Influencia de la ingesta de ácidos grasos omega-3, en la evolución de la inflamación presente en la artritis reumatoide.
- Susana Viñas Diz 1
- Mª José López Armada 2
- 1 Departamento de Fisioterapia, Medicina y Ciencias Biomédicas. Universidad de A Coruña. La Coruña. España
- 2 Grupo de Investigación en Envejecimiento e Inflamación, Instituto de Investigación Biomédica A Coruña (INIBIC). La Coruña. España
ISSN: 0211-6057
Ano de publicación: 2021
Volume: 41
Número: 3
Páxinas: 111-122
Tipo: Artigo
Outras publicacións en: Nutrición clínica y dietética hospitalaria
Resumo
Introduction: Due to a greater knowledge of the mecha-nisms involved in inflammatory processes, currently in thefield of rheumatoid arthritis (RA) there is a great interest inknowing if the lifestyle (diet, and / or physical exercise) in-fluences the development of the disease, since there are in-dications that nutrition may play an important role in the pre-disposition and / or resolution of the inflammatory process insaid pathology.Objectives:- Explain the effects of omega-3 fatty acids on the symp-toms present in patients with RA. We will analyze whet-her it is possible to influence inflammation, only by sup-plementing with omega-3, or it is necessary to carry outother dietary actions- Identify which are the most studied study variables whensupplementing with omega-3. - Identify which are the most used omega-3 doses, as wellas where the fatty acids that are supplemented comefrom.Methods: A bibliographic search was carried out in 6 da-tabases (Cochrane Library, Pubmed, Scopus, Web of Science(Wos), CINAHL, and SPORTDiscus), in December-January2021. The search terms were: “arthritis rheumatoid or rheu-matoid arthritis ”and“ fatty acids omega 3 or omega 3 fattyacids ”. The search has been restricted to meta-analysis, sys-tematic review, reviews, clinical trial, controlled and / or ran-domized clinical trial. Studies published in the last 5 years(2015-2020) carried out in humans, and published in Englishor Spanish. Results: 240 results were initially obtained. 70 articleswere eliminated for being duplicates, and 120 articles for notmeeting the inclusion criteria. 50 full-text articles were read,of which 30 articles were finally selected.Discussion / conclusions: In RA, supplemented omega-3have been shown to have beneficial effects on clinical parame-ters of the disease: decrease in the number of painful and swo-llen joints, improvements in morning stiffness, in grip strength,in the evaluation overall of the disease assessed by the doctor,and reduction of the use of AINEs and other drugs.
Referencias bibliográficas
- Shapira Y, Agmon-Levin N, Shoenfeld Y. Geoepidemiology of autoimmune rheumatic diseases. Nature Reviews Rheumatology. 2010;6(8):468-76.
- - Noa-Puig M, Más-Ferreiro R, mendoza-Castaño S, Valle-Clara M. Fisiología, tratamiento y modelos experimentales de artritis reumatoide. Revista Cubana de Farmacia. 2011;45(2):287-308.
- - Zaccardelli A, Friedlander HM, Ford JA, Sparks JA. Potential of lifestyle changes for reducing the risk of developing rheumatoid arthritis: Is an ounce of prevention worth a pound of cure? Clin Ther. 2019;41(7):1323-45.
- - Calder PC. Marine omega-3 fatty acids and inflammatory processes: Effects, mechanisms and clinical relevance. Biochim Biophys Acta. 2015;1851(4):469-84.
- - Simopoulos AP. An increase in the omega-6/omega-3 fatty acid ratio increases the risk for obesity”. Nutrients. 2016 [citado 28 enero 2021] ; 8(3):128. Disponible en: https://www.mdpi.com/2072-6643/8/3/128
- - Lorente-Cebrian S, Costa AGV, Navas-Carretero S, Zabala M, Laiglesia LM, Alfredo Martinez J, et al. An update on the role of omega-3 fatty acids on inflammatory and degenerative diseases. J. Physiol. Biochem. 2015;71(2):341-49.
