Journal Name:
J. Am. Coll. Nutr.
Article Title:
Omega-3 Fatty Acids in Inflammation and Autoimmune Diseases
Date Written:
2002
Volume:
21
Number:
6
Page:
495
Author(s):
Simopoulos, A.P.
Article:
Among the fatty acids, the omega-3 polyunsaturated fatty acids (PUFA) possess the most potent immunomodulatory activities. The n-3 fatty acids include fish oil derived eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and plant based alpha-linolenic acid (ALA). The increased omega-6/omega-3 ratio in Western diets most likely contributes to an increased incidence of cardiovascular disease and inflammatory disorders. The anti-inflammatory properties of omega-3 fatty acids, espe¬cially EPA, are due to competition with arachidonic acid (AA) as a substrate for cyclooxygenases and 5-lipoxygenase. The eicosanoids from the omega 6 and omega 3 fatty acids have opposing properties. The eicosanoids are considered a link between PUFA, inflammation and immunity.
Some of the effects of omega-3 PUFA are brought about by modulation of the amount and types of eicosanoids generated, and other effects are elicited by eicosanoid-independent mechanisms, including actions upon intracellular signaling pathways, transcription factor activity and gene expression. Animal experiments and clinical intervention studies indicate that omega-3 fatty acids have anti-inflammatory properties and, therefore, might be useful in the management of inflammatory and autoimmune diseases. Coronary heart disease, major depression, aging and cancer are characterized by an increased level of interleukin 1 (IL-1), a proinflammatory cytokine. Similarly, arthritis, Crohn’s disease, ulcerative colitis and lupus erythematosis are autoimmune diseases characterized by a high level of IL-1 and the proinflammatory leukotriene LTB4 produced by omega-6 fatty acids. There have been a number of clinical trials assessing the benefits of dietary supplementation with omega 3 fatty acids in several inflammatory and autoimmune diseases in humans, including rheumatoid arthritis, Crohn’s disease, ulcerative colitis, psoriasis, lupus erythematosus, multiple sclerosis and migraine headaches.
There is a clear need for more carefully designed and controlled clinical trials in the therapeutic application of omega-3 fatty acids to human autoimmune and inflammatory conditions. Nutritional supplementation with omega-3 fatty acids either as an alterna¬tive or adjunct therapy is potentially important, especially since current therapies with drugs have many side effects and the diseases are heterogeneous. In designing clinical interventions, genetic variation should be taken into consideration, since the level of cytokines is to a great extent genetically determined and the dose or amount of omega-3 fatty acids to suppress the proinflammatory state may vary. The importance of omega-3 essential fatty acids in the diet is now evident, as well as the need to return to a more physi¬ologic omega-6/omega-3 ratio of about 1-4/1 rather than the ratio of 20-16/1 provided by current Western diets. In order to improve the ratio of omega-6/omega-3 essential fatty acids, it will be necessary to decrease the intake of omega-6 fatty acids from vegetable oils and to increase the intake of omega-3 fatty acids by using oils rich in omega-3 fatty acids and increase the intake of fish to two to three times per week or take supple¬ments. Omega-3 fatty acids have been part of our diet since the beginning of time. It is only for the past 150 years that omega-3 fatty acids have been decreased in Western diets due to agri¬business and food processing. The need to return the omega-3 fatty acids into the food supply has been recognized by indus¬try, which is already producing omega-3 enriched products.
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