Charité - University Clinic Berlin, D-14195 Berlin, Germany.
Atherosclerosis. 2012 Dec;225(2):291-5. doi: 10.1016/j.atherosclerosis.2012.09.006. Epub 2012 Sep 18.
Intracranial artery stenosis (ICAS) is a narrowing of an intracranial artery, which is a common etiology for ischemic stroke. In this commentary, we review key aspects of the discrimination between non-stroke controls and ischemic stroke patients on the background of phospholipid ω3-fatty acid (DHA, EPA) composition. The discussion is embedded in the presentation of general effects of long-chain ω3 polyunsaturated fatty acids (PUFAs) in cardio-cerebro-vascular diseases (CCVDs) and Alzheimer dementia (AD).
ICAS is a common stroke subtype and has emerged as a major factor in recurrent stroke and vascular mortality. DHA and EPA are important fatty acids to distinguish between NCAS (no cerebral arteriosclerotic stenosis) and ICAS in stroke. The risk of ICAS is inversely correlated with the DHA content in phospholipids. Furthermore, a mechanistic explanation has been proposed for the beneficial effects of PUFAs in CCVDs and AD.
Whereas the beneficial effects of EPA/DHA for cardiovascular diseases and stroke seem to be beyond question, preventive effects in patients with very mild cognitive dysfunction and beginning Alzheimer's disease undoubtedly need confirmation by larger clinical trials. A collaborative international basic science approach is warranted considering cautiously designed studies in order to avoid ethical problems.
颅内动脉狭窄(ICAS)是颅内动脉狭窄,是缺血性卒中的常见病因。在这篇评论中,我们回顾了在磷脂ω3-脂肪酸(DHA、EPA)组成的背景下,区分非卒中和缺血性卒中患者的关键方面。讨论嵌入了长链ω3 多不饱和脂肪酸(PUFA)在心血管疾病(CCVD)和阿尔茨海默病(AD)中的一般作用的介绍。
ICAS 是一种常见的卒中亚型,已成为复发性卒中及血管性死亡率的主要因素。DHA 和 EPA 是区分卒中患者无颅内动脉粥样硬化性狭窄(NCAS)和 ICAS 的重要脂肪酸。ICAS 的风险与磷脂中 DHA 含量呈负相关。此外,还提出了一种机制解释,说明 PUFAs 在 CCVD 和 AD 中的有益作用。
尽管 EPA/DHA 对心血管疾病和卒中的有益作用似乎毋庸置疑,但在认知功能轻度障碍和早期阿尔茨海默病患者中的预防作用无疑需要更大规模的临床试验来证实。需要一种基于谨慎设计的研究的国际基础科学合作方法,以避免伦理问题。