Coss BA, Quintero MC, Olivas AF, Márquez IA

Language: Spanish
References: 19
Page: 51-61
PDF size: 255.39 Kb.

ABSTRACT

Introduction: Cystic fibrosis (CF) patients have an autosomal recessive inherited disease characterized by an imbalance of water, electrolytes, and mucus in multiple organs, which is associated with a high influx of persistent inflammatory cells and mediators. Recent evaluations have used essential fatty acids (omega 3) as immunomodulatory agents, however, at present there is still insufficient evidence for their recommendation in CF patients.
Objective: Evaluate randomized clinical studies that have employed omega-3 fatty acids as a therapy on inflammation in patients with cystic fibrosis.
Material and Methods: A qualitative systematic review was carried out according to the elements considered for the planning of a systematic review by Cochrane, in which double or triple blind Randomized Clinical Trials (RCTs) less than 10 years old were included.
Results:Three RCTs with good scientific quality presented positive effects on inflammatory biomarkers. The main findings involved an improvement in the circulating and erythrocyte fatty acid profile (increase in docosahexaenoic acid [DHA] and decrease in arachidonic acid). Consequently, this relationship improves multiple indicators such as interleukin-6 (IL-6) and human leukocyte elastase. The main limitations involve the lack of a specific biomarker to assess anti-inflammatory improvements in CF.
Conclusion: Long-term supplementation with DHA may improve inflammation in CF. Regulation of leukocyte activity and proinflammatory fatty acid profile appear to be responsible for the observed effects.

REFERENCES

1. Chen Q, Shen Y, Zheng J. A review of cystic fibrosis:Basic and clinical aspects. Animal Model Exp Med. 2021;4(3):220-232.doi: 10.1002/ame2.12180

2. Shteinberg M, Haq IJ, Polineni D, Davies JC. Cystic fibrosis.Lancet. 2021;397(10290):2195-2211. doi:10.1016/S0140-6736(20)32542-3

3. Cantin AM, Hartl D, Konstan MW, Chmiel JF. Inflammationin cystic fibrosis lung disease: Pathogenesis andtherapy. Journal of Cystic Fibrosis. 2015;14(4):419–30.doi:10.1016/j.jcf.2015.03.003

4. Roesch EA, Nichols DP, Chmiel JF. Inflammation in cysticfibrosis: An update. Pediatric Pulmonology. 2018;53(S3).doi:10.1002/ppul.24129

5. McBennett KA, Davis PB, Konstan MW. Increasing lifeexpectancy in cystic fibrosis: Advances and challenges.Pediatr Pulmonol. 2022;57 Suppl 1(Suppl 1):S5-S12.doi:10.1002/ppul.25733

6. Lands LC, Stanojevic S. Oral non-steroidal anti-inflammatorydrug therapy for lung disease in cystic fibrosis.Cochrane Database Syst Rev. 2019;9(9):CD001505.doi:10.1002/14651858.

7. McDonald CM, Bowser EK, Farnham K, Alvarez JA, PadulaL, Rozga M. Dietary Macronutrient Distributionand Nutrition Outcomes in Persons with Cystic Fibrosis:An Evidence Analysis Center Systematic Review. J AcadNutr Diet. 2021;121(8):1574-1590.e3. doi:10.1016/j.jand.2020.03.016

8. Véricel E, Mazur S, Colas R, Delaup V, Calzada C, ReixP, Durieu I, et al. Moderate intake of docosahexaenoicacid raises plasma and platelet vitamin E levels in cysticfibrosis patients. Prostaglandins Leukot Essent Fatty Acids.2016;115:41-47. doi: 10.1016/j.plefa.2016.10.008.

9. Morin C, Cantin AM, Vézina FA, Fortin S. The Efficacy ofMAG-DHA for Correcting AA/DHA Imbalance of CysticFibrosis Patients. Mar Drugs. 2018:26;16(6):184.doi:

10. 10.3390/md1606018410. Ayats-Vidal R, Bosque-García M, Cordobilla B, Asensio-De laCruz O, García-González M, Castro-Marrero J, et al. Changesof Erythrocyte Fatty Acids after Supplementation with HighlyConcentrated Docosahexaenoic Acid (DHA) in PediatricCystic Fibrosis: A Randomized Double-Blind Controlled Trial.J Clin Med. 2023;12(11):3704. doi: 10.3390/jcm12113704

11. Voynow JA, Zheng S, Kummarapurugu AB. Glycosaminoglycansas Multifunctional Anti-Elastase and Anti-Inflammatory Drugs in Cystic Fibrosis Lung Disease. FrontPharmacol. 2020;11:1011. doi: 10.3389/fphar.2020.01011

12. Hanssens L, Thiébaut I, Lefèvre N, Malfroot A, Knoop C,Duchateau J, Casimir G. The clinical benefits of long-termsupplementation with omega-3 fatty acids in cystic fibrosispatients - A pilot study. Prostaglandins Leukot Essent FattyAcids. 2016;108:45-50. doi: 10.1016/j.plefa.2016.03.014

13. Pastor Ó, Guzmán-Lafuente P, Serna J, Muñoz-HernándezM, López Neyra A, García-Rozas P, García-Seisdedos D, AlcázarA, Lasunción MA, Busto R, Lamas Ferreiro A. A comprehensiveevaluation of omega-3 fatty acid supplementationin cystic fibrosis patients using lipidomics. J Nutr Biochem.2019;63:197-205. doi: 10.1016/j.jnutbio.2018.09.026

14. López-Neyra A, Suárez L, Muñoz M, de Blas A, Ruiz deValbuena M, Garriga M, et al. Long-term docosahexaenoicacid (DHA) supplementation in cystic fibrosis patients:a randomized, multi-center, double-blind, placebocontrolledtrial. Prostaglandins Leukot Essent Fatty Acids.2020;162:102186. doi: 10.1016/j.plefa.2020.102186

15. Liu WC, Yang YH, Wang YC, Chang WM, Wang CW. Maresin:Macrophage mediator for resolving inflammation and bridgingtissue regeneration—a system-based preclinical systematicreview. International Journal of Molecular Sciences.2023; 24(13):11012. doi:10.3390/ijms241311012.

16. Ferreira I, Falcato F, Bandarra N, Rauter AP. Resolvins,Protectins, and Maresins: Dha-derived specialized proresolvingmediators, biosynthetic pathways, syntheticapproaches, and their role in inflammation. Molecules.2022;27(5): 1677. doi:10.3390/molecules27051677.

17. Cortés E, Rizo-Baeza MM, Aguilar MJ, Hidalgo MJ, Gil V. Relaciónentre los ácidos grasos en suero y en los fosfolípidosde membrana en niños sanos [Correspondence betweenthe fatty acids in healthy children serum and in membranephospholipids]. Nutr Hosp. 2013 Sep-Oct;28(5):1541-5.Spanish. doi: 10.3305/nh.2013.28.5.6528

18. Menzel A, Samouda H, Dohet F, Loap S, Ellulu MS, Bohn T.Common and Novel Markers for Measuring Inflammationand Oxidative Stress Ex Vivo in Research and ClinicalPractice-Which to Use Regarding Disease Outcomes?Antioxidants (Basel). 2021;10(3):414. doi: 10.3390/antiox10030414

19. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, HoffmannTC, Mulrow CD, et al. Declaración PRISMA 2020: una guíaactualizada para la publicación de revisiones sistemáticas.Rev Esp Cardiol 2021;74:790–9. https://doi.org/10.1016/j.recesp.2021.06.016.