Dietary omega-3 polyunsaturated fatty acids plus vitamin E restore immunodeficiency and prolong survival for severely ill patients with generalized malignancy

Gogos, Charalambos; Ginopoulos, P.; Salsa, Bassilis; Apostolidou, Euterpi; Zoumbos, N.; Kalfarentzos, Fotis

doi:10.1002/(sici)1097-0142(19980115)82:2<403::aid-cncr21>3.0.co;2-1

Cited by 277 publications

(199 citation statements)

References 22 publications

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“…The vast majority of the clinical trials in which fish oil derived n-3 PUFAs were tested report an increase (Wigmore et al, 1996(Wigmore et al, , 2000Barber et al, 1999Barber et al, , 2001Jatoi et al, 2004) or maintenance (Burns et al, 1999(Burns et al, , 2004Fearon et al, 2003) of body weight (BW), whereas in two other clinical trials no effect on the loss of BW was found (Gogos et al, 1998;Bruera et al, 2003). In the latter, however, the supplementation period was only 2 weeks (Bruera et al, 2003) and/or only a small number of patients was included (Gogos et al, 1998). In a clinical trial in pancreatic cancer patients, in which a fish oil-enriched product was tested against an isocaloric/isonitrogenous placebo, no differences between groups were found on either LBM or physical activity.…”

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confidence: 99%

Dietary supplementation with a specific combination of high protein, leucine, and fish oil improves muscle function and daily activity in tumour-bearing cachectic mice

et al. 2009

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Cancer cachexia is characterised by metabolic alterations leading to loss of adipose tissue and lean body mass and directly compromises physical performance and the quality of life of cancer patients. In a murine cancer cachectic model, the effects of dietary supplementation with a specific combination of high protein, leucine and fish oil on weight loss, muscle function and physical activity were investigated. Male CD2F1 mice, 6 -7 weeks old, were divided into body weight-matched groups: (1) control, (2) tumourbearing, and (3) tumour-bearing receiving experimental diets. Tumours were induced by s.c. inoculation with murine colon adenocarcinoma (C26) cells. Food intake, body mass, tumour size and 24 h-activity were monitored. Then, 20 days after tumour/ vehicle inoculation, the animals were killed and muscle function was tested ex vivo. Tumour-bearing mice showed reduced carcass, muscle and fat mass compared with controls. EDL muscle performance and total daily activity were impaired in the tumour-bearing mice. Addition of single nutrients resulted in no or modest effects. However, supplementation of the diet with the all-in combination of high protein, leucine and fish oil significantly reduced loss of carcass, muscle and fat mass (loss in mass 45, 52 and 65% of TB-con, respectively (Po0.02)) and improved muscle performance (loss of max force reduced to 55 -64% of TB-con (Po0.05)). Moreover, total daily activity normalised after intervention with the specific nutritional combination (50% of the reduction in activity of TB-con (Po0.05)). In conclusion, a nutritional combination of high protein, leucine and fish oil reduced cachectic symptoms and improved functional performance in cancer cachectic mice. Comparison of the nutritional combination with its individual modules revealed additive effects of the single components provided.

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confidence: 99%

Dietary supplementation with a specific combination of high protein, leucine, and fish oil improves muscle function and daily activity in tumour-bearing cachectic mice

et al. 2009

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“…The efficacy of fatty acid incorporation during our short-term fish oil supplementation may be compared with related studies. Other authors employing fish oil capsules (Barber et al, 1998;Gogos et al, 1998) or fish oilenriched enteral formula (Barber, 2001) to deliver similar amounts of fish oil to those reported here, report comparable elevations of per cent n-3 fatty acids in plasma PL of advanced cancer patients using longer intervention periods (Wigmore et al, 1997;Barber et al, 1999). In the present study, the ratio of 20 : 3 n-9 to 20 : 4 n-6 in plasma PL was reduced following the fish oil treatment and may suggest an improvement in essential fatty acid status.…”

Section: Discussionmentioning

confidence: 99%

Plasma and neutrophil fatty acid composition in advanced cancer patients and response to fish oil supplementation

