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Review
. 2016 Jan-Mar;29(1):37-43.

Inflammatory bowel disease: can omega-3 fatty acids really help?

Sandra Maria Barbalho  1 , Ricardo de Alvares Goulart  2 , Karina Quesada  3 , Marcelo Dib Bechara  4 , Antonely de Cássio Alves de Carvalho  5
Affiliations
Review

Inflammatory bowel disease: can omega-3 fatty acids really help?

Sandra Maria Barbalho et al. Ann Gastroenterol. 2016 Jan-Mar.

Abstract

Adjuvants to the traditional therapy of inflammatory bowel disease (IBD) have been studied to enhance the efficacy of the treatment and improve patients' quality of life. Omega-3 polyunsaturated fatty acids (ω3FA) have been associated with attenuation of the inflammatory responses in IBD, possibly acting as substrates for anti-inflammatory eicosanoid production, similar to prostaglandins and leukotrienes. ω3FA also act as substrates for the synthesis of resolvins, maresins and protectins, indispensable in resolving inflammation processes. These acids may influence the development or course of IBD by: reducing oxidative stress, production of tumor necrosis factor-α and proinflammatory cytokines; working as chemopreventive agents; and decreasing the expression of adhesion molecules. There are numerous controversies in the literature on the effects of ω3FA in the prevention or treatment of IBD, but their effects in reducing inflammation is incontestable. Therefore, more studies are warranted to elucidate the pathophysiological mechanisms and establish the recommended daily intake to prevent or induce remission in IBD patients.

Keywords: Crohn’s disease; Ulcerative colitis; omega-3 polyunsaturated fatty acids.

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Conflict of interest statement

Conflict of Interest: None

Figures

Figure 1
Figure 1
Pathophysiology of inflammatory bowel disease. The imbalance in mucinous layer allows higher permeability of the intestinal epithelium leading to an increase in the uptake of antigens. Dendritic cells and macrophages recognize commensal microbiota and become activated. Activation of nuclear factor kappa B (NFκB) increases the synthesis of proinflammatory cytokines as tumor necrosis factor (TNF)-α, interleukin (IL) -6, -12, -23, and -1β. Modified from Ordas et al [10] TLR, toll-like receptor
Figure 2
Figure 2
Synthesis of eicosanoids from ω3 FA: 3 series prostanoids TXA3, PGE3 and PGI3 and 5 series leukotrienes LTB5, LTC5-LTE5. Modified from Barbalho et al [33] and Din et al [37] ω3 FA, omega 3 fatty acid; TXA3, thromboxane A3; PGE3, prostaglandin E3; PGI3 and 5, prostaglandin I3 and 5; LTB5, leukotriene B5; LTC5-LTE5, leukotriene C5-leukotriene E5
Figure 3
Figure 3
Structure of omega 3 fatty acids: first double bond at the third carbon molecule from the methyl end of the chain. There are three possibilities for names: C18:3n-3, C20:5n-3 and C22:6n-3omega, respectively linolenic acid, eicosapentanoic acid and docosahexanoic acid
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