n-3 polyunsaturated fatty acids supplementation in psoriasis: a review

Psoriasis is an immune mediated chronic inflammatory disease of unknown etiology and characterized by epidermal hyperplasia and inappropriate immune activation, which affects the skin and joints as well.The immunopathogenesis of psoriasis involves changes in the innate and acquired (T lymphocytes) immune system. The cells of the innate immune system when activated produce growth factors, cytokines, and chemokines that act on cells of the acquired immune system and vice versa, being characterized as atype 1 immune response disease. Fish oil n-3 polyunsaturated fatty acids, mainly eicosapentaenoic (EPA), and docosahexaenoic acids (DHA), reduce symptoms in many inflammatory skin diseases. The mechanism of action of fish oil in the treatment of psoriasis is widely based on the alteration of epidermal and blood cell membrane lipid composition. In the present study, we performed a review of the several studies, which analyzed the action of n-3 polyunsaturated fatty acids in patients with psoriasis. Taken together, the majority of the studies showed that n-3 polyunsaturated fatty acids, mainly from marine origin, have beneficial effects and can be utilized as adjuvant therapy in psoriasis treatment. Both oral and intravenous administration of fish oil n-3 polyunsaturated fatty acids had positive effects. However, further studies are warranted to answer many intriguing questions, for instance, the ideal quantity of fish oil to be utilized, the effect on different forms and severity of psoriasis and last, but not least, the consequences of using fish oil n-3 polyunsaturated fatty acids on the cardiovascular features of patients with psoriasis.

Role of fish oil in gasoline vapor-induced lung damage in adult male albino rats

Background: Exposure to gasoline vapor is known to produce oxidative stress and induce pulmonary diseases. Fish oil was found to play a role in the prevention of chronic lung diseases through its antioxidant and anti-inflammatory properties

Aim of the study: To study the role of fish oil in lung changes induced by gasoline vapor inhalation in male adult albino rats

Materials and methods: Eighty adult male albino rats were divided randomly into four groups of 20 rats each: control, gasoline-exposed, gasoline+fish oil-concomitant, and fish oil-treated groups. The rats of the control group were subjected to fresh air, whereas rats of the gasoline-exposed group were exposed to gasoline vapor for 10 weeks. Rats of the concomitant group received 0.5 ml/kg fish oil orally daily while being exposed to gasoline vapor. Rats of the fish oil-treated group only received fish oil. Right and left lungs were processed for light and electron microscopic examination, respectively

Results: Lung tissues of gasoline vapor-exposed rats showed collapsed alveoli, thick interalveolar septa, inflammatory cell infiltration, intra-alveolar exudates, hemorrhage, fibrosis, and hypocellularity. Rats of the concomitant group showed a marked reduction in these pathological features

Conclusion: There is evidence that fish oil can ameliorate lung changes induced by gasoline vapor inhalation

Avaliação de colesterol e triglicerídeos séricos em cães saudáveis suplementados com ômega n-3 / Evaluation of serum cholesterol and triglycerides in healthy dogs supplemented with ômega-3 N

A análise da concentração sérica de colesterol e triglicerídeos foi realizada em 20 cães, sem raça definida, saudáveis, 10 machos e 10 fêmeas, previamente e após a suplementação por 30 dias com ácidos graxos poli-insaturados de cadeia longa derivados do ômega n-3 (497mg ácido docosa-hexaenoico e 780mg ácido eicosapentanoico). A concentração sérica de colesterol apresentou redução significativa após a suplementação em ambos os sexos (271,6±79,8mg/dL; 236,2±67,6mg/dL, antes e após suplementação, respectivamente). Em relação à concentração sérica de triglicerídeos, houve redução apenas nas fêmeas (57,8±12,1mg/dL; 45,2±7,8mg/dL, antes e após suplementação, respectivamente), não havendo efeito da suplementação nos machos.

