Skip to main content
×
Home

Omega-3 long-chain polyunsaturated fatty acids supplementation on inflammatory biomakers: a systematic review of randomised clinical trials

  • Oscar D. Rangel-Huerta (a1), Concepcion M. Aguilera (a1), Maria D. Mesa (a1) and Angel Gil (a1)
Abstract

Inflammation is part of the normal host response to infection and injury. Eicosanoids, cytokines, chemokines, adhesion molecules and other inflammatory molecules are frequently produced during this process. Numerous studies in humans have documented the inflammation-limiting properties of omega-3 fatty acids, but only a few have been randomised clinical trials. The aim of this study was to perform a systematic search of randomised clinical trials on omega-3 fatty acids and inflammatory biomarkers in all subjects including healthy and ill persons up to February 2011 using PubMed and LILACS databases, defined by a specific equation using MeSH terms and limited to randomised clinical trials; there was no any a priori decision to include some diseases and not others. The quality of each publication was validated by using the JADAD scale and the CONSORT checklist. Inflammatory biomarkers were considered as primary outcomes. Twenty-six publications of the last 10 years were selected. Studies included healthy subjects and patients with cardiovascular disease and other chronic and acute diseases; all reported the number of subjects, type of study, type and doses of omega-3 fatty acids, main outcomes and major inflammatory biomarkers. Dietary omega-3 fatty acids are associated with plasma biomarker levels, reflecting lower levels of inflammation and endothelial activation in cardiovascular disease and other chronic and acute diseases, including chronic renal disease, sepsis and acute pancreatitis. However, further research is required before definitive recommendations can be made about the routine use of omega-3 fatty acids in critically ill patients or with neurodegenerative or chronic renal disease.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Omega-3 long-chain polyunsaturated fatty acids supplementation on inflammatory biomakers: a systematic review of randomised clinical trials
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about sending content to Dropbox.

      Omega-3 long-chain polyunsaturated fatty acids supplementation on inflammatory biomakers: a systematic review of randomised clinical trials
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about sending content to Google Drive.

