty Acids, Omega-3 / Q000493:pharmacokinetics / Q000494:pharmacology* / Q000627:therapeutic use*; D043371:Fatty Acids, Omega-6; D005231:Fatty Acids, Unsaturated / Q000493:pharmacokinetics / Q000494:pharmacology* / Q000627:therapeutic use*; D005260:Female; D005527:Food, Fortified; D006801:Humans; D007975:Leukotriene B4 / Q000097:blood*; D008297:Male; D010743:Phospholipids / Q000097:blood; D011446:Prospective Studies; D012129:Respiratory Function Tests
D004042:Dietary Fats, Unsaturated; D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6; D005231:Fatty Acids, Unsaturated; D010743:Phospholipids; D007975:Leukotriene B4; D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid