Early evidence of efficacy for orally administered SPM-enriched marine lipid fraction on quality of life and pain in a sample of adults with chronic pain

Background Marine lipids contain omega-3 fatty acids that can be metabolized into anti-inflammatory and pro-resolving mediators—namely 17-HDHA and 18-HEPE—which can serve as modulators of the pain experience. The purpose of this study was to determine the impact of 4 weeks of oral supplementation with a fractionated marine lipid concentration, standardized to 17-HDHA and 18-HEPE, on health-related quality of life and inflammation in adults with chronic pain. Methods This study was a prospective, non-randomized, open-label clinical trial. Forty-four adults with ≥ moderate pain intensity for at least 3 months were recruited. The primary outcome was change in health-related quality of life (QOL) using the Patient Reported Outcomes Measurement Information System-43 Profile (PROMIS-43) and the American Chronic Pain Association (ACPA) QOL scale. Exploratory outcomes assessed safety and tolerability, changes in anxiety and depression, levels of pain intensity and interference, patient satisfaction, and impression of change. Changes in blood biomarkers of inflammation (hs-CRP and ESR) were also explored. Results Outcome measures were collected at Baseline, Week 2, and Week 4 (primary endpoint). At Week 4, PROMIS-43 QOL subdomains changed with significance from baseline (p < 0.05), with borderline changes in the ACPA Quality of Life scale (p < 0.052). Exploratory analyses revealed significant changes (p < 0.05) in all measures of pain intensity, pain interference, depression, and anxiety. There were no statistically significant changes in either hs-CRP or ESR, which stayed within normal limits. Conclusion We conclude that oral supplementation with a fractionated marine lipid concentration standardized to 17-HDHA and 18-HEPE may improve quality of life, reduce pain intensity and interference, and improve mood within 4 weeks in adults with chronic pain. The consistency and magnitude of these results support the need for placebo-controlled clinical trials of marine lipid concentrations standardized to 17-HDHA and 18-HEPE. Trial registration ClinicalTrials.gov: Influence of an Omega-3 SPM Supplement on Quality of Life, NCT02683850. Registered 17 February 2016—retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02683850.

Conditions Associated with Marine Lipid-Induced Milk Fat Depression in Sheep Cause Shifts in the In Vitro Ruminal Metabolism of 1-13C Oleic Acid

Shifts in ruminal oleic acid (OA) metabolism have received little research attention but recent studies have suggested their association with marine lipid-induced milk fat depression (MFD) in ewes and cows. Measurement of specific products of OA within the complex mixture of digesta lipids is however challenging. Therefore, this in vitro trial combined the isotopic labelling technique with the use of rumen inoculum from cannulated sheep fed a diet supplemented or not with 2% of fish oil (which has been demonstrated to cause MFD in dairy ruminants) to characterize the metabolism of OA in response to ruminal alterations associated with MFD. The products of 13C-OA after 24 h of incubation were analysed by gas chromatography-combustion isotope ratio mass spectrometry (GC-C-IRMS). Numerous 13C-labeled 18:1 intermediates and oxygenated FA were detected and no elongation or desaturation of 13OA occurred. Diet supplementation with fish oil (i.e., MFD conditions) resulted in no unique metabolites of 13OA but in relevant changes in the relative contribution of specific metabolic pathways. The inhibition of 18:0 saturation caused by this treatment appeared largely attributable to increased oxygenated FA proportion, in particular the candidate milk fat inhibitor 10-oxo-18:0, and warrants further research on the association between MFD and oxygenated FA. Changes in the concentration of 13C-labeled trans 18:1 intermediates but not in cis 18:1, were also observed.