The analysis of serum cholesterol and triglycerides was performed in 20 healthy mongrel dogs, 10 male and 10 female, before and after supplementation for 30 days with fatty acids of long chain polyunsaturated derived from omega-3 n (497mg docosahexaenoic acid and 780mg eicosapentaenoic acid). The serum cholesterol presented a significant reduction after supplementation in both sexes (271.6±79.8mg/dL; 236,2±67,6mg/dL, before and after supplementation respectively). Regarding serum triglycerides, there was a reduction only in females (57.8±12,1mg/dL; 45.2±7,8mg/dL, before and after supplementation respectively), with no effect of supplementation in males.

Validation of the Oxford Classification of IgA Nephropathy: A Single-Center Study in Korean Adults

BACKGROUND/AIMS: The recently published Oxford classification of IgA nephropathy (IgAN) proposed a split system for histological grading, based on prognostic pathological features. This new classification system must be validated in a variety of cohorts. We investigated whether these pathological features were applicable to an adult Korean population. METHODS: In total, 69 adult Korean patients with IgAN were analyzed using the Oxford classification system at Soonchunhyang University Hospital, Seoul, Korea. All cases were categorized according to Lee's classification. Renal biopsies from all patients were scored by a pathologist who was blinded to the clinical data for pathological variables. Inclusion criteria were age greater than 18 years and at least 36 months of follow-up. We excluded cases with secondary IgAN, diabetic nephropathy combined other glomerulopathies, less than 36 months of follow-up, and those that progressed rapidly. RESULTS: The median age of the patients was 34 years (range, 27 to 45). Mean arterial blood pressure was 97 +/- 10 mmHg at the time of biopsy. The median follow-up period was 85 months (range, 60 to 114). Kaplan-Meier analysis showed significant prognostic predictions for M, E, and T lesions. A Cox proportional hazard regression analysis also revealed prognostic predictions for E and T lesions. CONCLUSIONS: Using the Oxford classification in IgAN, E, and T lesions predicted renal outcome in Korean adults after taking clinical variables into account.

Nefropatía por Inmunoglobulina A: Guía de práctica clínica / Immunoglobulin A nephropathy: Clinical Practice Guidelines

La nefropatía por Inmunoglobulina A (N.IgA) es la causa más frecuente de enfermedad glomerular a nivel mundial, 15-50% de los pacientes presentan pérdida progresiva de la función renal en 10-20 años; el resto remisión clínica o hematuria/ proteinuria persistente. Su tratamiento óptimo es incierto. Nuestro objetivo fue desarrollar recomendaciones basadas en la evidencia a través de búsqueda en bases de datos Medline, Embase, Lilacs, Cochrane Trials Register. Los investigadores analizaron la calidad de los estudios independientemente, usando la Cochrane Renal Group checklist: aleatorización, carácter ciego, intención de tratar y pérdidas en el seguimiento. La evidencia se clasificó en niveles y la recomendación en grados, según el Centre for Evidence-Based Medicine, Oxford, con dos enfoques principales: Terapia inmunosupresora (corticoides, citostáticos, ciclosporina A y micofenolato mofetilo): Nivel I a, grado A. Terapia combinada con inmunosupresores en adultos: Nivel II b, grado B. Corticoides más ciclofosfamida o azatioprina en niños: Nivel II b, grado C. Ciclosporina y micofenolato-mofetilo: Nivel II b, grado B. Terapia no inmunosupresora: inhibidores del sistema renina-angiotensina (IEAC) y/o bloqueantes del receptor de angiotensina II (BRAII), aceite de pescado, estatinas, antiplaquetarios y tonsilectomía: Nivel I a, grado A. Niños: IECA y BRAII con monitoreo de función renal y de nivel sérico de potasio: Nivel I b, grado B. En nefropatía progresiva, antiplaquetarios como tratamiento coadyuvante: Nivel I, grado C. Aceite de pescado como soporte adicionado de BRAII e IECA en pacientes con lesiones histológicas leves y baja reducción de la filtración glomerular: Nivel II b, grado B (no en niños). No hay evidencias para recomendar estatinas en niños; en mayores de 5 años con síndrome nefrótico e hipercolesterolemia usar sólo con monitoreo de fosfocreatin-kinasa sérica. No hay evidencias para recomendar la tonsilectomía.

