Bourre J M
INSERM Research Director. Unit U26 Neuro-pharmaco-nutrition. Hopital Fernand Widal, 200 rue du Faubourg Saint Denis. 75745 Paris cedex 10.
J Nutr Health Aging. 2004;8(3):163-74.
Among various organs, in the brain, the fatty acids most extensively studied are omega-3 fatty acids. Alpha-linolenic acid (18:3omega3) deficiency alters the structure and function of membranes and induces minor cerebral dysfunctions, as demonstrated in animal models and subsequently in human infants. Even though the brain is materially an organ like any other, that is to say elaborated from substances present in the diet (sometimes exclusively), for long it was not accepted that food can have an influence on brain structure, and thus on its function. Lipids, and especially omega-3 fatty acids, provided the first coherent experimental demonstration of the effect of diet (nutrients) on the structure and function of the brain. In fact the brain, after adipose tissue, is the organ richest in lipids, whose only role is to participate in membrane structure. First it was shown that the differentiation and functioning of cultured brain cells requires not only alpha-linolenic acid (the major component of the omega-3, omega3 family), but also the very long omega-3 and omega-6 carbon chains (1). It was then demonstrated that alpha-linolenic acid deficiency alters the course of brain development, perturbs the composition and physicochemical properties of brain cell membranes, neurones, oligodendrocytes, and astrocytes (2). This leads to physicochemical modifications, induces biochemical and physiological perturbations, and results in neurosensory and behavioural upset (3). Consequently, the nature of polyunsaturated fatty acids (in particular omega-3) present in formula milks for infants (premature and term) conditions the visual and cerebral abilities, including intellectual. Moreover, dietary omega-3 fatty acids are certainly involved in the prevention of some aspects of cardiovascular disease (including at the level of cerebral vascularization), and in some neuropsychiatric disorders, particularly depression, as well as in dementia, notably Alzheimer's disease. Recent results have shown that dietary alpha-linolenic acid deficiency induces more marked abnormalities in certain cerebral structures than in others, as the frontal cortex and pituitary gland are more severely affected. These selective lesions are accompanied by behavioural disorders more particularly affecting certain tests (habituation, adaptation to new situations). Biochemical and behavioural abnormalities are partially reversed by a dietary phospholipid supplement, especially omega-3-rich egg yolk extracts or pig brain. A dose-effect study showed that animal phospholipids are more effective than plant phospholipids to reverse the consequences of alpha-linolenic acid deficiency, partly because they provide very long preformed chains. Alpha-linolenic acid deficiency decreases the perception of pleasure, by slightly altering the efficacy of sensory organs and by affecting certain cerebral structures. Age-related impairment of hearing, vision and smell is due to both decreased efficacy of the parts of the brain concerned and disorders of sensory receptors, particularly of the inner ear or retina. For example, a given level of perception of a sweet taste requires a larger quantity of sugar in subjects with alpha-linolenic acid deficiency. In view of occidental eating habits, as omega-6 fatty acid deficiency has never been observed, its impact on the brain has not been studied. In contrast, omega-9 fatty acid deficiency, specifically oleic acid deficiency, induces a reduction of this fatty acid in many tissues, except the brain (but the sciatic nerve is affected). This fatty acid is therefore not synthesized in sufficient quantities, at least during pregnancy-lactation, implying a need for dietary intake. It must be remembered that organization of the neurons is almost complete several weeks before birth, and that these neurons remain for the subject's life time. Consequently, any disturbance of these neurons, an alteration of their connections, and impaired turnover of their constituents at any stage of life, will tend to accelerate ageing. The enzymatic activities of sytivities of synthesis of long-chain polyunsaturated fatty acids from linoleic and alpha-linolenic acids are very limited in the brain: this organ therefore depends on an exogenous supply. Consequently, fatty acids that are essential for the brain are arachidonic acid and cervonic acid, derived from the diet, unless they are synthesized by the liver from linoleic acid and alpha-linolenic acid. The age-related reduction of hepatic desaturase activities (which participate in the synthesis of long chains, together with elongases) can impair turnover of cerebral membranes. In many structures, especially in the frontal cortex, a reduction of cervonic and arachidonic acids is observed during ageing, predominantly associated with a reduction of phosphatidylethanolamines (mainly in the form of plasmalogens). Peroxisomal oxidation of polyunsaturated fatty acids decreases in the brain during ageing, participating in decreased turnover of membrane fatty acids, which are also less effectively protected against peroxidation by free radicals.
