Omega-3 Fatty Acids in Rheumatic Diseases

 

Omega-3 Fatty Acids in Rheumatic Diseases

 

A Critical Review

 

Umair Akbar, BS, Melissa Yang, BS, Divya Kurian, BS, and Chandra Mohan, MD, PhD

 

 

 

 

CONCLUSIONS

The majority of PUFAs consumed in the modernWDare n-6

PUFAs, drastically outranking n-3 PUFA intake. Ample evidence

indicates that increased EPA/DHA levels can modify the production

of eicosanoids, toward a more anti-inflammatory profile. This

competition most likely occurs as both AA and EPA compete as

substrates for the COX and lipoxygenase pathways for eicosanoid

production. Given the importance of these pathways in rheumatic

diseases, one would predict that EPA/DHA would be beneficial

in various rheumatic diseases. Several positive-outcome clinical

trials in RA present good evidence for the beneficial role of

omega-3 fatty acid intake. In addition, there are several shortterm

positive-outcome clinical trials that have been conducted

on lupus patients; however, lengthier trials, of up to a decade or

more, with greater cohort size and control for multiple confounding

factors need to be conducted to establish any long-term benefits.

Conversely, the evidence is inconclusive on the role of fish oil

supplementation in OA, with limited data and few published studies

being available. Finally, fewer no trials have been conducted in

other rheumatic diseases. Longer-term trials are warranted to establish

the long-term benefits of fish oil supplements in the different

rheumatic diseases. Besides establishing the impact of fish oil

supplementation on clinical activity indices, it would also be important

to test the NSAID-sparing and steroid-sparing potential

of fish oil supplements. Another open area for investigation is

whether EPA and DHA may have differential impacts on the cardiovascular

and neurological manifestations associated with rheumatic

diseases, respectively. Finally, the molecular mechanism of

action through which fish oil supplements may modulate autoimmune

inflammation warrants further study.

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