- - Di Giuseppe D, Wallin A, Bottai M, Askling J, Wolk A. Long-term intake of dietary long-chain n-3 polyunsaturated fatty acids and risk of rheumatoid arthritis: A prospective cohort study of women. Ann Rheum Dis 2014; 73(11): 1949-53.
- - Gan RW, Young KA, Zerbe GO, Kristen Demoruelle M, Weisman MH, Buckner JH, et al. Lower omega-3 fatty acids are associated with the presence of anti-cyclic citrullinated peptide autoantibodies in a population at risk for future rheumatoid arthritis: A nested case-control study. Rheumatology (United Kingdom). 2015;55(2):367–76.
- - Gan RW, Demoruelle MK, Deane KD, Weisman MH, Buckner JH, Gregersen PK, et al. Omega-3 fatty acids are associated with a lower prevalence of autoantibodies in shared epitopepositive subjects at risk for rheumatoid arthritis. Ann. Rheum. Dis. 2017;76(1):147–52.
- - Sparks JA, Iversen MD, Yu Z, Triedman NA, Prado MG, Kroouze RM, et al. Disclosure of Personalized Rheumatoid Arthritis Risk Using Genetics, Biomarkers, and Lifestyle Factors to Motivate Health Behavior Improvements: A Randomized Controlled Trial. Arthritis Care Res. 2018;70(6):823-33.
- - Vadell AKE, Bärebring L, Hulander E, Gjertsson I, Lindqvist HM, Winkvist A. Anti-inflammatory Diet In Rheumatoid Arthritis (ADIRA) - a randomized, controlled crossover trial indicating effects on disease activity. Am. J. Clin. Nutr. 2020;111(6):1203-13.
- - Philippou E, Petersson SD, Erodotou S, Giallouri E, Rodomar C, Nikiphorou E. Dietary intake, dietary interventions, nutrient supplements and rheumatoid arthritis: systematic review of the evidence. Proc Nutr Soc. 2019;78(OCE1):E21–E21.
- - Akbar U, Yang M, Kurian D, Mohan C. Omega-3 fatty acids in rheumatic diseases a critical review. J Clin Rheumatol. 2017;23(6):330-39.
- - Navarini L, Afeltra A, Afflitto GG, Margiotta DPE. Polyunsaturated fatty acids: any role in rheumatoid arthritis?. Lipids Health Dis. [Internet]. 2017 [citado 28 enero 2021];16(1):197. Disponible en: https://lipidworld.biomedcentral.com/track/pdf/10.1186/s12944-017-0586-3.pdf
- - Senftleber NK, Nielsen SM, Andersen JR, Bliddal H, Tarp S, Lauritzen L, Furst DE, Suarez-Almazor ME, Lyddiatt A, Christensen R. Marine oil supplements for arthritis pain: A systematic review and meta-analysis of randomized trials. Nutrients [Internet]. 2017 [citado 28 enero 2021];9(1):42. Disponible en: https://www.mdpi.com/2072-6643/9/1/42
- - Schorpion A, Kolasinski SL, Marantidou F, Panagiotakos DP. Intake of ω-3 polyunsaturated fatty acids in patients with rheumatoid arthritis: A systematic review and meta-analysis. Nutrition. 2018;45:114-124.
- - Gioxari A, Kaliora AC, Marantidou F, Panagiotakos DP. Intake of omega-3 polyunsaturated fatty acids in patients with rheumatoid arthritis: A systematic review and meta-analysis. Nutrition. 2018;45:114-24.
- - Dawczynski C, Hackermeier U, Viehweger M, Stange R, Springer M, Jahreis G. Incorporation of n-3 PUFA and γ-linolenic acid in blood lipids and red blood cell lipids together with their influence on disease activity in patients with chronic inflammatory arthritis-a randomized controlled human intervention trial. Lipids Health Dis [Internet]. 2011 [citado 2 febrero 2021];10:130. Disponible en: https://core.ac.uk/download/pdf/8610652.pdf
- - Sanhueza-Catalán J, Durán-Agüero S, Torres-García J. Los ácidos grasos dietarios y su relación con la salud. Nutr Hosp 2015;32(3):1364-75.