      Omega-3 long-chain polyunsaturated fatty acids supplementation on inflammatory biomakers: a systematic review of randomised clinical trials
      Available formats
      ×
Copyright
Corresponding author
*Corresponding author: A. Gil, fax +34 958 248960, email agil@ugr.es
References
Hide All
1 Romano M (2008) Inflammation resolution: does the bone marrow have a say? Am J Hematol 83, 435436.
2 Calder PC (2006) Polyunsaturated fatty acids and inflammation. Prostaglandins Leukot Essent Fatty Acids 75, 197202.
3 Calder PC (2007) Immunomodulation by omega-3 fatty acids. Prostaglandins Other Lipid Mediat 77, 327335.
4 Seki H, Tani Y & Arita M (2009) Omega-3 PUFA derived anti-inflammatory lipid mediator resolvin E1. Prostaglandins Other Lipid Mediat 89, 126130.
5 Mataix Verdú, José Francisco & Gil Á (2005) Libro Blanco de los Omega-3. Los ácidos grasos poliinsaturados Omega 3 y monoinsaturados tipo oleico y su papel en la salud.
6 Medzhitov R (2008) Origin and physiological roles of inflammation. Nature 454, 428435.
7 Singer P, Shapiro H, Theilla M, et al. (2008) Anti-inflammatory properties of omega-3 fatty acids in critical illness: novel mechanisms and an integrative perspective. Intensive Care Med 34, 15801592.
8 Gil A, María Aguilera C, Gil-Campos M & Cañete R (2007) Altered signalling and gene expression associated with the immune system and the inflammatory response in obesity. Br J Nutr 98, Suppl. 1, S121S126.
9 Basu S (2010) Bioactive eicosanoids: Role of prostaglandin F2α and F2-isoprostanes in inflammation and oxidative stress related pathology. Mols Cells 30, 383391.
10 Serhan CN, Yacoubian S & Yang R (2008) Anti-inflammatory and pro-resolving lipid mediators. Annu Rev Pathol 3, 279.
11 Calder PC (2006) N-3 Polyunsaturated Fatty Acids, Inflammation, and Inflammatory Diseases. Am J Clin Nutr 83, 1505S1519S.
12 Charo IF & Ransohoff RM (2006) The many roles of chemokines and chemokine receptors in inflammation. N Engl J Med 9, 610621.
13 Giugliano D, Ceriello A & Esposito K (2006) The effects of diet on inflammation: emphasis on the metabolic syndrome. J Am Coll Cardiol 15, 677685.
14 Galli C & Calder PC (2009) Effects of fat and fatty acid intake on inflammatory and immune responses: a critical review. Ann Nutr Metab 55, 123139.
15 Schwab JM & Serhan CN (2006) Lipoxins and new lipid mediators in the resolution of inflammation. Curr Opin Pharmacol 6, 414420.
16 Jadad R, Moore R, Carroll D, et al. (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 17, 112.
17 Schulz KF, Altman DG & Moher D (2010) CONSORT 2010 statement: Updated guidelines for reporting parallel group randomised trials. J Pharmacol Pharmacother 1, 100107.
18 Pot GK, Brouwer IA, Enneman A, et al. (2009) No effect of fish oil supplementation on serum inflammatory markers and their interrelationships: a randomized controlled trial in healthy, middle-aged individuals. Eur J Clin Nutr 63, 13531359.
19 Bouwens M, van de Rest O, Dellschaft N, et al. (2009) Fish-oil supplementation induces antiinflammatory gene expression profiles in human blood mononuclear cells. Am J Clin Nutr 90, 415424.
20 Yusof HM, Miles E & Calder P (2008) Influence of very long-chain n-3 fatty acids on plasma markers of inflammation in middle-aged men. Prostaglandins Leukot Essent Fatty Acids 78, 219228.
21 Schubert R, Kitz R, Beermann C, et al. (2007) Influence of low-dose polyunsaturated fatty acids supplementation on the inflammatory response of healthy adults. Nutrition 23, 724730.
22 Fujioka S, Hamazaki K, Itomura M, et al. (2006) The effects of eicosapentaenoic acid-fortified food on inflammatory markers in healthy subjects–A randomized, placebo-controlled, double-blind study. J Nutr Sci Vitaminol 52, 261265.
23 Mayer K, Gokorsch S, Fegbeutel C, et al. (2003) Parenteral nutrition with fish oil modulates cytokine response in patients with sepsis. Am J Respir Crit Care Med 15, 13211328.
24 Thies F, Miles E, Nebe-von-Caron G, et al. (2001) Influence of dietary supplementation with long-chain n-3 or n-6 polyunsaturated fatty acids on blood inflammatory cell populations and functions and on plasma soluble adhesion molecules in healthy adults. Lipids 36, 11831193.
25 Nieman DC, Henson D, McAnulty SR, et al. (2009) N-3 Polyunsaturated Fatty Acids Do Not Alter Immune and Inflammation Measures in Endurance Athletes. Int J Sport Nutr Exerc Metab 19, 536546.
26 Bloomer RJ, Larson DE, Fisher-Wellman KH, et al. (2009) Effect of eicosapentaenoic and docosahexaenoic acid on resting and exercise-induced inflammatory and oxidative stress biomarkers: a randomized, placebo controlled, cross-over study. Lipids Health Dis 19, 836.
27 Cawood AL, Ding R, Napper FL, Young , et al. (2010) Eicosapentaenoic acid (EPA) from highly concentrated n-3 fatty acid ethyl esters is incorporated into advanced atherosclerotic plaques and higher plaque EPA is associated with decreased plaque inflammation and increased stability. Atherosclerosis 20, 252259.
28 Zhao YT, Shao L, Teng LL, et al. (2009) Effects of n-3 polyunsaturated fatty acid therapy on plasma inflammatory markers and N-terminal pro-brain natriuretic peptide in elderly patients with chronic heart failure. J Int Med Res 37, 18311841.
29 Tulk HMF & Robinson LE (2009) Modifying the n-6/n-3 polyunsaturated fatty acid ratio of a high-saturated fat challenge does not acutely attenuate postprandial changes in inflammatory markers in men with metabolic syndrome. Metabolism 58, 17091716.
