The effect of Omega-3 fatty acid supplementation in systemic lupus erythematosus patients: A systematic review

Objective Many rheumatologists are inundated with questions about what “natural remedies” and “anti-autoimmune diets” exist for decreasing Systemic Lupus Erythematosus (SLE) disease activity. Over the last three decades, there has been an abundance of data from several different trials about omega-3 fatty acids sourced from fish oil, but the findings have been contradictory. This review seeks to present this data so that evidence-based recommendations can be given to patients, supporting the use of an adjuvant regimen with their present immunosuppression. Methods A literature search was conducted using the PubMed, Google Scholar, MEDLINE, and Scopus electronic databases to retrieve relevant articles for this review. Trials conducted on human subjects with SLE with full publications in English were included from 1 January 1980 to 1 April 2021. The impact of fish oil-derived omega-3 fatty acid supplementation on specific clinical features, the innate and adaptive immune response, biomarkers, and disease activity measures were assessed. The initial search yielded 7519 articles, but only 13 met our criteria and were eligible for this review. Results Data from thirteen articles were assessed. Ten trials assessed disease activity as an outcome, with eight trials demonstrating an improvement in patients in the omega-3 fatty acid group as assessed by a validated clinical tool or individual patient criteria. There was a significant improvement in Systemic Lupus Activity Measure-Revised (SLAM-R) scores at week 12 ( p = .009) and week 24 ( p < .001). Additionally, a reduction of urinary 8-isoprostane, a non-invasive marker of disease activity, was observed. There was no treatment benefit seen with respect to renal parameters such as serum creatinine or 24-hour urine protein; or systemic parameters such as C3, C4, or anti-double stranded DNA (anti-dsDNA) levels regardless of the dose of the omega-3 LUPUS fatty acids or duration of the trial. Conclusion While there is conflicting evidence about the benefits of omega-3 fatty acid supplementation on SLE disease activity, specific measures have demonstrated benefits. Current data show that there is a potential benefit on disease activity as demonstrated by SLAM-R, Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), and British Isles Lupus Assessment Group (BILAG) scores and plasma membrane arachidonic acid composition and urinary 8-isoprostane levels, with minimal adverse events.

Has the time come to consider Omega-3 to be part of treatment protocol for atopy and neurodevelopmental disorder?

Omega-3 fatty acid benefits health throughout life. It is especially important for children’s health. It improves symptoms of children with autism and other neurodevelopmental disorders by improving communication and language development and improving behaviour and cognitive function. It also helps in controlling asthma and other atopic conditions. Adding omega-3 to routine management plan for children with asthma, allergic rhinitis, and neurodevelopment worth consideration.

Protective Effects of Omega-3 Fatty Acid on Salt Induced Microscopic Changes in Femur of Female Sprague Dawley Rats

Osteoporosis is a major risk factor for fracture affects an enormous number of people of both genders worldwide. Objectives: To evaluate the shielding effect of omega-3 fatty acids on high salt induced histological findings in femur of rats. Study Design: Randomized Control Trial. Methodology: Female rats (n=30) were divided into three groups. Group A recieved high salt diet (8%NaCl) while group B recieved omega-3-treated salt loaded diet receiving 260 mg/kg body weight with 8% NaCl solution (8 weeks), control group received standard diet. Tissue from mid shaft and proximal end of femur was obtained to study the osteoblast number, mid cortical bone thickness and trabecular bone architecture. Statistical analysis: SPSS software, v 21 analyzed data. Results: Protective effects were seen in Omega-3 fatty acid supplemented experimental group B with increase in osteoblast number, mid cortical bone thickness and increase in microstructure of trabeculae. Conclusion: We concluded that dietary nutrient like omega-3 fatty acid is a helpful tool in eliminating adverse effects of salt on bones by enhancing osteoblastic activity thus reducing its remodeling. Keywords: Bone, Osteoblast, Omega-3 fatty acid, Salt and Trabeculae.

Possible Protective Effects of Omega 3, Diazepam and their Combination Against Yohimbine-Induced Clonic Seizure in Mice: Comparative Study

Yohimbine is actually confirmed in the United States to be utilized for erectile dysfunction; and recently such drug has become commonly used in body-building communities for its presumed lipolytic and sympathomimetic effects. But ingestion of such drug can bring about epileptic neurotoxic effects. Many antiepileptic drugs can be utilized to counteract myoclonic seizure; furthermore, diazepam can be used to oppose such type of seizure; in addition, surrogate therapeutic options such as omega 3 may also be utilized. In this study, twenty-four (24) mice of both sexes weighing 20-25g were randomly-allocated into 4 groups (6 animals each group) as follows: Group I- Yohimbine-induced clonic seizure [mice orally-administered DMSO (10%), and after 30 min, animals Sc. injected with 45mg/kg yohimbine). Group II- Diazepam-treated as standard drug: It is Sc. injected at a dose of 2mg/kg, and after 30 minutes, yohimbine at a dose of 45mg/kg is Sc. injected. Group III- Omega 3 (40 mg/kg) is orally-administered, and after 30 min 45mg/kg yohimbine is Sc. injected. Group IV- Combination of omega 3 (40mg/kg) is orally-administered then and after ten minutes, diazepam was IP injected 2mg/kg then after 20 minute, 45mg/kg yohimbine is Sc. Injected. The result of this study showed that omega 3 has non-optimal antiepileptic effect; where, it is un-able to reduce the onset and frequency of epilepsy tone in mice during several time periods (30-120min); and data weren’t significantly different when compared to diazepam. But omega 3 reduced onset of epilepsy in combination with diazepam when compared with diazepam alone. As well as omega 3 caused small percent changes frequency of epilepsy tone through 120 min when compared with other groups. Conclusion: Omega 3 fatty acid had partial beneficial effect; where, alone it has a role for decreasing onset of epilepsy; but, its combination with diazepam had significant role for reducing onset of epilepsy against yohimbine-induced seizure model. Additionally, omega 3 alone and in combination with diazepam have negligible role for reduction frequency of epilepsy.

Effect of omega-3 fatty acid on contrast-induced nephropathy

Renal failure that develops acutely after the use of iodinated contrast material is called "contrast-induced nephropathy". It is a complication with high morbidity and mortality risk. Current treatments are aimed at protecting kidney functions, new treatment methods are being researched. This study aims to demonstrate the therapeutic effects of omega-3 fatty acids on CIN, taking into account the possible clinical usage of iodinated contrast media and the benefits of omega-3 fatty acids. Methods. A total of 30 rats were studied, divided into four groups. Only saline was administered by gavage to group 1, only IV urography to group 2, only 400 mg omega-3 to group 3, and urography and 400 mg omega-3 to group 4. At the end of the study, kidney tissue and serum oxidative and antioxidant markers, and creatinine levels were analyzed. Result. While the degrees of glutathione peroxidase, catalase and total antioxidant capacity in kidney tissue and serum tests of rats treated with omega-3 fatty acid increased statistically; total oxidant capacity and malondialdehyde levels were found to be significantly lower. Furthermore, blood urea nitrogen and creatinine levels were found to be significantly lower in the omega-3 treated group. Conclusion. Omega-3 fatty acids had therapeutic effects in the experimental CIN model. As a result, we believe omega-3 fatty acids can be used as an alternative to existing supportive medicines in this common disease with few therapy options.