Immunoglobulin A nephropathy (N.IgA) is the world most common glomerular disease; 15-50% of patients develop loss of renal function in 10-20 years, and the rest remission or mild proteinuria/ hematuria. The optimal treatment is uncertain. Our aim was to develop evidence-based recommendations through research in Medline, Embasse, Lilacs and Cochrane Central Register of Controlled Trials. The study-quality was independently assessed by the reviewers following the Cochrane Renal Group checklist: randomization, blinding, intention-to-treat analysis and follow-up period. Levels of evidence and grades of recommendation were assigned according to Center for Evidence-Based Medicine, Oxford. Two approaches were considered: Immunosuppressive therapy (corticosteroids, cytostatics, cyclosporine A, mycophenolate-mofetil): Level I a, grade A. -Combined suppressive therapy in adults. Corticosteroids plus cytotoxics drugs (cyclophosphamide/azathioprine): Level II b, grade B. In children with severe IgA nephropathy: Level II b, grade D. Cyclosporine and mycophenolate- mophetil: Level II b, grade C. Cyclosporine and mycophenolate-mophetil: Level ll b, grade C. -Non immunosuppressive therapy: reninangiotensin converting enzyme inhibitors (ACEI) and/or angiotensin II receptor blockers (ARB), fish oil, statins, antiplatelets and tonsillectomy. ACEI and/or ARB, in patients with proteinuria =1 g: Level I a, grade A. In children with moderate proteinuria: ACEI and/or ARB with close monitoring of renal function and serum potassium level: Level II b, grade B. Antiplatelet as supportive treatment: Level I a, grade C. Fish oil in addition to ACEI or ARB in patients with mild histological lesions: Level II b, grade B (Not in children). Statins: no evidence to recommend these drugs in children. In patients > 5 years with nephrotic syndrome and hyper-cholesterolemia, use statins with close monitoring of serum creatine-kinase. There is no evidence to recommend tonsillectomy.

Cápsulas de óleo de peixe: percepção da dosagem e finalidade de consumo / Capsules of fish oil: the perception of strength and purpose of consumption

O objetivo desse estudo foi conhecer o perfil do consumidor de cápsulas de óleo de peixe compradas em farmácias de manipulação, localizadas no Estado do Rio de Janeiro tendo como referencial a finalidade de consumo. O projeto foi desenvolvido no município do Rio de Janeiro e município de Duque de Caxias que apresentaram maior número de farmácias de manipulação regularizadas no Conselho Regional de Farmácia do Rio de Janeiro (CRF-RJ). Como estratégia para obtenção de informações sobre o consumo, utilizou-se o banco de dados Pharma, programa de gerenciamento de farmácias de manipulação, e entrevistas realizadas com os consumidores. A população pesquisada foi majoritariamente feminina, na faixa etária de 15 a 24 anos, solteiras e cursando nível superior. Em relação aos objetivos de consumo de cápsulas de óleo de peixe na amostra pesquisada, verificou-se que a maioria dos consumidores (41,32%) utilizou o produto visando a diminuição dos níveis de colesterol e 32,6% desta população a obtenção de ação antioxidante com fins estéticos. Concluiu-se que o consumidor não possui conhecimento a respeito das dosagens adequadas farmacologicamente a finalidade de consumo desse produto. Somente 3,94% da população estudada conhecia a dosagem adequada para alcançar os respectivos objetivos terapêuticos. Pode-se observar que a maioria dos consumidores de cápsulas de óleo de peixe da amostra pesquisada utilizou o produto baseando-se em informações de amigos, internet, revistas e televisão. Dos sujeitos da pesquisa do sexo masculino, somente 6,06% consultou um médico enquanto que esta frequência foi de 16,66% na população do sexo feminino. Este estudo visou ainda fornecer subsídios para a formulação de propostas de controle para a utilização de alimentos funcionais e fundamentar parâmetros que garantam a proteção à saúde da população pelos órgãos competentes, através da venda segura de suplementos alimentares no Brasil.

