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Vol. 46. Issue 2.
Pages 70-77 (February 2010)
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Vol. 46. Issue 2.
Pages 70-77 (February 2010)
Original Article
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Fatty Acid Supplementation Improves Respiratory, Inflammatory and Nutritional Parameters in Adults with Cystic Fibrosis
La suplementación con ácidos grasos mejora parámetros respiratorios, inflamatorios y nutricionales en adultos con fibrosis quística
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Gabriel Olveiraa,c, Casilda Olveirab,
Corresponding author
casi1547@separ.es

Corresponding author.
, Eva Acostab, Francisco Espíldorab, Lourdes Garrido-Sánchezd,e, Eva García-Escobara,c, Gemma Rojo-Martíneza,c, Montserrat Gonzaloa, Federico Soriguera,c
a Servicio de Endocrinología y Nutrición, Hospital Regional Universitario Carlos Haya, Málaga, Spain
b CIBERDEM, CIBER de Diabetes y Enfermedades Metabólicas, Instituto de Salud Carlos III, Madrid, Spain
c Servicio de Neumología, Hospital Regional Universitario Carlos Haya, Málaga, Spain
d CIBERDEM, CIBER Fisiopatología, Obesidad y Nutrición (CB06/03), Instituto de Salud Carlos III, Madrid, Spain
e Servicio de Endocrinología y Nutrición, Hospital Clínico Virgen de la Victoria, Málaga, Spain
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Abstract
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 oneyear 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-oxidised 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.

Keywords:
Cystic fibrosis
Inflammation
Anti-inflammatory therapy
Lung function
Pulmonary exacerbations
Fatty acids
Omega-3
Supplement
Tumor necrosis factor alpha
Resumen
Introducción

La afectación pulmonar es la causa más importante de morbimortalidad en la fibrosis quística (FQ) y la inflamación-infección bronquial crónica condiciona el deterioro progresivo de la función pulmonar. Los tratamientos destinados a reducir la respuesta inflamatoria podrían ser beneficiosos.

Objetivos

Valorar el efecto de la suplementación oral durante un año en pacientes adultos con FQ, de una combinación de ácidos grasos sobre parámetros respiratorios, antropométricos, inflamatorios, de calidad de vida y sobre el perfil de AG de los fosfolípidos séricos (AGFS).

Pacientes y método

Diecisiete pacientes recibieron diariamente durante un año: 324mg de ácido eicosapentaenoico, 216mg de ácido docosahexaenoico, 480mg de ácido linoleico y 258mg de ácido gammalinolénico. Se valoraron marcadores inflamatorios, parámetros espirométricos, reagudizaciones respiratorias, consumo de antibióticos, calidad de vida (St. George), antropometría y los AGFS.

Resultados

Al final del tratamiento se observó, de forma significativa, una disminución de reagudizaciones y del consumo de antibióticos con mejoría de los parámetros espirométricos, de la masa magra y la dinamometría. Concomitantemente, se observó una reducción significativa de los anticuerpos anti-LDL oxidada (inmunoglobulina [Ig] G e IgM) y de los niveles séricos del factor de necrosis tumoral α, así como un incremento de sus receptores solubles. Los niveles de AGFS mejoraron con un aumento significativo de DHA, AG-omega-3 y ácido linoleico, y un descenso de monoinsaturados y del cociente araquidónico/DHA.

Conclusiones

La suplementación con una mezcla definida de AG durante un año parece mejorar los parámetros respiratorios (espirométricos, reagudizaciones y consumo de antibióticos), inflamatorios y antropométricos en pacientes adultos con FQ.

Palabras clave:
Fibrosis quística
Inflamación
Tratamiento antiinflamatorio
Función pulmonar
Reagudizaciones respiratorias
Ácidos grasos
Omega-3
Suplementación
Factor de necrosis tumoral
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