Effects of fish oil supplementation in rheumatoid arthritis. Randomized placebo-controlled intervention with n-3 LC-PUFA-supplemented yoghurt: effects on circulating eicosanoids and cardiovascular risk factors. Effect of three sources of long-chain fatty acids on the plasma fatty acid profile, plasma prostaglandin E2 concentrations, and pruritus symptoms in hemodialysis patients. Prostaglandin E2 production and T cell function after fish-oil supplementation: response to antioxidant cosupplementation. Effects of a fish-oil and vegetable-oil formula on aggregation and ethanolamine-containing lysophospholipid generation in activated human platelets and on leukotriene production in stimulated neutrophils. Effects of fish oil supplementation in the third trimester of pregnancy on prostacyclin and thromboxane production. Dietary fish oil and olive oil supplementation in patients with rheumatoid arthritis. Clinical and immunologic effects. The influence of low intake of n-3 fatty acids on platelets in elderly people. Effect of fish oil (n-3 polyunsaturated fatty acids) on plasma lipids, lipoproteins and inflammatory markers in HIV-infected patients treated with antiretroviral therapy: A randomized, double-blind, placebo-controlled study Eicosapentaenoic and docosahexaenoic acid supplementations reduce platelet aggregation and hemostatic markers differentially in men and women. Impact of EPA ingestion on COX- and LOX-mediated eicosanoid synthesis in skin with and without a pro-inflammatory UVR challenge – Report of a randomised controlled study in humans Low dose supplementation with two different marine oils does not reduce pro-inflammatory eicosanoids and cytokines in vivo. Plasma lipid levels and platelet and neutrophil function in patients with vascular disease following fish oil and olive oil supplementation. Effect of n-3 polyunsaturated fatty acid supplementation in patients with rheumatoid arthritis: a 16-week randomized, double-blind, placebo-controlled, parallel-design multicenter study in Korea. Effects of fish oil supplementation on platelet survival and ex vivo platelet function in hypercholesterolemic patients. Essential fatty acid deficiency profiles in idiopathic immunoglobulin A nephropathy. Can n-3 PUFA reduce cardiac arrhythmias? Results of a clinical trial. Omega-3 Fatty Acids Supplementation Attenuates Inflammatory Markers After Eccentric Exercise in Untrained Men Effects of the fish-oil supplementation on the immune and inflammatory responses in elite swimmers. The antihypertensive effects of fish oil. A controlled study of polyunsaturated fatty acid supplements in essential hypertension.
Sixteen patients with rheumatoid arthritis entered a trial to determine the clinical and biochemical effects of dietary supplementation with fractionated fish oil fatty acids . A r and omised , double blind , placebo controlled crossover design with 12 week treatment periods was used . Treatment with non-steroidal anti-inflammatory drugs and with disease modifying drugs was continued throughout the study . Placebo consisted of fractionated coconut oil . The following results favoured fish oil rather than placebo :  joint swelling index and duration of early morning stiffness . Other clinical indices improved but did not reach statistical significance . During fish oil supplementation relative amounts of eicosapentaenoic acid and docosahexaenoic acid in the plasma cholesterol ester and neutrophil membrane phospholipid fractions increased , mainly at the expense of the omega-6 fatty acids . The mean neutrophil leucotriene B4 production in vitro showed a reduction after 12 weeks of fish oil supplementation . Leucotriene B5 production , which could not be detected either in the control or in the placebo period , rose to substantial quantities during fish oil treatment . This study shows that dietary fish oil supplementation is effective in suppressing clinical symptoms of rheumatoid arthritis BACKGROUND & AIMS The study examined the value of n-3 LC-PUFA-enriched yogurt as means of improving cardiovascular health  . DESIGN Fifty three mildly hypertriacylglycerolemic subjects ( TAG ≥ 1.7 mmol/L ) participated in a r and omized , placebo-controlled , double-blind , parallel design ed study . The subjects consumed 1 ) control yoghurt ; 2 ) yoghurt enriched with 0.8 g n-3 LC-PUFA/d ; or 3 ) yoghurt enriched with 3 g n-3 LC-PUFA/d for a period of 10 wks . Blood sample s were taken at the beginning and the end of the study period . RESULTS Following daily intake of 3 g n-3 LC-PUFA for 10 weeks , n-3 LC-PUFA levels increased significantly in plasma and red blood cells ( RBC ) with concomitant increase in the EPA-derived mediators ( PGE₃ , 12- , 15- , 18-HEPE ) in plasma whilst cardiovascular risk factors such as HDL , TAG , AA/EPA ratio , and n-3 index were improved ( P < 0.05 ) ; the decrease of TAG and increase in HDL were associated with the CD36 genotype . CONCLUSION The observed increase of n-3 LC-PUFA in RBC and plasma lipids due to intake of n-3 LC-PUFA enriched yoghurt result ed in a reduction of cardiovascular risk factors and inflammatory mediators showing that daily consumption of n-3 PUFA enriched yoghurt can be an effective way of supplementing the daily diet and improving cardiovascular health Patients with chronic renal failure exhibit plasma fatty acid patterns indicative of essential fatty acid deficiency . The plasma fatty acid profile of 25 hemodialysis patients with a history of pruritus symptoms indicated lower 20:3n-9 ( eicosatrienoic acid ) , 20:4n-6 ( arachidonic acid ) , and 20:5n-3 ( eicosapentaenoic acid ) concentrations ; a higher 18:1n-9 ( oleic acid ) concentration ; and above-normal ranges of prostagl and in E2 ( PGE2 ) compared with 22 subjects chosen from a normal population . No significant difference in 22:6n-3 ( docosahexaenoic acid ) was shown between the hemodialysis patients and the normal subjects . The dietary intake of 20:5n-3 was higher and that of 18:1n-9 lower in the patients compared with the normal population group . In this 8-wk double-blind study the hemodialysis patients were r and omly assigned to receive daily supplements of 6 g ethyl ester of either fish oil , olive oil , or safflower oil . At the end of 8 wk of treatment the fish oil group ( FO group ) had a greater decrease in 18:1n-9 ( P < 0.05 ) , greater increases in 20:5n-3 and 22:6n-3 ( P < 0.01 ) , and trends toward a greater decrease in 20:4n-6 , a greater increase in PGE2 concentrations , and greater improvement in pruritus scores ( 0.10 > P > 0.05 ) compared with the other two groups . The increases in 20:5n-3 and 22:6n-3 in the FO group indicate compliance with fish oil supplementation . Results indicate that hemodialysis patients have abnormal fatty acid profiles and increased PGE2 values .  Fish oil intervention changes the fatty acid profile and may improve the symptoms of pruritus BACKGROUND Prostagl and in E(2 ) ( PGE(2 ) ) inhibits lymphocyte proliferation and the production of interferon-gamma ( IFN-gamma ) by peripheral blood mononuclear cells , but the effect of PGE(2 ) on interleukin 4 ( IL-4 ) production is unclear . Fish oil , which contains eicosapentaenoic and docosahexaenoic acids , inhibits production of PGE(2 ) . The effects of fish oil on lymphocyte proliferation and production of IFN-gamma and IL-4 are unclear and may be influenced by the availability of antioxidants . OBJECTIVE We investigated the effect of dietary fish oil with and without antioxidant cosupplementation on lymphocyte proliferation and the production of PGE(2 ) , IFN-gamma , and IL-4 by peripheral blood mononuclear cells . DESIGN Sixteen healthy men received dietary fish-oil supplements providing 0.3 , 1 , and 2 g eicosapentaenoic acid plus docosahexaenoic acid/d for 4 consecutive weeks each ( total of 12 wk ) . All subjects were r and omly assigned to daily cosupplementation with either antioxidants ( 200 microg Se , 3 mg Mn , 30 mg RRR-alpha-tocopheryl succinate , 90 mg ascorbic acid , 450 micro g vitamin A ) or placebo . RESULTS Fish-oil supplementation decreased PGE(2 ) production and increased IFN-gamma production and lymphocyte proliferation from baseline values . Cosupplementation with antioxidants did not affect cytokine production or lymphocyte proliferation . CONCLUSION Dietary fish oil modulates production of IFN-gamma and lymphocyte proliferation in a manner consistent with decreased production of PGE(2 ) , but this effect is not modified by antioxidant cosupplementation The effects of consuming a liquid formula containing either fish oil enriched in omega-3 fatty acids or vegetable oil enriched in oleic acid was evaluated in 20 male subjects r and omly allocated into two groups over a 42-d period . A decrease in collagen-induced aggregation by using washed platelet suspensions was found in both groups after nutritional supplementation . A considerable rise in omega-3 and a decrease in omega-6 fatty acids occurred in the platelet phospholipid