Polyunsaturated fatty acids levels and initial presentation of somatic symptoms induced by interferon-alpha therapy in patients with chronic hepatitis C viral infection

Abstract

Objectives: Somatic symptoms are common in depressive disorder and are similar to sickness behaviors due to inflammatory activation after cytokine administration. Omega-3 polyunsaturated fatty acids (PUFAs) are natural anti-inflammatory agents and may reduce inflammation-induced behavioral changes. The aim of this study was to investigate the role of PUFAs on the development of somatic symptoms and depression in patients of hepatitis C virus infection (HCV) receiving interferon-alpha therapy (IFN-α) in a prospective manner.

Methods: In this 24-week, prospective cohort study, 43 patients with chronic HCV ongoing IFN-α therapy were assessed with the mini-international neuropsychiatric interview for major depressive episodes and neurotoxicity rating scale (NRS) for somatic symptoms.

Results: One-third later developed IFN-α-induced depression (depression (DEP) group). As compared to subjects without depression, DEP group had higher NRS scores (P < 0.001), lower eicosapentaenoic acid (EPA) levels (P = 0.038) at week 2. Somatic symptoms, regardless of painful/non-painful characteristics, had positive association with arachidonic acid (P < 0.05), and negative association with EPA (P < 0.05).

Conclusion: This study implies that early intervention with omega-3 PUFAs might be a promising strategy to prevent depression and somatic symptoms in patients receiving cytokine therapy.

Keywords:

• Depression
• Painful symptoms
• n-3
• PUFAs
• Omega-3

Acknowledgements

The work was supported by the following grants: MOST103-2320-B-039-MY3, MOST103-2320-B-038-012-MY3, NSC 103-2923-B-039-002-MY3, 102-2911-I-039-501, 101-2628-B-039-001-MY3, and 101-2320-B-038-020-MY2 from the Ministry of Science and Technology and CMU103-S-03, DMR-103-078, 102-068, and 101-081 from the China Medical University in Taiwan.

Disclaimer statements

Contributors

K.-P.S. created the concept, designed the study, received the research funding, and prepared and revised the manuscript. J.P.-C.C. designed the study, performed the clinical assessments, and prepared and revised the manuscript. H.-C.L., H.-T.Y., W.-P.S., and C.-Y.P. helped with subject enrollment and conducted the study. P.G., A.W., and C.M.P. undertook the interpretation of the results and performed the literature search and manuscript preparation. All the authors have approved the final manuscript and take responsibility for the integrity and accuracy of this study.

Funding

None.

Conflicts of interest

There are no conflicts of interest.

Ethics approval

This paper has conformed to the guidelines issued in the Declaration of Helsinki, and should usually have received approval by the Institutional Review Board of China Medical University Hospital.

ORCID

Jane Pei-Chen Chang http://orcid.org/0000-0001-5582-0928

Kuan-Pin Su http://orcid.org/0000-0002-4501-2502