Polyunsaturated fatty acids: any role in rheumatoid arthritis?

Abstract

BackgroundPolyunsaturated fatty acids (PUFAs) are members of the family of fatty acids and are included in the diet. Particularly, western diet is usually low in n-3 PUFAs and high in n-6 PUFAs. PUFAs play a central role in the homeostasis of immune system: n-6 PUFAs have predominantly pro-inflammatory features, while n-3 PUFAs seem to exert anti-inflammatory and pro-resolving properties. Rheumatoid arthritis (RA) is a chronic inflammatory arthritis in which many inflammatory pathways contribute to joint and systemic inflammation, disease activity, and structural damage. Research on PUFAs could represent an important opportunity to better understand the pathogenesis and to improve the management of RA patients.MethodsWe searched PubMed, Embase, EBSCO-Medline, Cochrane Central Register of Controlled Trials (CENTRAL), CNKI and Wanfang to identify primary research reporting the role of n-3 PUFAs in rheumatoid arthritis both in humans and in animal models up to the end of March 2017.ResultsData from animal models allows to hypothesize that n-3 PUFAs supplementation may represent an interesting perspective in future research as much in prevention as in treating RA. In humans, several case-control and prospective cohort studies suggest that a high content of n-3 PUFAs in the diet could have a protective role for incident RA in subjects at risk. Moreover, n-3 PUFAs supplementation has been assessed as a valuable therapeutic option also for patients with RA, particularly in order to improve the pain symptoms, the tender joint count, the duration of morning stiffness and the frequency of NSAIDs assumption.Conclusionsn-3 PUFAs supplementation could represent a promising therapeutic option to better control many features of RA. The impact of n-3 PUFAs on radiographic progression and synovial histopathology has not been yet evaluated, as well as their role in early arthritis and the combination with biologics.

Oral administration of the selective GPR120/FFA4 agonist compound A is not effective in alleviating tissue inflammation in mouse models of prototypical autoimmune diseases

“…The setup of these trials was quite heterogeneous in respect to the ω3‐PUFAs preparations, doses, and routes of administration used as well as in respect to the features of the patient cohorts and the clinical parameters used to benchmark therapeutic effects. The results of these trials have recently been exhaustively summarized and analyzed in two systematic reviews . Collectively, most trials investigating the effect in rheumatoid arthritis demonstrated moderate, beneficial effects .…”

“…The results of these trials have recently been exhaustively summarized and analyzed in two systematic reviews . Collectively, most trials investigating the effect in rheumatoid arthritis demonstrated moderate, beneficial effects . The results on the therapeutic effects of ω3‐PUFAs on psoriasis have been more contradictory with some trials reporting beneficial effects, others finding no effect .…”

“…4,5 Collectively, most trials investigating the effect in rheumatoid arthritis demonstrated moderate, beneficial effects. 5 The results on the therapeutic effects of ω3-PUFAs on psoriasis have been more contradictory with some trials reporting beneficial effects, others finding no effect. 4 The potential reasons for these conflicting results are manifold.…”

Commercial and Therapeutic Potential of Plant-Based Fatty Acids

“…Recent studies show the importance of PUFAs as essential fatty acids, and their nutritional value in human health and disease prevention. Intake of PUFAs has been associated primarily with decreased risk of cardiovascular diseases and normal brain development [66][67][68]. They also present anti-inflammatory effects and contribute to the good functioning of vision.…”

“…Specifically, the biological activities of essential fatty acids (ALA and LA) influence on the functions and responsiveness of cell membranes, tissue metabolism, hormone signals, and others. The beneficial effects of PUFAs can be mediated by different mechanisms, including altering or regulating cell membrane structures, regulating intracellular signaling pathways, modulating gene transcription, and regulating the production of bioactive lipid mediators or production of eicosanoids (prostaglandins, leukotrienes, and thromboxanes) [68,73].…”