Bakgrund: Astma är en inflammationssjukdom i luftvägarna, och en av de vanligaste kroniska sjukdomarna hos barn globalt sett. Vanligast är astma hos barn mellan 3 och 15 år, men hälften av alla barn som diagnostiserats med astma som barn har även betydande besvär upp i vuxen ålder. För en del av populationen har inte traditionell läkemedelsbehandling någon effekt, varför alternativa behandlingsmetoder så som omega-3 tillskott bör undersökas. Syfte: Syftet med innevarande litteraturstudie var att kartlägga om det finns evidens för om omega-3 tillskott kan användas i förebyggande eller symtomlindrande syfte hos barn (0–18 år) som löper hög risk för att utveckla astma eller som är diagnostiserade med astma. Metod: Studien utformades som en systematisk litteraturstudie. Litteratursökningar har genomförts i databaserna Pubmed, CINAHL och Medline. Sökningarna bestod av sökblocken astma, barn eller ungdomar och omega-3 tillskott/omega-3 fettsyror. Resultat: Denna studie inkluderar fem RCT-studier med syftet att undersöka om omega-3 tillskott kunde förebygga astma eller minska symtomen av astma hos barn, totalt 939 barn med astma har studerats i de fem studierna. Fyra studier påvisade att omega-3 tillskott till barn med astma inte har någon klinisk relevans medan en studie påvisade att klinisk relevans fanns. Slutsats: Denna systematiska litteraturstudie resulterade i att det inte finns någon evidens för att omega-3 tillskott skulle verka förebyggande eller symtomlindrande för barn med astma. RCT-studierna som inkluderats i denna systematiska litteraturöversikt är mycket heterogena och därför behövs vidare forskning på omega-3 tillskotts kliniska relevans. / Background: Asthma is an inflammatory disease in the airways, and is one of the most common chronic diseases in children globally. Asthma is most common in children between 3 to 15 years of age, but 50 % of children diagnosed with asthma as a child also have significant problems as adults. For some part of the population traditional drug treatment has no effect, indicating that alternative treatment methods, such as omega-3 supplements, should be investigated further. Aim: The aim of the current literature study was to investigate if there is any evidence of whether omega-3 supplements can be used for preventive or symptom-relieving purposes in children (0-18 years of age), who are at high risk of developing asthma or who have been diagnosed with asthma. Methods: The study was designed as a systematic review. Literature searches have been conducted using the Pubmed, CINAHL and Medline databases. The searches consisted of the search blocks asthma, children or adolescents and omega-3 supplements/omega-3 fatty acids. Results: This study includes five RCT studies that was aimed to investigate whether omega-3 supplements could prevent asthma or reduce the symptoms of asthma in children, a total of 939 children with asthma have been studied in the five studies. Four studies showed that omega-3 supplements for children with asthma have no clinical relevance, while one study showed that clinical relevance existed. Conclusion: This systematic review proved that no evidence for omega-3 supplements treatment, for preventive or symptom relieving purposes, in children with asthma exists. The RCT studies included in this systematic review are very heterogeneous and therefore further research on the clinical relevance of omega-3 supplement is needed.

