Yes / The naturally-occurring omega (ω)-3 polyunsaturated fatty acid (PUFA) eicosapentaenoic acid (EPA) reduces colorectal adenoma (polyp) number and size in patients with familial adenomatous polyposis. The safety profile and potential cardiovascular benefits associated with ω-3 PUFAs make EPA a strong candidate for colorectal cancer (CRC) chemoprevention, alone or in combination with aspirin, which itself has recognized anti-CRC activity. Colorectal adenoma number and size are recognized as biomarkers of future CRC risk and are established as surrogate end-points in CRC chemoprevention trials. The seAFOod Polyp Prevention Trial is a randomized, double-blind, placebo-controlled, 2 × 2 factorial ‘efficacy’ study, which will determine whether EPA prevents colorectal adenomas, either alone or in combination with aspirin. Participants are 55–73 year-old patients, who have been identified as ‘high risk’ (detection of ≥5 small adenomas or ≥3 adenomas with at least one being ≥10 mm in diameter) at screening colonoscopy in the English Bowel Cancer Screening Programme (BCSP). Exclusion criteria include the need for more than one repeat endoscopy within the three-month BCSP screening period, malignant change in an adenoma, regular use of aspirin or non-aspirin non-steroidal anti-inflammatory drugs, regular use of fish oil supplements and concomitant warfarin or anti-platelet agent therapy. Patients are randomized to either EPA-free fatty acid 1 g twice daily or identical placebo AND aspirin 300 mg once daily or identical placebo, for approximately 12 months. The primary end-point is the number of participants with one or more adenomas detected at routine one-year BCSP surveillance colonoscopy. Secondary end-points include the number of adenomas (total and ‘advanced’) per patient, the location (left versus right colon) of colorectal adenomas and the number of participants re-classified as ‘intermediate risk’ for future surveillance. Exploratory end-points include levels of bioactive lipid mediators such as ω-3 PUFAs, resolvin E1 and PGE-M in plasma, urine, erythrocytes and rectal mucosa in order to gain insights into the mechanism(s) of action of EPA and aspirin, alone and in combination, as well as to discover predictive biomarkers of chemopreventive efficacy. The recruitment target is 904 patients. / Medical Research Council (MRC) and managed by the National Institute for Health Research (NIHR) on behalf of the MRC-NIHR partnership

No / Background Oral administration of the omega-3 fatty acid eicosapentaenoic acid (EPA), as the free fatty acid (FFA), leads to EPA incorporation into, and reduced growth of, experimental colorectal cancer liver metastases (CRCLM). Design: We performed a Phase II double-blind, randomised, placebo-controlled trial of EPA-FFA 2 g daily in patients undergoing liver resection surgery for CRCLM. The patients took EPA-FFA (n=43) or placebo (n=45) prior to surgery. The primary end-point was the CRCLM Ki67 proliferation index (PI). Secondary end-points included safety and tolerability of EPA-FFA, tumour fatty acid content and CD31-positive vascularity. We also analysed overall survival (OS) and disease-free survival (DFS). Results The median (range) duration of EPA-FFA treatment was 30 (12–65) days. Treatment groups were well matched with no significant difference in disease burden at surgery or preoperative chemotherapy. EPA-FFA treatment was well tolerated with no excess of postoperative complications. Tumour tissue from EPA-FFA-treated patients demonstrated a 40% increase in EPA content (p=0.0008), no difference in Ki67 PI, but reduced vascularity in ‘EPA-naïve’ individuals (p=0.075). EPA-FFA also demonstrated antiangiogenic activity in vitro. In the first 18 months after CRCLM resection, EPA-FFA-treated individuals obtained OS benefit compared with placebo, although early CRC recurrence rates were similar. Conclusions EPA-FFA therapy is safe and well tolerated in patients with advanced CRC undergoing liver surgery. EPA-FFA may have antiangiogenic properties. Remarkably, limited preoperative treatment may provide postoperative OS benefit. Phase III clinical evaluation of prolonged EPA-FFA treatment in CRCLM patients is warranted. Trial Identifier: ClinicalTrials.gov NCT01070355. / The Cancer Research UK Clinical Trials Awards and Advisory Committee approved the Trial. PML and ADR were supported by Department of Health/Cancer Research UK Yorkshire Experimental Cancer Medicine Centre funding. The Trial was adopted by the UKCRN Clinical Trials Portfolio (UKCRN ID 8946) allowing West Yorkshire Comprehensive Local Research Network funding of Pharmacy costs. SLA Pharma AG funded some of the experimental work and provided EPA-FFA and placebo. SLA Pharma AG played no role in the design or execution of the Trial. Laboratory costs were also supported by the Leeds Teaching Hospitals Charitable Foundation (Rays of Hope).

