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首页> 外文期刊>The Internet Journal of Asthma, Allergy and Immunology >Randomized Cross-Over Controlled Pilot Study of Docosahexaenoic Acid Supplementation on Airway Inflammation and Hyperpnea-Induced Bronchoconstriction in Adults with Asthma
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Randomized Cross-Over Controlled Pilot Study of Docosahexaenoic Acid Supplementation on Airway Inflammation and Hyperpnea-Induced Bronchoconstriction in Adults with Asthma

机译：补充二十二碳六烯酸对成人哮喘患者气道炎症和高通气引起的支气管收缩的随机对照研究

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Background: Fish oil supplementation has been shown to attenuate hyperpnea- and exercise-induced bronchoconstriction. In vitro studies suggest that the omega-3 polyunsaturated fatty acid docosahexaenoic acid (DHA), rather than eicosapentaenoic acid, may be the potent component of fish oil.Objective: Therefore, the main aim of this study was to determine whether DHA supplementation can attenuate hyperpnea-induced bronchoconstriction (HIB) and airway inflammation in adults with asthma compared to placebo.Methods: Nine subjects (aged 18-30 years) with asthma and HIB participated in a randomized, double-blind, placebo-controlled crossover trial where they received either 4.0 g of DHA or placebo capsules for 3 weeks. Following a 2-week washout phase, subjects then received the opposite supplement for 3 weeks. Subjects were tested in a laboratory following an initial 2-week run-in phase and after each supplementation phase. Each time, bronchoprovocation was elicited with eucapnic voluntary hyperventilation (EVH), a surrogate for an exercise challenge. Prior to and following the EVH challenge, pulmonary function, exhaled breath condensate (EBC) pH, and EBC concentrations of 8-isoprostane and the DHA metabolites 17S-hydroxydocosahexaenoic acid and protectin D1 were measured. This study was registered at clinicaltrials.gov (study # NCT01200446).Results: Nine subjects completed the crossover design protocol without any adverse effects. There were no significant changes (p > 0.05) in any variables measured (i.e., percent change in forced expiratory volume-1-sec, EBC pH, 8-isoprostane, protectin D1 and 17S-hydroxydocosahexaenoic acid) among the pre-supplementation, placebo, and DHA tests. The effect size (ω2) for the maximum percent change in FEV1 was 0.08.Conclusion: The data indicate that supplementation with 4.0 g of DHA for 3 weeks does not attenuate HIB or airway inflammation in asthmatic subjects compared to baseline or placebo. Variations in study design, including time course, dose, and route of administration, should be conducted to further address DHA’s role as a potential treatment for HIB. Introduction The Center for Disease Control recently reported that 8.2% of the United States population has asthma [1]. Exercise-induced bronchoconstriction (EIB) is an important complication of this chronic inflammatory disease of the airways as patients with asthma often report limitations in their physical activity [2]. Moreover, EIB is an indication that a patient’s current asthma treatment may be inadequate [3]. As nearly a third of the estimated $19.7 billion in direct and indirect healthcare costs for asthma in 2007 stemmed from prescription medications [4], there is a growing interest in non-pharmacological alternatives to treat this condition.A nutritional approach is an appealing alternative as the prevalence of asthma has been linked to societal changes in diet [5]. Moreover, dietary supplement use is already popular in both the general and asthmatic populations, for according to a recent National Health and Nutrition Examination Survey, approximately 50% of people in both of these populations reported "dietary supplement use in the last 30 days." [6]. It is thus important to study these nutritional supplements and their effect on asthma in order to form a scientific basis upon which clinicians can recommend their proper and safe use. Omega-3 polyunsaturated fatty acid (PUFA) supplementation is used by 6.7% of asthmatics as nutritional therapy [6]. The omega-3 PUFAs eicosapentaenoic acid (EPA) and docosahexaenoic (DHA) are the primary components of fish oil. Previous research has shown that supplementation with fish oil (3.2 g EPA and 2.0-2.2 g DHA per day for 3 weeks) reduces airway inflammation and EIB in elite athletes without asthma [7] and in adults with asthma [8,9]. The mechanism of action of the omega-3 PUFAs is thought to involve decreasing the availability of the more pro-inflammatory omega-6 PUFA- derived metabolites (i
机译：背景：补充鱼油已显示可减轻呼吸过度和运动引起的支气管收缩。体外研究表明，鱼油中可能含有omega-3多不饱和脂肪酸二十二碳六烯酸（DHA）而不是二十碳五烯酸。目的：因此，这项研究的主要目的是确定补充DHA是否可以减轻方法：9名哮喘和HIB患者（18-30岁）参加了一项随机，双盲，安慰剂对照交叉试验，其中9例18-30岁的哮喘和HIB受试者接受了哮喘的成年人的高通气诱发的支气管收缩（HIB）和气道炎症服用4.0克DHA或安慰剂胶囊3周。经过2周的冲洗阶段，受试者随后接受了相反的补充剂3周。在最初的2周磨合期之后以及每个补充阶段之后，都要在实验室对受试者进行测试。每次，通过优步自发性过度换气（EVH）引发支气管激发，这是运动挑战的替代物。在EVH攻击之前和之后，测量了肺功能，呼出气冷凝物（EBC）pH值以及8-异前列腺素和DHA代谢物17S-羟基二十二碳六烯酸和保护素D1的EBC浓度。该研究已在Clinicaltrials.gov上注册（研究号NCT01200446）。结果：9名受试者完成了交叉设计方案，没有任何不良影响。补充剂，安慰剂之间的任何变量（例如，呼气量-1秒变化，EBC pH，8-异前列腺素，保护素D1和17S-羟基二十二碳六烯酸的变化百分比）均无显着变化（p> 0.05）。和DHA测试。 FEV1的最大百分比变化的效应大小（ω2）为0.08。结论：数据表明，与基线或安慰剂相比，在哮喘受试者中补充4.0 g DHA持续3周不能减轻HIB或气道炎症。应该进行研究设计的变化，包括时间，剂量和给药途径，以进一步说明DHA作为HIB潜在治疗剂的作用。引言疾病控制中心最近报告说，美国人口的8.2％患有哮喘[1]。运动诱发的支气管收缩（EIB）是这种慢性气道炎性疾病的重要并发症，因为哮喘患者经常报告其身体活动受限[2]。此外，EIB指示患者当前的哮喘治疗可能不充分[3]。 2007年，哮喘直接和间接的医疗保健费用估计为197亿美元，其中近三分之一来自处方药[4]，因此人们对治疗这种疾病的非药物替代疗法的兴趣日益浓厚。哮喘的患病率与饮食的社会变化有关[5]。而且，膳食补充剂的使用在普通人群和哮喘人群中都已经很流行，因为根据最近的国家健康和营养调查，这两个人群中大约有50％的人报告“过去30天内食用膳​​食补充剂”。 [6]。因此，重要的是研究这些营养补充剂及其对哮喘的作用，以便为临床医生推荐适当和安全的使用方法提供科学依据。 6.7％的哮喘患者使用Omega-3多不饱和脂肪酸（PUFA）补充剂作为营养疗法[6]。 omega-3 PUFA二十碳五烯酸（EPA）和二十二碳六烯酸（DHA）是鱼油的主要成分。先前的研究表明，鱼油补充（3.2 g EPA和2.0-2.2 g DHA每天持续3周）可减少无哮喘精英运动员[7]和患有哮喘的成年人[8,9]的气道炎症和EIB。认为omega-3 PUFA的作用机制涉及降低更具促炎性的omega-6 PUFA衍生代谢物的可用性（i

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