Pratt

Watanabe

Bruera³

et al. 2002

Br J Cancer

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Metabolic demand and altered supply of essential nutrients is poorly characterised in patients with advanced cancer. A possible imbalance or deficiency of essential fatty acids is suggested by reported beneficial effects of fish oil supplementation. To assess fatty acid status (composition of plasma and neutrophil phospholipids) in advanced cancer patients before and after 14 days of supplementation (12±1 g day −1 ) with fish (eicosapentaenoic acid, and docosahexaenoic acid) or placebo (olive) oil. Blood was drawn from cancer patients experiencing weight loss of >5% body weight ( n =23). Fatty acid composition of plasma phospholipids and the major phospholipid classes of isolated neutrophils were determined using gas liquid chromatography. At baseline, patients with advanced cancer exhibited low levels (<30% of normal values) of plasma phospholipids and constituent fatty acids and elevated 20 : 4 n -6 content in neutrophil phospholipids. High n -6/ n -3 fatty acid ratios in neutrophil and plasma phospholipids were inversely related to body mass index. Fish oil supplementation raised eicosapentaenoic acid and docosahexaenoic acid content in plasma but not neutrophil phospholipids. 20 : 4 n -6 content was reduced in neutrophil PI following supplementation with fish oil. Change in body weight during the supplementation period related directly to increases in eicosapentaenoic acid in plasma. Advanced cancer patients have alterations in lipid metabolism potentially due to nutritional status and/or chemotherapy. Potential obstacles in fatty acid utilisation must be addressed in future trials aiming to improve outcomes using nutritional intervention with fish oils. British Journal of Cancer (2002) 87 , 1370–1378. doi: 10.1038/sj.bjc.6600659 www.bjcancer.com © 2002 Cancer Research UK

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“…Gogos et al (1998) have failed to find effects of supplementation of 5 . 1 g EPA + DHA/d for 6 weeks on serum TNFa, IL-6 and IL-1 levels and on ex vivo IL-1 and IL-6 production by blood mononuclear cells.…”

Section: Cancermentioning

confidence: 99%

Differential immunomodulation with long-chainn-3 PUFA in health and chronic disease

Sijben¹,

2007

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The balance of intake of n-6 and n-3 PUFA, and consequently their relative incorporation into immune cells, is important in determining the development and severity of immune and inflammatory responses. Some disorders characterised by exaggerated inflammation and excessive formation of inflammatory markers have become among the most important causes of death and disability in man in modern societies. The recognition that long-chain n-3 PUFA have the potential to inhibit (excessive) inflammatory responses has led to a large number of clinical investigations with these fatty acids in inflammatory conditions as well as in healthy subjects. The present review explores the presence of dose-related effects of long-chain n-3 PUFA supplementation on immune markers and differences between healthy subjects and those with inflammatory conditions, because of the important implications for the transfer of information gained from studies with healthy subjects to patient populations, e.g. for establishing dose levels for specific applications. The effects of long-chain n-3 PUFA supplementation on ex vivo lymphocyte proliferation and cytokine production by lymphocytes and monocytes in healthy subjects have been studied in twenty-seven, twenty-five and forty-six treatment cohorts respectively, at intake levels ranging from 0 . 2 g EPA + DHA/d to 7 . 0 g EPA + DHA/d. Most studies, particularly those with the highest quality study design, have found no effects on these immune markers. Significant effects on lymphocyte proliferation are decreased responses in seven of eight cohorts, particularly in older subjects. The direction of the significant changes in cytokine production by lymphocytes is inconsistent and only found at supplementation levels ‡ 2 . 0 g EPA + DHA/d. Significant changes in inflammatory cytokine production by monocytes are decreases in their production in all instances. Overall, these studies fail to reveal strong dose-response effects of EPA + DHA on the outcomes measured and suggest that healthy subjects are relatively insensitive to immunomodulation with longchain n-3 PUFA, even at intake levels that substantially raise their concentrations in phospholipids of immune cells. In patients with inflammatory conditions cytokine concentrations or production are influenced by EPA + DHA supplementation in a relatively large number of studies. Some of these studies suggest that local effects at the site of inflammation might be more pronounced than systemic effects and disease-related markers are more sensitive to the immunomodulatory effects, indicating that the presence of inflamed tissue or 'sensitised' immune cells in inflammatory disorders might increase sensitivity to the immunomodulatory effects of long-chain n-3 PUFA. In a substantial number of these studies clinical benefits related to the inflammatory state of the condition have been observed in the absence of significant effects on immune markers of inflammation. This finding suggests that conditionspecific clinical end points might be more sensitive markers...

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Dietary omega-3 polyunsaturated fatty acids plus vitamin E restore immunodeficiency and prolong survival for severely ill patients with generalized malignancy

Abstract: Malnutrition appears to be an important predictor of survival for patients with end stage malignant disease. Omega-3 polyunsaturated fatty acids had a significant immunomodulating effect and seemed to prolong the survival of malnourished patients with generalized malignancy.

Cited by 277 publications

References 22 publications

Dietary supplementation with a specific combination of high protein, leucine, and fish oil improves muscle function and daily activity in tumour-bearing cachectic mice

Dietary supplementation with a specific combination of high protein, leucine, and fish oil improves muscle function and daily activity in tumour-bearing cachectic mice

Plasma and neutrophil fatty acid composition in advanced cancer patients and response to fish oil supplementation

Differential immunomodulation with long-chainn-3 PUFA in health and chronic disease

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