No / Inflammatory bowel diseases are associated with increased risk of developing colitis-associated colorectal cancer (CAC). Epidemiological data show that the consumption of ω-3 polyunsaturated fatty acids (ω-3 PUFAs) decreases the risk of sporadic colorectal cancer (CRC). Importantly, recent data have shown that eicosapentaenoic acid-free fatty acid (EPA-FFA) reduces polyp formation and growth in models of familial adenomatous polyposis. However, the effects of dietary EPA-FFA are unknown in CAC. We tested the effectiveness of substituting EPA-FFA, for other dietary fats, in preventing inflammation and cancer in the AOM-DSS model of CAC. The AOM-DSS protocols were designed to evaluate the effect of EPA-FFA on both initiation and promotion of carcinogenesis. We found that EPA-FFA diet strongly decreased tumor multiplicity, incidence and maximum tumor size in the promotion and initiation arms. Moreover EPA–FFA, in particular in the initiation arm, led to reduced cell proliferation and nuclear β-catenin expression, whilst it increased apoptosis. In both arms, EPA-FFA treatment led to increased membrane switch from ω-6 to ω-3 PUFAs and a concomitant reduction in PGE2 production. We observed no significant changes in intestinal inflammation between EPA-FFA treated arms and AOM-DSS controls. Importantly, we found that EPA-FFA treatment restored the loss of Notch signaling found in the AOM-DSS control and resulted in the enrichment of Lactobacillus species in the gut microbiota. Taken together, our data suggest that EPA-FFA is an excellent candidate for CRC chemoprevention in CAC.

Yes / Background: The omega-3 polyunsaturated fatty acid eicosapentaenoic acid (EPA) and aspirin both have proof of concept for colorectal cancer chemoprevention, aligned with an excellent safety profile. Therefore, we aimed to test the efficacy of EPA and aspirin, alone and in combination and compared with a placebo, in individuals with sporadic colorectal neoplasia detected at colonoscopy. Methods: In a multicentre, randomised, double-blind, placebo-controlled, 2 × 2 factorial trial, patients aged 55–73 years who were identified during colonoscopy as being at high risk in the English Bowel Cancer Screening Programme (BCSP; ≥3 adenomas if at least one was ≥10 mm in diameter or ≥5 adenomas if these were <10 mm in diameter) were recruited from 53 BCSP endoscopy units in England, UK. Patients were randomly allocated (1:1:1:1) using a secure web-based server to receive 2 g EPA-free fatty acid (FFA) per day (either as the FFA or triglyceride), 300 mg aspirin per day, both treatments in combination, or placebo for 12 months using random permuted blocks of randomly varying size, and stratified by BCSP site. Research staff and participants were masked to group assignment. The primary endpoint was the adenoma detection rate (ADR; the proportion of participants with any adenoma) at 1 year surveillance colonoscopy analysed in all participants with observable follow-up data using a so-called at-the-margins approach, adjusted for BCSP site and repeat endoscopy at baseline. The safety population included all participants who received at least one dose of study drug. The trial is registered with the International Standard Randomised Controlled Trials Number registry, number ISRCTN05926847. Findings: Between Nov 11, 2011, and June 10, 2016, 709 participants were randomly assigned to four treatment groups (176 to placebo, 179 to EPA, 177 to aspirin, and 177 to EPA plus aspirin). Adenoma outcome data were available for 163 (93%) patients in the placebo group, 153 (85%) in the EPA group, 163 (92%) in the aspirin group, and 161 (91%) in the EPA plus aspirin group. The ADR was 61% (100 of 163) in the placebo group, 63% (97 of 153) in the EPA group, 61% (100 of 163) in the aspirin group, and 61% (98 of 161) in the EPA plus aspirin group, with no evidence of any effect for EPA (risk ratio [RR] 0·98, 95% CI 0·87 to 1·12; risk difference –0·9%, –8·8 to 6·9; p=0·81) or aspirin (RR 0·99 (0·87 to 1·12; risk difference –0·6%, –8·5 to 7·2; p=0·88). EPA and aspirin were well tolerated (78 [44%] of 176 had ≥1 adverse event in the placebo group compared with 82 [46%] in the EPA group, 68 [39%] in the aspirin group, and 76 [45%] in the EPA plus aspirin group), although the number of gastrointestinal adverse events was increased in the EPA alone group at 146 events (compared with 85 in the placebo group, 86 in the aspirin group, and 68 in the aspirin plus placebo group). Six upper-gastrointestinal bleeding events were reported across the treatment groups (two in the EPA group, three in the aspirin group, and one in the placebo group). Interpretation Neither EPA nor aspirin treatment were associated with a reduction in the proportion of patients with at least one colorectal adenoma. Further research is needed regarding the effect on colorectal adenoma number according to adenoma type and location. Optimal use of EPA and aspirin might need a precision medicine approach to adenoma recurrence. / Efficacy and Mechanism Evaluation Programme, a UK Medical Research Council and National Institute for Health Research partnership. / Research Development Fund Publication Prize Award winner, November 2018.

