Protective Effect of Fish Oil Supplementation on Exercise-Induced Bronchoconstriction in Asthma

Mickleborough, Timothy D.; Lindley, Martin R.; Ionescu, Alina; Fly, Alyce D.

doi:10.1378/chest.129.1.39

Cited by 213 publications

(171 citation statements)

References 40 publications

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“…The only comparable study of asthma has reported the effects of a high level of fish oil (5 . 2 g EPA + DHA/d) on sputum inflammatory cytokines and pulmonary function in exercise-induced broncho-constriction (Mickleborough et al 2006). Concentrations of TNFa and IL-1b in the sputum supernatant fraction were found to be significantly lower (P <0 .…”

Section: Lung Inflammationmentioning

confidence: 90%

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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Section: Lung Inflammationmentioning

confidence: 90%

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

Sijben¹,

2007

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“…Adrenal suppression at high doses, growth retardation in children and adolescents and reduction in bone density are observed with usage of some inhaled corticosteroids (54,55) . The other anti-inflammatory treatments for EIB include LT antagonists, disodium cromoglycate, nedocromile sodium, β2-agonists, and ipratropium bromide which have well-established, longterm negative heath side effects providing an impetus for nonpharmacological therapies among researchers and clinical experts (56)(57)(58) .…”

Section: Nutrition Research Reviewsmentioning

confidence: 99%

“…RCT cross-over design Three-arm comparison of fish oil v. evening primrose oil (n-6 group) v. olive oil using liquid oil supplementation 2-week run-in period followed by 30 (57) RCT, double-blind, cross-over, placebocontrolled trial 3-week supplementation period in each arm 2-week washout phase n-3: 3·2 g EPA and 2·0 g DHA Placebo: Matched capsules with olive oil 16 subjects Age 23 ± 1·6 years Participants with clinically treated mild-moderate asthma with a FEV 1 >70 % predicted Improved pulmonary function to below the diagnostic EIB threshold Reduction in medication usage Reduction in induced sputum differential cell count percentage and concentrations of LTC 4 -LTE 4 , PGD 2 , IL-1β and TNF-α before and following exercise on the n-3 fatty acid diet Significant reduction in LTB 4 and a significant increase in LTB 5 generation from activated polymorphonuclear cells on the n-3 fatty acid diet n-3 Fatty acids and asthma (126) RCT, double-blind, cross-over study Subjects entered the study on their normal diet, and then received either fish oil capsules or placebo n-3: 3·2 g EPA and 2·0 g of DHA Placebo: Matched capsules with olive oil 10 athletes and 10 controls Age (asthmatics 23·2 ± 1·9 years; controls 22·4 ± 1·7 years) Participants with clinically diagnosed EIB No effect on pre-exercise pulmonary function in either group Improved post-exercise pulmonary function Reduction in LTE 4 , 9α, 11β-PG F 2 , LTB 4 , TNF-α, and IL-1β, on the n-3 PUFA diet compared with baseline and placebo diets and after exercise challenge Studies reporting benefits of n-3 supplementation (in children)…”

Section: Evidence From N-3 Intervention Trials In Asthmamentioning

confidence: 99%

n-3 Fatty acids and asthma

2016

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Asthma is one of the most common and prevalent problems worldwide affecting over 300 million individuals. There is some evidence from observational and intervention studies to suggest a beneficial effect of n-3 PUFA in inflammatory diseases, specifically asthma. Marine-based n-3 PUFA have therefore been proposed as a possible complementary/alternative therapy for asthma. The proposed anti-inflammatory effects of n-3 fatty acids may be linked to a change in cell membrane composition. This altered membrane composition following n-3 fatty acid supplementation (primarily EPA and DHA) can modify lipid mediator generation via the production of eicosanoids with a reduced inflammatory potential/impact. A recently identified group of lipid mediators derived from EPA including E-series resolvins are proposed to be important in the resolution of inflammation. Reduced inflammation attenuates the severity of asthma including symptoms (dyspnoea) and exerts a bronchodilatory effect. There have been no major health side effects reported with the dietary supplementation of n-3 fatty acids or their mediators; consequently supplementing with n-3 fatty acids is an attractive non-pharmacological intervention which may benefit asthma.

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“…As such, individuals from populations traditionally with this type of diet have a high percentage of the omega-6 fatty acid arachidonic acid and very low fractions of the omega-3 fatty acid eicosapentaenoic acid (EPA) within their inflammatory cells (Gibney and Hunter 1993;Sperling et al 1993). However, dietary supplementation with omega-3 fatty acids increases the fraction of omega-3s EPA and docosahezaenoic acid (DHA) within the plasma membrane of cells (De Caterina et al 1994;Kew et al 2004;Meydani et al 1993;Mickleborough et al 2006;Mickleborough et al 2003;Sperling et al 1993) which subsequently produces less biologically active inflammatory mediators (Calder 2003;Obata et al 1999). …”

Section: Introductionmentioning

confidence: 99%

“…As such significant associations between fish intake and lung function suggest that omega-3 fatty acids may have a beneficial influence on pulmonary physiology (Laerum et al 2007;Schwartz and Weiss 1994). Mickleborough and colleagues have demonstrated the protective effects of fish oil on exercise induced bronchoconstriction in asthmatic populations (Mickleborough et al 2006;Mickleborough et al 2003). In addition, Tecklenburg-Lund et al (2010) reduced airway inflammation in asthmatic subjects following a 3wk period of fish oil supplementation (Tecklenburg-Lund et al 2010).…”

Section: Introductionmentioning

confidence: 99%

The effects of short-term fish oil supplementation on pulmonary function and airway inflammation following a high-fat meal

2013

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Protective Effect of Fish Oil Supplementation on Exercise-Induced Bronchoconstriction in Asthma

Cited by 213 publications

References 40 publications

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

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

n-3 Fatty acids and asthma

The effects of short-term fish oil supplementation on pulmonary function and airway inflammation following a high-fat meal

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