Dunstan Janet A, Mori Trevor A, Barden Anne, Beilin Lawrence J, Taylor Angie L, Holt Patrick G, Prescott Susan L
School of Paediatrics and Child Health, University of Western Australia, Perth, Australia.
J Allergy Clin Immunol. 2003 Dec;112(6):1178-84. doi: 10.1016/j.jaci.2003.09.009.
There is growing interest in the potential role of anti-inflammatory n-3 polyunsaturated fatty acids (n-3 PUFAs) in the prevention of allergic disease.
We sought to determine whether maternal dietary supplementation with n-3 PUFAs during pregnancy could modify immune responses in infants.
In a randomized, controlled trial 98 atopic, pregnant women received fish oil (3.7 g n-3 PUFAs per day) or placebo from 20 weeks' gestation until delivery. Neonatal PUFA levels and immunologic response to allergens were measured at birth.
Eighty-three women completed the study. Fish oil supplementation (n = 40) achieved significantly higher proportions of n-3 PUFAs in neonatal erythrocyte membranes (mean +/- SD, 17.75% +/- 1.85% as a percentage of total fatty acids) compared with the control group (n = 43, 13.69% +/- 1.22%, P <.001). All neonatal cytokine (IL-5, IL-13, IL-10, and IFN-gamma) responses (to all allergens) tended to be lower in the fish oil group (statistically significant only for IL-10 in response to cat). Although this study was not designed to examine clinical effects, we noted that infants in the fish oil group were 3 times less likely to have a positive skin prick test to egg at 1 year of age (odds ratio, 0.34; 95% confidence interval, 0.11 to 1.02; P =.055). Although there was no difference in the frequency of atopic dermatitis at 1 year of age, infants in the fish oil group also had significantly less severe disease (odds ratio, 0.09; 95% confidence interval, 0.01 to 0.94; P =.045).
These data suggest a potential reduction in subsequent infant allergy after maternal PUFA supplementation. More detailed follow-up studies are required in larger cohorts to establish the robustness of these findings and to ascertain their significance in relation to longer-term modification of allergic disease in children.
抗炎性 n-3 多不饱和脂肪酸（n-3 PUFAs）在预防过敏性疾病中的潜在作用正受到越来越多的关注。
我们试图确定孕期母亲饮食中补充 n-3 PUFAs 是否会改变婴儿的免疫反应。
在一项随机对照试验中，98 名患有特应性疾病的孕妇从妊娠 20 周起至分娩期间接受鱼油（每天 3.7 g n-3 PUFAs）或安慰剂。在出生时测量新生儿的多不饱和脂肪酸水平和对过敏原的免疫反应。
83 名女性完成了研究。与对照组（n = 43，13.69%±1.22%，P <.001）相比，补充鱼油组（n = 40）新生儿红细胞膜中 n-3 PUFAs 的比例显著更高（平均±标准差，占总脂肪酸的 17.75%±1.85%）。鱼油组中所有新生儿细胞因子（IL-5、IL-13、IL-10 和 IFN-γ）对所有过敏原的反应均趋于降低（仅对猫过敏原的 IL-10 反应具有统计学意义）。尽管本研究并非旨在检查临床效果，但我们注意到鱼油组婴儿在 1 岁时对鸡蛋进行皮肤点刺试验呈阳性的可能性降低了 3 倍（比值比，0.34；95%置信区间，0.11 至 1.02；P =.055）。虽然 1 岁时特应性皮炎的发生率没有差异，但鱼油组婴儿的疾病严重程度也显著更低（比值比，0.09；95%置信区间，0.01 至 0.94；P =.045）。
这些数据表明母亲补充多不饱和脂肪酸后，婴儿随后发生过敏的可能性可能降低。需要在更大的队列中进行更详细的随访研究，以确定这些发现的稳健性，并确定它们在儿童过敏性疾病长期改变方面的意义。
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