with fish-oil consumption . The degree of eicosapentaenoic acid ( EPA , 20:5n-3 ) enrichment ( fish-oil group ) was dramatically greater in the ether-containing plasmenylethanolamine ( 13.5 mol% of fatty acids ; mol% of fatty acids = moles per 100 moles of total fatty acids ) than in phosphatidylethanolamine ( 2.8 mol% ) or phosphatidylcholine ( 2.9 mol% ) . Neither treatment significantly influenced the agonist-induced accumulation of lysoplasmenylethanolamine as derived via phospholipase A2 hydrolysis of plasmenylethanolamine . HPLC measurements of eicosanoid production in A23187-stimulated neutrophils revealed a considerable decrease in the formation of arachidonic acid-derived leukotriene B4 ( LTB4 ) , by 41 % , and 5-HETE ( 5-hydroxyeicosatetraenoic acid ) , by 30 % , in the fish-oil group along with the appearance of the corresponding EPA-derived products [ LTB5 and 5-HEPE ( 5-hydroxyeicosapentaenoic acid ) ] . No such alterations in the formation of lipoxygenase products were found with the vegetable oil treatment OBJECTIVE Disturbance in thromboxane and prostacyclin bio synthesis has been observed in preeclampsia . We studied whether fish oil supplementation in late pregnancy interferes with maternal and fetal production of thromboxane A2 and prostacyclin I2 . STUDY DESIGN Forty-seven women in the thirtieth week of pregnancy were r and omly assigned in a ratio of 2:1:1 to receive fish oil ( 2.7 gm of n-3 fatty acid per day [ Pikasol ] , or either olive oil or no oil supplementation as controls .  Metabolites of thromboxane A2 and A3 and of prostacyclin I2 and I3 were quantified by mass spectrometry methods in serum and urine , respectively . Maternal serum and urine were sample d at baseline , in the thirty-third and thirty-seventh weeks of pregnancy . Fetal serum was sample d at delivery . RESULTS At the thirty-seventh week the mean concentrations of the eicosapentaenoic-derived metabolites , thromboxane B3 and prostacyclin I3 , was twofold to threefold higher ( p < 0.001 ) in the group receiving fish oil compared with combined control groups . There were no significant effects of fish oil on the prostacyclin I2 metabolite , although there was a trend toward a reduction in thromboxane B2 in this group . In umbilical cord blood the mean concentration of thromboxane B2 was lowest in the group receiving fish oil ( p = 0.03 ) . CONCLUSIONS Fish oil was metabolized to the eicosapentaenoic acid-derived eicosanoids thromboxane A3 and prostacyclin I3 in pregnant women . Correspondingly , analog products of arachidonic acid tended to be depressed . It remains to be established whether these biochemical effects will prove beneficial in the prevention or treatment of preeclampsia and intrauterine growth retardation Forty-nine patients with active rheumatoid arthritis completed a 24-week , prospect i ve , double-blind , r and omized study of dietary supplementation with 2 different dosages of fish oil and 1 dosage of olive oil . Clinical evaluations were performed at baseline and every 6 weeks thereafter , and immunologic variables were measured at baseline and after 24 weeks of study . The 3 groups of patients were matched for age , sex , disease severity , and use of disease-modifying antirheumatic drugs ( DMARDs ) . Subjects continued receiving DMARDs and other background medications without change during the study . Twenty patients consumed daily dietary supplements of n3 fatty acids containing 27 mg/kg eicosapentaenoic acid ( EPA ) and 18 mg/kg docosahexaenoic acid ( DHA ) ( low dose ) , 17 patients ingested 54 mg/kg EPA and 36 mg/kg DHA ( high dose ) , and 12 patients ingested olive oil capsules containing 6.8 gm of oleic acid . Significant improvements from baseline in the number of tender joints were noted in the low-dose group at week 24 ( P = 0.05 ) and in the high-dose group at week 18 ( P = 0.04 ) and 24 ( P = 0.02 ) . Significant decreases from baseline in the number of swollen joints were noted in the low-dose group at weeks 12 ( P = 0.003 ) , 18 ( P = 0.002 ) , and 24 ( P = 0.001 ) and in the high-dose group at weeks 12 ( P = 0.0001 ) , 18 ( P = 0.008 ) , and 24 ( P = 0.02 ) . A total of 5 of 45 clinical measures were significantly changed from baseline in the olive oil group , 8 of 45 in the low-dose fish oil group , and 21 of 45 in the high-dose fish oil group during the study ( P = 0.0002 ) . Neutrophil leukotriene B4 production decreased by 19 % from baseline in the low-dose fish oil group ( P = 