30 Browning LM, Krebs JD, Moore CS, et al. (2007) The impact of long chain n-3 polyunsaturated fatty acid supplementation on inflammation, insulin sensitivity and CVD risk in a group of overweight women with an inflammatory phenotype. Diabetes Obes Metab 9, 7080.
31 Engler MM, Engler MB & Malloy MJ (2005) Effect of docosahexaenoic acid on lipoprotein subclasses in hyperlipidemic children (the EARLY study). Am J Cardiol 95, 869871.
32 Mori T, Woodman RJ, Burke V, et al. (2003) Effect of eicosapentaenoic acid and docosahexaenoic acid on oxidative stress and inflammatory markers in treated-hypertensive type 2 diabetic subjects. Free Radic Biol Med 35, 772781.
33 Skulas-Ray AC, Kris-Etherton PM, Harris WS, et al. (2011) Dose-response effects of omega-3 fatty acids on triglycerides, inflammation, and endothelial function in healthy persons with moderate hypertriglyceridemia. Am J Clin Nutr 93, 243.
34 Bowden RG, Wilson RL, Deike E, et al. (2011) Fish oil supplementation lowers C-reactive protein levels independent of triglyceride reduction in patients with end-stage renal disease. Nutr Clin Pract 24, 508512.
35 Perunicic-Pekovic GB, Rasic ZR, Pljesa SI, et al. (2007) Effect of n-3 fatty acids on nutritional status and inflammatory markers in haemodialysis patients. Nephrology 12, 331336.
36 Freund-Levi Y, Hjorth E, Lindberg C, et al. (2009) Effects of omega-3 fatty acids on inflammatory markers in cerebrospinal fluid and plasma in Alzheimer's disease: the OmegAD study. Dement Geriatr Cogn Disord 27, 481490.
37 Vedin I, Cederholm T, Freund Levi Y, et al. (2008) Effects of docosahexaenoic acid–rich n-3 fatty acid supplementation on cytokine release from blood mononuclear leukocytes: the OmegAD study. Am J Clin Nutr 87, 1616.
38 Barbosa VM, Miles Ea, Calhau C, et al. (2010) Effects of a fish oil containing lipid emulsion on plasma phospholipid fatty acids, inflammatory markers, and clinical outcomes in septic patients: a randomized, controlled clinical trial. Crit Care 14, R5.
39 Mayer K, Meyer S, Reinholz-Muhly M, et al. (2003). Short-time infusion of fish oil-based lipid emulsions, approved for parenteral nutrition, reduces monocyte proinflammatory cytokine generation and adhesive interaction with endothelium in humans. J Immunol 171, 4837.
40 Wang X, Li W, Li N, et al. (2008) w-3 Fatty Acids–Supplemented Parenteral Nutrition Decreases hyperinflammatory response and attenuates systemic disease sequelae in severe acute pancreatitis: A Randomized and controlled study. Nutr Clin Pract Nutr Clin Pract 32, 236241.
41 Nilsen DW, Almdahl SM, Svensson B, et al. (1993) Lipopolysaccharide induced monocyte thromboplastin synthesis and coagulation responses in patients undergoing coronary bypass surgery after preoperative supplementation with n-3 fatty acids. Thromb Haemost 20, 900902.
42 Nieman DC, Henson DA, Gross SJ, et al. (2007) Quercetin reduces illness but not immune perturbations after intensive exercise. Med Sci Sports Exerc 39, 15611569.
43 Bruunsgaard H, Pedersen M & Pedersen BK (2001) Aging and proinflammatory cytokines. Curr Opin Hematol 8, 131136.
44 Toft AD, Thorn M, Ostrowski K, et al. (2000) N-3 polyunsaturated fatty acids do not affect cytokine response to strenuous exercise. J Appl Physiol 89, 24012406.
45 Smith LA, Paszkiewicz GM, Hutson AD, et al. (2010) Inflammatory response of lung macrophages and epithelial cells to tobacco smoke: a literature review of ex vivo investigations. Immunol Res 46, 94126.
46 Vernaglione L, Cristofano C & Chimienti S (2008) Omega-3 polyunsaturated fatty acids and proxies of cardiovascular disease in hemodialysis: a prospective cohort study. J Nephrol 21, 99105.
47 Saifullah A, Watkins BA, Saha C, et al. (2007) Oral fish oil supplementation raises blood omega-3 levels and lowers C-reactive protein in haemodialysis patients–a pilot study. Nephrol Dial Transplant. 22, 35613567.
48 Martin JM & Stapleton RD (2010) Omega-3 fatty acids in critical illness. Nutr Rev 68, 531541.
49 Bannenberg G & Serhan CN (2010) Specialized pro-resolving lipid mediators in the inflammatory response: An update. Biochim Biophys Acta 1801, 12601273.
50 FAO/WHO (2010) Fats and fatty acids in human nutrition Report of an expert consultation. 91 (66), Rome.
51 Kris-Etherton PM (2000) Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Circulation 106, 27472757.
52 Nälsén C, Vessby B, Berglund L, Uusitupa M, Hermansen K, Riccardi G, et al. (2006) Dietary (n-3) fatty acids reduce plasma F2-isoprostanes but not prostaglandin F2alpha in healthy humans. J Nutr 136, 12221228.
53 Higdon JV, Liu J, Du SH, Morrow JD, Ames BN & Wander RC (2000) Supplementation of postmenopausal women with fish oil rich in eicosapentaenoic acid and docosahexaenoic acid is not associated with greater in vivo lipid peroxidation compared with oils rich in oleate and linoleate as assessed by plasma malondialdehyde. Am J Clin Nutr 72, 714722.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

British Journal of Nutrition
  • ISSN: 0007-1145
  • EISSN: 1475-2662
  • URL: /core/journals/british-journal-of-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 54
Total number of PDF views: 458 *
Loading metrics...

Abstract views

Total abstract views: 837 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 22nd November 2017. This data will be updated every 24 hours.