The aim of this study was to identify consumer capsules of fish oil purchased in pharmacies, located in Rio de Janeiro referencing the purpose of consumption. The project was developed in Rio de Janeiro and Duque de Caxias with the highest number of pharmacies in regularized by the Regional PharmacyConcil (CRF-RJ). We used information from the database Pharma is a management program for pharmacies, and interviews with consumers. The research population was predominantly female, aged 15 to 24, unmarried and studying in higher education. For the purposes of consumption in the sample surveyed, it was found that most consumers (41.32%) used the capsules of fish oil in order to reduce the levels of cholesterol and 32.6% of this population had the goal of consumption to obtain an antioxidant for cosmetic purposes. One of the possible conclusions is the ignorance of consumers regarding appropriate dosages pharmacologically the goal of consumption of this product. Only 3.94% of the women knew the correct dosage to achieve their therapeutic goals, while 96.06% did not know the proper dosage. This study found that most consumers of capsules of fish oil from our sample used the product based on information from friends, internet, magazines and television. Among men surveyed, only 6.06% consulted a doctor while this rate was 16.66% for female audience. This result represents a risk to the health of consumers by undermining the goals of consumption when the dosage of functional food is not eaten as recommended pharmacological. This study also aimed to provide information for formulating proposals for the control and use of functional foods and establish parameters that ensure the protection of health of the population by the competent bodies, through the sale of dietary supplements safe in Brazil.

Efeitos e mecanismos de ação dos ácidos graxos poliinsaturados n-3 na prevenção de doenças cardiovasculares / Mechanisms of action of polyunsaturated n-3 fatty acids for cardiovascular disease prevention

A ingestão de óleo de peixe tem demonstrado efeitos benéficos na prevenção das doenças cardiovasculares (DCV) e este efeito está relacionado à presença de ácidos graxos poliinsaturados n-3, em especial dos ácidos eicosapentaenóico (EPA, C20:5n-3) e docosahexaenóico (DHA, C22:6n-3), encontrados nos óleos de peixes de águas frias e profundas como salmão, arenque, atum e sardinhas. Estes compostos têm demonstrado importante ação antilipêmica, antiinflamatória, antitrombótica, antiarrítimica, anti-hipertensiva, entre outras. A ingestão de óleo de peixe em pacientes com doença cardíaca isquêmica e hiperlipoproteinemia diminuiu os níveis séricos de fibrinogênio, a viscosidade plasmática e a resistência vascular periférica total. Eles também atuam ajudando a manter a elasticidade da parede das artérias, impedindo a coagulação do sangue, reduzindo a pressão sangüínea e estabilizando a arritmia cardíaca. O seu principal efeito nas doenças coronárias é a redução da produção de tromboxana A2, agregante plaquetário que favorece a trombose. Outra ação destes compostos é a redução nos níveis de triacilgliceróis e da lipoproteína de densidade muito baixa (VLDL), porém com aumento da lipoproteína de baixa densidade (LDL). O aumento da LDL com redução da VLDL parece estar relacionado com a conversão da VLDL em LDL ou à redução na atividade do receptor de LDL. O EPA e o DHA modulam a resposta inflamatória, atuando na diminuição da transcrição de citocinas pró-inflamatórias e na expressão de moléculas de adesão na superfície vascular. Este estudo propõe-se a revisar os principais mecanismos envolvidos na prevenção de DCV pelos ácidos graxos n-3.

