BACKGROUND: Polyunsaturated fatty acids (PUFAs) are members of the family of fatty acids and are included in the diet. Particularly, western diet is usually low in n-3 PUFAs and high in n-6 PUFAs. PUFAs play a central role in the homeostasis of immune system: n-6 PUFAs have predominantly pro-inflammatory features, while n-3 PUFAs seem to exert anti-inflammatory and pro-resolving properties. Rheumatoid arthritis (RA) is a chronic inflammatory arthritis in which many inflammatory pathways contribute to joint and systemic inflammation, disease activity, and structural damage. Research on PUFAs could represent an important opportunity to better understand the pathogenesis and to improve the management of RA patients.
METHODS: We searched PubMed, Embase, EBSCO-Medline, Cochrane Central Register of Controlled Trials (CENTRAL), CNKI and Wanfang to identify primary research reporting the role of n-3 PUFAs in rheumatoid arthritis both in humans and in animal models up to the end of March 2017.
RESULTS: Data from animal models allows to hypothesize that n-3 PUFAs supplementation may represent an interesting perspective in future research as much in prevention as in treating RA. In humans, several case-control and prospective cohort studies suggest that a high content of n-3 PUFAs in the diet could have a protective role for incident RA in subjects at risk. Moreover, n-3 PUFAs supplementation has been assessed as a valuable therapeutic option also for patients with RA, particularly in order to improve the pain symptoms, the tender joint count, the duration of morning stiffness and the frequency of NSAIDs assumption.
CONCLUSIONS: n-3 PUFAs supplementation could represent a promising therapeutic option to better control many features of RA. The impact of n-3 PUFAs on radiographic progression and synovial histopathology has not been yet evaluated, as well as their role in early arthritis and the combination with biologics.
INTRODUCCIÓN: Las características clínicas de la artritis reumatoide (AR) justifican su enfoque multidisciplinario, en el que se incluye la intervención nutricional. Ciertos componentes nutricionales influyen en el metabolismo celular e interfieren en el proceso inflamatorio patológico, de modo que puedan actuar como coadyuvante en el tratamiento de muchas enfermedades inflamatorias, entre las que se encuentra en AR - excluyeron.
OBJETIVO: Analizar las evidencias relacionadas con los efectos terapéuticos de los ácidos grasos poliinsaturados, la dieta mediterránea, el aceite de oliva y de determinados nutrientes antioxidantes, sobre la inflamación crónica y AR sintomatología.
MÉTODOS: Revisión no sistemática de Cochrane, Pubmed, Scopus, Sportdiscus y Amed, de 2003 a marzo de 2013, y las sucesivas solicitudes de criterios de inclusión y exclusión.
RESULTADOS: La evidencia sobre los ácidos grasos poliinsaturados sugiere que producen una mejoría clínica y los efectos inhibitorios sobre la respuesta inflamatoria AR. En cuanto a la dieta mediterránea, la evidencia señala que disminuye tanto la actividad del dolor y la enfermedad. En el caso del aceite de oliva, aunque no hay suficientes estudios, algunos efectos se observan como la reducción de los marcadores inflamatorios y la inhibición estrés oxidativo. Por último, limita y se encontró evidencia contradictoria sobre la eficacia de los antioxidantes.
CONCLUSIÓN: No existen estudios que sugieren que algunos elementos dietéticos (ácidos grasos poliinsaturados, dieta mediterránea y antioxidantes) tienen efectos anti-inflamatorios y disminuyen la actividad de la enfermedad AR. Se requieren más estudios para potenciar los resultados en aquellos aspectos donde la evidencia es todavía no concluyente.
Polyunsaturated fatty acids (PUFAs) are members of the family of fatty acids and are included in the diet. Particularly, western diet is usually low in n-3 PUFAs and high in n-6 PUFAs. PUFAs play a central role in the homeostasis of immune system: n-6 PUFAs have predominantly pro-inflammatory features, while n-3 PUFAs seem to exert anti-inflammatory and pro-resolving properties. Rheumatoid arthritis (RA) is a chronic inflammatory arthritis in which many inflammatory pathways contribute to joint and systemic inflammation, disease activity, and structural damage. Research on PUFAs could represent an important opportunity to better understand the pathogenesis and to improve the management of RA patients.
METHODS:
We searched PubMed, Embase, EBSCO-Medline, Cochrane Central Register of Controlled Trials (CENTRAL), CNKI and Wanfang to identify primary research reporting the role of n-3 PUFAs in rheumatoid arthritis both in humans and in animal models up to the end of March 2017.
RESULTS:
Data from animal models allows to hypothesize that n-3 PUFAs supplementation may represent an interesting perspective in future research as much in prevention as in treating RA. In humans, several case-control and prospective cohort studies suggest that a high content of n-3 PUFAs in the diet could have a protective role for incident RA in subjects at risk. Moreover, n-3 PUFAs supplementation has been assessed as a valuable therapeutic option also for patients with RA, particularly in order to improve the pain symptoms, the tender joint count, the duration of morning stiffness and the frequency of NSAIDs assumption.
CONCLUSIONS:
n-3 PUFAs supplementation could represent a promising therapeutic option to better control many features of RA. The impact of n-3 PUFAs on radiographic progression and synovial histopathology has not been yet evaluated, as well as their role in early arthritis and the combination with biologics.
