title: Oral supplementation with gamma-linolenic acid extracted from Mucor circinelloides improves the deformability of red blood cells in hemodialysis patients.
abstract: BACKGROUND
  The development of abnormalities in red blood cell (RBC) deformability in patients undergoing hemodialysis remains a major problem, because it is related to peripheral microcirculation, oxygen supply, and various complications in such patients. gamma-Linolenic acid (GLA; 18:3n-6), one of the polyunsaturated fatty acids and a precursor of prostaglandin E(1), is reported to have a favorable effect on the deformability of circulating blood cells in diabetic patients.
  
  
  METHODS
  In order to clarify the efficacy of GLA on RBC deformability in 7 patients undergoing maintenance hemodialysis, we examined in a pilot study the changes in the deformability of RBC and the changes in the phospholipid fatty acid composition in both plasma and RBC membrane before and after high-dose oral supplementation with GLA derived from Mucor circinelloides for 12 weeks.
  
  
  RESULTS
  Before supplementation, the micropore passage time of RBC suspension, which is an indicator of RBC deformability, in these patients was markedly longer than that in healthy control subjects. After administering GLA, the prolonged passage time of the patients both rapidly and steadily decreased and nearly reached control levels. Light microscopic observations of RBCs using Giemsa stain revealed a decreased number of poikilocytes after supplementation. An analysis of the fatty acid composition before treatment and 8 weeks after starting the treatment showed the dihomo-gamma-linolenic acid (DGLA; 20:3n-6) level in the plasma to have increased (p < 0.05), while the arachidonic acid (AA; 20:4n-6) concentration in the RBC membrane decreased (p < 0.05). The level of DGLA in the RBC membrane, the level of GLA, and the ratio of GLA + DGLA/AA in plasma and RBC membrane did not change significantly; however, these all tended to increase.
  
  
  CONCLUSIONS
  The results of this pilot study indicate that the oral supplementation of GLA extracted from M. circinelloides improves the poor RBC deformability in hemodialysis patients, partly by inducing changes in the composition of fatty acids in plasma and RBC membrane.
authors.affiliation: Department of Dermatology, Mito Saiseikai General Hospital, Mito, Japan. m-saisei@po.net-ibaraki.ne.jp
authors.forename: S
authors.initials: S
authors.lastname: Iijima
authors.forename: F
authors.initials: F
authors.lastname: Otsuka
authors.forename: H
authors.initials: H
authors.lastname: Kikuchi
authors.forename: K
authors.initials: K
authors.lastname: Yamada
authors.forename: T
authors.initials: T
authors.lastname: Nakajima
authors.forename: K
authors.initials: K
authors.lastname: Yahiro
authors.forename: A
authors.initials: A
authors.lastname: Kondo
mesh_terms: D000328:Adult; D000368:Aged; D019587:Dietary Supplements; D004907:Erythrocyte Deformability / Q000187:drug effects*; D005921:Glomerulonephritis / Q000150:complications; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009089:Mucor; D006435:Renal Dialysis; D017965:gamma-Linolenic Acid / Q000008:administration & dosage / Q000302:isolation & purification / Q000627:therapeutic use*
chemical_list: D017965:gamma-Linolenic Acid