Yes / Background: Oral administration of purified omega-3 (ω-3) PUFAs is associated with changes to the fecal microbiome. However, it is not known whether this effect is associated with increased PUFA concentrations in the gut. Objectives: We investigated the luminal bioavailability of oral ω-3 PUFAs (daily dose 1 g EPA and 1g DHA free fatty acid equivalents as triglycerides in soft-gel capsules, twice daily) and changes to the gut microbiome, in the ileum. Methods: Ileostomy fluid (IF) and blood were obtained at baseline, after first capsule dosing (median 2 h), and at a similar time after final dosing on day 28, in 11 individuals (median age 63 y) with a temporary ileostomy. Fatty acids were measured by LC–tandem MS. The ileal microbiome was characterized by 16S rRNA PCR and Illumina sequencing. Results: There was a mean 6.0 ± 9.8-fold and 6.6 ± 9.6-fold increase in ileal EPA and DHA concentrations (primary outcome), respectively, at 28 d, which was associated with increased RBC ω-3 PUFA content (P ≤ 0.05). The first oral dose did not increase the ileal ω-3 PUFA concentration except in 4 individuals, who displayed high luminal EPA and DHA concentrations, which reduced to concentrations similar to the overall study population at day 28, suggesting physiological adaptation. Bacteroides, Clostridium, and Streptococcus were abundant bacterial genera in the ileum. Ileal microbiome variability over time and between individuals was large, with no consistent change associated with acute ω-3 PUFA dosing. However, high concentrations of EPA and DHA in IF on day 28 were associated with higher abundance of Bacteroides (r2 > 0.86, P < 0.05) and reduced abundance of other genera, including Actinomyces (r2 > 0.94, P < 0.05). Conclusions: Oral administration of ω-3 PUFAs leads to increased luminal ω-3 PUFA concentrations and changes to the microbiome, in the ileum of individuals with a temporary ileostomy.

The aim of this thesis was to isolate the compounds responsible for the antibacterial activity of cell extracts of the marine diatom, Phaeodactylum tricornutum. Marine microalgae are not only important primary producers but, due to their phylogenetic diversity, they are also a potential source of novel bioactive compounds. The marine diatom, P. tricornutum, was selected for study because its cell extracts are known to be antibacterial but the compounds responsible have not been isolated. In this thesis, the compounds responsible for the antibacterial activity are isolated from aqueous methanol P. tricornutum cell extracts by column chromatography and reverse phase high-performance liquid chromatography using a bioassay-guided approach. The compounds in three active fractions were identified by mass spectrometry and nuclear magnetic resonance spectroscopy as the unsaturated fatty acids (5Z, 8Z, 11Z, 14Z, 17Z)-eicosapentaenoic acid, (9Z)-hexadecenoic acid and (6Z, 9Z, 12Z)-hexadecatrienoic acid. The fatty acids were found to be antibacterial against Staphylococcus aureus at micromolar concentrations. P. tricornutum exists in different cell morphs and, interestingly, extracts prepared from cultures in the fusiform morph were found to have greater antibacterial activity than extracts from oval cultures. This is explained by greater levels of the three antibacterial fatty acids in the fusiform cell extracts. The antibacterial fatty acids are proposed to be released by enzyme action when the diatom cells lose their integrity. The release of free fatty acids by diatoms is suggested to be a simple, very low cost population-level activated defence mechanism against potential pathogenic bacteria triggered when the cell loses its integrity. Further, this pathway may act against multiple threats to the microalga, including grazers, as fatty acids exhibit activity in diverse biological assays. Finally, whilst two of the fatty acids, (9Z)-hexadecenoic acid and (5Z, 8Z, 11Z, 14Z, 17Z)-eicosapentaenoic acid, inhibited the growth of MRSA their usefulness as therapeutic compounds may be limited due to their instability and their broad biological activity.

