Fish oils produce anti-inflammatory effects and improve body weight in severe heart failure.
BACKGROUND
Fish oils have been shown to reduce production of tumor necrosis factor-alpha (TNF-alpha) in healthy subjects. We sought to evaluate the effects of fish oils on pro-inflammatory cytokines and body weight in patients with advanced heart failure.


METHODS
Fourteen patients (New York Heart Association [NYHA] Class III to IV heart failure) were randomized in a double-blinded trial to active therapy with 8 g of n-3 fatty acids (Group A, n = 7) or placebo (Group B, n = 7) for 18 weeks. TNF-alpha and interleukin-1 (IL-1) production were measured by radioimmunoassay after endotoxin stimulation of peripheral blood mononuclear cells.


RESULTS
Placebo-treated patients had a 44% increase in TNF-alpha (from 1.28 to 1.84 pg/ml; p = 0.07) but no significant change in IL-1 (from 0.68 to 0.78 pg/ml) production. n-3 fatty acids resulted in a 59% reduction in TNF-alpha (from 1.64 to 0.68 pg/ml; p = 0.02) and 39% decrease in IL-1 (from 1.98 to 1.21 pg/ml; p = 0.09) production. There was an inverse correlation between change in TNF-alpha production and change in percent body fat (r = -0.6; p = 0.02).


CONCLUSIONS
Fish oils decrease TNF-alpha production in heart failure and improve body weight. Fish oil therapy may represent a novel therapeutic approach in late-stage heart failure characterized by cardiac cachexia.
Mehra
Mandeep R
MR
Division of Cardiology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA. mmehra@medicine.umaryland.edu
Lavie
Carl J
CJ
Ventura
Hector O
HO
Milani
Richard V
RV
D000273:Adipose Tissue / Q000473:pathology; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001835:Body Weight / Q000187:drug effects*; D004311:Double-Blind Method; D005227:Fatty Acids / Q000097:blood; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use*; D005260:Female; D005395:Fish Oils / Q000627:therapeutic use*; D006333:Heart Failure / Q000097:blood / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D007375:Interleukin-1 / Q000097:blood; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D014409:Tumor Necrosis Factor-alpha / Q000096:biosynthesis / Q000378:metabolism
D000893:Anti-Inflammatory Agents; D005227:Fatty Acids; D015525:Fatty Acids, Omega-3; D005395:Fish Oils; D007375:Interleukin-1; D014409:Tumor Necrosis Factor-alpha