title: Incorporation of n-3 PUFA and γ-linolenic acid in blood lipids and red blood cell lipids together with their influence on disease activity in patients with chronic inflammatory arthritis--a randomized controlled human intervention trial.
abstract: OBJECTIVE
  Marine n-3 fatty acids and γ-linolenic acid both have anti-inflammatory effects and may be useful to help treat inflammatory diseases. The effects of these alone or combined were examined in patients with arthritis in a randomized controlled trial.
  
  
  METHODS
  Patients with rheumatoid arthritis or psoriatic arthritis were randomized into four groups in a double-blind, placebo-controlled parallel designed study. Patients received the respective capsules (1: 3.0 g n-3 LC-PUFA/d; 2: 3.2 g γ-linolenic acid/d; 3: 1.6 g n-3 LC-PUFA + 1.8 g γ-linolenic acid/d; 4: 3.0 g olive oil) for a twelve week period. Clinical status was evaluated and blood samples were taken at the beginning and at the end of the period. Differences before and after intervention were tested with paired t-test or with Wilcoxon test for non-normal data distribution.
  
  
  RESULTS
  60 patients (54 rheumatoid arthritis, 6 psoriatic arthritis) were randomised, 47 finished per protocol. In group 1, the ratio of arachidonic acid (AA)/eicosapentaenoic acid (EPA) decreased from 6.5 ± 3.7 to 2.7 ± 2.1 in plasma lipids and from 25.1 ± 10.1 to 7.2 ± 4.7 in erythrocyte membranes (p ≤ 0.001). There was no significant influence on AA/EPA ratio due to interventions in group 2-4. In group 2, the intake of γ-linolenic acid resulted in a strong rise of γ-linolenic acid and dihomo-γ-linolenic acid concentrations in plasma lipids, cholesteryl esters, and erythrocyte membranes. The combination of n-3 LC-PUFA and γ-linolenic acid (group 3) led to an increase of γ-linolenic acid and dihomo-γ-linolenic acid concentrations in plasma lipids, cholesteryl esters, and erythrocyte mem-branes. This increase was only half of that in group 2.
  
  
  CONCLUSIONS
  Incorporation of eicosanoid precursor FAs was influenced by an intake of n-3 LC-PUFA and γ-linolenic acid suggesting a possible benefit for therapy of chronic inflammatory diseases.
  
  
  BACKGROUND
  ClinicalTrials NCT01179971.
authors.affiliation: Department of Nutritional Physiology, Institute of Nutrition, Friedrich Schiller University of Jena, Dornburger Str. 24, D-07743 Jena, Germany.
authors.forename: Christine
authors.initials: C
authors.lastname: Dawczynski
authors.forename: Ursula
authors.initials: U
authors.lastname: Hackermeier
authors.forename: Martin
authors.initials: M
authors.lastname: Viehweger
authors.forename: Rainer
authors.initials: R
authors.lastname: Stange
authors.forename: Monika
authors.initials: M
authors.lastname: Springer
authors.forename: Gerhard
authors.initials: G
authors.lastname: Jahreis
mesh_terms: D015126:8,11,14-Eicosatrienoic Acid / Q000097:blood; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016718:Arachidonic Acid / Q000097:blood; D015535:Arthritis, Psoriatic / Q000097:blood / Q000188:drug therapy*; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000188:drug therapy*; D015118:Eicosapentaenoic Acid / Q000097:blood; D004912:Erythrocytes / Q000187:drug effects / Q000378:metabolism*; D015525:Fatty Acids, Omega-3 / Q000378:metabolism / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D050356:Lipid Metabolism / Q000187:drug effects; D008297:Male; D008563:Membrane Lipids / Q000378:metabolism; D008875:Middle Aged; D017965:gamma-Linolenic Acid / Q000378:metabolism / Q000627:therapeutic use*
chemical_list: D015525:Fatty Acids, Omega-3; D008563:Membrane Lipids; D016718:Arachidonic Acid; D017965:gamma-Linolenic Acid; D015118:Eicosapentaenoic Acid; D015126:8,11,14-Eicosatrienoic Acid