Ever since the emergence of the hypothesis that linked the aetiology of schizophrenia with abnormal membrane phospholipids composition, an increasing number of evidences have suggested reduced membrane polyunsaturated fatty acids in patients with schizophrenia. This has led to a conduct of several studies to evaluate the efficacy of omega-3 fatty acid supplement in the modification of membrane phospholipids and treatment of schizophrenia. The two main omega-3 fatty acid classes, EPA and DHA, play a vital role in membranes. This project work reviews omega-3 fatty acid studies and summarizes their outcomes. Eight original articles (nine studies) were reviewed. Six out of nine studies measured RBC membrane fatty acids levels and all six studies reported a significant increase in EPA after EPA supplement. Two studies reported increased DHA post omega-3 fatty acid and DHA supplement, respectively. One study observed a dose-dependent increment in DHA after EPA supplement. Improved symptoms were observed in seven studies, while one study found a worsening of symptoms in patients with low baseline PUFA. Moreover, out of the six studies that evaluated the correlation between symptom change and membrane fatty acids change, three studies observed a correlation between increased EPA and symptom improvement. One study reported an increased AA associated with improved symptoms, in contrast to another study, which found a correlation between increased AA and worsened symptoms. The conclusion from this project work is that EPA supplement can increase the EPA levels in membranes; however, its therapeutic effect in schizophrenia requires further investigation using larger studies. / Ända sedan tillkomsten av hypotesen som länkade etiologin av schizofreni med onormala sammansättningar av membranfosfolipider, har bevis för nedsatt membranfettsyror hos patienter med schizofreni ökat. Detta har lett till genomförandet av flera studier för att utvärdera effekten av omega-3 supplement i modifieringen av membranfosfolipider och i behandling av schizofreni. De två viktigaste omega-3 klasserna, EPA och DHA, spelar en viktig roll i membran. Detta projektarbete granskar de omega-3 studierna och sammanfattar deras resultat. Åtta originalartiklar (nio studier) granskades. Sex av nio studier mätte nivåer av RBC membranfettsyror och alla sex studierna rapporterade en signifikant ökning av EPA efter EPA behandling. Två studier rapporterade ökad DHA efter omega-3 och DHA behandling, respektive. En studie observerade en dosberoende ökning i DHA efter EPA behandling. Förbättrade symtom observerades i sju studier, medan en studie fann en försämring av symtom hos patienter med låg baseline PUFA. Av de sex studier som utvärderade sambandet mellan symtomförändring och förändring i membranfettsyror, hittade två studier samband mellan ökad EPA och symtomförbättring. En studie rapporterade en ökad AA i samband med förbättrade symtom, i motsats till en annan studie, som fann ett samband mellan ökad AA och försämrade symtom. Slutsatsen från detta projektarbete är att EPA tillägg ökar nivåer av EPA i membranfosfolipider; men dess terapeutiska effekt vid schizofreni kräver ytterligare utredning med hjälp av större studier.