L'obésité est un facteur de risque majeur pour le développement de maladies psychiatriques, telles que le trouble dépressif majeur et la schizophrénie. Une consommation excessive de graisses saturées est bien connue pour provoquer non seulement des troubles métaboliques, mais également des comportements anormaux chez les modèles animaux et les humains. Les acides gras saturés augmentent l'inflammation dans divers tissus. Plusieurs études ont démontré que l'activation de la microglie en tant qu'acteur central de la neuroinflammation joue un rôle crucial dans l'anxiété liée à l'inflammation et les comportements dépressifs dans les cas d'obésité. En outre, il existe de plus en plus de preuves démontrant l'effet bénéfique de la supplémentation en acides gras polyinsaturés n-3 (AGPI n-3) sur les comportements cognitifs, anxieux et dépressifs. Nous avons précédemment montré que la supplémentation en AGPI n-3 via l'administration d'huile de poisson (FO) a des effets anxiolytiques sur les souris rendues obèses par une diète riche en gras saturés (SHFD). De plus, l'activation du récepteur couplé aux protéines G 120 (GPR120), un récepteur des AGPI n-3, dans le cerveau, attenue l'anxiété et les comportements dépressifs induits par la SHFD. Cependant, les mécanismes par lesquels GPR120 régule les changements induits par la SHFD dans les comportements liés à l'humeur ne sont toujours pas compris. Dans la présente étude, nous avons étudié le rôle du GPR120 dans les troubles anxieux et dépressifs reliés à la neuroinflammation. Parmi plusieurs types de cellules neurales, la microglie exprime fortement GPR120. Un agoniste de GPR120 (Compound A; CpdA) réduit la production et la libération de cytokines inflammatoires (IL-1B, IL-6, MCP1 et TNF-α) induites par les lipopolysaccharides (LPS) dans la microglie en culture. D'autre part, l'administration centrale de CpdA par injection intracérébroventriculaire (ICV) améliore le comportement anxieux et de malaise suite à l’injection de LPS systémique in vivo. De plus, l'acide eicosapentaénoique (EPA) et l'acide docosahexaénoique (DHA) sont des AGPI n-3 et des agonistes naturels du GPR120. L'EPA et le DHA suppriment l'inflammation dans un modèle de culture de microglies primaires, telle qu'évaluée par l'expression et la sécrétion de cytokines. Ces résultats suggèrent que l'activation du GPR120 contribue à l'amélioration de l'anxiété et des comportements de type dépressif liés à l'inflammation grâce à la régulation de la microglie. / Obesity is a major risk factor for the development of psychiatric diseases, such as major depressive disorder and anxiety. Excess intake of saturated fat is well known to cause not only metabolic diseases, but also abnormal behavior in humans and animal models. Saturated fatty acids enhance peripheral and central inflammation. Several studies have demonstrated that microglia activation as a central player in neuroinflammation plays a crucial role in inflammation-related anxiety and depressive-like behaviors in the case of obesity. Also, there is increasing evidence to demonstrate the beneficial effect of n-3 PUFAs supplementation on cognitive, anxiety and depressive-like behaviors. Previously, we reported that the n-3 PUFAs supplementation by the administration of fish oil (FO) has demonstrated anxiolytic effects on saturated high fat diet (SHFD)-induced obese mice and that, the activation of G-protein coupled receptor 120 (GPR120), a lipid sensor for n-3 poly-unsaturated fatty acids (n-3 PUFAs), in the brain rescued SHFD-induced anxiety and depressive-like behaviors. However, it is still unclear how GPR120 regulates SHFD-induced changes in mood-related behaviors. In the present study, we focused on the role of GPR120 on neuroinflammation in inflammation-related anxiety and depressive-like behaviors. Amongst the several types of brain cells, microglia demonstrated a high expression of GPR120. Compound A (CpdA), a selective agonist of GPR120, reduced lipopolysaccharide (LPS)-induced inflammatory cytokine (IL-1B, IL-6, MCP1, and TNF-a) expression and release in cultured microglia. Additionally, central administration of cpdA via intracerebroventricular (ICV) injection ameliorated neuroinflammation and systemic LPS injection-induced anxiety-like and sickness behavior in vivo. Furthermore, n-3 PUFAs eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) as natural agonists of GPR120 suppressed inflammation in primary cultured microglia as assessed by cytokine expression. These results suggest that GPR120 activation contributes to the amelioration of inflammation-related anxiety and depressive-like behaviors through the regulation of microglia.

Indiana University-Purdue University Indianapolis (IUPUI) / Our laboratory has previously identified the clock gene D-box Binding Protein (DBP) as a candidate gene for bipolar disorder and alcoholism using a Convergent Functional Genomics (CFG) approach. In subsequent work, we established mice with a homozygous deletion of DBP as a stress-reactive genetic animal model of bipolar disorder and co-morbid alcoholism. In the present study, we found that the omega-3 fatty acid, DHA, may have mood stabilizing capabilities in stressed DBP knockout mice, and reduces alcohol consumption in these mice as well as in the alcohol preferring (P) rats. Given their potential health benefits and their relative lack of negative side-effects, omega-3 fatty acids may become an important supplement for bipolar patients and co-morbid alcoholics, a potential that warrants continued research.