0.0003 ) and 20 % in the high-dose group ( P = 0.03 ) , while macrophage interleukin-1 production decreased by 38.5 % in the olive oil group ( P not significant ) , 40.6 % in the low-dose group ( P = 0.06 ) , and 54.7 % in the high-dose group ( P = 0.0005 ) . Tritiated thymidine incorporation in peripheral blood mononuclear cells after stimulation with concanavalin A increased significantly in all 3 groups after 24 weeks , compared with baseline values . We conclude that the clinical benefits of dietary supplementation with omega-3 fatty acids are more commonly observed in patients consuming higher dosages of fish oil  for time intervals that are longer than those previously studied . Dietary supplementation with olive oil is also associated with certain changes in immune function , which require further investigation A total of ten healthy elderly subjects ingested one capsule of 600 mg ( corresponding to 150 mg docosahexaenoic acid and 30 mg eicosapentaenoic acid ) RO-PUFA triglycerides per day and ten others ingested one capsule of 600 mg sunflower oil as a placebo for 42 days . In the n-3 polyunsaturated fatty acids ( PUFA ) group , a significant decrease of systolic blood pressure was observed , as well as a trend towards a decrease in both platelet activation and basal formation of thromboxane B(2 ) . Also , a slight but significant increase of docosahexaenoic acid was observed in the phosphatidylethanolamine fraction as well as a significant increase of vitamin E level after the n-3 PUFA intake . Moreover , the basal production of malondialdehyde significantly decreased . No modification was observed for all these parameters in the placebo group . We conclude that a small intake of n-3 PUFA decreased the oxidative stress in platelets of elderly people and could be beneficial in subjects with atherothrombotic tendencies by lowering the cell peroxide tone Patients on  antiretroviral therapy  are reported to have an increased risk of cardiovascular disease . We aim ed to investigate the effect of n-3 polyunsaturated fatty acids ( n-3 PUFAs ) on plasma lipids , lipoproteins and inflammatory markers in HIV-infected patients treated with antiretroviral therapy .  We r and omized 51 patients in a placebo-controlled , double-blind trial to receive either 2 capsules of Omacor ® twice daily or 2 capsules of placebo .  Compliance was measured by determining levels of eicosapentaenoic acid ( EPA ) and docosahexaenoic acid ( DHA ) in neutrophils . Plasma triglycerides were reduced in the n-3 PUFA group by 0.14 mmol/l after 12 weeks of treatment ( n=26 ) , while plasma triglycerides increased by 0.36 mmol/l in the control group ( n=25 ) . The difference between groups was significant , p=0.03 . No significant effect of treatment was found for total cholesterol , high-density lipoprotein ( HDL ) or low-density lipoprotein ( LDL ) cholesterol or apolipoproteins . There was a significant increase in leukotriene B5 ( LTB5 ) and LTB5/LTB4 ratio in the n-3 PUFA group compared to the control group . Baseline values for intercellular adhesion molecule-1 ( ICAM ) , vascular cell adhesion molecule-1 ( VCAM ) and highly sensitive C-reactive protein ( hsCRP ) were comparable at baseline , and the intervention did not change these parameters significantly . The present study showed that treatment with n-3 PUFA  slightly decreased plasma triglycerides and induced anti-inflammatory effects by increasing formation of anti-inflammatory LTB5 Although long-chain n3 polyunsaturated fatty acids [ n3 PUFAs ; eicosapentaenoic acid ( EPA ) and docosahexaenoic acid ( DHA ) ] have been reported to reduce platelet aggregation , the available evidence on this is equivocal . We previously demonstrated that the acute effects of n3 PUFA supplementation on platelet aggregation are sex specific . We aim ed to determine if this gender bias is maintained during long-term n3 PUFA supplementation and whether this translates to other hemostatic markers . A double-blinded , r and omized , placebo controlled trial was conducted in 94 healthy men and women .  