Omega-3 fatty acids, particularly docosahexaenoic (DHA) and eicospentaenoic acid (EPA), are important mediators for cardiovascular disease, fetal/infant development, neurological disorders and inflammatory diseases. Supplementation and washout studies are important for future research on the physiological effects of omega-3 fatty acids and for determination of the proper washout period for future cross-over studies. In this study, omega-3 fatty acid blood biomarker comparisons are made for the n-3 HUFA score (% of n-3 HUFAs in total HUFAs) and omega-3 index (sum of EPA + DHA) in plasma, erythrocytes, whole blood and a novel finger-tip prick blood method (FTPB) of analysis. This FTPB method of fatty acid analysis is further tested to determine the potential for its use in fatty acid analysis. In addition, gender differences in response to omega-3 fish oil supplementation are analyzed in all four blood fractions. Nine males and seven females were supplemented with 8 fish-oil capsules per day (providing 3.2 g/day EPA and 1.6 g/day DHA) for four weeks, followed by an eight-week omega-3 washout period. Venous plasma, erythrocyte and whole blood samples were collected during weeks 0, 4, 8 and 12 and FTPB samples were collected weekly during supplementation and washout fatty acid analysis was performed. EPA and DHA incorporation is lowest in magnitude in erythrocytes relative to all other blood fractions. Omega-3 blood biomarker comparisons demonstrate that the n-3 HUFA score is a more reliable measure across all blood fractions compared to the omega-3 index. In addition, the n-3 HUFA score demonstrates no differences (p > 0.05) between FTPB and whole blood analysis, providing evidence to support its usefulness as a tool for fatty acid analysis. However, differences (p < 0.05) do exist between these methods for saturated fatty acid, monounsaturated fatty acids, omega-6 polyunsaturated fatty acids (PUFAs) and omega-3 PUFAs. Baseline fatty acid levels for DHA, and the DHA:EPA and DHA:DPA ratios tend to be higher (p < 0.05) in females, and docosapentaenoic acid n-3 (DPAn-3) is higher (p > 0.05) in males across all blood fractions. Furthermore, a gender effect (p < 0.05) is seen for the DHA:EPA ratio across all blood fractions. At baseline, female DHA:EPA is higher (p < 0.05) than males with supplementation lowering both male and female values and removing any differences (p > 0.05) between genders. Washout results in a return of levels towards baseline, however, baseline levels are not fully reached. Furthermore, while gender differences do begin to reform during washout, these differences are not significant (p > 0.05). In conclusion, omega-3 fatty acid responses, particularly DHA:EPA ratio, demonstrate significant gender differences that may be related to differences in long-chain PUFA synthesis pathways between males and females. In addition, the n-3 HUFA score may be a more valuable omega-3 blood biomarker than the omega-3 index, as the n-3 HUFA score displays more consistent levels across all blood fractions. Finally, the FTPB method of analysis may be a useful tool in the measurement of fatty acid composition, however, some microwave methylation problems do exist, specifically in the phospholipid class of lipids.

Omega-3 fatty acids, particularly docosahexaenoic (DHA) and eicospentaenoic acid (EPA), are important mediators for cardiovascular disease, fetal/infant development, neurological disorders and inflammatory diseases. Supplementation and washout studies are important for future research on the physiological effects of omega-3 fatty acids and for determination of the proper washout period for future cross-over studies. In this study, omega-3 fatty acid blood biomarker comparisons are made for the n-3 HUFA score (% of n-3 HUFAs in total HUFAs) and omega-3 index (sum of EPA + DHA) in plasma, erythrocytes, whole blood and a novel finger-tip prick blood method (FTPB) of analysis. This FTPB method of fatty acid analysis is further tested to determine the potential for its use in fatty acid analysis. In addition, gender differences in response to omega-3 fish oil supplementation are analyzed in all four blood fractions. Nine males and seven females were supplemented with 8 fish-oil capsules per day (providing 3.2 g/day EPA and 1.6 g/day DHA) for four weeks, followed by an eight-week omega-3 washout period. Venous plasma, erythrocyte and whole blood samples were collected during weeks 0, 4, 8 and 12 and FTPB samples were collected weekly during supplementation and washout fatty acid analysis was performed. EPA and DHA incorporation is lowest in magnitude in erythrocytes relative to all other blood fractions. Omega-3 blood biomarker comparisons demonstrate that the n-3 HUFA score is a more reliable measure across all blood fractions compared to the omega-3 index. In addition, the n-3 HUFA score demonstrates no differences (p > 0.05) between FTPB and whole blood analysis, providing evidence to support its usefulness as a tool for fatty acid analysis. However, differences (p < 0.05) do exist between these methods for saturated fatty acid, monounsaturated fatty acids, omega-6 polyunsaturated fatty acids (PUFAs) and omega-3 PUFAs. Baseline fatty acid levels for DHA, and the DHA:EPA and DHA:DPA ratios tend to be higher (p < 0.05) in females, and docosapentaenoic acid n-3 (DPAn-3) is higher (p > 0.05) in males across all blood fractions. Furthermore, a gender effect (p < 0.05) is seen for the DHA:EPA ratio across all blood fractions. At baseline, female DHA:EPA is higher (p < 0.05) than males with supplementation lowering both male and female values and removing any differences (p > 0.05) between genders. Washout results in a return of levels towards baseline, however, baseline levels are not fully reached. Furthermore, while gender differences do begin to reform during washout, these differences are not significant (p > 0.05). In conclusion, omega-3 fatty acid responses, particularly DHA:EPA ratio, demonstrate significant gender differences that may be related to differences in long-chain PUFA synthesis pathways between males and females. In addition, the n-3 HUFA score may be a more valuable omega-3 blood biomarker than the omega-3 index, as the n-3 HUFA score displays more consistent levels across all blood fractions. Finally, the FTPB method of analysis may be a useful tool in the measurement of fatty acid composition, however, some microwave methylation problems do exist, specifically in the phospholipid class of lipids.