Purpose: To 1) critically appraise available randomized controlled trials (RTCs) addressing the efficacy of long-chain ω-3 fatty acids as a secondary prevention agent of hypertriglyceridemia, and 2) make recommendations for clinical practice. Data Sources: All RCTs identified from several databases from 1993-2003 were reviewed by two independent reviewers who extracted data from each study and used the previously tested Boyack and Lookinland Methodological Quality Index (MQI) to determine study quality. Results: Ten studies reported long-chain ω-3 fatty acids to be effective in the treatment of hypertriglyceridemia. The average decrease in triglycerides (TG) was 29%, total cholesterol (TC) 11.6%, very low density lipoprotein (VLDL) 30.2%, and low-density lipoprotein (LDL) 32.5%. One study found LDLs to increase by 25%. The average increase in high-density lipoprotein (HDL) was 10%. The overall average MQI score was 36% (26%-54%). Many of the RCTs had serious shortcomings including short duration, lack of a power analysis, no intention to treat analysis, no report of blind assessment of outcome, and lack of dietary control as a confounding variable. Conclusions/Implications: Overall study methodology was weak. Although the evidence supporting the use of long-chain ω-3 fatty acids in the secondary prevention of hypertriglyceridemia is reasonably strong, until there are larger RCTs of stronger methodological quality, it is not recommended to treat hypertriglyceridemia with ω-3 fatty acid supplementation in lieu of lipid lowering medications.

The American Heart Association (AHA) recently confirmed common recommendations of one to two fish dishes per week in order to prevent cardiovascular disease (CVD). Nevertheless, the natural fluctuations of lipids and fatty acids (FA) in processed seafood caught little public attention. Moreover, consumers of unprocessed seafood in general do not know how much omega-3 fatty acids (omega-3 FA) within servings they actually ingest. The few studies published until today considering this aspect have been re-evaluated in today’s context. They included four observational studies with canned fatty coldwater fish (mackerel and herring from the same region, season, producer and research group). Their outcomes were similar to those conducted in the following years using supplements. Cans containing seafood (especially fatty coldwater fish) with declared content of omega-3 FA are ready-to-use products. Human studies have shown a higher bioavailability of omega-3 FA by joint uptake of fat. Canned fatty coldwater fish contain omega-3 FA plus plenty of fat in one and the same foodstuff. That suggests a new dietary paradigm with mixed concepts including several sources with declared content of omega-3 FA for reducing the cardiovascular risk and other acknowledged indications.

No description available.

Introdução: A terapia antirretroviral (ART) mudou o curso da Aids, porém está associada a alterações metabólicas e aumento do risco de doenças cardiovasculares. Objetivo: Avaliar o efeito da suplementação com ácidos graxos ômega-3 de origem marinha no perfil lipídico, na homeostase da glicose, na distribuição de gordura corporal e nos marcadores inflamatórios de adultos com HIV em ART. Métodos: Artigo 1. Trata-se de uma revisão sistemática da literatura com metanálise. Realizou-se busca por ensaios clínicos na base de dados PubMed; 33 artigos foram localizados, seis cumpriram os critérios de inclusão e quatro apresentavam qualidade metodológica adequada. Foi realizada metanálise com efeitos fixos e descrição das diferenças de médias sumárias (DMS (IC95 por cento )). Artigos 2 e 3. Trata-se de um ensaio clínico aleatorizado e controlado. Foram recrutados 120 adultos com idade entre 19 e 64 anos, de ambos os sexos. Os indivíduos alocados no grupo intervenção foram suplementados por 24 semanas com 3g de óleo de peixe/dia (900mg de ácidos graxos ômega-3) e indivíduos alocados no grupo controle receberam placebo (óleo de soja). Resultados: