Do we need ‘new’ omega-3 polyunsaturated fatty acids formulations?

Figures & data

Table 1. Suggested indication for omega-3 polyunsaturated fatty acids supplementation in clinical practice based on RCTs and meta-analyses.

Field	Disease	Level of evidence
Cardiovascular	Hypertriglyceridemia	Meta-analysis of RCTs
	Post-infarction arrhythmia	Meta-analysis of RCTs
	Hypertension	Meta-analysis of RCTs
Pneumology	Asthma prevention	Meta-analysis of epidemiological data
	Chronic respiratory diseases	RCTs
	Cystic fibrosis	RCTs
Autoimmune disease	Allergy/atopic eczema	RCTs
	Rheumatoid arthritis	RCTs
	Psoriasis	RCTs
	Inflammatory bowel diseases	RCTs
Ophthalmology	Age-related degenerative macular disease	RCTs
	Dry eyes	RCTs
Psychiatry	Psychosis	RCTs
	Depression	Meta-analysis of RCTs
Neurology	Relapsing-remitting multiple sclerosis	RCTs
	Some epilepsies	RCTs
Nephrology	IgA nephropathy	RCTs
Dermatology	Cutaneous wounds	RCTs

Data taken from [1].

RCT: Randomized clinical trial.

Table 2. Pharmacological effects of omega-3 polyunsaturated fatty acids demonstrated in humans with potential relevance in cardiovascular disease prevention.

Interaction with omega-6 fatty acids

—Production of inactive leukotrienes and thromboxanes

Decrease in biological mediators

—IL-1, IL-2, TNF, PDGF

Effect on blood lipoprotein levels

—Decrease in plasma VLDL and triglyceride levels

Hypotensive effect

—Changes in eicosanoids, in blood viscosity, in hormonal-cellular response, in renin secretion, decreased response to vasopressors

Decrease in plasma viscosity

—Decreased plasma fibrinogen

Effects on coagulation

—Prolonged bleeding time, decrease in fibrinogen, factor VII, von Willebrand factor, increase in fibrinolysis

Increased arterial compliance

—Increased production of nitric oxide

Effects on adhesion molecules

—Decreased ICAM-1, VCAM-1, E-selectin levels

Effects on vascular smooth muscle cells

—Modulation of proliferation, migration and apoptosis and improved vasoreactivity by interaction with intracellular calcium dynamics

ICAM-1: Intercellular adhesion molecule 1; PDGF: Platelet-derived growth factor; VCAM-1: Vascular cell adhesion molecule 1; VLDL: Very-low-density lipoprotein.

Cicero AF, Reggi A, Parini A, et al. Application of polyunsaturated fatty acids in internal medicine: beyond the established cardiovascular effects. Arch Med Sci 2012;8(5):784-93

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