Orientadores: Maria Julia Marques, Selma Maria Michelin Matheus / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-08-21T06:49:40Z (GMT). No. of bitstreams: 1 DeCarvalho_SamaraCamacari_M.pdf: 1740331 bytes, checksum: ad4bf7c2d274ea63e20314141eeb1e83 (MD5) Previous issue date: 2012 / Resumo: A distrofia muscular de Duchenne (DMD) é uma miopatia progressiva causada pela ausência da proteína distrofina e necrose muscular progressiva. No camundongo mdx, modelo da DMD, a resposta inflamatória é exacerbada e populações distintas de macrófagos, M1 e M2, influenciam a degeneração e regeneração muscular, respectivamente, regulando a progressão da doença. Anti-inflamatórios esteróides são utilizados para a terapia farmacológica da DMD. Contudo, os efeitos colaterais decorrentes do seu uso contínuo estimulam o desenvolvimento de novas terapias farmacológicas para esta doença. No presente trabalho, verificamos os efeitos do ácido eicosapentaenóico (EPA) sobre os macrófagos M1 e M2 nos músculos bíceps braquial (BB), diafragma (DIA) e quadríceps femoral (QDR) do camundongo mdx. Camundongos mdx (14 dias de vida pós-natal) receberam 300mg/Kg de EPA diluído em óleo mineral, via gavagem, diariamente, por 16 dias. Camundongos mdx não tratados e camundongos C57BL/10 não tratados receberam óleo mineral via gavagem, pelo mesmo período. Verificamos que o EPA diminuiu a mionecrose (redução da CK no plasma) e aumentou o número de fibras com núcleo periférico, principalmente no BB e DIA. Em todos os músculos estudados, o tratamento com EPA diminuiu significativamente a área total de inflamação. Nos músculos BB e DIA, o tratamento com EPA aumentou a área de macrófagos M2. No QDR, observou-se predominância de regeneração muscular após o EPA, evidenciada por extensas áreas contendo fibras com núcleo central, em diferentes estágios de regeneração. Estes resultados sugerem que o EPA altera o balanço entre os macrófagos M1 e M2, promovendo diminuição de macrófagos M1, citotóxicos, o que pode contribuir para a proteção contra a mionecrose dos músculos distróficos / Abstract: Duchenne muscular dystrophy (DMD) is a progressive myopathy characterized by the absence of dystrophin and progressive muscle necrosis. In the mdx mice model of DMD, the inflammatory response is exacerbated and distinct macrophage populations, M1 and M2, influence muscle degeneration and regeneration, respectively, regulating the progression of the disease. Antiinflammatory steroids are the choice pharmacological therapy for DMD. However, their side effects stimulate the development of new drug therapies for this disease. In the present study, we observed the effects of eicosapentaenoic acid (EPA) on M1 and M2 macrophages in the biceps brachii (BB), diaphragm (DIA) and quadriceps (QDR) muscles of the mdx mice. Mdx mice (14 days old) received 300mg/kg of EPA diluted in mineral oil by gavage, daily, for 16 days. Untreated mdx and C57BL/10 mice received mineral oil by gavage for the same period. We observed that EPA decreased myonecrosis (reduced plasma CK) and increased the number of fibers with peripheral nuclei, mainly in the BB and DIA. In all muscles, treatment with EPA significantly decreased the total area of inflammation. In DIA and BB muscles, treatment with EPA increased the area of M2 macrophage. In the QDR, there was a predominance of muscle regeneration after EPA, with extensive areas containing fibers with central nuclei at different stages of regeneration. These results suggest that EPA affects the balance of M1 and M2 macrophages in dystrophic muscles, with a trend towards a decrease in the cytotoxic M1 phenotype, which may contribute to the protection against myonecrosis in the dystrophic muscles / Mestrado / Anatomia / Mestra em Biologia Celular e Estrutural