RESEARCH - Antioxidants and fatty acids in the amelioration of RA and related disorders

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Br J Nutr. 2001 Mar;85(3):251-69.

Antioxidants and fatty acids in the amelioration of rheumatoid arthritis

and related disorders.

Darlington LG, Stone TW.

Epsom General Hospital, Dorking Rd., Epsom, Surrey KT18 7EG, UK.

gdarlington@...

The generation of reactive oxygen species (free radicals) is an

important factor in the development and maintenance of rheumatoid

arthritis in humans and animal models. One source of free radicals is

nitric oxide produced within the synoviocytes and chondrocytes and

giving rise to the highly toxic radical peroxynitrite. Several

cytokines, including tumour necrosis factor-alpha (TNFalpha) are

involved in the formation of free radicals, partly by increasing the

activity of nitric oxide synthase. Indeed, nitric oxide may mediate some

of the deleterious effects of cytokines on bone resorption. Aspirin,

tetracyclines, steroids and methotrexate can suppress nitric oxide

synthase. Dietary antioxidants include ascorbate and the tocopherols and

beneficial effects of high doses have been reported especially in

osteoarthritis. There is also evidence for beneficial effects of

beta-carotene and selenium, the latter being a component of the

antioxidant enzyme glutathione peroxidase. The polyunsaturated fatty

acids (PUFA) include the n-3 compounds, some of which are precursors of

eicosanoid synthesis, and the n-6 group which can increase formation of

the pro-inflammatory cytokines TNFalpha and interleukin-6, and of

reactive oxygen species. Some prostaglandins, however, suppress cytokine

formation, so that n-3 PUFA often oppose the inflammatory effects of

some n-6-PUFA. gamma-linolenic acid (GLA) is a precursor of

prostaglandin E1, a fact which may account for its reported ability to

ameliorate arthritic symptoms. Fish oil supplements, rich in n-3 PUFA

such as eicosapentaenoic acid have been claimed as beneficial in

rheumatoid arthritis, possibly by suppression of the immune system and

its cytokine repertoire. Some other oils of marine origin (e.g. from the

green-lipped mussel) and a range of vegetable oils (e.g. olive oil and

evening primrose oil) have indirect anti-inflammatory actions, probably

mediated via prostaglandin E1. Overall, there is a growing scientific

rationale for the use of dietary supplements as adjuncts in the

treatment of inflammatory disorders such as rheumatoid arthritis and

osteoarthritis.

PMID: 11299072

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=pubmed & dopt=Abstra\

ct & list_uids=11299072 & itool=iconabstr

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