Comparing the effect of including omega-3 to treatment regimen in elderly patients with ulcerative colitis with placebo: A randomized clinical tria

Abstract

Introduction: Ulcerative colitis is a chronic inflammatory disease which reduces the quality of life and patients’ productivity. People in different ages could be affected since its complications such as colon perforation and cancer are common. Oxidative stress is reported to create an imbalance between reactive oxygen species (ROS) and antioxidant defense systems which occurs in inflammatory tissues and predisposing malignant tumors. Objectives: We aimed to evaluate the effects of omega-3 on inflammatory, antioxidant, and oxidative markers of patients with ulcerative colitis. Patients and Methods: Seventy elderly patients with ulcerative colitis referring to Rasoul-e-Akram hospital (Iran University of Medical Sciences) with mild or moderate phase of the disease were investigated. Patients were undergoing their protocol treatment. Patients were randomly assigned to the block randomization assignment, including 35 patients (routine + omega-3) or control (routine + placebo). Based on a researcher-made checklist, the severity of the disease, as well as the oxidant, antioxidant, and inflammatory factors of the patients were determined before and after 2 months of treatment. Finally, the changes in these factors were compared between groups. Results: Among the 70 participants, 35 were in the control and 35 in the intervention group. All subjects were present during the whole period of the study, so the attrition rate was 0%. No significant difference was observed between the mean of BMI (body mass index) as kg/m2, waist circumference (cm), systolic pressure (mm Hg), and diastolic pressure (mm Hg) in both groups before and after the intervention. The measure of optimal changes in serum levels of MDA (malondialdehyde oxidant), AGEs (advanced glycation end-products), oxidized LDL (oxidized low density lipoprotein), TNF-α (tumor necrosis factor-alpha) and the improvement of antioxidant catalase copper markers were significantly higher in the intervention group, compared to the control one. Conclusion: Administration of omega-3 as an auxiliary component in the treatment of patients significantly reduced the levels of inflammatory and oxidative markers and a significant increase in antioxidant markers in the serum and improved blood pressure in patients with ulcerative colitis.

Antioxidant Therapy in Inflammatory Bowel Disease: A Systematic Review and a Meta-Analysis of Randomized Clinical Trials

“…In this systematic review with meta-analysis, a total of 19 studies were identified according to the predefined inclusion criteria (Figure 1). Among them, 9 studies (47.3%) focused solely on patients with UC [11][12][13][14][15][16][17][18][19], 6 studies (31.6%) included only patients with DC [20][21][22][23][24][25], and 4 studies (21.0%) encompassed both diseases (CD and UC) [26][27][28][29]. Most of the studies (n = 17; 89.5%) involved adult patients, while 2 studies (11.5%) were specifically conducted on children and adolescents [24,25].…”

“…Most of the studies (n = 17; 89.5%) involved adult patients, while 2 studies (11.5%) were specifically conducted on children and adolescents [24,25]. The selected studies exhibited diverse designs, with 15 studies (78.9%) being double-blind, placebo-controlled randomized trials [11,12,[14][15][16][17][18][19][20][21][22][23][26][27][28].…”

“…Co-enzime Q10 and azathioprin traditional medication used in the treatment of IBD-were investigated by [18,25] (T 1). A wide range of substances were tested in the included studies, including micronutrients such as antioxidant vitamin complexes [21] or isolated vitamins [13,22,29], zinc [20], the amino acid glutamine [23], functional foods such as flaxseed [14], and omega-3 fatty acids [11,17,20]. The polyphenols [12,24] or polyphenol-rich foods [16,19], plant extracts [15,26,27] and probiotics [28] were also investigated.…”

“…Regarding the evaluated biomarkers of antioxidant defense, prominent ones included superoxide dismutase (SOD) [11,12,17,[19][20][21][24][25][26], glutathione peroxidase (GPx) [17,19,21,24], and catalase [11,17,25], as well as antioxidant capacity [11][12][13]15,16,19,21,27]. Lipid membrane damage (lipid peroxidation-PL) was the most investigated macromolecular damage by the authors [11,12,[15][16][17]19,[22][23][24], while only two studies assessed transcription factors such as factor nuclear kappa B (NFκB) [15] and nuclear factor erythroid 2-related factor 2 (Nrf2) [25]. Legend: * = gene expression; n = total number; ↑ = increased; ↓ = reduced.…”

The effect of seafood oil omega-3 supplementation on ulcerative colitis remission: A systematic review

“…Thus, antioxidants such as marine oil omega-3 can downregulate the inducible isoforms of nitric oxide, myeloperoxidase, lipoxygenases, cyclooxygenase, and nicotinamide adenine dinucleotide phosphate oxidase. They can also prevent the formation of free radicals by enhancing glutathione peroxidase, catalase, superoxide dismutase, paraoxonase, and peroxiredoxins (46,47,53).…”