Intravenous omega-3 fatty acids are associated with better clinical outcome and less inflammation in patients with predicted severe acute pancreatitis: A randomised double blind controlled trial

Al-Leswas, D.; Eltweri, A.; Chung, Wen Yuan; Arshad, Ali; Stephenson, James A.; Al-Taan, Omer; Pollard, C.; Fisk, Helena L.; Calder, Philip C.; Garcea, Giuseppe; Metcalfe, Matthew S.; Dennison, Ashley R.

doi:10.1016/j.clnu.2018.04.003

Cited by 12 publications

(14 citation statements)

References 38 publications

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“…With the dose of EPA and DHA given to the participants, we observed that EPA and DHA levels rose and plateaued within 1 and 3 months in plasma and RBC membranes, respectively, after starting omega 3. The peak levels of EPA and DHA achieved in the plasma and RBC membranes of our participants were comparable to those of earlier studies in which similar amounts of EPA + DHA were administered, both orally and intravenously ( 38 – 40 ). While the plasma levels of EPA and DHA dropped rapidly after discontinuation of omega 3, the RBC membrane levels of EPA and, especially, DHA, remained significantly higher 6 months after going off omega 3, suggesting a potentially long-lasting impact of omega 3 supplementation on RBC membrane DHA levels.…”

Section: Discussionsupporting

confidence: 86%

Omega 3 supplementation reduces C-reactive protein, prostaglandin E2 and the granulocyte/lymphocyte ratio in heavy smokers: An open-label randomized crossover trial

et al. 2022

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ObjectivesGiven the current controversy concerning the efficacy of omega 3 supplements at reducing inflammation, we evaluated the safety and efficacy of omega 3 on reducing inflammation in people with a 6-year lung cancer risk >1.5% and a C reactive protein (CRP) level >2 mg/L in a phase IIa cross-over study.Materials and methodsForty-nine healthy participants ages 55 to 80, who were still smoking or had smoked in the past with ≥30 pack-years smoking history, living in British Columbia, Canada, were randomized in an open-label trial to receive 2.4 g eicosapentaenoic acid (EPA) + 1.2 g docosahexaenoic acid (DHA)/day for 6 months followed by observation for 6 months or observation for 6 months first and then active treatment for the next 6 months. Blood samples were collected over 1 year for measurement of plasma CRP, plasma and red blood cell (RBC) membrane levels of EPA, DHA and other fatty acids, Prostaglandin E2 (PGE2), Leukotriene B4 (LTB4) and an inflammatory marker panel.ResultsTwenty one participants who began the trial within the active arm completed the trial while 20 participants who started in the control arm completed the study. Taking omega 3 resulted in a significant decrease in plasma CRP and PGE2 but not LTB4 levels. Importantly, the effect size for the primary outcome, CRP values, at the end of the intervention relative to baseline was medium (Cohen's d = 0.56). DHA, but not EPA levels in RBC membranes inversely correlated with PGE2 levels. Omega 3 also led to a significant reduction in granulocytes and an increase in lymphocytes. These high-dose omega 3 supplements were well tolerated, with only minor gastrointestinal symptoms in a subset of participants.ConclusionOmega 3 fatty acids taken at 3.6 g/day significantly reduce systemic inflammation with negligible adverse health effects in people who smoke or have smoked and are at high risk of lung cancer.ClinicalTrials.gov, NCT number: NCT03936621.

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Section: Discussionsupporting

confidence: 86%

Omega 3 supplementation reduces C-reactive protein, prostaglandin E2 and the granulocyte/lymphocyte ratio in heavy smokers: An open-label randomized crossover trial

et al. 2022

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“…Five papers from the primary literature were collectively identified (receiving 5 or more votes) as most important by the authors. [25][26][27][28][29] Results from the sorting process are depicted in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…Al-Leswas D et al 25 Intravenous omega-3 fatty acids are associated with better clinical outcome and less inflammation in patients with predicted severe acute pancreatitis: A randomized double blind controlled trial.…”

