Docosahexaenoic acid in the treatment of rheumatoid arthritis: A double-blind, placebo-controlled, randomized cross-over study with microalgae vs. sunflower oil

被引：71

作者：

Dawczynski, C. ^{[1
,5
,6
]}

Dittrich, M. ^{[1
]}

Neumann, T. ^{[2
]}

Goetze, K. ^{[2
]}

Welzel, A. ^{[2
]}

Oelzner, P. ^{[2
]}

Voelker, S. ^{[3
]}

Schaible, A. M. ^{[3
]}

Troisi, F. ^{[3
]}

Thomas, L. ^{[3
]}

Pace, S. ^{[3
]}

Koeberle, A. ^{[3
]}

Werz, O. ^{[3
]}

Schlattmann, P. ^{[4
]}

Lorkowski, S. ^{[1
,5
]}

Jahreis, G. ^{[1
,6
]}

机构：

[1] Friedrich Schiller Univ Jena, Inst Nutr, Dept Nutr Physiol, Dornburger Str 25, D-07743 Jena, Germany

[2] Jena Univ Hosp, Dept Internal Med 3, Erlanger Allee 101, D-07747 Jena, Germany

[3] Friedrich Schiller Univ Jena, Dept Pharmaceut Med Chem, Philosophenweg 14, D-07743 Jena, Germany

[4] Jena Univ Hosp, Dept Med Stat Informat & Documentat, Bachstr 18, D-07743 Jena, Germany

[5] Friedrich Schiller Univ Jena, Inst Nutr, Dept Nutr Biochem & Physiol, Dornburger Str 25, D-07743 Jena, Germany

[6] Competence Cluster Nutr & Cardiovasc Hlth NutriCA, Dornburger Str 25, D-07743 Jena, Germany

来源：

CLINICAL NUTRITION | 2018年 / 37卷 / 02期

关键词：

Rheumatoid arthritis; Docosahexaenoic acid; Docosanoids; Nutrition; Inflammation; Diseases activity; POLYUNSATURATED FATTY-ACIDS; DIETARY FISH OIL; EICOSAPENTAENOIC ACID; LEUKOTRIENE BIOSYNTHESIS; OLIVE OIL; SUPPLEMENTATION; THROMBOXANE; INHIBITORS; DISEASE; ASTHMA;

D O I：

10.1016/j.clnu.2017.02.021

中图分类号：

R15 [营养卫生、食品卫生]; TS201 [基础科学];

学科分类号：

100403 ;

摘要：

The potential of fish or fish oil as supplier for eicosapentaenoic acid (EPA, C20:5n3) and docosahexaenoic acid (DHA, C22:6n3) for reducing cardiovascular risk factors and supporting therapy of chronic inflamatory diseases, has been investigated intensively, but our knowledge about the physiological effects of the individual compounds EPA and DHA are limited. Study design: In this double-blind pilot study, thirty-eight patients with defined RA were allocated to consume foods enriched with microalgae oil from Schizochytrium sp. (2.1 g DHA/d) or sunflower oil (placebo) for 10 weeks (cross-over), maintaining the regular RA medication during the study. Results: In contrast to placebo, the daily consumption of DHA led to a decline in the sum of tender and swollen joints (68/66) from 13.9 +/- 7.4 to 9.9 +/- 7.0 (p = 0.010), total DAS28 from 4.3 +/- 1.0 to 3.9 +/- 1.2 (p = 0.072), and ultrasound score (U5-7) from 15.1 +/- 9.5 to 12.4 +/- 7.0 (p = 0.160). The consumption of placebo products caused an increase of the n-6 PUFA linoleic acid and arachidonic acid (AA) in erythrocyte lipids (EL, p < 0.05). The amount of DHA was doubled in EL of DHA-supplemented patients and the ratios of AA/EPA and AA/DHA dropped significantly. We speculate that the production of pro-inflammatory/non-resolving AA-derived eicosanoids might decrease in relation to anti-inflammatory/pro-resolving DHA- and EPA-derived lipid mediators. In fact, plasma concentrations of AA-derived thromboxane B-2 and the capacity of blood to convert AA to the pro-inflammatory 5-lipoxygenase product 5-hydroxyeicosatetraenoic acid were significantly reduced, while levels of the DHA-derived maresin/resolyin precursors 14-/17-hydroxydocosahexaenoic acid significantly increased due to DHA supplementation. Conclusion: The study shows for the first time that supplemented microalgae DHA ameliorates disease activity in patients with RA along with a shift in the balance of AA- and DHA-derived lipid mediators towards an anti-inflammatory/pro-resolving state. (C) 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

引用

页码：494 / 504

页数：11

共 42 条

[1] Anti-inflammatory effects of a low arachidonic acid diet and fish oil in patients with rheumatoid arthritis [J].