Polyunsaturated fatty acids and rheumatoid arthritis
Polyunsaturated fatty acids and rheumatoid arthritis
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DOI：
10.1097/00075197-200103000-00006
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发表时间：
2001-03-01
影响因子：
3.1
通讯作者：
Zurier, RB
中科院分区：
文献类型：
--
作者：
Calder, PC;Zurier, RB
类风湿关节炎的特点是T淋巴细胞、巨噬细胞和浆细胞浸润滑膜，并开始慢性炎症状态，涉及促炎细胞因子的过度产生和失调的T-helper-l型反应。由花生四烯酸和细胞因子合成的类二十烷类会导致软骨和骨骼的进行性破坏。n-6多不饱和脂肪酸-亚麻酸是二同质-亚麻酸的前体。后者和鱼油中发现的n-3多不饱和脂肪酸二十碳五烯酸能够减少花生四烯酸衍生的二十碳烷酸的产生，减少促炎细胞因子和活性氧的产生，以及淋巴细胞的反应性。许多双盲、安慰剂对照试验表明-亚麻酸和鱼油对类风湿关节炎的各种临床结果有显著改善。这些脂肪酸应作为类风湿性关节炎正常治疗方法的一部分。然而，目前还不清楚脂肪酸的最佳剂量是多少，或者将它们联合使用是否会有额外的好处。(C) 2001利平科特·威廉姆斯·威尔金斯。
Rheumatoid arthritis is characterized by infiltration of T lymphocytes, macrophages and plasma cells into the synovium, and the initiation of a chronic inflammatory state that involves overproduction of proinflammatory cytokines and a dysregulated T-helper-l-type response. Eicosanoids synthesized from arachidonic acid and cytokines cause progressive destruction of cartilage and bone. The n-6 polyunsaturated fatty acid gamma-linolenic acid is the precursor of di-homo-gamma-linolenic acid. The latter and the n-3 polyunsaturated fatty acid eicosapentaenoic acid, which is found in fish oil, are able to decrease the production of arachidonic acid-derived eicosanoids and to decrease the production of proinflammatory cytokines and reactive oxygen species, and the reactivity of lymphocytes. A number of double-blind, placebo-controlled trials of gamma-linolenic acid and fish oil in rheumatoid arthritis have shown significant improvements in a variety of clinical outcomes. These fatty acids should be included as part of the normal therapeutic approach to rheumatoid arthritis. However, it is unclear what the optimal dosage of the fatty acids is, or whether there would be extra benefit from using them in combination. (C) 2001 Lippincott Williams Wilkins.