title: Insights into the inhibition of platelet activation by omega-3 polyunsaturated fatty acids: beyond aspirin and clopidogrel.
abstract: OBJECTIVE
  We sought to examine the effects of escalating doses of omega-3 polyunsaturated fatty acid (PUFA) supplements on platelet function using light transmission aggregometry (LTA) and electrophoretic quasi-elastic light scattering technology (EQELS).
  
  
  BACKGROUND
  PUFA may inhibit platelet function through fatty acid substitution in the platelet membrane by changing the surface charge density and causing decreased production of thromboxane A2. EQELS can measure platelet surface charge density and determine whether the platelet is in resting or activated state.
  
  
  METHODS
  A total of 30 volunteers were divided in 3 groups of 10 as follows: Group A, no antiplatelet agent; Group B, daily aspirin only, and Group C, daily aspirin and clopidogrel. All patients received escalating doses of omega-3PUFA from 1 to 8 g daily over 24 weeks. Platelet function was measured by template bleeding time, LTA, and EQELS at baseline and at 6, 12, 18 and 24 weeks.
  
  
  RESULTS
  Mean bleeding time increased in a dose-dependent manner with escalating omega-3 PUFA doses. LTA confirmed expected antiplatelet effects of aspirin and clopidogrel, but did not detect any additional antiplatelet effects of omega-3 PUFA. EQELS showed a significant increase in the negative resting platelet charge compared to baseline and an attenuated response to arachidonic acid mediated platelet activation. No bleeding events were observed.
  
  
  CONCLUSIONS
  In this pilot study we were able to successfully measure platelet surface charge variation as a measure of omega-3 PUFA effect on platelets. Our results suggest that omega-3 PUFA increase the total platelet surface charge and, therefore, attenuate platelet activation, even among patients taking aspirin or aspirin plus clopidogrel. Further studies are needed to determine the clinical significance of these measured effects and EQELS results.
authors.affiliation: University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Mauricio G
authors.initials: MG
authors.lastname: Cohen
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Rossi
authors.forename: Jennifer
authors.initials: J
authors.lastname: Garbarino
authors.forename: Regina
authors.initials: R
authors.lastname: Bowling
authors.forename: Alison A
authors.initials: AA
authors.lastname: Motsinger-Reif
authors.forename: Carl
authors.initials: C
authors.lastname: Schuler
authors.forename: Allison G
authors.initials: AG
authors.lastname: Dupont
authors.forename: Don
authors.initials: D
authors.lastname: Gabriel
mesh_terms: D000328:Adult; D001241:Aspirin / Q000008:administration & dosage* / Q000009:adverse effects; D001760:Bleeding Time; D001792:Blood Platelets / Q000187:drug effects*; D016009:Chi-Square Distribution; D000077144:Clopidogrel; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D010865:Pilot Projects; D010974:Platelet Aggregation / Q000187:drug effects*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D010979:Platelet Function Tests; D011237:Predictive Value of Tests; D013499:Surface Properties; D013988:Ticlopidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D013997:Time Factors
chemical_list: D015525:Fatty Acids, Omega-3; D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin