Louvilla, is a 30-year female who is currently 11 weeks pregnant and is currently suffering from uncontrolled asthma. Her mother was also a known asthmatic. Louvilla asked her doctor if she could take supplements of medications that could prevent or lessen the likelihood of her baby getting asthma and at the same lessen the incidence of her asthma attacks. Recently there have been studies correlating the benefits of omega-3 fatty acids and its bioactive metabolites on chronic inflammatory diseases such as asthma.
ASTHMA
Asthma is a common respiratory disease worldwide. Inhaled corticosteroids have been the established treatment; unfortunately, around 5-10% of asthmatic patients have been noted to be resistant to this therapy, thus making it difficult to manage the disease. As of the moment, leukotriene and prostaglandin receptor antagonists are the latest drugs for the treatment of asthma, however recent findings show that pro-resolving lipid mediators could possibly be the subsequent therapeutic aims for allergic diseases. Leukotriene receptor antagonists are used for chronic inflammation by regulating the lipid metabolism. This could mean that the disease pathology of asthma could be controlled by regulating the abnormal lipid metabolism.
OMEGA-3 FATTY ACIDS
Polyunsaturated fatty acids such as omega-3 fatty acids, docosahexanoic acid (DHA) and eicosapentaenoic acid (EPA) are found primarily in fish oil. Many established studies have shown and proved that these complexes have protective roles in cardiovascular diseases namely myocardial or cerebral infarction, hypertension, and hyperlipidemia. Recently, there have been studies showing evidence that these compounds could also be beneficial in chronic inflammatory diseases such as chronic obstructive pulmonary disease (COPD), asthma, rheumatoid arthritis (RA) and inflammatory bowel disease (IBD). A more detailed study on asthmatic patients noted that the DHA content compared with arachidonic acid content was lower in healthy individuals than in asthmatic patients. This could mean that the DHA could have a protective role in chronic inflammation such as asthmatic patients and patients with allergic diseases.
This fatty acid and its derivatives have great potential for therapeutic use even though the methods of their effects are not entirely known. There have been plenty of epidemiological and observational studies focusing on the effects of intake of fish and omega-3 fatty acid supplement. Results of these studies concluded that atopic sensitization and allergic outcomes can be prevented by intake of fish and omega-3fatty acids supplements during pregnancy, infancy, and childhood.
PREGNANCY, LACTATION AND CHILDHOOD.
Favorable effects have been shown on allergic and atopic outcomes in infants and children born from pregnancies where there has been an increased fish intake during pregnancy. Lactating mothers who have intake of fish or omega-3 fatty acid supplements have higher levels of EPA in their breast milk. Milk that is high in EPA was associated with a lower risk of atopic dermatitis. Clinical trials which involved using fish oil supplement for pregnant and lactating mothers have suggested that the prevalence and severity of atopic dermatitis and food sensitization have been reduced up to the first year of life. The beneficial effects that could persist until the adolescent stage could include the reduction of the incidence of eczema, hay fever and asthma.
ADULTHOOD
In a study done by young American adults’ asthma morbidity was inversely associated with the intake of omega-3 fatty acid supplementation and fish. A low omega-3: omega-6 fatty acid ratio diet was thought to lead to the exacerbation and a possible increase in the morbidity of asthma and allergic diseases. In some studies, it was also noted that asthma onset was prevented and incidence of symptoms was lowered in young adults who take omega-3 fatty acid supplements. The lung function of young adults with asthma was also noted to have improved.
PHYSIOLOGY
Omega-3 acid such as EPA and DHA undergoes several enzymatic reactions to create specialized pro-resolving mediators (SPM) such as protectins, resolvins and maresins. Airway eosinophilic inflammation could be counter regulated by these mediators. SPM’s could also promote resolution of inflammation in vivo. Numerous reports on chronic inflammation such as severe asthma have showed that there is an impairment of the biosynthesis of SPM. These studies suggest that the resolution defect might be the cause of the chronic inflammation. Chronic inflammation which includes asthma, atopic dermatitis, RA, COPD, IBD and allergic diseases could greatly benefit from omega-3 fatty acids and its bioactive metabolites such as protectins, resolvins and maresins.