Nutrient supplementation with polyunsaturated fatty acids and micronutrients in rheumatoid arthritis: clinical and biochemical effects

Remans, PH; Sont, Jacob K.; Wagenaar, L.; Wouters-Wesseling, W.; Zuijderduin, W.M.; Jongma, A; Breedveld, Ferdinand C.; Laar, Jacob M van

doi:10.1038/sj.ejcn.1601883

Cited by 88 publications

(56 citation statements)

References 38 publications

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“…Otherwise, poor nutrient status is reported in RA patients [24]. Furthermore, a low intake of antioxidants [25] has been reported to be associated with higher levels of oxidative stress in RA patients [26,27]. In this context, dietary manipulation seems to be an important target in the treatment of RA.…”

Section: Laboratory Measurementsmentioning

confidence: 99%

Changes of Intestinal Microflora in Patients with Rheumatoid Arthritis during Fasting or a Mediterranean Diet

Abendroth

Michalsen²,

Lüdtke³

et al. 2010

Forsch Komplementmed

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Background: Therapeutic dietary interventions are effective treatments for rheumatoid arthritis (RA). The mechanisms to affect inflammation and clinical outcome in rheumatoid arthritis are only partly understood. Alterations in intestinal microflora are believed to be associated with disease activity in RA. Aim: To evaluate changes in short-chain fatty acid (SCFA) profiles and clinical outcome in RA during medical fasting or mediterranean diet. Methods: Fifty consecutive in-patients from an Integrative Medicine Department were included in a prospective observational, non-randomised, clinical trial. Patients underwent a 7-day fasting (MF) therapy or a Mediterranean diet (MD) as part of a multimodal therapeutic treatment approach. Results: The mean Disease Activity Score (DAS-28) significantly decreased in both groups (p < 0.001) from 5.7 ± 0.9 to 4.1 ± 1.3 in the MF and from 5.4 ± 1.4 to 4.5 ± 1.3 in the MG group, with no significant difference between the groups (p = 0.115). VAS showed a consecutive decrease of pain in both study groups which was significantly higher in the fasting group on day 7 (p = 0.049). No significant differences between the study groups were found in the profile of total-fatty acids (p = 0.069), butyrate (p = 0.611) and propionate (p = 0.419). Measurement of acetate, however, showed significant differences (p = 0.044) with an increase from 17,4 ± 9.8 µmol/g to 21,4 ± 16.4 µmol/g in MF compared to a decrease from 15,2 ± 10.4 µmol/g to 13,8 ± 9.3 µmol/g in MD. There was no significant correlation between dietary induced changes of SCFA and changes of disease activity. Conclusion: Alterations in SCFA were found in terms of significant changes to increased acetate levels in the fasting group. A correlation between changes of SCFA from intestinal microflora and disease activity in RA could not be revealed. Further studies are needed in the field of dietary inducible changes of the intestinal microflora in patients with RA.

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Section: Laboratory Measurementsmentioning

confidence: 99%

Changes of Intestinal Microflora in Patients with Rheumatoid Arthritis during Fasting or a Mediterranean Diet

Abendroth

Michalsen²,

Lüdtke³

et al. 2010

Forsch Komplementmed

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“…Experimental studies have provided evidence that incorporation of n-3 fatty acids into the diet also modifies inflammatory and immune reactions, making them potentially therapeutic for inflammatory and autoimmune response (8). In spite of the success in animal models (9)(10)(11), n-3 PUFA efficacy in humans is less conclusive (12,13).…”

mentioning

confidence: 97%

Dietary fish oil n−3 fatty acids increase regulatory cytokine production and exert anti‐inflammatory effects in two murine models of inflammation

Sierra

Lara-Villoslada

Comalada

et al. 2006

Lipids

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The higher incidence of inflammatory diseases in Western countries might be related, in part, to a high consumption of saturated fatty acids and n-6 polyunsaturated fatty acids (PUFA) and an insufficient intake of n-3 fatty acids. The purpose of this study was to examine the effects of dietary n-3 fatty acids on innate and specific immune response and their anti-inflammatory action in models of contact and atopic dermatitis. Balb/C mice were fed for 3 wk either n-6 or n-3 PUFA-fortified diets. After inducing a contact or an atopic dermatitis, immunological parameters were analyzed to evaluate the anti-inflammatory potential of these n-3 PUFA. n-3 PUFA reduced innate and specific immune responses through inhibition of TH1 and TH2 responses, increase of immunomodulatory cytokines such as IL-10, and regulation of gene expression. The inhibition of both kinds of responses was confirmed by the anti-inflammatory effect observed in contact and atopic dermatitis. Reduction in weight, edema, thickness, leukocyte infiltration, and enhancement of antioxidant defenses in the inflamed ears of mice from both models along with the prevention of delayed-type hypersensitivity induced in atopic dermatitis proved n-3 PUFA efficacy. Our data suggest that dietary fish oil-derived n-3 fatty acids have immunomodulatory effects and could be useful in inflammatory disorders.

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“…54 mg/kg EPA and 36 mg/kg DHA/day) and the administration period e.g. > 24 weeks (Kremer et al, 1990;Remans et al, 2004).…”

Section: Immunology Inflammation Allergymentioning

confidence: 99%

Opinion of the Scientific Panel on contaminants in the food chain [CONTAM] related to the safety assessment of wild and farmed fish

2005

EFSA Journal

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Nutrient supplementation with polyunsaturated fatty acids and micronutrients in rheumatoid arthritis: clinical and biochemical effects

Cited by 88 publications

References 38 publications

Changes of Intestinal Microflora in Patients with Rheumatoid Arthritis during Fasting or a Mediterranean Diet

Changes of Intestinal Microflora in Patients with Rheumatoid Arthritis during Fasting or a Mediterranean Diet

Dietary fish oil n−3 fatty acids increase regulatory cytokine production and exert anti‐inflammatory effects in two murine models of inflammation

Opinion of the Scientific Panel on contaminants in the food chain [CONTAM] related to the safety assessment of wild and farmed fish

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