Omega-3s for inflammation: the challenges of disease-specific therapies
This was the key message from Kaitlin Roke, director of scientific communications and outreach, during a GOED (Global Organisation for EPA and DHA Omega-3s) webinar last week.
She discussed the involvement of inflammation across multiple conditions and the established anti-inflammatory properties of EPA and DHA.
“Once ingested from food or supplements and metabolised, they are converted into specialised pro-resolving mediators. These can be eicosanoids, resolvins, protectins or maresins, which are typically thought to be anti-inflammatory and inflammation resolving”.
She highlighted new research investigating the dose-specific effect of EPA and DHA for these actions, which identified the wide-ranging mechanisms by which they influenced the inflammatory pathways.
Using the GOED clinical database, a tool previously launched to enable analysis of available studies, Roke identified the clinical markers of inflammation to include high-sensitivity C-reactive protein, interleukin-6, and tumour necrosis factor-alpha (TNF-a).
She emphasised: “Results from pairwise and network meta-analyses suggest that supplementation with either DHA or EPA does significantly reduce plasma markers of inflammation but does not differentially modulate systemic markers of subclinical inflammation.”
“So, at this time, it is difficult to characterise exactly which biomarker to look at, and how much EPA and DHA might be needed to elucidate an effect on inflammation,” she concluded, highlighting the need for further research to examine the investigate biomarkers within specific conditions.
Widespread inflammation
Roke drew attention to an analogy of inflammation: “Signs of inflammation are like a car’s dashboard engine lights – it tells you that something is wrong. But the response is not to take out the bulb because that’s not the problem. Instead, you look at what caused the light to turn on. This is the same with inflammation; it’s telling you something bigger is going on that requires your attention.”
She stressed how the approach of our healthcare system is often to take out the bulb, emphasising the need for further research into this area.
Roke highlighted: “The key health areas that EPA and DHA intakes can benefit including heart, pregnancy, prenatal, brain, and eye health. We need to think about how inflammation fits into these main health areas, as well as across the life span.”
She emphasised the importance of distinguishing between different types of inflammation, as well as short-term acute and long-term chronic types.
She said that inflammation can occur across a range of conditions at all of stages of life, from a bone injury occurring during childhood causing swelling, to gestational diabetes during pregnancy, to arthritis and joint pain in older age.
“In disease states we are often dealing with chronic inflammation, in which the signs can be silent. This seems counterintuitive, but this is really important and would need to be detected using a biomarker from a tissue or blood sample.”
She said that additional symptoms of chronic inflammation can include fatigue, fever, skin rash, or joint pain, with conditions including auto-immune, metabolic, and Alzheimer’s disease.
“Inflammation is affecting these conditions differently, so we’re not able to say that it’s working in the same way, but we know that inflammation is involved,” she said, emphasising the difficulties surrounding the targeting of inflammation-related conditions.
