Supplementation with n-3 and n-6 polyunsaturated fatty acids: effects on lipoxygenase activity and clinical symptoms of pruritus in hemodialysis patients.
OBJECTIVE
To investigate the effect of supplementation with different sources of oils rich in long chain fatty acids, ie, fish oil (FO) and safflower oil (SO), on the production of leukotriene B4 (LTB4) by polymorphonuclear leukocytes (PMNLs) in hemodialysis patients and the consequent effects on the symptoms of pruritus.


METHODS
Randomized, prospective, double-blind study for 2 treatment groups.


METHODS
Three Medical Center-affiliated units.


METHODS
Twenty-two patients on maintenance hemodialysis, of both sexes, age > or = 20 years with complaint of dry and/or itchy skin.


METHODS
Two groups of patients receiving daily supplements of 6 g ethyl ester of FO or SO for 16 weeks.


METHODS
Red blood cell (RBC) fatty acid profile, LTB 4 production by PMNLs, and pruritus symptoms at baseline and after supplementation.


RESULTS
After supplementation, the FO group had a higher RBC 22:6n3, total n-3 fatty acids, and ratio of total n-3 to total n-6 fatty acids (P < .05) than the SO group. The change in LTB4 production (pg/mL) from baseline to week 16 was 240.7 +/- 200.2 to 29.2 +/- 14.6 in the FO group and from 171.1 +/- 121.7 to 31.9 +/- 14.7 in the SO group. The overall pruritus score change was 16.7 +/- 11.4 to 8.9 +/- 9.2 in the FO group and from 17.5 +/- 8.8 to 13.1 +/- 5.6 in the SO group. FO supplementation did not result in a significant specific effect on LTB4 production by the PMNLs. There was a nonsignificant decrease in the pruritus scores that could be clinically significant and important to patients suffering with this condition.


CONCLUSIONS
Supplementation with FO results in significant incorporation of n-3 fatty acids in the RBCs. Intervention with both FO and SO resulted in a nonsignificant improvement of clinical symptoms of pruritus and a nonsignificant reduction in LTB 4 production by PMNLs in the hemodialysis patients. The percent decrease in total puritus score was greater for the FO group compared with the SO group.
Department of Foods and Nutrition, Purdue University, West Lafayette, IN, USA.
Roxana
R
Begum
Martha A
MA
Belury
John R
JR
Burgess
Louise W
LW
Peck
D000328:Adult; D000368:Aged; D001094:Arachidonate 5-Lipoxygenase / Q000097:blood*; D004042:Dietary Fats, Unsaturated / Q000008:administration & dosage*; D004311:Double-Blind Method; D004912:Erythrocytes / Q000737:chemistry; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D043371:Fatty Acids, Omega-6 / Q000008:administration & dosage*; D005260:Female; D005395:Fish Oils / Q000008:administration & dosage; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D007975:Leukotriene B4 / Q000096:biosynthesis; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000187:drug effects / Q000201:enzymology / Q000378:metabolism; D011446:Prospective Studies; D011537:Pruritus / Q000209:etiology / Q000517:prevention & control*; D006435:Renal Dialysis; D012450:Safflower Oil / Q000008:administration & dosage; D011795:Surveys and Questionnaires; D024502:alpha-Tocopherol / Q000008:administration & dosage / Q000031:analogs & derivatives; D024504:gamma-Tocopherol / Q000008:administration & dosage
D004042:Dietary Fats, Unsaturated; D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6; D005395:Fish Oils; C024838:alpha-tocopherol quinol; D007975:Leukotriene B4; D012450:Safflower Oil; D024504:gamma-Tocopherol; D001094:Arachidonate 5-Lipoxygenase; D024502:alpha-Tocopherol