Supplementation With Fatty Acids Influences the Airway Nitric Oxide and Inflammatory Markers in Patients With Cystic Fibrosis.

J Pediatr Gastroenterol Nutr. 2010 May;50(5):537-544.

Supplementation With Fatty Acids Influences the Airway Nitric Oxide and Inflammatory Markers in Patients With Cystic Fibrosis.

Keen C, Olin AC, Eriksson S, Ekman A, Lindblad A, Basu S, Beermann C, Strandvik B.

*Departments of Pediatrics, Sweden daggerOccupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden double daggerDepartment of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, Uppsala, Sweden section signDanone Research, Centre for Specialized Nutrition, Friedrichsdorf, Germany.

Abstract

OBJECTIVES:: To obtain a balance in the fatty acid (FA) metabolism is important for the inflammatory response and of special importance in cystic fibrosis (CF), which is characterized by impaired FA metabolism, chronic inflammation, and infection in the airways. Nitric oxide (NO) has antimicrobial properties and low nasal (nNO) and exhaled NO (FENO), commonly reported in CF that may affect bacterial status. The present study investigates the effect of different FA blends on nNO and FENO and immunological markers in patients with CF.

PATIENTS AND METHODS:: Forty-three patients with CF and "severe" mutations were consecutively enrolled in a randomized double-blind placebo-controlled study with 3 FA blends containing mainly n-3 or n-6 FA or saturated FA acting as placebo. FENO, nNO, serum phospholipid concentrations of FA, and biomarkers of inflammation were measured before and after 3 months of supplementation.

RESULTS:: Thirty-five patients in clinically stable condition completed the study. The serum phospholipid FA pattern changed significantly in all 3 groups. An increase of the n-6 FA, arachidonic acid, was associated with a decrease of FENO and nNO. The inflammatory biomarkers, erythrocyte sedimentation rate, and interleukin-8 decreased after supplementation with n-3 FA and erythrocyte sedimentation rate increased after supplementation with n-6 FA.

CONCLUSIONS:: This small pilot study indicated that the composition of dietary n-3 and n-6 FA influenced the inflammatory markers in CF. FENO and nNO were influenced by changes in the arachidonic acid concentration, supporting previous studies suggesting that both the lipid abnormality and the colonization with Pseudomonas influenced NO in the airways.

Fatty Acid Supplements Improve Respiratory, Inflammatory and Nutritional Parameters in Adults with Cystic Fibrosis

In addition to be aggressive about abx, the Swedes are also into supplementing essential fatty acids.

Arch Bronconeumol. 2009 Dec 30.

Fatty Acid Supplements Improve Respiratory, Inflammatory and Nutritional Parameters in Adults with Cystic Fibrosis

Olveira G, Olveira C, Acosta E, Espíldora F, Garrido-Sánchez L, García-Escobar E, Rojo-Martínez G, Gonzalo M, Soriguer F

Servicio de Endocrinología y Nutrición, Hospital Regional Universitario Carlos Haya, Málaga, España; CIBERDEM, CIBER de Diabetes y Enfermedades Metabólicas, Instituto de Salud Carlos III, Madrid, España.

INTRODUCTION AND AIMS: Chronic inflammation plays a major role in lung deterioration in cystic fibrosis (CF) patients and anti-inflammatory strategies have beneficial effects. To study the changes seen after a one-year course of low-dose dietary supplements with a mixture of fatty acids in adult patients with CF in chronic inflammation, pulmonary status (lung function, respiratory exacerbations and antibiotic consumption), quality of life and anthropometric parameters.

PATIENTS AND METHOD: Seventeen adult subjects with CF received 324mg of eicosapentaenoic, 216mg of docosahexaenoic, 480mg of linoleic and 258mg of gammalinolenic acid daily. We assessed inflammation markers, spirometry parameters, number and severity of respiratory exacerbations, antibiotic consumption, quality of life (St George's QoL), anthropometric parameters and serum phospholipid fatty acid composition.

RESULTS: At the end of the treatment period TNF alpha levels fell significantly and its soluble receptors (60 and 80) rose significantly. Levels of IgG and IgM anti-oxidized LDL antibodies fell significantly. Spirometry improved significantly. Annual respiratory exacerbations and days of antibiotic treatment fell significantly. The improvement in QoL was not significant. Serum levels of docosahexaenoic, total omega-3 and linoleic acid rose significantly and more favourable profiles were seen in monoenoic acids, arachidonic acid and the arachidonic/docosahexaenoic ratio. The fat-free mass and hand grip dynamometry improved significantly.

CONCLUSIONS: Low-dose supplements of n-3 and gammalinolenic fatty acids over a long period (one year) appears to improve pulmonary status (lung function, respiratory exacerbations and antibiotic consumption), inflammatory and anthropometric parameters in adults with CF.