Artigo 1. Após 8-16 semanas de intervenção com 900-3360mg de ácidos graxos ômega-3/dia, observou-se redução de -80,34mg/dL (IC 95 por cento : -129,08 a -31,60) nas concentrações de triglicérides. A análise agregada de estudos com média de concentração de triglicérides > 300mg/dL no baseline e intervenção com 1800-2900mg de ácidos graxos ômega-3/dia resultou em redução de -129,72mg/dL (IC95 por cento : -206,54 a -52,91). Artigos 2 e 3. Foram considerados nas análises dados de 83 sujeitos. Os modelos multinível não revelaram relação estatisticamente significante entre a suplementação com óleo de peixe e as mudanças longitudinais nas concentrações de triglicérides (p=0,335), LDL-C (p= 0,078), HDL-C (p=0,383), colesterol total (p=0,072), apo B (p=0,522), apo A1 (p=0,420), razão LDL-C/apo B (p=0,107), índice homa-2 IR (p=0,387), IMC (p=0,068), circunferência da cintura (p=0,128), relação cintura/quadril (p=0,359), PCR ultra sensível (p=0,918), fibrinogênio (p=0,148), e fator VIII (p=0,073). Conclusões: Artigo 1. Diferentes doses de ácidos graxos ômega-3 reduziram modo significativo as concentrações de triglicérides, confirmando a potencial aplicabilidade desse nutriente no tratamento da hipertrigliceridemia em pessoas que vivem com HIV em ART. Artigos 2 e 3. Uma dose relativamente baixa de óleo de peixe para pessoas que vivem com HIV em ART não alterou o perfil lipídico, a homeostase da glicose, a distribuição de gordura corporal e a concentração de marcadores inflamatórios. Recomenda-se, em estudos subseqüentes, a avaliação do efeito de doses mais elevadas, bem como a determinação de marcadores inflamatórios mais sensíveis / Background: Although the antiretroviral therapy (ART) revolutionized the care of HIV-infected subjects, it has been associated with metabolic abnormalities and increased risk of cardiovascular diseases. Aims: To review the effects of marine omega-3 fatty acids on lipid profile, insulin resistance and inflammatory markers in subjects living with HIV on ART. Methods: Paper 1. Thirty three articles were found in a PubMed search; six met the inclusion criteria; and four of them were considered of adequate quality and included. Meta-analysis with fixed effects was performed and weighted mean differences (WMD (95 per cent CI)) were described. Paper 2 and 3. The study was conducted in an HIV/Aids care centre affiliated to the Medical School, University of Sao Paulo. This was a randomized controlled trial that assessed the effects of 3g fish oil/day (900mg of omega-3 fatty acids) or 3g soy oil/day (placebo). A hundred and twenty subjects aged between 19 and 64 years were recruited. The statistical analyses were performed in Stata 9. Results: Paper 1. Data from 83 subjects were included in the analyses. The overall reduction on triglyceride concentrations after 8-16 weeks of treatment with 900-3360mg of omega-3/day was WMD=-80.34mg/dL (95 per cent CI: -129.08 to -31.60). The pooled result of studies with mean triglyceride > 300 mg/dL at baseline and 1800-2900mg omega-3/day was WMD=-129.72mg (95 per cent CI: -206.54 to -52.91). Paper 2 and 3. Multilevel analyses revealed no statistically significant relationships between fish oil supplementation and the longitudinal changes in triglyceride (p= 0.335), LDL-C (p= 0.078), HDL-C (p= 0.383), total cholesterol (p=0.072), apo B (p= 0.522), apo A1 (p=0.420), LDL-C/apo B ratio (p=0.107), homa-2 IR index (p=0.387), BMI (p=0.068), waist circumference (p=0.128), waist/hip ratio (p=0.359), hs-CRP (p=0.918), fibrinogen (p=0.148), and VIII factor (p=0.073). Conclusions: Paper 1. Different doses of omega-3 fatty acids reduced significantly triglyceride concentrations confirming the potential applicability of this nutrient on the management of hypertriglyceridemia in HIV-infected subjects on ART. Paper 2 and 3. A relatively low dose of fish oil for HIV subjects on ART did not change lipid profile, insulin resistance, body fat distribution, and inflammatory markers. Further investigations should considerer the assessment of higher doses and more sensitivity inflammatory markers