- - Li X, Bi X, Wang S, Zhang Z, Li F, Zhao AZ. Therapeutic potential of omega-3 polyunsaturated fatty acids in human autoimmune diseases. Front. Immunol [Internet]. 2019[citado 2 febrero 2021];10:2241. Disponible en: https://www.frontiersin.org/articles/10.3389/fimmu.2019.02241/full
- - Valenzuela R,Tapia G, González M, Valenzuela A. Ácidos grasos omega-3 (EPA y DHA) y su aplicación en diversas situaciones clínicas. Rev Chil Nutr. 2011;38(3):356-67.
- - Castellanos L, Rodríguez M. El efecto de omega-3 en la salud humana y consideraciones en la ingesta. Rev Chil Nutr. 2015;42(1):90-95.
- - Abdolmaleki F, Kovanen PT, Mardani R, Gheibi-Hayat SM, Bo S, Sahebkar A.
- Resolvins: Emerging players in autoimmune and inflammatory diseases. Clin Rev Allergy Immunol. 2020;58(1):82-91.
- - Calder PC. Omega-3 fatty acids and inflammatory processes: from molecules to man. Biochem Soc Trans. 2017;45(5):1105-15.
- - McCoy SS, Stannard J, Kahlenberg JM. Targeting the inflammasome in rheumatic diseases. Am. J. Transl. Res. 2016;167(1):125-37.
- - Rajaei E, Mowla K, Ghorbani A, Bahadoram S, Bahadoram M, Dargahi-Malamir M. The effect of omega-3 fatty acids in patients with active rheumatoid arthritis receiving DMARDs therapy: Double-blind randomized controlled trial. Glob J Health Sci. 2015;8(7):18-25.
- - Proudman SM, James MJ, Spargo LD, Metcalf RG, Sullivan TR, Rischmueller M, et al. Fish oil in recent onset rheumatoid arthritis: a randomised, double-blind controlled trial within algorithm-based drug use. Ann. Rheum. Dis. 2015;74(1):89-95.
- - Proudman SM, Cleland LG, Metcalf RG, Sullivan TR, Spargo LD, James MJ. Plasma n-3 fatty acids and clinical outcomes in recent-onset rheumatoid arthritis. Br J Nutr. 2015;114(6):885-90.
- - Veselinovic M, Vasiljevic D, Vucic V, Arsic A, Petrovic S, Tomic-Lucic A, et al. Clinical benefits of n-3 PUFA and ɤ-Linolenic acid in patients with rheumatoid arthritis. Nutrients [Internet]. 2017[citado 28 enero 2021];9(4):325. Disponible en: https://www.mdpi.com/2072-6643/9/4/325
- - Tomic-Smiljanic M, Vasiljevic D, Lucic-Tomic A, Andjelkovic N, Jakovljevic V, Bolovich S, et al. Influence of different supplementation on platelet aggregation in patients with rheumatoid arthritis. Clin Rheumatol. 2019;38(9):2443-50.
- - Cai K, Whittle SL, Richards BL, Ramiro S, Falzon L, Buchbinder R. Marine oil supplements for rheumatoid arthritis. Cochrane Database of Systematic Reviews. 2019;11. Art. No.: CD010250. DOI: 10.1002/14651858.CD010250.
- - Lanchais K, Capel F, Tournadre A. Could omega 3 fatty acids preserve muscle health in rheumatoid arthritis? Nutrients [Internet]. 2020[citado 28 enero 2021];12(1):223. Disponible en: https://www.mdpi.com/2072-6643/12/1/223
- - Jiang J, Li K, Wang F, Yang B, Fu Y, Zheng J, et al. Effect of marine-derived n-3 polyunsaturated fatty acids on major eicosanoids: A systematic review and meta-Analysis from 18 randomized controlled trials. Plos One. 2016;11(1):e0147351.
