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Nutrition Research for Doctors
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Pain & Inflammation
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James JM, et al. Dietary polyunsaturated fatty acids and inflammatory mediator production. Am J Clin Nutr 2000;71(suppl):343S-8S.
Inflammation is characterized symptomatically by Pain, Redness, and Swelling.
Disordered or excessive inflammation also entails loss of function.
This clinical pathology results from the release of inflammatory mediators, predominantly from activated leukocytes that migrate into the target area.
Among the key inflammatory mediators are the n-6 eicosanoids, Prostaglandin E2 (PGE2) and Leukotriene B4 (LTB4), which are derived from the n-6 polyunsaturated fatty acid (PUFA) Arachidonic Acid (AA; 20:4n26).
Also important are the cytokines, Interleukin 1b (IL-1b) and Tumor Necrosis Factor-a (TNF-a), and there is strong evidence for the involvement of TNF-a in the joint pathology of rheumatoid arthritis.
Many anti-inflammatory pharmaceutical products inhibit the production of certain eicosanoids and cytokines and it is here that possibilities exist for therapies that incorporate n-3 and n-9 dietary fatty acids.
The pro-inflammatory eicosanoids mentioned above are derived from the n-6 fatty acid Arachidonic Acid (AA), which is maintained at high cellular concentrations by the high n-6 and low n-3 polyunsaturated fatty acid content of the modern Western diet.
Eicosapentaenoic acid (EPA) and Docosahexaenoic acid (DHA) can act as competitive inhibitors of AA conversion to PGE2 and LTB4, and decreased synthesis of one or both of these eicosanoids has been observed after inclusion of flaxseed oil or fish oil in the diet.
Analogous to the effect of n-3 fatty acids, inclusion of n-9 fatty acid Eicosatrienoic acid in the diet also results in decreased synthesis of LTB4.
Regarding the pro-inflammatory cytokines, Tumor Necrosis Factor-a (TNF-a) and Interleukin 1b, studies of healthy volunteers and rheumatoid arthritis patients have shown 90% inhibition of cytokine production after dietary supplementation with fish oil.
Use of flaxseed oil in domestic food preparation also reduced production of these cytokines.
Many anti-inflammatory pharmacotherapies are directed at inhibiting the production of these inflammatory mediators and thus possibilities exist for therapies that incorporate n-3 and n-9 dietary fatty acids.
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