INTRODUÇÃO: Emulsão lipídica parenteral composta por óleo de peixe, rica em ácidos graxos ômega-3, é infundida associada a emulsões lipídicas convencionais, como parte da terapia nutricional parenteral. Em pacientes cirúrgicos, a infusão perioperatória de emulsão lipídica de óleo de peixe se associa à preservação de funções imunológicas e modulação favorável de mediadores inflamatórios pós-operatórios, com redução na frequência de complicações infecciosas e no tempo de internação em unidade de terapia intensiva e hospitalar. Os benefícios descritos encorajam a infusão parenteral isolada de emulsão lipídica de óleo de peixe, como fármaconutriente adjuvante no tratamento de pacientes cirúrgicos, independente da indicação de terapia nutricional parenteral. OBJETIVO: O presente estudo avaliou o efeito da infusão parenteral pré-operatória, por curto prazo, de emulsão lipídica de óleo de peixe isolada sobre a resposta imunológica pósoperatória e a evolução clínica imediata de pacientes com câncer gastrintestinal. MÉTODOS: Estudo prospectivo, aleatório, duplo-cego e controlado em 63 pacientes cirúrgicos eletivos com câncer gastrintestinal. Os doentes receberam infusão por veia periférica (0,2g gordura/kg de peso corpóreo/dia) de emulsão lipídica parenteral de óleo de peixe (Omegaven® 10% - Fresenius-Kabi) ou emulsão lipídica parenteral controle (Lipovenos MCT® 10% - Fresenius-Kabi) durante os 3 últimos dias pré-operatórios. Amostras de sangue foram coletadas antes e após a infusão parenteral das emulsões lipídicas e nos 3º e 6º (apenas para citocinas) dias pósoperatórios. Analisou-se a concentração plasmática de IL-6 e IL-10 e a migração, fagocitose, explosão oxidativa e expressão de moléculas HLA-DR e CD32 leucocitárias. A frequência de complicações infecciosas e tempo de internação na unidade de terapia intensiva e hospitalar também foram avaliados no período pós-operatório imediato. RESULTADOS: No período pós-operatório, pacientes tratados com emulsão de óleo de peixe tiveram aumento de IL-10 (dia 3, p < 0,0001), diminuição de IL-6 (dia 3, p = 0,029) e IL-10 (dia 6 p < 0,0001), menor diminuição da explosão oxidativa leucocitária (p = 0,028), manutenção da porcentagem de monócitos exprimindo HLA-DR (p = 0,046) e CD32 (p = 0,025) e aumento da intensidade da expressão de CD32 por neutrófilos (p=0,010), em comparação a pacientes tratados com emulsão lipídica controle. A migração leucocitária não foi influenciada. Não foram encontradas diferenças na frequência de infecções e no tempo de permanência na unidade de terapia intensiva e hospitalar. CONCLUSÕES: A infusão pré-operatória, por curto prazo, de emulsão lipídica parenteral de óleo de peixe isolada, como fármaco-nutriente, melhora a resposta imunológica pós-operatória de pacientes com câncer gastrintestinal sem estar associada à melhora significativa na frequência de infecções e tempo de permanência na unidade de terapia intensiva e hospitalar. / BACKGROUND: Parenteral lipid emulsion composed by fish oil, rich in omega-3 fatty acids, is infused in addition to other standard lipid emulsions, as part of parenteral nutrition therapy. In surgical patients, the perioperative infusion of fish oil lipid emulsion is associated with immune functions preservation and favorably modulation of postoperative inflammatory mediators, with decreased infectious complications and length of intensive care unit and hospital stay. These reported benefits encourage the use of fish oil lipid emulsion alone, as a pharmacological adjuvant agent for the treatment of surgical patients, independent of parenteral nutritional therapy indication. AIM: This clinical trial assessed the effect of short-term preoperative infusion of fish oil lipid emulsion alone on postoperative immune response and immediate clinical outcomes of patients with gastroenterological cancer. METHOD: In a prospective, randomized, controlled and double-blind design, elective surgical patients