Platelet aggregation , thromboxane ( TX ) B2 , P-selectin ( P-sel ) , von Willebr and factor ( vWF ) , and plasminogen activator inhibitor-1 were measured at baseline and 4 wk postsupplementation with EPA-rich ( 1000 mg EPA:200 mg DHA ) or DHA-rich ( 200 mg EPA:1000 mg DHA ) oil capsules daily . The effects of n3 PUFA on platelet activity were compared between men and women . In men and women combined , EPA and DHA  reduced platelet aggregation following 4 wk of supplementation relative to placebo ( -11.8 % , P = 0.016 ; and -14.8 % , P = 0.001 , respectively ) . In subgroup analyses , in men , only the EPA treatment reduced platelet aggregation by -18.4 % compared with placebo ( P = 0.005 ) and women ( P = 0.011 ) . In contrast , in women , only the DHA treatment reduced platelet aggregation ( -18.9 % ) compared with placebo ( P = 0.001 ) and men ( P = 0.017 ) . Significant sex × treatment interactions were also observed on hemostatic markers and uptake of n3 PUFAs . The significant interactions between sex and specific , supplemental , long-chain n3 PUFAs result in platelet aggregation being differentially affected in men and women . With respect to thrombotic disease risk , men are more likely to benefit from supplementation with EPA , whereas women are more responsive to DHA Scope Eicosapentaenoic acid ( EPA ) , abundant in oily fish , is reported to reduce skin inflammation and provide photoprotection , potential mechanisms include competition with arachidonic acid ( AA ) for metabolism by cyclooxygenases/lipoxygenases to less pro-inflammatory mediators . We thus examine impact of EPA intake on levels of AA , EPA and their result ing eicosanoids in human skin with or without ultraviolet radiation ( UVR ) challenge . Methods and results In a double-blind r and omised controlled study , 79 females took 5 g EPA-rich or control lipid for 12 wk .  Pre- and post-supplementation , red blood cell and skin polyunsaturated fatty acids were assessed by GC , and eicosanoids from unexposed and UVR-exposed skin by LC-MS/MS . Active supplementation increased red blood cell and dermal EPA versus control ( both p < 0.001 ) , lowering relative AA : EPA content ( 4:1 versus 15:1 and 5:1 versus 11:1 , respectively ; both p < 0.001 ) . Pre-supplementation , UVR increased PGE2 , 12-hydroxyeicosatetraenoic acids , 12-HEPE ( all p < 0.001 ) and PGE3 ( p < 0.05 ) . Post-EPA , PGE2 was reduced in unchallenged skin ( p < 0.05 ) while EPA-derived PGE3 ( non-sign ) and 12-HEPE ( p < 0.01 ) were elevated post-UVR . Thus , post-EPA , PGE2:PGE3 was lower in unchallenged ( 12:1 versus 28:1 ; p < 0.05 ) and UVR exposed ( 12:1 versus 54:1 ; p < 0.01 ) skin ; 12-hydroxyeicosatetraenoic acids:12-HEPE was lower in UVR-exposed skin ( 3:1 versus 11:1 ; p < 0.001 ) . Conclusion Dietary EPA augments skin EPA : AA content , shifting eicosanoid synthesis towards less pro-inflammatory species , and promoting a regulatory milieu under basal conditions and in response to inflammatory insult In view of the reported potential anti-inflammatory activity of the New Zeal and green lipped mussel ( NZGLM ) , we aim ed to compare the effect of low dose marine oil supplementation , from mussels and fish , in reducing blood markers of inflammation .  Thirty apparently healthy males and females were recruited from the general public in Melbourne , Australia to participate in a double blind , r and omised , parallel intervention study . Subjects were consuming approximately 73 mg of omega-3 long chain polyunsaturated fatty acids ( n-3 LCPUFA ) daily in their background diet prior to the commencement of the intervention . Subjects were r and omly assigned to consume either 2 mL/day of the NZGLM oil preparation ( mixed with olive oil and dl-alpha-tocopherol ) or fish oil preparation ( also mixed with olive oil and dl-alpha-tocopherol ) for six weeks . Two mL of the oils contained 241 mg and 181 mg of n-3 LCPUFA , respectively . Neutrophil phospholipid fatty acids , serum thromboxane B2 ( TXB2 ) , stimulated monocyte production of prostagl and in E2 ( PGE2 ) , interleukin-1 beta ( IL-1 beta ) and tumor necrosis factor alpha ( TNFalpha ) were measured . During the intervention , the total intakes of n-3 LCPUFA from the background diet and the supplements were 199 mg/d and 173 mg/day for the NZGLM and FO groups , respectively . Following six weeks of supplementation , both groups showed a small , but significant increase in neutrophil phospholipid proportion of eicosapentaenoic acid . The NZGLM group also showed a significant increase in docosahexaenoic acid levels . There were no significant changes with time or treatment for TXB2 , PGE2 , IL-1 beta or TNFalpha . This study showed that low dose supplementation with n-3 LCPUFA from two different marine oil preparations showed no difference in inflammatory markers in this group of healthy individuals . Further studies are warranted including