A biomarker of n-3 compliance in patients taking fish oil for rheumatoid arthritis

Assessing the risk of insecticides to Actinopterygii in the combination of ecological planting and rearing

In order to study the co-existing environment of pests and economic animals, the toxicity of 15 insecticides to Plutella xylostella, Monopterus albus, and Paramisgurnus dabryanus was tested. Combined with the recommended maximum doses in the field and bioassay, the results showed that for the three insecticides that were of relatively low toxicity to M. albus and P. dabryanus, spinetoram showed the best control effect on P. xylostella, followed by chlorfenapyr and chlorantraniliprole. However, P. xylostella showed a relatively high resistance to chlorfenapyr. Therefore, the best insecticide suitable for the fields with the cauliflower-finless eel or cauliflower-loach planting and rearing combination was spinetoram, followed by chlorantraniliprole and chlorfenapyr. Other insecticides such as emamectin benzoate, Bacillus thuringiensis (Bt), matrine, and so on were effective against the diamondback moth, but they were not suitable for use because of their high toxicity to the finless eel and loach.

Survey on Heavy Metals Contamination and Health Risk Assessment in Commercially Valuable Asian Swamp Eel, Monopterus albus from Kelantan, Malaysia

This work investigates the metals concentration in the tissues of Asian swamp eel, Monopterus albus. Five selected tissues, including liver, gill, bone, skin, and muscle were examined for the concentration of Zn, Cu, Cd, Pb, and Ni. The concentrations of Cd and Pb were found high in the muscle tissues of the eels. Additionally, high amounts of Zn and Cu metals were observed in the liver, whereas the Cd, Pb, and Ni metals were highly detected in gill. The accumulation of Zn, Cu, Cd, Pb, and Ni in both skin and bone of the eel seems to vary between seasons. Low levels of Zn, Cu, and Ni were identified in the muscle tissues of the eels. This study revealed that the concentration of Cd and Pb in the muscle tissues of Asian swamp eels exceeded the permissible limits by the US EPA, suggesting the consumption of the muscle may be hazardous and can severely affect one’s health.

Synovial fluid and plasma n3 long chain polyunsaturated fatty acids in patients with inflammatory arthritis

Relationships between n-3 long chain polyunsaturated fatty acids (LC-PUFA) in plasma and synovial fluid (SF) were examined in 36 patients with knee effusion within the context of a variety of rheumatic diagnoses and various stated fish oil (FO) intakes (from 0 to 30mL of standard FO daily) of variable duration. In a sub-group of patients, correlations between PUFA in SF mononuclear cells (MNC) and cell-free supernatants of SF and between SF MNC and peripheral blood (PB) MNC were examined. Correlations were also sought between clinical data (stated FO intake, pain score) and n-3 LC-PUFA. Correlations between plasma n-3 LC-PUFA and SF n-3 LC-PUFA were very strong (r(2)>0.9, p<0.001). The LC-PUFA profiles of SF supernatants differed from those of MNC. PUFA profiles in PB MNC and SF MNC were similar, except for a higher proportion of DHA in the latter. Positive correlations were observed between stated intakes of FO and EPA in plasma and SF (for both r=0.37, p=0.02) and DHA in plasma (r=0.37, p=0.02) and SF (r=0.36, p=0.03). n-3 LC-PUFA in plasma and SF correlated inversely with pain score (plasma r(2)=0.16, p<0.02; SF r(2) 0.32, p=0.001). In conclusion, plasma n-3 LC-PUFA is a strong indicator of SF n-3 LC-PUFA status across a broad range of rheumatic diagnoses and FO intakes. Higher n-3 LC-PUFA in plasma and SF were associated with lesser pain experience.

Mercury contamination in Khramulia (Capoeta capoeta) from the Cheshme Kile and Zarrin Gol Rivers in Iran and human health risk assessment

Total mercury concentrations were determined in muscle tissue of Khramulia (Capoeta capoeta) captured in the Cheshme Kile and Zarrin Gol Rivers, Iran. In Cheshme Kile River, 49 fish samples were collected. The mean total mercury concentration in the muscles of C. capoeta from this area was 249 ng g(-1) dw. In Zarrin Gol River, where 62 fish samples were collected, the total mercury in muscles averaged 164 ng g(-1) dw. A significant difference was found between means of mercury in the rivers (p < 0.001). All samples from the two rivers had mean mercury concentrations below the maximum allowable limits for mercury set by the Food and Agriculture Organization, World Health Organization, Standardization Administration of China and Environmental Protection Agency. The results of this study indicate that the values of hazard target quotient and estimated weekly intake are low and represent a negligible risk for human health.