with gastrointestinal cancer (n= 63) received, for the last 3 pre-operative days, peripheral infusion (0.2g fat/kg of body weight./d) of fish oil lipid emulsion (Omegaven® 10% - Fresenius-Kabi) or control lipid emulsion (Lipovenos MCT® 10% - Fresenius-Kabi). Peripheral blood samples were collected before and after lipid emulsion infusion at the 3rd and 6th (only for cytokines) postoperative days to analyze plasma concentration of IL-6 and IL-10, as well as leukocyte migration, phagocytosis, oxidative burst and expression of HLADR and CD32 molecules. Postoperative infections, length of intensive care unit and hospital stay were also measured. RESULTS: At postoperative period, patients treated with fish oil lipid emulsion had increase of IL-10 (day 3, p < 0.0001), decrease of IL-6 (day 3, p = 0.029) and IL-10 (day 6, p<0.0001), lower decrease of leukocyte oxidative burst (p=0.023), maintenance of the percentage of monocytes expressing HLA-DR (p=0.046) and CD32 (p=0,025) and increase of the intensity of CD32 expression on neutrophil surface (p=0,010), when compared to patients treated to control lipid emulsion. The leukocyte chemotaxis was not affected. No changes were observed on postoperative infections and length of intensive care unit and hospital stay. CONCLUSION: Short-term preoperative infusion of fish oil lipid parenteral emulsion alone improves postoperative immune response of patients with gastrointestinal cancer without benefit on infections frequency and length of intensive care unit and hospital stays.

Dentro da perspectiva da utilização de compostos fenólicos como antioxidantes naturais para minimizar os efeitos in vitro e in vivo do processo oxidativo dos lípides insaturados, foi realizada a monitoração dietética de duas dietas ricas em lípides das séries &#969;3 e &#969;6 e a suplementação de um chá de uma mistura de especiarias, em ratos Wistar, com o objetivo de verificar a influência dos compostos fenólicos, presentes nas especiarias, sobre o metabolismo de ácidos graxos das séries &#969;3 e &#969;6. Extratos e frações das especiarias mostarda, canela e erva doce foram obtidos e tiveram suas atividades antioxidantes testadas em sistemas aquoso (cooxidação de substratos com o uso de ácido linoléico/&#946;-caroteno) e lipídico (RANCIMAT) e o perfil de compostos fenólicos identificados e quantificados por CGMS. A partir de uma mistura de especiarias, foi elaborado um chá que foi fornecido aos animais de cada grupo dietético (&#969;3 e &#969;6). Após 45 dias de tratamento, os animais foram sacrificados e tiveram seus tecidos coletados para análise de TBARs e do perfil lipídico por CGMS. Todos os extratos das especiarias apresentaram atividade antioxidante equivalente ou superior ao BHT. Foram identificados por CGMS os ácidos fenólicos: catecol, salicílico e caféico. Foi obtido nos tecidos dos animais que o somatório do perfil de ácidos graxos saturados e dos insaturados apresentaram diferença entre os grupos testes e controles. Logo, no tecido cerebral, o EPA foi incorporado apenas no grupo &#969;3 que recebeu o extrato das especiarias. Já para o DHA, do mesmo grupo dietético, os tecidos hepático e renal também apresentaram incorporação aumentada em relação ao controle. No grupo dietético &#969;6, destaca-se um aumento no percentual de incorporação do ácido linoléico nos tecidos cardíaco e renal no grupo experimental. Enquanto, para o ácido araquidônico, houve diferença em todos os tecidos. Já, para os resultados da lipoperoxidação, observou-se que todos os tecidos dos animais que receberam o extrato das especiarias apresentaram baixos valores em comparação aos seus respectivos controles. Este estudo também avaliou a ação de compostos fenólicos do chá da mistura das especiarias mostarda, canela e erva doce sobre as enzimas lipoxigenase e cicloxigenase. O extrato da mistura das especiarias a 100 e 200 ppm foi adicionado no meio de reação contendo o substrato e a enzima lipoxigenase 1B da Sigma com 112.000 und/mg. A cicloxigenase foi obtida