dose response trials and studies in population s with inflammatory conditions This double-blind study was design ed to examine and compare the effects of supplementing the existing diet with fish oil or olive oil on lipids and cell function in patients with peripheral vascular disease . Thirty-two patients with symptomatic and angiographically demonstrated peripheral vascular disease were screened , matched , and r and omly allocated to take either 15 g/d fish oil or olive oil for 4 weeks . Fish oil reduced serum triglyceride levels by 26 % , but increased total cholesterol levels due to a significant increase in both low-density lipoprotein cholesterol ( LDL-C ) and high-density lipoprotein-2 cholesterol ( HDL2-C ) . There was a nonsignificant decrease in HDL3-C levels .  Olive oil reduced total cholesterol levels , accountable to a significantly decrease in LDL-C levels . Serum thromboxane B2 ( TXB2 ) levels remained unchanged following fish oil , but were significantly increased by olive oil .  Urinary excretion of TXB2 and 6-keto-PGF1 alpha was unaffected by either oil supplement . Platelet aggregation , which was measured in platelet-rich plasma in response to two doses of collagen or platelet-activating factor ( PAF ) , was significantly reduced after fish oil , but was increased by olive oil . Following fish oil , there was a significant increase in eicosapentaenoic acid ( EPA , 20:5 ) and docosahexaenoic acid ( DHA , 22:6 ) levels and a decrease in arachidonic acid content of platelet phospholipids . The platelet fatty acid composition after olive oil was unchanged . Fish oil decreased neutrophil leukotriene B4 ( LTB4 ) generation following calcium ionophore stimulation by 33 % , while leukotriene B5 levels increased significantly . Neutrophil PAF production and plasma lyso-PAF were unaffected by either oil . ( ABSTRACT TRUNCATED AT 250 WORDS N-3 polyunsaturated fatty acids ( PUFA ) have anti-inflammatory effects and may be useful for the treatment of inflammatory diseases such as rheumatoid arthritis (RA).We examined the efficacy of eicosapentaenoic acid ( EPA ) and docosahexaenoic acid ( DHA ) supplementation on RA on top of st and ard anti-inflammatory treatment . Patients with RA were r and omized into two groups in a double-blind , placebo-controlled , parallel- design multicenter study . One hundred nine patients received five capsules of either n-3 PUFA ( 2.090 g of EPA and 1.165 g of DHA ) or high-oleic-acid sunflower oil for 16 weeks . Eighty-one patients completed the study , and no adverse effects were reported . Dietary intake did not change significantly during the study . There were significant increases in n-3 PUFA and EPA levels in erythrocytes in the n-3 PUFA group versus the placebo group , but decreases in n-6 PUFA , 18:2n6 , 20:4n6 and 18:1n9 levels in the n-3 PUFA group versus the placebo group . N-3 PUFA supplementation had no significant effects on nonsteroidal anti-inflammatory drug ( NSAID ) requirements , clinical symptoms of RA or the concentration of cytokines , eicosanoids and bone turnover markers . However , n-3 PUFA supplementation significantly decreased NSAID requirements and leukotriene B4 levels in patients who weighed more than 55 kg . Our results suggest that n-3 PUFA supplementation has no significant effect on RA but may decrease the requirement for NSAIDs in Korean patients with RA who weigh more than 55 kg Little is known about the effects of dietary supplementation on platelet survival with low doses of n-3 and n-6 fatty acids in patients with hypercholesterolemia . The effects of a 6-week intervention with fish oil capsules ( daily intake : 216 mg eicosapentaenoic acid , 140 mg docosahexaenoic acid , 390 mg gamma-linolenic acid , and 3480 mg linoleic acid ) on in vivo platelet survival ( 111 In-oxine labeled platelets ) and on ex vivo markers of platelet activation were investigated in a placebo-controlled , double-blind study with 26 hypercholesterolemic patients .  