Toxic metals in commercial marine fish in Oman with reference to national and international standards

Commercially important fresh (581) and frozen (292) marine fish samples of 10 species were collected from seafood factories and evaluated using AAS and ICP-OES. Metal levels significantly (p<0.05) varied within and between species. However, there were no significant correlations among metals. There were significant interspecific differences for all metals, and yellowfin tuna had the highest level of cadmium and mercury however, red seabream had maximum numbers above the standards. The metal accumulation significantly varied between bottom feeders of intermediately size locally caught fish. The mean cadmium level ranged from 0.0049 to 0.036 mg kg(-1) and 1.37% of the total samples exceeded the EU and FAO standards. Mean lead content varied between 0.029 and 0.196 mg kg(-1), few samples crossed the EU (2.63%) and FAO (1.6%) limits. Mean mercury level ranged from 0.015 to 0.101 mg kg(-1) and none of the samples exceeded the EU limit. Of the total samples analyzed red seabream (2.06%), yellowfin tuna (1.14%), emperor (0.34%), santer bream (0.22%), king fish (0.11%) and skipjack tuna (0.11%) samples crossed the EU limits. In general, fish from these regions are within the safety levels recommended by various organizations and do not pose a health risk in terms of human diet.

Adherence to fish oil intervention in patients with chronic kidney disease

OBJECTIVE

With growing recognition of the role of inflammation in the development of chronic and acute disease, fish oil is increasingly used as a therapeutic agent, but the nature of the intervention may pose barriers to adherence in clinical populations. Our objective was to investigate the feasibility of using a fish oil supplement in hemodialysis patients.

DESIGN

This was a nonrandomized intervention study.

SETTING

Eligible patients were recruited at the Hemodialysis Unit of Wesley Hospital, Brisbane, Queensland, Australia.

PATIENTS

The sample included 28 maintenance hemodialysis patients out of 43 eligible patients in the unit. Exclusion criteria included patients regularly taking a fish oil supplement at baseline, receiving hemodialysis for less than 3 months, or being unable to give informed consent.

INTERVENTION

Eicosapentaenoic acid (EPA) was administered at 2000 mg/day (4 capsules) for 12 weeks. Adherence was measured at baseline and weekly throughout the study according to changes in plasma EPA, and was further measured subjectively by self-report.

RESULTS

Twenty patients (74%) adhered to the prescription based on changes in plasma EPA, whereas an additional two patients self-reported good adherence. There was a positive relationship between fish oil intake and change in plasma EPA. Most patients did not report problems with taking the fish oil. Using the baseline data, it was not possible to characterize adherent patients.

CONCLUSIONS

Despite potential barriers, including the need to take a large number of prescribed medications already, 74% of hemodialysis patients adhered to the intervention. This study demonstrated the feasibility of using fish oil in a clinical population.

Long-term moderate intervention with n-3 long-chain PUFA-supplemented dairy products: effects on pathophysiological biomarkers in patients with rheumatoid arthritis

n-3 long-chain PUFA (n-3 LC-PUFA) may improve cardiovascular and inflammatory diseases. The effects of n-3 LC-PUFA-supplemented dairy products on inflammation and immunological parameters, biomarkers of oxidative stress, serum lipids, and on disease activity were determined in patients with rheumatoid arthritis (RA). Forty-five subjects (forty-three females and two males) were randomly divided into two groups in a double-blind, placebo-controlled cross-over study. Both groups received placebo or verum products consecutively for 3 months with a 2-month washout phase between the two periods. Blood samples were taken at the beginning and at the end of each period. The dairy products generally improved serum lipids by increasing HDL and lowering lipoprotein a. The n-3 LC-PUFA supplements act to lower TAG. Additionally, a decreased lipopolysaccharide-stimulated cylo-oxygenase-2 expression was found in patients who had consumed the enriched dairy products. The majority of the CD analysed were not influenced, although n-3 LC-PUFA did suppress the immune response as lymphocytes and monocytes were found to be significantly decreased. The n-3 LC-PUFA did not increase the biomarkers of oxidative stress such as 8-iso-PGF(2alpha) and 15-keto-dihydro PGF(2alpha), and DNA damage like 7,8-dihydro-8-oxo-2'-deoxyguanosine. The long-term consumption of dairy products (2 x 12 weeks) diminished the excretion of hydroxypyridinium crosslinks, and favoured the diastolic blood pressure. The consumption of moderate doses of n-3 LC-PUFA in combination with dairy products did not improve the disease activity. However, there is evidence of cardioprotective effects. Furthermore, the long-term consumption of dairy products acts against the cartilage and bone destruction in RA.

Dietary omega-3 fats for treatment of inflammatory joint disease: efficacy and utility

There is high level evidence (meta-analysis of randomized, controlled trials) for symptomatic benefits from fish oil use in rheumatoid arthritis, and there is biologic plausibility for its clinical effects. Fish oil also has safety advantages in reducing cardiovascular risk via direct cardiovascular effects and via nonsteroidal anti-inflammatory drug-sparing. This is an important aspect of fish oil use, given the increased cardiovascular risk in rheumatoid arthritis. Perceived barriers to clinical use are readily addressed.