Fish oil ingestion has shown beneficial effects for cardiovascular disease (CVD) prevention, and this effect is related to the polyunsaturated fatty acids, specially eicosapentaenoic (EPA, C20:5n-3) and docosahexaenoic (DHA, C22:6n-3), found in fish from cold and deep water, such as salmon, tune and sardine. These compounds have important antilipidemic, antiinflammatory, antithrombotic, antiarrhytmic, and antihypertensive action. Fish oil ingestion in patients with ischemic heart disease and hyperlipoproteinemia decreased fibrinogen serum levels, plasmatic viscosity and total peripheral resistance. They also act by helping to maintain artery wall elasticity, preventing blood coagulation, reducing blood pressure and preventing fatal cardiac arrhythmias. Their major effect in coronary disease isthe decrease production of thromboxane A2, platelet aggregant that favors thrombosis; another effect is the reduction of tryacylglicerol levels and very low density lipoprotein (VLDL), although with low density lipoprotein (LDL) increase. This increment seems related to the conversion of VLDL in LDL or to the decreased activity of LDL receptor. EPA and DHA modulate inflammatory reaction through the reduction of pro-inflammatory cytokines transcription and adhesion molecules expression on the vascular surface. This review proposes to study the main mechanisms evolved in CVD prevention by n-3 polyunsaturated fatty acids.

Colonic secretion studied in vitro in rats fed polyunsaturated fatty acids.

Recent studies primarily in man have shown that cod fish oil rich in polyunsaturated fatty acids (PUFA) are beneficial to certain inflammatory diseases such as ulcerative colitis. This study was undertaken to observe any change in intestinal secretion where the tissues have been treated with cod fish and sunflower oils. Male Sprague Dawley rats weighing 200 gms were fed omega-3 fatty acids for 50 days. Changes in colonic secretion (fed with PUFA) were studied in-vitro in an Ussing chamber. Rat colon which were not fed with PUFA served as controls. Basal intestinal short circuit in PUFA group were comparable with control group in stripped rat colon. The results showed significant high short circuit current in cod fish oil and sunflower oil treated tissues. When stripped colonic tissues (fed with PUFA) were stimulated by EC50 of carbachol, bradykinin and prostaglandin; there was no significant changes in Short circuit current. PGE2 and LTB4 levels were measured in rat colon fed with PUFA by using radioimmunoassay. Biochemical changes in PGE2 and LTB4 levels showed LTB4 were significantly raised in both cod fish oil group and sunflower oil group. This study reveals that intestinal permeability increases in the rat colon (fed with PUFA) as indicated by high short circuit current. The high levels of leukotriene in colonic tissues also explains the high basal short circuit current in the present study.

Effect of combined supplementation of fish oil with garlic pearls on the serum lipid profile in hypercholesterolemic subjects.

BACKGROUND: Elevated total cholesterol, especially low-density lipoprotein has been documented as the leading risk factor for the coronary artery disease among Indians. Studies with fish oil supplementation alone have shown an increase in low-density lipoprotein, thereby enhancing the risk associated with incidence of coronary artery disease in hypercholesterolemic subjects. In view of this, the effect of a combined supplementation of fish oil with garlic pearls on the serum lipid profile of hypercholesterolemic subjects was studied. METHODS AND RESULTS: We administered 600 mg of fish oil with 500 mg of garlic pearls (garlic oil) per day to 16 hypercholesterolemic subjects (age range: 30-60 years) with a total cholesterol above 220 mg/dl for 60 days. The effect of this combined supplementation was compared with that of a control group (16 hypercholesterolemic subjects) without any supplementation. The baseline body height and weight of all the subjects were recorded. Significant reductions were seen in all the lipid parameters (except high-density lipoprotein which was increased) in the test group after 60 days compared to that of the control group. The total cholesterol, low-density lipoprotein, serum triglyceride, very low-density lipoprotein, and the total cholesterol: high-density lipoprotein ratio reduced by 20%, 21%, 37%, 36.7%, and 23.4%, respectively, and the high-density lipoprotein increased by 5.1% after 60 days of supplementation. CONCLUSIONS: The co-administration of garlic pearls with fish oil was found to be more effective than placebo in the management of dyslipidemia.

Effect of fish oil on oxidative stress, lipid profile and renal function in IgA nephropathy.

