Diabetes Research Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
Eur Rev Med Pharmacol Sci. 2023 Aug;27(15):7380-7400. doi: 10.26355/eurrev_202308_33310.
Omega-3 polyunsaturated fatty acids (PUFA) have demonstrated anti-inflammatory properties, while Omega-6 have pro-inflammatory effects, and the balance between the two is an important aspect of healthy nutrition. Over the last 30 years, however, the Western diet has shifted largely from Omega-3 to Omega-6 consumption. Uncontrolled aberrant and chronic inflammation is a leading component of many common diseases, including arthritis, cardiovascular diseases, neurodegenerative diseases, cancer, obesity, autoimmune diseases, and infective diseases. Eicosanoids derived from Omega-6 participate in the inflammatory process, while Omega-3 PUFA have the opposite effect. Many favorable effects of Omega-3 are believed to result from their anti-inflammatory properties, but eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) also have inhibitory effects on immune cells and reduce proinflammatory cytokine release. All these mechanisms can be beneficial in autoimmunity. No effective preventions or definite cures for autoimmune diseases are yet known because pathophysiology is also unclear. Omega-3 fatty acid supplementation is associated with a significant reduction in disease activity in several autoimmune diseases, like type 1 diabetes (T1D), rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and multiple sclerosis (MS). Studies of viral diseases, including COVID-19, show improvement in symptom severity, recovery prognosis, and probability of survival with the use of Omega-3. Finally, the evidence of the beneficial effect of Omega-3 on metabolic diseases associated with aging is persuasive; various studies have demonstrated that their consumption improves lipids, fatty liver disease, obesity, cognitive function, and cardiovascular complications of chronic kidney disease (CKD). Omega-3 PUFA have also been shown to support an anti-inflammatory effect in older age and to have favorable effects on age-related disease's complications, frailty, and mortality. A healthy Omega-6/3 PUFA ratio should be targeted for the modulation of low-grade inflammation, as well as for the prevention of immune dysregulation and complications of uncontrolled inflammation triggered by infections, development, and progression of autoimmune disorders, and the consequences of oxidative stress due to aging. There is still a need for randomized clinical studies to validate current evidence supporting supplementation with correct doses of Omega-3 PUFA in autoimmune and chronic disease prevention.
ω-3 多不饱和脂肪酸（PUFA）具有抗炎特性，而 ω-6 则具有促炎作用，两者之间的平衡是健康营养的一个重要方面。然而，在过去的 30 年里，西方饮食结构已经从 ω-3 转变为 ω-6 的大量消耗。不受控制的异常和慢性炎症是许多常见疾病的主要组成部分，包括关节炎、心血管疾病、神经退行性疾病、癌症、肥胖、自身免疫性疾病和传染病。来源于 ω-6 的类二十烷酸参与炎症过程，而 ω-3 PUFA 则具有相反的作用。人们认为 ω-3 的许多有益作用是由于其抗炎特性，但二十碳五烯酸（EPA）和二十二碳六烯酸（DHA）也对免疫细胞具有抑制作用，并减少促炎细胞因子的释放。所有这些机制在自身免疫中都可能是有益的。由于病理生理学尚不清楚，目前还没有针对自身免疫性疾病的有效预防或明确治疗方法。ω-3 脂肪酸补充剂与几种自身免疫性疾病的疾病活动显著减少有关，如 1 型糖尿病（T1D）、类风湿性关节炎（RA）、系统性红斑狼疮（SLE）和多发性硬化症（MS）。对包括 COVID-19 在内的病毒疾病的研究表明，使用 ω-3 可以改善症状严重程度、恢复预后和生存率。最后，ω-3 对与衰老相关的代谢疾病有益影响的证据令人信服；各种研究表明，它们的消耗可以改善脂质、脂肪肝、肥胖、认知功能和慢性肾脏病（CKD）的心血管并发症。ω-3 PUFA 也被证明在老年时具有抗炎作用，并对与年龄相关的疾病并发症、虚弱和死亡率有有利影响。应该针对低水平炎症的调节，以及针对免疫失调的预防，以及感染、发展和自身免疫性疾病进展引发的不受控制的炎症的并发症，以及由于衰老导致的氧化应激的后果，来靶向健康的 ω-6/3 PUFA 比值。仍然需要随机临床试验来验证目前支持在自身免疫和慢性病预防中正确剂量补充 ω-3 PUFA 的证据。
