Callan Nini, Hanes Doug, Bradley Ryan
National University of Natural Medicine, Helfgott Research Institute, 2220 SW 1st Ave, Portland, OR, 97201, USA.
Herbert Wertheim School of Public Health, University of California, San Diego, La Jolla, CA, USA.
J Transl Med. 2020 Oct 21;18(1):401. doi: 10.1186/s12967-020-02569-5.
Marine lipids contain omega-3 fatty acids that can be metabolized into anti-inflammatory and pro-resolving mediators-namely 17-HDHA and 18-HEPE-which can serve as modulators of the pain experience. The purpose of this study was to determine the impact of 4 weeks of oral supplementation with a fractionated marine lipid concentration, standardized to 17-HDHA and 18-HEPE, on health-related quality of life and inflammation in adults with chronic pain.
This study was a prospective, non-randomized, open-label clinical trial. Forty-four adults with ≥ moderate pain intensity for at least 3 months were recruited. The primary outcome was change in health-related quality of life (QOL) using the Patient Reported Outcomes Measurement Information System-43 Profile (PROMIS-43) and the American Chronic Pain Association (ACPA) QOL scale. Exploratory outcomes assessed safety and tolerability, changes in anxiety and depression, levels of pain intensity and interference, patient satisfaction, and impression of change. Changes in blood biomarkers of inflammation (hs-CRP and ESR) were also explored.
Outcome measures were collected at Baseline, Week 2, and Week 4 (primary endpoint). At Week 4, PROMIS-43 QOL subdomains changed with significance from baseline (p < 0.05), with borderline changes in the ACPA Quality of Life scale (p < 0.052). Exploratory analyses revealed significant changes (p < 0.05) in all measures of pain intensity, pain interference, depression, and anxiety. There were no statistically significant changes in either hs-CRP or ESR, which stayed within normal limits.
We conclude that oral supplementation with a fractionated marine lipid concentration standardized to 17-HDHA and 18-HEPE may improve quality of life, reduce pain intensity and interference, and improve mood within 4 weeks in adults with chronic pain. The consistency and magnitude of these results support the need for placebo-controlled clinical trials of marine lipid concentrations standardized to 17-HDHA and 18-HEPE. Trial registration ClinicalTrials.gov: Influence of an Omega-3 SPM Supplement on Quality of Life, NCT02683850. Registered 17 February 2016-retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02683850 .
海洋脂质含有ω-3脂肪酸,可代谢为抗炎和促消退介质,即17-羟二十二碳六烯酸(17-HDHA)和18-羟二十碳五烯酸(18-HEPE),它们可作为疼痛体验的调节因子。本研究的目的是确定口服补充4周标准化为17-HDHA和18-HEPE的分级海洋脂质浓缩物对慢性疼痛成年人健康相关生活质量和炎症的影响。
本研究是一项前瞻性、非随机、开放标签的临床试验。招募了44名疼痛强度≥中度且持续至少3个月的成年人。主要结局是使用患者报告结局测量信息系统-43简表(PROMIS-43)和美国慢性疼痛协会(ACPA)生活质量量表评估的健康相关生活质量变化。探索性结局评估安全性和耐受性、焦虑和抑郁的变化、疼痛强度和干扰水平、患者满意度以及变化印象。还探讨了炎症血液生物标志物(高敏C反应蛋白和红细胞沉降率)的变化。
在基线、第2周和第4周(主要终点)收集结局指标。在第4周时,PROMIS-43生活质量子领域与基线相比有显著变化(p<0.05),ACPA生活质量量表有临界变化(p<0.052)。探索性分析显示,疼痛强度、疼痛干扰、抑郁和焦虑的所有测量指标均有显著变化(p<0.05)。高敏C反应蛋白和红细胞沉降率均无统计学显著变化,均保持在正常范围内。
我们得出结论,口服补充标准化为17-HDHA和18-HEPE的分级海洋脂质浓缩物可能在4周内改善慢性疼痛成年人的生活质量、降低疼痛强度和干扰,并改善情绪。这些结果的一致性和程度支持需要对标准化为17-HDHA和18-HEPE的海洋脂质浓缩物进行安慰剂对照临床试验。试验注册ClinicalTrials.gov:ω-3 SPM补充剂对生活质量的影响,NCT02683850。2016年2月17日注册——追溯注册,https://clinicaltrials.gov/ct2/show/NCT02683850 。