.: Ophthalmology Can fish oil prevent retinopathy?
.: R & D Grants awarded to develop novel medical devices
Omega-3 fatty acids, found in certain foods and popular fish-oil supplements, may protect against some forms of blindness, say researchers Lois Smith, MD, PhD, and Kip Connor, PhD, of Children's Hospital Boston's Department of Ophthalmology. Their findings, published in the online Nature Medicine June 24, will soon be put to the test in a clinical trial.
Retinopathy, or abnormal blood-vessel growth in the eye's retina, affects about 40,000 premature infants and four million diabetic patients in the United States. It begins with a loss of blood vessels, starving the retina of oxygen and triggering alarm signals to spur new vessel growth. But the new vessels are malformed and over-abundant; in late-stage disease, they actually pull the retina away from its supporting layer, causing blindness.
Studying retinopathy in a mouse model, Smith, Connor and collaborators at the National Eye Institute fed mice diets rich in either omega-3 fatty acids (DHA and EPA) or omega-6 fatty acids. Mice on the omega-3 diet had less initial vessel loss in the retina than the omega-6-fed mice, and had nearly 50 percent less pathological vessel growth afterward. Their retinas also had decreased production of TNF-alpha, an inflammatory compound, whereas production increased on the omega-6-rich diet.
"Our studies suggest that after initial loss, vessels re-grew more quickly and efficiently in the omega-3-fed mice, increasing oxygen supply and dampening the inflammatory alarm signals that lead to pathologic vessel growth," says Connor.
Omega-3 fatty acids—often lacking in Western diets—are highly concentrated in the retina. Premature infants, born too early to get them from their mothers, are particularly deficient in omega-3 and at high risk for vision loss.
The clinical trial will be conducted in collaboration with Mark Puder, MD, PhD, in Surgery, and will follow premature newborns who are receiving omega-3 supplementation as part of their IV nutrition solution. The hope is that these babies' retinas will develop more normally. "We want to mimic what the infants would be getting from their mothers in utero, right from the beginning," says Smith. "Because once the retina is detached, there's little you can do."
Three Children's Hospital Boston research teams have been awarded grants from the Center for Integration of Medicine and Innovative Technology (CIMIT), a Boston-based nonprofit that's proving to be an important source of support for early-stage device research at the hospital.
With CIMIT support, Simon Warfield, PhD, of the Department of Radiology, is developing a brain imaging system that can more accurately locate brain lesions in patients with epilepsy, thereby helping to increase the precision of operations. Adam Wolfberg, MD, MPH, of the Department of Neurology, is working on an improved, unobtrusive fetal monitor that uses sensors placed on the mother's abdomen to record fetal heart rate and detect EKG patterns that signal a dangerous intrauterine infection. Joseph Madsen, MD, in the Department of Neurosurgery, is creating a system to noninvasively measure pressure inside the skulls of patients with head injury, hydrocephalus, subarachnoid hemorrhage and other conditions. His goal is to create a portable device for use by emergency technicians or in battlefield situations.
"The classic CIMIT applicant is a clinician who is tormented by a problem he sees in his patients and wants to work with other researchers to find a solution," says Donald Ingber, MD, PhD, of Vascular Biology, a liaison with CIMIT.
Past CIMIT grantees include Martha Murray, MD (Orthopedic Surgery), for better, noninvasive ways to heal knee injuries; Adre du Plessis, MD (Neurology), for a bedside monitor of cerebral blood flow to identify premature infants at risk for brain injury; John Mayer, MD (Cardiovascular Surgery), to create tissue-engineered, "living" heart valves for children with congenital heart disease; Dario Fauza, MD (Surgery), to enhance imaging during fetal surgery; and Frank Pigula, MD (Cardiac Surgery), to develop a better endoscope for fetal surgery.