Distal proctocolitis and n-3 polyunsaturated fatty acids (n-3 PUFAs): The mucosal effect in situ

Y Z Almallah, S W Ewen, A El-Tahir, N A G Mowat, P W Brunt, T S Sinclair, S D Heys, O Eremin

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Abstract

It has been postulated that patients with ulcerative colitis (UC) have altered reactivity of gut-associated lymphoid tissue. In such cases there is intense infiltration of the mucosa with immune competent cells and associated tissue damage. We have shown previously that the dietary supplementation with the n-3 polyunsaturated fatty acids (n-3 PUFAs), eicosapentaenoic acid;EPA), and docosahexaenoic acid (DHA) results in significant systemic immune suppression. The aim of this study, therefore, was to evaluate the in situ effect of n-3 PUFAs on distal proctocolitis. Each patient received either fish oil extract (EPA 3.2 g, DHA 2.4 g) (n = 9) or sunflower oil (n = 9) daily in a double blind manner for six months. Monthly assessment included: (1) disease activity using clinical, sigmoidoscopic, and histological scores and (2) immunohistochemical analysis (immunoglobulins, CD profiles) of rectal biopsy specimens (before and after six months supplementation) using monoclonal antibodies and quantitative computer-assisted video image analysis. Prior to receiving supplementation, patients with proctocolitis (n = 18) Showed significantly higher numbers of cells expressing CD3 (pan T cells) and HLA-DR and IgM containing cells compared with non-colitic controls (II = 8). Six months supplementation with n-3 PUFAs resulted in significant reduction in the number of cells expressing CD3 and HLA and the percentage of cells containing IgM. There was no significant change in the CD20 nor the percentage of IgG or IgA containing cells in either group of patients with procto-colitis. In patients receiving n-3 PUFA supplementation, there was improvement in the disease activity and histological scores, compared with pretreatment evaluation. This study has demonstrated both evidence of suppression of in situ immune reactivity and concurrent reduction in disease activity in patients with proctocolitis receiving n-3 PUFA supplementation. This may have important implication for therapy in patients with ulcerative colitis.

Original languageEnglish
Pages (from-to)68-76
Number of pages9
JournalJournal of Allergy and Clinical Immunology
Volume20
Publication statusPublished - 2000

Keywords

  • n-3 polyunsaturated fatty acids
  • procto-colitis
  • imunohistochemistry
  • INFLAMMATORY BOWEL-DISEASE
  • INTESTINAL MONONUCLEAR-CELLS
  • ULCERATIVE-COLITIS
  • CROHNS-DISEASE
  • FISH-OIL
  • BIOPSY SPECIMENS
  • DIETARY SUPPLEMENTATION
  • NATURAL CYTOTOXICITY
  • CYTOKINE PRODUCTION
  • PERIPHERAL-BLOOD

Cite this

Almallah, Y. Z., Ewen, S. W., El-Tahir, A., Mowat, N. A. G., Brunt, P. W., Sinclair, T. S., Heys, S. D., & Eremin, O. (2000). Distal proctocolitis and n-3 polyunsaturated fatty acids (n-3 PUFAs): The mucosal effect in situ. Journal of Allergy and Clinical Immunology, 20, 68-76.