在各种器官中,大脑是对脂肪酸研究最为广泛的器官,其中研究最多的是ω-3脂肪酸。α-亚麻酸(18:3ω3)缺乏会改变细胞膜的结构和功能,并引发轻微的脑功能障碍,这在动物模型以及随后的人类婴儿研究中都得到了证实。尽管从物质构成上来说,大脑与其他器官并无二致,也就是说它由饮食中摄入的物质(有时是完全由饮食中的物质)构成,但长期以来,人们并不认为食物会对大脑结构进而对其功能产生影响。脂质,尤其是ω-3脂肪酸,首次为饮食(营养物质)对大脑结构和功能的影响提供了连贯的实验证据。事实上,大脑是继脂肪组织之后脂质含量最丰富的器官,其脂质唯一的作用是参与膜结构的组成。首先有研究表明,培养的脑细胞的分化和功能不仅需要α-亚麻酸(ω-3家族的主要成分),还需要极长链的ω-3和ω-6碳链(1)。随后又证实,α-亚麻酸缺乏会改变大脑发育进程,扰乱脑细胞、神经元、少突胶质细胞和星形胶质细胞膜的组成及物理化学性质(2)。这会导致物理化学性质的改变,引发生化和生理紊乱,并导致神经感觉和行为失调(3)。因此,婴儿配方奶(早产儿和足月儿)中多不饱和脂肪酸(尤其是ω-3)的性质会影响婴儿的视觉和脑功能,包括智力。此外,饮食中的ω-3脂肪酸肯定与预防某些心血管疾病(包括脑血管生成方面)、某些神经精神疾病,特别是抑郁症以及痴呆症,尤其是阿尔茨海默病有关。最近的研究结果表明,饮食中α-亚麻酸缺乏在某些脑结构中引发的异常比其他结构更明显,如额叶皮质和垂体受影响更严重。这些选择性损伤伴随着行为障碍,尤其影响某些测试(习惯化、对新情况的适应)。生化和行为异常可通过饮食补充磷脂部分得到逆转,特别是富含ω-3的蛋黄提取物或猪脑。一项剂量效应研究表明,动物磷脂比植物磷脂更有效地逆转α-亚麻酸缺乏的后果,部分原因是它们提供了预先形成的极长链。α-亚麻酸缺乏会降低愉悦感,这是通过轻微改变感觉器官的效能以及影响某些脑结构实现的。与年龄相关听力、视力和嗅觉的减退,既归因于相关脑区效能的降低,也归因于感觉受体,特别是内耳或视网膜的功能紊乱。例如,对于α-亚麻酸缺乏的个体,要达到相同的甜味感知水平需要摄入更多的糖。鉴于西方人的饮食习惯,由于从未观察到ω-6脂肪酸缺乏的情况,因此尚未对其对大脑的影响进行研究。相反,ω-9脂肪酸缺乏,特别是油酸缺乏,会导致许多组织中这种脂肪酸含量降低,但大脑除外(但坐骨神经会受影响)。因此,这种脂肪酸至少在怀孕 - 哺乳期无法合成足够的量,这意味着需要通过饮食摄入。必须记住,神经元的组织在出生前几周就几乎完成,并且这些神经元会伴随个体一生。因此,在生命的任何阶段,这些神经元的任何干扰、它们连接的改变以及其成分周转的受损,都将倾向于加速衰老。大脑中从亚油酸和α-亚麻酸合成长链多不饱和脂肪酸的酶活性非常有限:因此这个器官依赖于外源供应。因此,对大脑至关重要的脂肪酸是花生四烯酸和二十二碳六烯酸,它们源自饮食,除非肝脏从亚油酸和α-亚麻酸合成它们。与年龄相关的肝脏去饱和酶活性降低(其与延长酶一起参与长链合成)会损害脑膜的周转。在许多结构中,尤其是额叶皮质,衰老过程中会观察到二十二碳六烯酸和花生四烯酸减少,这主要与磷脂酰乙醇胺(主要以缩醛磷脂的形式)减少有关。衰老过程中大脑中多不饱和脂肪酸的过氧化物酶体氧化减少,这参与了膜脂肪酸周转的减少,并且膜脂肪酸也更难以有效抵御自由基的过氧化作用。