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Reduction of pain episodes and prothrombotic activity in sickle cell disease by dietary n-3 fatty acids.

Abstract

The effects of dietary n-3 fatty acids (n-3FAs) on the frequency of pain episodes and ex vivo blood tests of thrombosis have been evaluated in patients with sickle cell disease (SCD) utilizing a double-blind, olive oil-controlled clinical trial. Dietary n-3FA therapy (0.1 g/kg/d) was provided as menhaden fish oil (0.25 g/kg/d) containing 12% eicosapentaenoic acid (EPA), and 18% docosahexaenoic acid (DHA). Within 1 month dietary n-3FAs exchanged with n-6FAs in plasma and erythrocyte membrane phospholipids (p <0.01 in all cases). Treatment with dietary n-3FAs for 1 year reduced the frequency of pain episodes requiring presentation to the hospital from 7.8 events during the preceding year to 3.8 events/year (p <0.01; n = 5). By contrast, subjects receiving control dietary olive oil (n = 5) experienced 7.1 pain events/year, compared to 7.6 during the previous year (p >0.4). The reduction in episodes in n-3FA-treated subjects was also significant when compared to control subjects (p <0.01). Dietary n-3FA therapy was not associated with hemorrhagic, gastrointestinal or other adverse effects. Compared to 10 asymptomatic African-American controls, sickle cell subjects demonstrated significantly increased pretreatment: 1) flow cytometric expression of platelet membrane P-selectin (CD62p; p <0.01) and annexin V binding sites (p = 0.02); 2) plasma levels of platelet-specific secretory proteins platelet factor 4 (PF4) and beta-thromboglobulin (betaTG) (p <0.01 in both cases); 3) plasma products of thrombin generation, prothrombin fragment 1.2 (F1.2) and thrombin:antithrombin (TAT) complex (p <0.01 in both cases); and 4) plasma levels of thrombolytic products, D-dimer and plasmin:antiplasmin (PAP) complex (p <0.01 in both cases). Treatment with dietary n-3FAs concurrently decreased plasma levels of F1.2, D-dimer, and PAP (p <0.05, compared to olive oil controls), implying that the reduction in pain events was related to n-3FA-dependent inhibition of thrombosis. We conclude that dietary n-3FAs reduce the frequency of pain episodes perhaps by reducing prothrombotic activity in sickle cell disease.

Authors+Show Affiliations

,

Department of Hematology and Oncology, Winship Cancer Institute, Emory University School of Medicine and Georgia Sickle Cell Center of Grady Memorial Hospital, Atlanta 30303, USA.

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Source

Thrombosis and haemostasis 85:6 2001 Jun pg 966-74

MeSH

Adult
Anemia, Sickle Cell
Biomarkers
Blood Cell Count
Blood Coagulation Factors
Case-Control Studies
Double-Blind Method
Erythrocyte Membrane
Fatty Acids, Omega-3
Female
Fibrinolytic Agents
Fish Oils
Humans
Male
Olive Oil
Pain
Phospholipids
Plant Oils
Platelet Activation
Prospective Studies
Thrombophilia

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

11434703

Citation

Tomer, A, et al. "Reduction of Pain Episodes and Prothrombotic Activity in Sickle Cell Disease By Dietary N-3 Fatty Acids." Thrombosis and Haemostasis, vol. 85, no. 6, 2001, pp. 966-74.
Tomer A, Kasey S, Connor WE, et al. Reduction of pain episodes and prothrombotic activity in sickle cell disease by dietary n-3 fatty acids. Thromb Haemost. 2001;85(6):966-74.
Tomer, A., Kasey, S., Connor, W. E., Clark, S., Harker, L. A., & Eckman, J. R. (2001). Reduction of pain episodes and prothrombotic activity in sickle cell disease by dietary n-3 fatty acids. Thrombosis and Haemostasis, 85(6), pp. 966-74.
Tomer A, et al. Reduction of Pain Episodes and Prothrombotic Activity in Sickle Cell Disease By Dietary N-3 Fatty Acids. Thromb Haemost. 2001;85(6):966-74. PubMed PMID: 11434703.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reduction of pain episodes and prothrombotic activity in sickle cell disease by dietary n-3 fatty acids. AU - Tomer,A, AU - Kasey,S, AU - Connor,W E, AU - Clark,S, AU - Harker,L A, AU - Eckman,J R, PY - 2001/7/4/pubmed PY - 2002/7/12/medline PY - 2001/7/4/entrez SP - 966 EP - 74 JF - Thrombosis and haemostasis JO - Thromb. Haemost. VL - 85 IS - 6 N2 - The effects of dietary n-3 fatty acids (n-3FAs) on the frequency of pain episodes and ex vivo blood tests of thrombosis have been evaluated in patients with sickle cell disease (SCD) utilizing a double-blind, olive oil-controlled clinical trial. Dietary n-3FA therapy (0.1 g/kg/d) was provided as menhaden fish oil (0.25 g/kg/d) containing 12% eicosapentaenoic acid (EPA), and 18% docosahexaenoic acid (DHA). Within 1 month dietary n-3FAs exchanged with n-6FAs in plasma and erythrocyte membrane phospholipids (p <0.01 in all cases). Treatment with dietary n-3FAs for 1 year reduced the frequency of pain episodes requiring presentation to the hospital from 7.8 events during the preceding year to 3.8 events/year (p <0.01; n = 5). By contrast, subjects receiving control dietary olive oil (n = 5) experienced 7.1 pain events/year, compared to 7.6 during the previous year (p >0.4). The reduction in episodes in n-3FA-treated subjects was also significant when compared to control subjects (p <0.01). Dietary n-3FA therapy was not associated with hemorrhagic, gastrointestinal or other adverse effects. Compared to 10 asymptomatic African-American controls, sickle cell subjects demonstrated significantly increased pretreatment: 1) flow cytometric expression of platelet membrane P-selectin (CD62p; p <0.01) and annexin V binding sites (p = 0.02); 2) plasma levels of platelet-specific secretory proteins platelet factor 4 (PF4) and beta-thromboglobulin (betaTG) (p <0.01 in both cases); 3) plasma products of thrombin generation, prothrombin fragment 1.2 (F1.2) and thrombin:antithrombin (TAT) complex (p <0.01 in both cases); and 4) plasma levels of thrombolytic products, D-dimer and plasmin:antiplasmin (PAP) complex (p <0.01 in both cases). Treatment with dietary n-3FAs concurrently decreased plasma levels of F1.2, D-dimer, and PAP (p <0.05, compared to olive oil controls), implying that the reduction in pain events was related to n-3FA-dependent inhibition of thrombosis. We conclude that dietary n-3FAs reduce the frequency of pain episodes perhaps by reducing prothrombotic activity in sickle cell disease. SN - 0340-6245 UR - https://www.unboundmedicine.com/medline/citation/11434703/full_citation L2 - https://ClinicalTrials.gov/search/term=11434703 [PUBMED-IDS] DB - PRIME DP - Unbound Medicine ER -