Tuesday, July 11, 2017

Omega-3 fatty acids at the 2017 EULAR Annual Meeting in Madrid

The most interesting feature of omega-3 fatty acids (ω-3 FA) is the conversion into docosahexaenoic acid [DHA], out of which resolvins are derived [1], which are termed specialized proresolving mediators [SPMs]. SPMs possess potent anti-inflammation, tissue protection, and tissue healing activities.
Let’s see what science told us at the 2017 EULAR Annual Meeting in Madrid on omega-3 fatty acids.

H.A. Benabdoune and colleagues presented [2]: “REGULATION OF OSTEOCLAST RECRUITMENT AND ACTIVATION BY RESOLVIN D1”. The study is on murine macrophages and human osteoblasts. The results show, that RvD1 [resolvin D1] strongly reduces osteoclast recruitment and activation. RvD1 decreases bone resorption. The authors concluded: “Our in vitro results clearly show that RvD1 may play an important role in the regulation of bone metabolism. Additionally to our previous data, our findings suggest that RvD1 may offer a novel and original perspective to make a real contribution to musculoskeletal and bone diseases therapy.”

R. Castillo and colleagues looked at [3]: “THE EFFECT OF OMEGA-3 FATTY ACIDS ON DISEASE ACTIVITY, ENDOTHELIAL FUNCTION, INFLAMMATORY MARKERS, AND LIPID PROFILE IN SYSTEMIC LUPUS ERYTHEMATOSUS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED, CONTROLLED TRIALS”. But they had to conclude: “The limited data on the use of omega-3 fatty acids has not shown clear benefit in improving disease activity, endothelial function, inflammatory markers, or lipid profile in patients with SLE [stemic lupus erythematodes]. Larger studies for longer durations using standardized scales for measuring outcomes are needed.”

Am I disappointed? Yes.

In 2013 S.M. Proudman and colleagues published [4]: “Fish oil in recent onset rheumatoid arthritis: a randomised, double-blind controlled trial within algorithm-based drug use”. The authors concluded: “FO [fish oil] was associated with benefits additional to those achieved by combination ‘treat-to-target’ DMARDs [disease modifying anti rheumatic drugs] with similar MTX [methotrexate] use. These included reduced triple DMARD failure and a higher rate of ACR [American College of Rheumatology] remission.”

So, why am I disappointed? Patients ask for guidance in dietary interventions. We as the scientific part of therapy leave this field open to quacks. I think that there is quite a lot of research to be done, which won’t be sponsored by the pharmaceutical industry, yet we need this basic research.

Links and References:
[2] DOI: 10.1136/annrheumdis-2017-eular.2934
[3] DOI: 10.1136/annrheumdis-2017-eular.2666


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