Ácidos graxos ômega-3 e lúpus eritematoso sistêmico: influência no perfil inflamatório, na atividade da doença e nos exames bioquímicos

Abstract

Introduction: Systemic lupus erythematosus (SLE) is an autoimmune disease, which results in systemic inflammation and tissue damage. A few studies have demonstrated that omega-3 fatty acids reduces the concentrations of eicosanoids, cytokines, chemokines, C-reactive protein (CRP) and other biomarkers of inflammation. Supplementation with this class of lipids may bring benefits to treatment of inflammatory diseases such as SLE. Objectives: 1-carry out are view of the scientific literature on the effects of omega-3 fatty acids in patients with SLE; 2- analyze the effect of omega-3 fatty acids supplementation on disease activity, biochemistry tests and plasma levels of cytokines (IL- 4, IL -6, IL-10, IL-17A , TNF-α , leptin and adiponectin). Methods: This clinical trial encompassed 49 women with SLE, 22 in the study group and 27 in the control group. The study group patients received 2g of omega-3 daily (1040mg EPA + 200mg DHA) for 12 weeks. Disease activity was assessed by SLEDAI-2K, cytokines (IL-4, IL-6, IL-10, IL-17A and TNF-α) by ultrasensitive flow cytometryand leptin and adiponectin by ELISA, at the beginning of the study (T0) and at the end (T1). Nutritional status was assessment by body mass indexand bioimpedance. Resultos: Omega-3 did not impact on disease activity and serum levels of cytokines. A significant increase in serum total cholesterol (T0=180.0 (456.0-193.5) mg/dL and T1=188.0 (162.0-214.5) mg/dL, p=0.012), LDL-c (T0=100.0 (88.0-120.5) mg/dL and T1=115.5 (90.0-129.2) mg/dL, p=0.003) and glucose (T0=77.5 (75.0-84.5) mg/dL and T1=83.0 (75.0-87.0) mg/dL, p=0.043) in the group that received supplementation was seen. CRP levels increased significantly in the control group (T0=5.0 (4.9-9.6) mg/dL and T1=5.0 (4.9-11.6) mg/dL, p=0.009) while they remained unchanged in the study group. In this sample, 69.4% (34) of the patients were overweight (BMI≥25.0 kg/m2) and in 73.5% (36) the percentage of body fat was higher than recommended. Conclusions: Future trials are required to better assess the relationship between omega-3 supplementation, levels of cholesterol and inflammation in SLE. Furthermore, these trials should also assess what the effective dosage and duration of treatment.