In vivo platelet survival increased in the fish oil group ( T ) from a mean of 159+/-14 hours to a mean of 164+/-12 hours ( p=0.025 ) , whereas it remained unchanged in the placebo ( P ) group ( T vs. P ; p=0.055 ) . Ex vivo , thromboxane B2 decreased from a mean of 225+/-16 to 212+/-21 ng/mL ( p=0.003 ) in T but did not change in P ( T vs. P : p=0.002 ) . Malondialdehyde formation was lowered significantly by fish oil supplementation from a mean of 5.49+/-1.3 to 5.12+/-1.05 nM/10(9 ) platelets , p=0.005 , as compared with P ( T vs. P ; p=0.018 ) . The trendwise decrease in 11-DH-thromboxane B2 plasma levels was not significant nor was the increase in platelet sensitivity to prostagl and in I2 by fish oil . Baseline platelet survival in patients with hyperlipoproteinemia type IIa was not different from those with hyperlipoproteinemia IIb and response to treatment in terms of platelet activation markers was not either . The changes in platelet activation parameters in T were associated with significant reductions in cholesterol ( -2.9 % ) , low density lipoprotein cholesterol ( -3.5 % ) , and triglycerides ( -12.4 % ) . Both ex vivo and in vivo platelet activation parameters exhibited signs of decreased activation by a 6-week diet supplemented with n-3 and n-6 fatty acids , which might be beneficial in reducing atherothrombotic risk , in patients with hyperlipoproteinemia type IIa and IIb The profiles of fatty acids ( FAs ) of plasma phospholipids ( the compartment reflecting the essential FA status of tissue lipids ) , nonesterified FAs ( the precursor pool for autacoid synthesis ) , urine protein excretion , and glomerular filtration rate were measured before and after supplementation with fish oil in 15 patients with immunoglobulin A nephropathy . In the FA profiles , there was deficient 18:3 omega 3 ( alpha-linolenic acid ) , the parent compound of omega 3 polyunsaturated FA , and deficient chain elongation products of both omega 3 and omega 6 polyunsaturated FAs with replacement by saturated and monounsaturated short-chain , odd-chain , and branched-chain FAs , producing significant loss of omega 3 FA . These alterations indicate nutritional or functional ( omega 3 ) and metabolic ( omega 6 ) deficiencies . Additionally , the mean melting point of the FAs was significantly increased , implying an inherent decrease in cell membrane fluidity . Enhancement of 20 : 5 omega 3 ( eicosapentaenoic acid ) and 22:6 omega 3 ( docosahexaenoic acid ) and suppression of 20:4 omega 6 ( arachidonate ) after supplementation with fish oil were accompanied by important decreases in proteinuria and improved glomerular filtration rate . Omega-3 polyunsaturated FAs may favorably influence immunoglobulin A nephropathy through a modulation of the pathologic actions of the omega 6 eicosanoids and other diverse actions on various mediators produced by an initial immune injury Dietary n-3 polyunsaturated fatty acids ( PUFA ) derived from fatty fish or fish oil may reduce the incidence of lethal myocardial infa rct ion and sudden cardiac death . This might be due to a prevention of fatal cardiac arrhythmias . So far , however , only few clinical data are available being adequate to define indications for an antiarrhythmic treatment with n-3 PUFA . In a r and omized , double-blind , placebo-controlled study 65 patients with cardiac arrhythmias without coronary heart disease or heart failure were subdivided into 2 groups . One group ( n = 33 ) was supplemented with encapsulated fish oil ( 3g/day , equivalent to 1g/day of n-3 PUFA ) over 6 months . The other group ( n = 32 ) was given 3g/day of olive oil as placebo . In the fish oil group a decrease of serum triglycerides , total cholesterol , LDL cholesterol , plasma free fatty acids and thromboxane B2 as well as an increase of HDL cholesterol were observed . Moreover , a reduced incidence of atrial and ventricular premature complexes , couplets and triplets were documented . Accordingly , higher grade s of Lown 's classification switched to lower grade s at the end of the dietary period . No changes were seen in the placebo group . The data indicate an antiarrhythmic action of n-3 PUFA under conditions of clinical practice which might help to explain the reduced incidence of fatal myocardial infa rct ion and sudden cardiac death in cohorts on a fish-rich diet or supplemented with n-3 PUFA . Further studies elucidating the possible link between the reduced incidence of cardiac arrhythmias and sudden cardiac death by dietary intake of n-3 PUFA are warranted Objective : To examine the effect of ingestion of omega-3 ( N-3 ) fatty acids on the production of interleukin ( IL ) 6 , tumor necrosis factor ( TNF ) α , prostagl and in ( PG ) E2 , lactate dehydrogenase ( LDH ) , creatine kinase ( CK ) , and myoglobin ( Mb ) during an eccentric exercise program . Design : A r and omized , double-blinded , repeated measures design was used for this study . Setting : The study was performed in the Exercise