The omega-3 polyunsaturated fatty acids in fish oil have been shown to produce beneficial effects, such as a reduction in blood pressure, proteinuria, lipid levels and inflammation. Aggregated immunoglobulin A obtained from IgA nephropathy patients induced greater oxygen free radicals in polymorphonuclear leukocytes than other glomerulopathy. All of which may affect the course of IgA nephropathy. Twenty-three adult patients with biopsy proven IgA nephropathy, with proteinuria more than 1 g/day, serum creatinine less than 3 mg/dl and blood pressure control less than 130/80 mmHg were given omega-3 polyunsaturated fatty acids (PUFA) in the form of an Omacor capsule 4 g/day equivalent to eicosapentaenoic acid (EPA) 1.88 g and docosahexaenoic acid (DHA) 1.48 g for 6 months. A 3 to 6 month follow-up was planned, with monthly evaluations of the patients. By six months, the serum triglyceride was significantly reduced (143.45 +/- 62.65 vs 91 +/- 42.89 mg/dl, p = 0.002), serum cholesterol was also reduced but not statistically significant (234.16 +/- 56.29 vs 219.76 +/- 51.25 mg/dl, p = 0.07). There was a trend of increased serum high density lipoprotein (HDL)-cholesterol (39.26 +/- 10.56 vs 42.72 +/- 8.37 mg/dl, p = 0.056). Urine beta-2-microglobulin was elevated in IgA patients and decreased statistically significant after 3 months (453 +/- 580 vs 308 +/- 274 microg/24 h, p < 0.001) and 6 months of fish oil therapy (453 +/- 580 vs 142 +/- 182, p < 0.03) while urine N-acetyl-glucosaminidase (NAG) was of no significant difference both before and after fish oil administration (21 +/- 10 vs 22 +/- 10 and 21 +/- 9 U/24 h, p = 0.08). Plasma malondialdehyde (MDA), the end product of oxidative stress was statistically, significantly decreased (1.09 +/- 0.51 vs 0.89 +/- 0.49 nmol/L, p = 0.003). The study did not show any change in blood pressure, proteinuria, or serum creatinine. The authors conclude from the results of this study that patients with idiopathic IgA nephropathy with proteinuria and mildly reduced GFR did not benefit from short-term treatment with 4 g per day of omega-3 PUFA regarding the total protein excretion and glomerular filtration rate (GFR), but the advantage was the improvement in tubular dysfunction, lipid profiles, and oxidative stress.

El aceite de pescado mejora el control de la glicemia sin alterar los lípidos plasmáticos en ratas con tolerancia glucosada anormal / The fish oil betterment the control of the glycemy without alter them lipids plasmatics in rats with abnormal glucosed permissiveness

El objetivo del presente estudio fue determinar el efecto del tratamiento con dosis moderadas de aceite de pescado por tiempo prolongado, sobre el control de la glicemia y lipidos plasmáticos en ratas machas Sprague Dawley espontáneamente intolerante a la glucosa (IG). 37 ratas con tolerancia glucosada anormal fueron divididos en dos grupos, una experimental (19 ratas), que recibió por sonda orogástrica aceite de pescado (MAXEPA) (40 mg/Kg/día) durante 16 semanas y un grupo control constituido por 18 ratas, el cual recibió el mismo volumen de solución salina. Mientras que la glicemia basal y posterior a la sobrecarga glucosada mostraron una mejoría significativa (control basal 118,83 ñ 3,23 30' 165,45 ñ 12,1; 60' 153,1 ñ 10,65; 120 139,9 ñ 4,49 mg/dl vs aceite de pescado basal 108,6 ñ 3,15 [p<0,03]; 30 140,2 ñ 8,83 [p<0,05] mg/dl), sin embargo, los hallazgos sobre el perfil lipídico no fueron significativos

Efeito comparativo entre ácidos graxos w3 e sulfassalazina sobre indicadores de atividade da doença e a cinética da 15N-Glicina no tratamento de pacientes com retocolite inespecífica / Comparison of omega 3 fatty acids and sulfasalazine in ulcerative colitis

