Uchiyama-Tanaka Yoko, Mori Yasukiyo
Yoko Clinic, Kitakyushu, Fukuoka, Japan.
Ther Apher Dial. 2010 Jun;14(3):303-7. doi: 10.1111/j.1744-9987.2009.00791.x.
Eicosapentaenoic acid (EPA), which is purified from fish oil, attenuates inflammatory responses by decreasing eicosanoid and cytokine production. EPA reportedly improves renal survival in patients with immunoglobulin (Ig)A nephropathy; however, this is unconfirmed. We studied the effects of EPA on IgA nephropathy patients. Eighteen biopsy-confirmed IgA nephropathy patients (aged 31 +/- 3 years) were enrolled. The prognoses based on glomerular findings were good (N = 5), relatively poor (N = 12), and poor (N = 1). EPA was administered at 1.8 g/day for 12 months. Five biopsy-confirmed IgA nephropathy patients were enrolled as control subjects. Administration of other drugs used to treat IgA nephropathy was not changed. The estimated creatinine clearance (eCCr), serum creatinine (Cr) concentration, urinary protein creatinine ratio (U/P), and other clinical parameters were checked. In the EPA group, the Cr went from 0.8 +/- 0.2 mg/dL to 0.7 +/- 0.2 mg/dL after 12 months of EPA treatment, and the U/P went from 550 +/- 580 mg/g Cr to 330 +/- 920 mg/g Cr. The values did not differ significantly; however, Cr and U/P tended to improve, with no adverse effects from the EPA. The eCCr improved significantly (99 +/- 7-110 +/- 8 mL/min, P = 0.001) in the EPA group, but not in the control group (126 +/- 12-120 +/- 13, P > 0.05). The effect of EPA in patients with IgA nephropathy is not pronounced, but these results suggest that EPA is a safe and worthwhile supplement to the drugs used to treat this disease.
从鱼油中提纯的二十碳五烯酸(EPA)通过减少类花生酸和细胞因子的产生来减轻炎症反应。据报道,EPA可改善免疫球蛋白A(IgA)肾病患者的肾脏存活率;然而,这一点尚未得到证实。我们研究了EPA对IgA肾病患者的影响。纳入了18例经活检确诊的IgA肾病患者(年龄31±3岁)。根据肾小球病变情况,预后良好的有5例,相对较差的有12例,差的有1例。给予EPA 1.8克/天,持续12个月。纳入5例经活检确诊的IgA肾病患者作为对照。用于治疗IgA肾病的其他药物的使用情况未改变。检查了估计的肌酐清除率(eCCr)、血清肌酐(Cr)浓度、尿蛋白肌酐比值(U/P)及其他临床参数。在EPA组,EPA治疗12个月后,Cr从0.8±0.2毫克/分升降至0.7±0.2毫克/分升,U/P从550±580毫克/克肌酐降至330±920毫克/克肌酐。这些数值无显著差异;然而,Cr和U/P有改善趋势,且EPA无不良反应。EPA组的eCCr显著改善(从99±7毫升/分钟升至110±8毫升/分钟,P = 0.001),而对照组无改善(从126±12毫升/分钟降至120±13毫升/分钟,P>0.05)。EPA对IgA肾病患者的疗效不显著,但这些结果表明,EPA是治疗该疾病所用药物的一种安全且值得使用的补充剂。