Heavy metals: Implications associated to fish consumption

Metals are being utilized of ways in industries and agriculture; particularly heavy metals such as mercury, cadmium, lead and arsenic constitute a significant potential threat to human health because they are associated to many adverse effects on health. The consumption of fish is recommended because it is a good source of omega-3 fatty acids, which have been associated with health benefits due to its cardio-protective effects. However, the content of heavy metals discovered in some fish makes it difficult to establish clearly the role of fish consumption on a healthy diet. Therefore the present mini-review accounts for the recent evidence of the effect of these toxic metals on the human health and their possible implications in fish consumption.

Response-Driven Combination Therapy with Conventional Disease-Modifying Antirheumatic Drugs Can Achieve High Response Rates in Early Rheumatoid Arthritis with Minimal Glucocorticoid and Nonsteroidal Anti-Inflammatory Drug Use

OBJECTIVES

To assess the safety and efficacy of combination therapy in recent-onset rheumatoid arthritis (RA), with dose adjustments determined by response, in a clinic setting over 3 years.

METHODS

Disease-modifying antirheumatic drug (DMARD)-naive patients with RA of median duration of 12 weeks (n = 61) attending an early arthritis clinic were treated with methotrexate, sulfasalazine, hydroxychloroquine, and fish oil. Dosage adjustments and additions of further DMARDs were contingent on response to therapy and tolerance. Outcome measures for efficacy were Disease Activity Score (DAS28), clinical remission, and modified Sharp radiographic score and for safety, adverse events, and DMARD withdrawal.

RESULTS

At baseline, subjects had at least moderately active disease (mean +/- SD DAS28 was 5.3 +/- 1.1), impaired function as measured by the modified Health Assessment Questionnaire (mHAQ) (0.9 +/- 0.5), and 37% had bone erosions. By 3 months, 29% were in remission; this increased to 54% at 3 years. The greatest fall in DAS28 and improvement in mHAQ scores occurred in the first 12 months. Erosions were detected in 62% at 3 years. The mean dose of parenteral glucocorticoid was equivalent to 0.1 mg/d of prednisolone. After 3 years, 48% remained on triple therapy; fish oil was consumed by 75% of patients, and 21% used nonsteroidal anti-inflammatory drugs. Gastrointestinal intolerance was the most frequent unwanted event (leading to DMARD withdrawal in 17 patients). Sulfasalazine was most frequently withdrawn (30%).

CONCLUSION

This implementation study demonstrates the feasibility, safety, and efficacy of combination therapy with inexpensive DMARDs, fish oil, and minimal glucocorticoid use, in routine clinical practice using predefined rules for dosage adjustment.

Incorporation and washout of n-3 polyunsaturated fatty acids after diet supplementation in clinical studies

Current evidence suggests that at least part of the cardioprotective benefits of consumption of long-chain n-3 polyunsaturated fatty acids (PUFAs) relates to their incorporation into the phospholipids of cardiac cell membranes. Dietary supplementation with purified extracts of n-3 PUFAs derived from fish oil rapidly alters the composition of fatty acids in blood cell membranes and in other tissues. The present review summarises the time-course and dose-dependent incorporation and washout of n-3 PUFAs in the clinical setting and discusses the implications of these pharmacokinetic data in terms of biological effects.

Comparison between plasma and erythrocyte fatty acid content as biomarkers of fatty acid intake in US women

BACKGROUND

Erythrocyte fatty acids may be superior to plasma fatty acids for reflecting long-term fatty acid intake because of less sensitivity to recent intake and a slower turnover rate.

OBJECTIVE

The objective was to compare the fatty acid content of erythrocytes with that of plasma with respect to their abilities to reflect usual fatty acid intake.

DESIGN

Fatty acids in plasma and erythrocytes were measured by capillary gas-liquid chromatography in 306 US women aged 43-69 y. Fatty acid intake was assessed with a food-frequency questionnaire, which was validated for measuring intakes of various fatty acids.

RESULTS

Docosahexaenoic acid (DHA, 22:6n-3) in erythrocytes and plasma provided the strongest correlations with its intake, but erythrocyte DHA concentrations [Spearman's partial correlation coefficient (r(s))=0.56] were better than plasma DHA concentrations (r(s)=0.48) as a biomarker. Total trans fatty acids (r(s)=0.43) and total 18:1 trans isomers (r(s)=0.42) in erythrocytes were also more strongly correlated with intake than were those in plasma (r(s)=0.30 and r(s)=0.29, respectively). Moderate correlations were observed for linoleic acid (18:2n-6; erythrocytes, r(s)=0.24; plasma, r(s)=0.25), alpha-linolenic acid (18:3n-3; erythrocytes, r(s)=0.18; plasma, r(s)=0.23), and eicosapentaenoic acid (20:5 n-3; erythrocytes, r(s)=0.38; plasma, r(s)=0.21). For polyunsaturated and trans fatty acids, correlations between intakes and biomarkers improved moderately when average intakes over previous years were used.