A açäo antiinflamatória da sulfassalazina (SS) e dos ácidos graxos poliinsaturados w3 foi estudada, comparativamente, em 10 pacientes (cinco homens e cinco mulheres) com média de idade de 48ñ12 anos, portadores de retocolite ulcerativa inespecífica nas formas leve e moderada, divididos em 2 grupos. Cada grupo recebeu, durante 2 meses, SS (2g/dia) ou ácidos graxos w3 de óleo de peixe (5,4g/dia), segundo delineamento cruzado em que o tratamento com w3 foi seguido de 2 meses de "washout". A avaliaçäo da atividade da doença (clínico, laboratorial, histológica e retossigmoidoscópica), do estado nutricional e do metabolismo protéico global (15N-glicina) foram realizados no início (M1), após 2 meses (M2) e no final do tratamento (M3). No pré tratamento (M1) nenhum paciente se encontrava desnutrido, permanecendo desta forma até M3. Apenas um paciente descompensou durante o estudo, quando fazia uso de ácidos graxos w3. A menor atividade da doença foi observada nos períodos em que a SS foi empregada. Isto pode ser detectado mediante alguns indicadores clínicos (sangramento retal, número de evacuaçöes e consistência das fezes), laboratoriais (contagem de plaquetas, VHS, PCR e alfa1-glicoproteína ácida) e escore histopatológico (a 15 cm da reborda anal). As principais alteraçöes do metabolismo protéico foram no sentido do menor ritmo metabólico conseqüente ao uso da SS. Desta forma, a atividade da doença parece menos responsiva aos ácidos graxos w3, que à SS, o que pode ser detectado pelos indicadores clássicos mais sensíveis, e também pelo estudo cinético de aminoácidos.

Atividade biológica e uso clínico do óleo de peixe / Biological activity of fish oil

Acidos graxos ômega-3 (n-3), encontrados principalmente na gordura de peixes marinhos, sao representados pelos ácidos alfa-linolênico, eicosapentaenóico e docosahexaenóico. Após 72 horas de suplementaçao dietética com esses ácidos graxos, há alteraçao da composiçao da membrana celular e diminuiçao na síntese de prostaglandinas e tromboxanes da série 2 e leucotrienos da série 4 e ocorre substituiçao por prostaglandinas, tromboxanes, e leucotrienos das séries 3 e 5, respectivamente. Estas alteraçoes podem modular a resposta inflamatória e interferir em mecanismos patológicos. Os ácidos graxos n-3 têm sido usados em cardiopatias, com resultados favoráveis na diminuiçao da colesterolemia e pressao arterial e em doenças imunológicas como psoríase, artrite reumatóide e doença de Crohn. Experimentalmente, o ácido graxo n-3 diminuiu o crescimento de tumores e suprimiu metástases. Os autores consideram a biofisiologia dos ácidos graxos n-3 e refletem sobre os resultados de seu uso clínico até o momento.

Dyslipidemia in patients with chronic renal failure and in renal transplant patients.

Indian studies on lipid profile abnormalities in chronic renal failure (CRF) have varied from no abnormalities at all to significant abnormality (hypertriglyceridemia and reduced HDL) as described in the Western literature. Moreover, there is no Indian study on the effect of renal transplantation on the abnormal lipid profile of CRF. The aim of our study was to determine the lipid profile of CRF patients on conservative treatment, end stage renal disease (ESRD) patients on maintenance hemodialysis (HD) treatment and renal transplant patients. We also looked at the effect of fish oil rich in polyunsaturated fatty acids (Max-EPA) on hypertriglyceridemia of CRF. The study included 4 groups; Gp I: control subjects (n = 9, age = 30 +/- 5 yrs), Gp II: CRF patients on conservative treatment (n = 9, age = 49 +/- 17 yrs), Gp III: ESRD patients on HD for at least 3 months (n = 19, age = 53 +/- 9 yrs), Gp IV: 3 months post-renal transplant patients (n = 9, age 31 +/- 11 yrs). The lipids and lipoproteins analysed include total cholesterol, HDL, LDL, triglycerides, Apo A1 and Apo B. It was observed that in Gp II patients triglycerides were significantly elevated (p < .05) and Apo A1/Apo B significantly abnormally lower (p < .001) compared to Gp I. In Gp IV patients, there was no significant difference in lipid profile compared to Gp I. With the use of Max-EPA in 5 patients with hypertriglyceridemia, there was a significant improvement in hypertriglyceridemia (p < .05). Our study suggests: 1) significant hypertriglyceridemia does develop in a majority of CRF patients. The abnormality probably improves with dialysis treatment and renal transplantation. 2) A lower Apo A1/Apo B ratio in CRF patients may account for higher risk of atherosclerosis. 3) Fish oil rich in polyunsaturated fatty acids improves hypertriglyceridemia of CRF.

