Omega‐3 Polyunsaturated Fatty Acids and Lung Cancer: nutrition or Pharmacology?

Abstract

Omega-3 polyunsaturated fatty acid (ω-3 PUFA) supplements for chemoprevention of different types of cancer including lung cancer has been investigated in recent years. ω-3 PUFAs are considered immunonutrients, commonly used in the nutritional therapy of cancer patients. ω-3 PUFAs play essential roles in cell signaling and in cell structure and fluidity of membranes. They participate in the resolution of inflammation and have anti-inflammatory effects. Lung cancer patients suffer complications, such as anorexia-cachexia syndrome, pain and depression. The European Society for Clinical Nutrition and Metabolism (ESPEN) 2017 guidelines for cancer patients only discuss the use of ω-3 PUFAs for cancer-cachexia treatment, leaving aside other cancer-related complications that could potentially be managed by ω-3 PUFAs. This review aims to elucidate whether the effects of ω-3 PUFAs in lung cancer is supplementary, pharmacological or both. In addition, clinical studies, evidence in cell lines and animal models suggest how ω-3 PUFAs induce anticancer effects. ω-3 PUFAs and their metabolites are suggested to modulate pivotal pathways underlying the progression or complications of lung cancer, indicating that this is a promising field to be explored. Further investigation is still required to analyze the benefits of ω-3 PUFAs as supplementation or pharmacological treatment in lung cancer.

Disclosure statement

The authors declare that they have no conflicts of interest.

Author Contributions

Owen Vega contributed to background information, sections on clinical trials and Table 1.

Table 1. Summary of effects of the ω-3 PUFAs intake in lung cancer patients.

Shaheen Abkenari contributed to sections on mouse models, Table 3 and Figures 1 and 2.

Figure 2. Ilustrates the COX family of enzymes acting on ω-6 and ω-3 PUFAs ARA and EPA/DHA respectively. COX-1 enzyme is constitutively expressed and acts on both ω-6 and ω-3 PUFAs to form PGE2 and PGE3 respectively. In contrast, COX-2 is produced as an inflammatory response and acts predominantly on ARA to increase PGE2 production. EPA/ DHA have been shown to inhibit activity of COX-2 thereby downregulating production of PGE2.

Figure 3. Illustrates a summary of this review of the anticancer and pro-cancer effects of ω-3 and ω-6 PUFAs evident in clinical patient studies (top two sections), in cell lines (middle two sections), and In Vivo models (bottom two sections).

Table 3. Summary of the effect of the ω-3 and ω-6 PUFAs in an In Vivo models.

Zhen Tong contributed to sections on evidence in cell lines and Table 2.

Table 2. Summary of effects in ω-3 and ω-six PUFAs on lung cancer cells.

Austin Tedman contributed to background information and Figure 1.

Sara Huerta-Yepez contributed to the abstract, conclusion and the coordination of the manuscript.

All authors revised and approved the final manuscript.

Additional information

Funding

The study was funded by the Mexico Federal Funds [Grant HIM/2017/014, S.H.-Y.],