Matsuyama Wataru, Mitsuyama Hideo, Watanabe Masaki, Oonakahara Ken-ichi, Higashimoto Ikkou, Osame Mitsuhiro, Arimura Kimiyoshi
Division of Respiratory Medicine, Respiratory and Stress Care Center, Kagoshima University Hospital, Sakuragaoka 8-35-1, Kagoshima 890-8520, Japan.
Chest. 2005 Dec;128(6):3817-27. doi: 10.1378/chest.128.6.3817.
COPD, the fifth-leading cause of death worldwide, is characterized by chronic inflammation. However, no available agent can effectively cure this inflammation. A dietary supplement containing omega-3 polyunsaturated fatty acids (PUFAs) has anti-inflammatory effects. In this study, we hypothesized that nutritional support with omega-3 PUFA-rich diets may be useful for treating COPD, and we compared the clinical features and inflammatory mediator levels between the COPD patients who received an omega-3 PUFA-rich supplement and those who received a nonrich supplement.
Sixty-four COPD patients received 400 kilocalories per day of an omega-3 PUFA-rich supplement (n-3 group) or an omega-3 PUFA-nonrich supplement (n-6 group) for 2 years. We prospectively investigated the clinical features of these patients and measured the levels of inflammatory mediators.
In 6-min walk testing, the dyspnea Borg scale and decrease of arterial oxygen saturation measured by pulse oximetry significantly improved in the n-3 group. Leukotriene B4 levels in serum and sputum and tumor necrosis factor-alpha and interleukin-8 levels in sputum decreased significantly in the n-3 group, while there was no significant change in the n-6 group. Two patients in the n-3 group and three patients in the n-6 group had mild diarrhea, and three patients in the n-3 group and three patients in the n-6 group had nausea; however, their symptoms were controllable and they improved with treatment. With multiple regression analysis, it was proved that the omega-3 PUFA-rich diet significantly contributed to the change in cytokine levels in this study.
We suggest nutritional support with an omega-3 PUFA-rich diet as a safe and practical method for treating COPD.
慢性阻塞性肺疾病(COPD)是全球第五大致死原因,其特征为慢性炎症。然而,目前尚无有效药物能治愈这种炎症。一种含有ω-3多不饱和脂肪酸(PUFAs)的膳食补充剂具有抗炎作用。在本研究中,我们假设富含ω-3多不饱和脂肪酸的饮食提供营养支持可能对治疗COPD有用,并比较了接受富含ω-3多不饱和脂肪酸补充剂的COPD患者与接受非富含该脂肪酸补充剂的患者的临床特征和炎症介质水平。
64例COPD患者每天接受400千卡富含ω-3多不饱和脂肪酸的补充剂(n-3组)或不含ω-3多不饱和脂肪酸的补充剂(n-6组),持续2年。我们前瞻性地研究了这些患者的临床特征,并测量了炎症介质水平。
在6分钟步行试验中,n-3组患者的呼吸困难Borg量表评分以及通过脉搏血氧饱和度测量的动脉血氧饱和度下降情况均有显著改善。n-3组患者血清和痰液中的白三烯B4水平以及痰液中的肿瘤坏死因子-α和白细胞介素-8水平显著降低,而n-6组无显著变化。n-3组有两名患者和n-六组有三名患者出现轻度腹泻,n-3组有三名患者和n-6组有三名患者出现恶心;然而,他们的症状可控,经治疗后有所改善。通过多元回归分析,证明在本研究中富含ω-3多不饱和脂肪酸的饮食对细胞因子水平的变化有显著影响。
我们建议采用富含ω-3多不饱和脂肪酸的饮食提供营养支持,作为一种安全实用的COPD治疗方法。