Aterosclerose e ácidos graxos ômega-3 / Atherosclerosis and omega-3 fatty acid

Os autores apresentam uma revisäo da aterosclerose e ácidos graxos ômega-3. Têm por objetivo chamar a atençäo para um alimento näo muito consumido pela populaçäo brasileira e, segundo muitos pesquisadores, com propriedades que podem ajudar na prevençäo da aterosclerose - o PEIXE

Tratamiento de psoriasis con aceite de pescado / Treatment of the psoriasis with fisk oil

Se realizó un estudio abierto en 25 pacientes portadores de psoriasis crónica resistentes a otros tratamientos. El ensayo consistió en la administración de aceite de pescado por un período de seis meses. La respuesta de los pacientes fué excelente con mejoría de las lesiones entre un 50 a 90%. Se analizan los resultados

Una nueva prueba funcional para el diagnóstico etiológico de las hipertrigliceridemias primarias, mediante la administración de ácidos grasos n-3 / An news test functional for the diagnostic etiologic the primary hipertriaglyceridemias, intervening the administration of fatty acids n-3

Las hipertrigliceridemias humanas se producen por aumento de síntesis de triglicéridos (TG) y/o por déficit de degradación. La sobreproducción hepática de lipoproteínas de muy baja densidad (VLDL) es difícilmente demostrable. Para tipificarla utilizamos ácidos n-3 (AG n-3), que inhiben la producción hepática de TG-VLDL. Se ha diseñado una prueba funcional que consiste en administrar 3,6 g/día de AG n-3 durante 5 días, midiendo lipoproteínas basales y post prueba. Se estudiaron 22 pacientes con hipertrigliceridemias primarias, con peso normal, cuya adherencia a la prueba se comprobó por el aumento de AG n-3 plasmáticos de 2,8+0,5 a 7,2+0,7% (X+ES) (p<0,001). Se agruparon los pacientes según su fenotipo de dislipoproteinemia clasificada por OMS. Diez pacientes, tipo IV, mostraron las siguientes variaciones (pre a post, mg/dl) (X+ES) TG: 454+50 a 237+22 (p<0,001): colesterol de LDL (C-LDL): 112+8 a 144+7 (p<0,01). Colesterol de VLDL (C-VLDL): 62+18 a 30+8 (p<0,02). Ocho pacientes tipo IIb mostraron TG:344+72 a 233+55 (p<0.001). C-LDL:197+9 a 196+19 (NS) y C-VLDL: 43+11 a 33+8 (NS). Un paciente, tipo V con lipoproteínas lipasa inactiva y lipasa hepática de actividad normal no varió los TG, otro del mismo tipo disminuyó los TG de 1.644 a 700. Dos pacientes de tipo III con colesterol en lipoproteínas intermedias de 50 a 67 mg/dl respectivamente, no modificaron la trigliceridemia. Se distinguen los pacientes de tipo IV, que respondieron a la prueba disminuyendo la síntesis de TG de los tipos V y III que no respondieron. Los pacientes IIb no disminuyeron el C-LDL, lo que sugiere que este aumento no se debe a sobreproducción de la precursora VLDL.