Section: Discussionmentioning

confidence: 99%

Significant Published Articles in 2020 for Pharmacy Nutrition Support Practice

et al. 2021

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Purpose: The purpose of this article is to assist the pharmacist engaged in nutrition support therapy in staying current with pertinent literature. Methods: Several clinical pharmacists engaged in nutrition support therapy compiled a list of articles published in 2020 considered important to their clinical practice. The citation list was compiled into a single spreadsheet where the author participants were asked to assess whether the article was considered important to nutrition support pharmacy practice. A culled list of publications was then identified whereby at least 5 out of the 8 author participants considered the paper to be important. Guideline and consensus papers from professional organizations, important to practice but not ranked, were also included. Results: A total of 169 articles were identified; 5 from the primary literature were voted by the group to be of high importance. An additional 17 guidelines, position, recommendation, or consensus papers were also identified. The top-ranked articles from the primary literature were summarized and a narrative regarding its implications to pharmacy nutrition support practice were provided. Conclusion: We recommend that pharmacists engaged in nutrition support therapy be familiar with these articles as it pertains to their practice.

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“…Two meta-analyses involving RCTs only with omega-3 fatty acid administration demonstrated significant reduced risk of mortality, infectious complications, length of hospital stay and new-organ failure without safety issue reported ( 24 , 25 ). A very recent RCT study also showed that intravenous omega-3 fatty acids administration also achieved better clinical outcomes in terms of lowering total blood leukocyte number, CRP, IL-8, multiple organ dysfunction score, sequential organ failure assessment score, and systemic inflammatory response syndrome ( 26 ). A case study in pregnant women with familial hypertriglyceridemia and type 2 diabetes mellitus (high-risk group of developing acute pancreatitis) suggested dietary supplementation of omega-3 fatty acids was of value in preventing pancreatitis ( 27 ).…”

Section: Discussionmentioning

confidence: 98%

Mendelian randomization in blood metabolites identifies triglycerides and fatty acids saturation level as associated traits linked to pancreatitis risk

Liu

Jiang

et al. 2022

Front. Nutr.

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BackgroundThere is very limited evidence on the causal effects of blood metabolites on pancreatitis risks. To reveal the causal associations between plasma metabolites and pancreatitis risks, we performed two-sample Mendelian randomization (MR) and Bayesian model averaging (MR-BMA) analyses in European ancestry.MethodsThe summary-level statistics from two genome-wide association studies with 249 and 123 metabolic traits derived from two separate cohorts involving ~115,000 (UK Biobank) and ~25,000 individuals from European ancestry were used for the analyses. The summary statistics of four pancreatitis datasets from FinnGen R5 and two pancreatitis datasets from UK Biobank were exploited as the outcome. We first performed univariable MR analysis with different metabolic GWAS data on multiple pancreatitis datasets to demonstrate the association pattern among different metabolites categories. Next, we exploited the MR-BMA method to pinpoint the dominating factors on the increased risk of pancreatitis.ResultsIn the primary analysis with 249 traits, we found that plasma triglycerides were positively associated with pancreatitis risk. Intriguingly, a large number of traits associated with saturation or unsaturation of fatty acids also demonstrated causal associations. The replication study analyzing 123 metabolic traits suggested that bisallylic groups levels and omega-3 fatty acids were inversely correlated with pancreatitis risk. MR-BMA analyses indicated that the ratio of triglycerides to total lipid in various HDL particles played leading roles in pancreatitis susceptibility. In addition, the degree of unsaturation, the ratio of polyunsaturated fatty acids to monounsaturated fatty acids and the level of monounsaturated fatty acids showed causal associations with either decreased or increased pancreatitis susceptibility.ConclusionsOur MR study provided an atlas of causal associations of genetically predicted blood metabolites on pancreatitis, and offered genetic insights showing intervention in triglycerides and the supplementation of unsaturated fatty acids are potential strategies in the primary prevention of pancreatitis.

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Intravenous omega-3 fatty acids are associated with better clinical outcome and less inflammation in patients with predicted severe acute pancreatitis: A randomised double blind controlled trial

Cited by 12 publications

References 38 publications

Omega 3 supplementation reduces C-reactive protein, prostaglandin E2 and the granulocyte/lymphocyte ratio in heavy smokers: An open-label randomized crossover trial

Omega 3 supplementation reduces C-reactive protein, prostaglandin E2 and the granulocyte/lymphocyte ratio in heavy smokers: An open-label randomized crossover trial

Significant Published Articles in 2020 for Pharmacy Nutrition Support Practice

Mendelian randomization in blood metabolites identifies triglycerides and fatty acids saturation level as associated traits linked to pancreatitis risk

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