The omega-3 and retinopathy of prematurity relationship

Abstract

The aim of this article is to examine the effect of omega-3 (ω-3) long-chain polyunsaturated fatty acids (LCPUFAs) intake on retinopathy of prematurity (ROP) by reviewing the experimental and clinical trials conducted on animal models and infants. LCPUFAs demonstrate cytoprotective and cytotherapeutic actions contributing to a number of anti-angiogenic and neuroprotective mechanisms within the retina. Their intake appears to have a beneficial effect on ischemia, oxidative stress, inflammation and cellular signaling mechanisms, influencing retinal cell gene expression and cellular differentiation. ω-3 LCPUFAs may modulate metabolic processes that activate molecules implicated in the pathogenesis of vasoproliferative and neurodegenerative retinal diseases such as ROP.

Oxidative Stress Markers and the Retinopathy of Prematurity

“…In the last decade, increased interest has been shown for PUFA actions such as (i) modulators of processes affecting retinal health and disease [71,72], (ii) the prevention of ROP based on the role of long-chain PUFAs, a subgroup of PUFAs [73][74][75], and (iii) the role of diet supplementation with omega-3 (ω-3) PUFAs in the prevention and treatment of ROP [73][74][75][76][77][78][79].…”

“…These molecules are classified by the number of carbons, double bonds, and proximity of the first double bond to the methyl (omega) terminal of the fatty acid acyl chain. In this regard, the ω-3 family of fatty acids has a double bond at the third carbon, while the ω-6 family has a double bond at the sixth carbon [71,75]. Among different essential fatty acids, docosahexaenoic acid (DHA; C22: 6ω-3) is the main structural lipid located in the retina together with its substrate, eicosapentaenoic acid (EPA; C20: 5ω-3) [71][72][73]77,78].…”

“…Literature data suggest that ω-3 and ω-6 PUFAs, among different functions to date, are still matter worthy of investigation as they can exert beneficial effects on oxidative stress prevention [71][72][73]. In particular, (i) since they are present in the diet as protective vascular factors, they promote the formation of cytoprotective and anti-inflammatory metabolites [72][73][74][75], (ii) as substrates for phospholipase A, they determine the concentration of downstream pro-angiogenic or anti-angiogenic bioactive metabolites [72,76], (iii) they determine changes in the concentrations of bioactive lipid mediators synthesized during the retina's response to stress stimuli [72][73][74][75][76], and (iv) DHA and AA, involved in a cascade angiogenic and pro-inflammatory events, are linked to transcription factors for genes that influence cell differentiation, metabolism, and growth [73][74][75]. Nonetheless, today, it is believed that the inflammatory and anti-inflammatory state of the tissue mainly depends on the lipid membrane composition [72].…”

The role of specialized pro-resolving mediators in maternal-fetal health

“…The role of omega-3 FA in protection against this retinal damage is well established, and studies have shown that SPM contribute to the mechanism of cyto-protection and point toward potential therapeutic use of SPM in other forms of retinopathy [38]. In a study by Connor et al [37], a mouse model was used to identify the effect of omega-3 PUFA, omega-6 PUFA, and their downstream lipid mediators on vascular destruction and regrowth in oxygen-induced retinopathy.…”

Plasma Oxidative Status in Preterm Infants Receiving LCPUFA Supplementation: A Pilot Study

“…DHA exhibits in vitro scavenging actions against ROS, limiting oxidative stress [14,15]. In addition, n-3 LCPUFA intake has beneficial effects against ROP, through protection of photoreceptors from oxidative stress [16], and supplementation during pregnancy and lactation decreased plasma hydroperoxides in newborns [17]. However, it was also observed that, under high oxidant stress conditions, LCPUFAs can be attacked by ROS and be oxidized into lipid peroxides, which are associated with oxidative damage and inflammation [18].…”