CONCLUSION

Erythrocyte n-3 fatty acids of marine origin and trans fatty acid content are suitable biomarkers for long-term intake.

Effects of fish-oil supplementation on myocardial fatty acids in humans

BACKGROUND

Increased fish or fish-oil consumption is associated with reduced risk of cardiac mortality, especially sudden death. This benefit putatively arises from the incorporation of the long-chain n-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) into cardiomyocyte phospholipids.

OBJECTIVE

The study examined the kinetics of incorporation of n-3 fatty acids into human myocardial membrane phospholipids during supplementation with fish oil and alpha-linolenic acid-rich flaxseed oil.

DESIGN

Patients with low self-reported fish intake (<1 fish meal/wk and no oil supplements) accepted for elective cardiac surgery involving cardiopulmonary bypass were randomly allocated to 1 of 6 groups: no supplement; fish oil (6 g EPA+DHA/d) for either 7, 14, or 21 d before surgery; flaxseed oil; or olive oil (both 10 mL/d for 21 d before surgery). Right atrial appendage tissue removed during surgery and blood collected at enrollment and before surgery were analyzed for phospholipid fatty acids.

RESULTS

Surgery rescheduling resulted in a range of treatment times from 7 to 118 d. In the fish-oil-treated subjects, accumulation of EPA and DHA in the right atrium was curvilinear with time and reached a maximum at approximately 30 d of treatment and displaced mainly arachidonic acid. Flaxseed oil supplementation yielded a small increase in atrial EPA but not DHA, whereas olive oil did not significantly change atrial n-3 fatty acids.

CONCLUSION

The results of the present study show that dietary n-3 fatty acids are rapidly incorporated into human myocardial phospholipids at the expense of arachidonic acid during high-dose fish-oil supplementation.

Diet and rheumatoid arthritis: a review of the literature

INTRODUCTION

Rheumatoid arthritis is a common inflammatory condition. A large number of patients seek alternative or complementary therapies of which diet is an important component. This article reviews the evidence for diet in rheumatoid arthritis along with the associated concept of oral tolerization.

METHODS

References were taken from Medline from 1966 to September 2004. The keywords, rheumatoid arthritis, diet, n-3 fatty acids, vitamins, and oral tolerization, were used.

RESULTS

Randomized controlled trials (RCTs) indicate that dietary supplementation with n-3 fatty acids provides modest symptomatic benefit in groups of patients with rheumatoid arthritis. Epidemiological studies and RCTs show cardiovascular benefits in the broader population and patients with ischemic heart disease. A number of mechanisms through which n-3 fats may reduce inflammation have been identified. In a small number of patients with rheumatoid arthritis, other dietary manipulation such as fasting, vegan, and elimination diets may have some benefit. However, many of these diets are impractical or difficult to sustain long term.

CONCLUSIONS

Dietary manipulation provides a means by which patients can a regain a sense of control over their disease. Dietary n-3 supplementation is practical and can be easily achieved with encapsulated or, less expensively, bottled fish oil.

Plasma coagulation factor VII activity and its correlates in healthy men

OBJECTIVE

The aim of this study was to investigate the plasma coagulation factor VII activity and its correlates in healthy Australian men.

DESIGN

Cross-sectional study.

SETTING

Free living subjects.

SUBJECTS

A total of 139 healthy Australian males aged 20-55 y with widely varying intakes of individual fatty acids.

OUTCOME MEASURES

The concentration of phospholipid fatty acids and the parameters of biochemistry were analysed by standard methods. Citrated plasma factor VII activity was measured by using the ACL 200 system with commercially available kits.

RESULTS

In the stepwise multiple regression, controlled for age, body mass index and dietary groups, the two most important variables of factor VII activity were selected in the forward entry model with R (2) = 0.474 and P < 0.0001 from 19 independent variables, which were significantly correlated with plasma factor VII activity in age-adjusted bivariate analysis where significance was considered at P < 0.01. Plasma factor VII activity was strongly negatively correlated with prothrombin time (PT) (Std. Coeff. -0.550), and significantly positively correlated with plasma phospholipid (PL) stearic acid (Std. Coeff. 0.285).

CONCLUSIONS

Increased factor VII activity was associated with shortening of PT. All types of fatty-acid concentrations of PLs were significantly positively correlated with factor VII activity; however, stearic acid was more potent than other fatty acids in healthy Australian men.

SPONSORSHIP

Meat Research Corporation of Australia.