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10 February 2017 - Nutraingredients - Fish oil asthma benefits may be blocked by medication

Will Chu

Omega-3 fatty acids could reduce the production of antibodies that cause allergic reactions and asthma symptoms. But the possible benefits are reduced by asthma medication, say researchers.


This new study adds to the existing evidence that an increased intake of the long-chain omega-3 fatty acids EPA and DHA - found in fish and seafood - can help reduce symptoms of asthma and other allergies.  Importantly, however, it also suggests that the steroid medications commonly used to control asthma might block their effectiveness in doing this.

Omega-3 EPA and DHA act as raw materials for a huge array of different 'lipid mediators' that help regulate immune function, blood flow, hormonal balance and many other functions, including gene expression and regulation.  Very broadly, substances derived within the body from omega-3 EPA and DHA have anti-anflammatory actions, and improve blood flow, while others made from the main long-chain omega-6 (arachidonic acid) tend to promote inflammation and enhance blood clotting.

Particularly important for controlling inflammation are so-called 'specialised proresolving mediators' - including substances made from both EPA and DHA known as 'resolvins' (because they actively help to resolve inflammation and bring it to an end).

In this study, most of the patients with asthma were using steroids either via inhalers, or as oral medication to control their symptoms; and those taking steroids in pill form showed reduced benefits from omega-3. 

As the researchers noted, this unexpected finding is in keeping with other evidence that immunosuppressive treatments like corticosteroids can also suppress the natural mechanisms for resolving inflammation provided by omega-3 lipid mediators.

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Asthma appears to be an allergic reaction to substances commonly breathed in through the air, such as animal dander, pollen, or dust mite and cockroach waste products. Some people have a genetic predisposition to react to certain allergens.

Omega-3 fatty acids could reduce the production of antibodies that cause allergic reactions and asthma symptoms. But the possible benefits are reduced by asthma medication, say researchers.

Using cell cultures from asthma patients, the team found that omega-3 fatty acids could reduce numbers of the IgE antibodies produced as a response to chronic airway inflammation.

However, corticosteroids used to treat severe asthma were found to block the oil’s effectiveness by interfering with cell signalling molecules that oversee the inflammatory process known as specialised proresolving mediators (SPMs).

Once ingested, omega-3 polyunsaturated fatty acids (PUFAs) convert to certain SPMs that halt inflammation without suppressing the immune system, said the team.

“Our results suggest that SPMs are important potential therapeutics for most patients with allergic asthma,” the authors stated.

“Further, our results highlight that immunosuppressive therapies like oral corticosteroids (OCS) also suppress endogenous resolution pathways and suggest one method by which OCS may actually exacerbate allergic diseases.”

Commercial SPM interest

Speaking to NutraIngredients  last year, Adam Ismail, GOED’s Executive Director predicted a growing interest in SPM products as a more convenient form of omega-3s for consumers to take.

“I think lipid mediator products are going to be big,” he said. “These will be huge in pharma, but also in nutrition.

“These mediators are resolvins and protectins, which are biological derivatives of EPA and DHA that have potent anti-inflammatory and cell protection properties.”

“SPM supplementation represents a more targeted nutritional approach to support the resolution of the immune response,” added Dr John Troup, Chief Science Officer at Metagenics.

“If an individual is unable to produce desirable levels of SPMs–due to lifestyle behaviour, dietary choices, or health status–in response to an immune challenge, the resolution of the immune response can be impacted.

Fish oils and inflammation

The findings in this study relate closely to a New England Journal of Medicine (NEJM) study reported earlier this year. Results from this research found that prenatal exposure to fish oil reduced the risk of wheeze and asthma in children.

Dr Richard Phipps, professor of Environmental Medicine at the University of Rochester Medical Center commented that the fish oil used as a dietary supplement in the NEJM study was a special high-quality preparation--and that consumers should practice caution when purchasing fish oil because they're not all the same.

“You really need high-quality, standardised material that's been processed and stored correctly before comparing results from one study to another study," he said.

"Our study used the pure, biologically active products in fish oil, known as 17-HDHA, and we've provided a clear line of evidence for why intake of high-quality fish oil is good."

Led by Dr Phipps, the team began by collecting blood from 17 subjects, isolating their B immune cells.

These cells were then subject to procedures that looked at the impact of pure omega-3-derived products on IgE and other molecules that fuel the disease. Here, findings were compared to that of healthy blood cells.

The majority of subjects enrolled in this study were taking corticosteroids in either pill form or by inhaler, depending upon severity of their asthma.

Results showed that all responded to the omega-3 fatty acids to some degree, as demonstrated by a reduction in the levels of IgE antibodies.

But an unexpected result found cells from a small group of subjects who were taking oral steroids, who exhibited less sensitivity to the omega-3 treatment.

Along with the NEJM study the use of fish oil has been shown to play an active role in mediating the anti-inflammatory response.

Additionally, there is a growing body of evidence that immunosuppressive treatments like corticosteroids also suppress resolution mechanisms.