Physiology Laboratory of the Urmia University . Participants : Forty-five men , who had not participated in any training program for 60 days before their participation in this study , were recruited . Interventions : Plasma levels of PGE2 , IL-6 , TNF-α , CK , LDH , and Mb were taken before supplementation , pre-exercise , and immediately , 24 , and 48 hours after eccentric exercise . Subjects were assigned to one of the experimental ( 1.8 g/d N-3 ) , placebo , or control groups . Main Outcome Measures : Plasma levels of PGE2 , IL-6 , and TNF-α were assessed using enzyme-linked immunosorbent assays kits . Plasma level of LDH , Mb , and CK were measured using an autoanalyzer , a c-counter , and an automatic blood analyzer , respectively . Results : The experimental group showed less elevation in TNF-α and PGE2 immediately , 24 , and 48 hours after exercise , when compared with the other groups . Significantly less elevation was shown in the concentration of IL-6 , CK , and Mb for the experimental group at 24 and 48 hours after exercise . The experimental group also demonstrated a significant trend toward reduction in the plasma concentration of LDH immediately , 24 , and 48 hours after the exercise program . Conclusions : Ingestion of N-3 can be effective in ameliorating , eccentric exercise – induced , inflammatory markers The effect of fish-oil supplementation ( FO-S ) on the immune responses of elite swimmers was investigated . In a r and omized placebo-controlled trial , swimmers received either fish-oil capsules ( n=10 ) containing long chain polyunsaturated fatty acids ( FA ) of n-3 ( LCPUFA n-3 ) or placebo capsules ( n=10 ) , both for 6 weeks . Plasma FA , immunological markers , insulin and cortisol were evaluated . The FO-S result ed in an increase in LCPUFA n-3 and a decrease in arachidonic n-6 FA in plasma and a reduction in the production of interferon-gamma by cultured cells . A reduction in the production of tumor necrosis factor-alpha was observed in both groups . An increase in interleukin-2 production and no significant difference in interleukin-4 were also observed . FO-S was able to attenuate the exercise-induced increases in prostagl and in E2 . Circulating concentrations of insulin did not change , while cortisol and glucose showed increase after the study period . These results suggest that FO-S influence exercise-associated immune responses in competitive swimmers Both n-3 and n-6 polyunsaturated fats have been suggested to lower blood pressure , an effect ascribed to altered bio synthesis of eicosanoids . To test these hypotheses , we studied blood pressure and eicosanoid production during supplementation of dietary fat for four weeks in 32 men with mild essential hypertension . Supplementation was preceded and followed by four-week run-in and recovery periods . Groups of eight subjects received either 10 ml or 50 ml of fish oil ( 3 or 15 g of n-3 fatty acids ) daily , 50 ml of safflower oil ( 39 g of n-6 fatty acids ) , or 50 ml of a mixture of oils that approximated the types of fat present in the American diet . The bio synthesis of eicosanoids was assessed by the measurement of urinary metabolites . Blood pressure decreased in the men who received the high dose of fish oil ( systolic pressure by a mean of 6.5 mm Hg [ P less than 0.03 ] and diastolic pressure by 4.4 mm Hg [ P less than 0.015 ] ) , but not in the other groups . Although the formation of vasodilatory prostacyclins ( prostagl and ins I2 and I3 ) increased initially , this increase was not maintained as blood pressure fell . The level of thromboxane A2 metabolites fell ; metabolites of thromboxane A3 were detected in the groups receiving fish oil . The formation of prostagl and in E2 increased during supplementation with safflower oil and tended to decrease with fish oil ; no prostagl and in E3 metabolite was detected . Our data indicate that high doses of fish oil can reduce blood pressure in men with essential hypertension . However , the clinical usefulness and safety of fish oil in the treatment of hypertension will require further study
BACKGROUND Marine-derived n-3 polyunsaturated fatty acids ( PUFA ) may have a beneficial effect on inflammation via lowering pro-inflammatory eicosanoid concentrations .
We aim ed to assess the effect of marine-derived n-3 PUFA on prostagl and in E2 ( PGE2 ) , thromboxane B2 ( TXB2 ) , and leukotriene B4 ( LTB4 ) through systematic review and meta- analysis of r and omized controlled trials .