Decreased oxidative stress in patients with ulcerative colitis supplemented with fish oil ω-3 fatty acids

• Published in: Nutrition (Burbank, Los Angeles County, Calif.) Vol. 19; no. 10; pp. 837 - 842
• Main Authors: Barbosa, Décio Sabbatini, Cecchini, Rubens, El Kadri, Mirian Zebian, Rodríguez, Maria Aparecida Marchesan, Burini, Roberto Carlos, Dichi, Isaias
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-10-2003; Elsevier
• Subjects: Adult; Biological and medical sciences; Blood Sedimentation - drug effects; Colitis, Ulcerative - blood; Colitis, Ulcerative - drug therapy; Colitis, Ulcerative - metabolism; Colon - pathology; Cross-Over Studies; Digestive system; Drug Therapy, Combination; Fatty Acids, Omega-3 - therapeutic use; Female; fish oil ω-3 fatty acids; Fish Oils - chemistry; free radicals; Gastrointestinal Agents - therapeutic use; Humans; Lipid Peroxidation - drug effects; Male; Medical sciences; oxidative stress; Oxidative Stress - drug effects; Pharmacology. Drug treatments; Reactive Oxygen Species - metabolism; Sigmoidoscopy; sulfasalazine; Sulfasalazine - therapeutic use; Treatment Outcome; ulcerative colitis; fish oil ω-3 fatty acids; sulfasalazine; free radicals; ulcerative colitis; oxidative stress; Sulfanilamide derivatives; Human; Oxidative stress; Sulfonamide; Antiinflammatory agent; Lipids; Supplemented diet; Edible oil; n-3 fatty acid; Fish oil; Free radical; Feeding; Inflammatory disease; Treatment; Animal oil; Unsaturated fatty acid; Digestive diseases; Intestinal disease; Sulfasalazine; Macronutrient; Ulcerative colitis
• ISSN: 0899-9007; 1873-1244
• DOI: 10.1016/S0899-9007(03)00162-X

The potential pathogenicity of free radicals may have a pivotal role in ulcerative colitis. Fish oil ω-3 fatty acids exert anti-inflammatory effects on patients with ulcerative colitis (UC), but the precise mechanism of the action of fish oil on oxidative stress is still controversial. The aim of the present work was to verify the blood oxidative stress in patients with UC and determine whether the association of sulfasalazine to fish oil ω-3 fatty acids is more effective than isolated use of sulfasalazine to reduce the oxidative stress.
Nine patients (seven female and two male; mean age = 40 ± 11 y) with mild or moderate active UC were studied in a randomized crossover design. In addition to their usual medication (2 g/d of sulfasalazine), they received fish oil ω-3 fatty acids (4.5 g/d) or placebo for 2-mo treatment periods that were separated by 2 mo, when they only received sulfasalazine. Nine healthy individuals served as control subjects to study the oxidative stress status. Disease activity was assessed by laboratory indicators (C-reactive protein, α
1-acid glycoprotein, α
1-antitrypsin, erythrocyte sedimentation rate, albumin, hemoglobin, and platelet count), sigmoidoscopy, and histology scores. Analysis of oxidative stress was assessed by plasma chemiluminescence and erythrocyte lipid peroxidation, both induced by tert butyl hydroperoxide (t-BuOOH) and by plasma malondialdehyde. Antioxidant status was assayed by total plasma antioxidant capacity (TRAP) and microsomal lipid peroxidation inhibition (LPI). Superoxide dismutase (SOD) and catalase erythrocyte enzymatic activities were also determined.
No significant changes were observed in any laboratory indicator or in the sigmoidoscopy or histology scores, with the exception of erythrocyte sedimentation rate, which decreased with both treatments. Oxidative stress was demonstrated by significant decreases in TRAP and LPI levels, increased chemiluminescence induced by t-BuOOH, and higher SOD activity in patients with UC. Treatment with fish oil ω-3 fatty acids reverted the chemiluminescence induced by t-BuOOH and LPI to baseline levels but that did not occur when patients received only sulfasalazine. Levels of plasma malondialdehyde, erythrocyte lipid peroxidation, and catalase were not different from those in the control group.
The results indicated that plasma oxidative stress occurs in patients with UC, and there was a significant decrease when the patients used sulfasalazine plus fish oil ω-3 fatty acids. However, there was no improvement in most laboratory indicators, sigmoidoscopy, and histology scores. The results suggested that ω-3 fatty acids may act as free radical scavengers protecting the patients against the overall effect of oxidative stress.