title: Systemic omega-6 essential fatty acid treatment and pge1 tear content in Sjögren's syndrome patients.
abstract: OBJECTIVE
  To determine the effect of oral omega-6 essential fatty acids on PGE(1) tear content and signs and symptoms of ocular discomfort in patients with Sjögren's syndrome (SS).
  
  
  METHODS
  This randomized, double-masked, controlled, clinical trial involved 40 patients with primary SS, divided into two groups: group 1: 20 patients (18 women, 2 men; mean age, 36.9 +/- 7.9 years [SD]) treated for 1 month with linoleic acid (LA; 112 mg), and gamma-linolenic acid (GLA; 15 mg) administered twice daily; group 2: 20 patients (19 women, 1 man; mean age, 36.3 +/- 5.5 years) treated twice daily with placebo. Patients underwent three examinations: at baseline (T0), after 1 month of treatment (T1), and 15 days after suspension of treatment (T2). At each examination, the following tests were performed: tear sampling (2 microL) from the inferior meniscus, tear break-up time (BUT), fluorescein stain of the ocular surface, and tear basal secretion. A symptom score was also obtained at each examination. PGE1 was evaluated by enzyme immunoassay. The primary efficacy variable was PGE1 content of tears.
  
  
  RESULTS
  The tear PGE1 levels were significantly increased in group 1 at T1 versus T0 (PGE1 level: T0, 44 +/- 5.4 ng/mL; T1, 58.3 +/- 5.5 ng/mL; P < 0.01 versus T0 and group 2 at T1). At examination T2, a statistically significant reduction of PGE1 levels toward baseline was observed (45.7 +/- 5.2 ng/mL; P < 0.01 versus T1). A statistically significant reduction of symptom score was observed in group 1 at examination T1 (P < 0.01 versus T0 and group 2 score). At examination T2, the symptom score was significantly higher than T1 but remained lower than T0. The corneal fluorescein stain in group 1 showed a statistically significant improvement at examination T1 versus T0 and group 2 (P < 0.01). This improvement was also present at T2 (P < 0.02). No statistically significant differences were found for the other tests. No statistically significant changes were observed in the patients in group 2 at all examination time points.
  
  
  CONCLUSIONS
  Omega-6 administration increases the PGE1 levels in tears of patients with SS and improves ocular surface signs and symptoms of ocular discomfort.
authors.affiliation: Policlinic University Hospital, Department of Surgical Specialties, Section of Ophthalmology and Refractive Surgery, University of Messina, Messina, Italy. paragona@unime.it
authors.forename: Pasquale
authors.initials: P
authors.lastname: Aragona
authors.forename: Claudio
authors.initials: C
authors.lastname: Bucolo
authors.forename: Rosaria
authors.initials: R
authors.lastname: Spinella
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Giuffrida
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ferreri
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000527:Alprostadil / Q000378:metabolism*; D003315:Cornea / Q000187:drug effects / Q000378:metabolism; D004311:Double-Blind Method; D005260:Female; D019793:Fluorescein; D015590:Fluorophotometry; D006801:Humans; D007124:Immunoenzyme Techniques; D019787:Linoleic Acid / Q000008:administration & dosage*; D008297:Male; D012859:Sjogren's Syndrome / Q000188:drug therapy* / Q000378:metabolism; D013666:Tears / Q000737:chemistry / Q000378:metabolism*; D017965:gamma-Linolenic Acid / Q000008:administration & dosage*
chemical_list: D017965:gamma-Linolenic Acid; D019787:Linoleic Acid; D000527:Alprostadil; D019793:Fluorescein