- - Miles EA, Calder PC. Influence of marine n-3 polyunsaturatedfatty acids on immune function and a systematic review of their effects on clinical outcomes in rheumatoid arthritis. BR J Nutr 2012;107(Suppl.2):S171-S184.
- - Crawford MA. Commentary on the workshop statement. Esentiality of and recommended dietary intakes for omega-6 and omega-3 fatty acids. Prostaglandins Leukot Essent Fatty Acids. 2000;63:131-34.
- - González- Cerdanas L, Rodriguez-Romero B, Carballo-Costa L. Importancia de los aspectos nutricionales en el proceso inflamatorio de pacientes con artritis reumatoide; una revisión. Nutr Hosp 2014;29(2):237-45.
- - Philippou E, Nikiphorou E. Are we really what we eat? Nutrition and its role in the onset of rheumatoid arthritis. Autoimmun Rev. 2018;17(11):1074-77.
- - Kwiatkowska B, Maslinska M. The place of omega-3 and omega-6 acids in supplementary treatment of inflammatory joint diseases. Reumatol. 2020;58(1):34-41.
- - Petersson S, Philippou E, Rodomar C, Nikiphorou E. The Mediterranean diet, fish oil supplements and Rheumatoid arthritis outcomes: evidence from clinical trials. Autoimmunity Reviews. 2018;17(11):1105-14.
- - Tedeschi SK, Costenbader KH. Is there a role for diet in the therapy of rheumatoid arthritis? Curr Rheumatol Rep [Internet]. 2016 [citado 2 febrero 2021];18(5):23. Disponible en: https://www.frontiersin.org/articles/10.3389/fimmu.2019.02241/full
- - Abdulrazaq M, Innes JK, Calder PC. Effect of omega-3 polyunsaturated fatty acids on arthritic pain: A systematic review. Nutrition. 2017;39-40:57-66.
- - Woodman RJ, Baghdadi LR, Shanahan EM, De Silva I, Hodgson JM, Mangoni AA. Diets high in n-3 fatty acids are associated with lower arterial stiffness in patients with rheumatoid arthritis: A latent profile analysis. Br. J. Nutr. 2019;121(2):182-94.
- - Valenzuela A, Sanhueza J. Aceites de origen marino; su importancia en la nutrición y en la ciencia de los alimentos. Rev Chil Nutr. 2009;36(3):246-57.
- - López-Farré A, Macaya C. Efectos antitombóticos y antiinflamatorios de los ácidos grasos omega-3. Res Esp Cardiol 2006;6:31D-37D.
- - Goldberg RJ, Katz J. A meta-analysis of the analgesic effects of omega-3 polyunsaturated fatty acid supplementation for inflammatory joint pain. Pain. 2007;129(1-2):210-23.
- - Lee Y.H., Bae S.C., Song G.G. “Omega-3 polyunsaturated fatty acids and the treatment of rheumatoid arthritis: a meta-analysis”. Curr Neuropharmacol. 2015;13(5):663-80.
- -Valenzuela A, Valenzuela R. Ácidos grasos omega-3 en la nutrición: ¿Cómo aportarlos?. Rev Chil Nutr. 2014;41(2):205-11.
- - Dyerberg J, Madsen P, Moller JM, Aardestrup I, Schmidt EB. Bioavailability of marine n-3 fatty acid formulations. Prostaglandins Leukot. Essent. Fatty Acids. [Internet]. 2010 [citado 2 febrero 2021];137-14. Disponible en: https://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.1069.6866&rep=rep1&type=pdf
- - Sulaiman W, Seung OP, Ismail- Man R. Patient’s knowledge and perception towards the use of non-steroidal anti-inflammatory drugs in rheumatology clinic northern Malaysia. Oman Med J. 2012; 27(6): 505-08.
- - Mohebi-Nejad A, Bikdeli B. Omega-3 supplements and cardiovascular diseases. Tanaffos. 2014; 13(1): 6-14.