de vesículas seminais de carneiro e seguiu-se o mesmo protocolo de atividade para a lipoxigenase. Indometacina foi o inibidor utilizado como controle positivo da reação. Observou-se que a 200 ppm, como na concentração do chá (0,02%), a lipoxigenase foi inibida em aproximadamente em 90%. Já para a cicloxigenase, o extrato a 200 ppm resultou numa média de 75% de inibição da atividade da enzima, enquanto que a indomentacina apresentou uma média de 77% de inibição. A absorção aparente do chá das especiarias indicou que os fenólicos presentes na mistura foram absorvidos em média de 75%. O estudo histopatológico dos intestinos delgados dos animais não apresentou nenhuma diferença na área de absorção entre o grupo experimental e o controle. Estes dados sugerem, portanto, um efeito antioxidante das substâncias fenólicas identificadas nas especiarias sobre os ácidos graxos das séries &#969;3 e &#969;6, podendo agir diretamente: (1) no alimento (óleo), (2) com modificação do perfil lipídico, (3) proteção quanto à oxidação de tecidos e (4) inibição das enzimas da biossíntese dos eicosanóides. / Considering the perspective for the use of phenolic compounds as natural antioxidants to minimize in vitro and in vivo effects of oxidative processes on unsaturated lipids, this work monitored Wistar rats fed with two diets rich in &#969;3 and &#969;6 polyunsaturated lipids, supplemented with tea made from a blend of spices. The objective of the work was to study the influence of phenolic compounds present in spices on the metabolism of &#969;3 and &#969;6 fatty acids. Extracts and fractions of mustard, cinnamon and anise were obtained and had their antioxidant activity tested in aqueous (co-oxidation of substrates using linoleic acid/&#946;-carotene) and lipidic systems (RANCIMAT). Their phenolic compounds profile was determined and quantified using CGMS. The rats of each diet group (&#969;3 and &#969;6) were given tea made from a blend of spices and sacrificed after 45 days. Their tissues were then collected and analyses of TBARS and lipid profile were performed using CGMS. Ali the extracts of spices showed equal or higher antioxidant activity than BHT. The following phenolic acids were identified using CGMS: cathecol, salicilic and cafeic. It was observed that the total amount of the profile of saturated and unsaturated fatty acids in the rat tissues were different in the test group and the control group. In brain tissue, EPA was found only in the &#969;3 diet group which was given the tea. Concerning DHA, liver and kidney tissues of the same diet group showed higher concentrations than the control group. In the &#969;6 diet group, an outstanding increase of linoleic acid in cardiac and kidney tissues was found. Concerning the arachidonic acid, a difference in concentration was observed in ali tissues. Ali the tissues from rats given the tea presented a lower level of lipid peroxidation than their respective control groups. The present research also evaluated the action of phenolic compounds found in the tea made from the blend of mustard, cinnamon and anise on the enzymes lipoxygenase and cycloxygenase. The extract of the blend of spices, in the concentrations of 100 and 200 ppm, was added to the substrate and Sigma lipoxygenase 112.000 units/mg. Cycloxygenase was obtained from sheep seminal bladders and underwent the same protocol as lipoxygenase. Indomethacin was the inhibitor used as the positive control of the reaction. It was observed that in the concentration of 200 ppm (that is 0.02%, the same concentration as in the tea), lipoxygenase presented an average 90% inhibition. The extract of cycloxygenase 200 ppm presented 75% inhibition of the enzyme activity, while indomethacin presented an average 77% inhibition. It was found that around 75% of the phenolic compounds present in the tea made from the blend of spices were absorbed, thus leading to the conclusion that apparent absorption of the tea took place. Histopathologic examinations on the small intestines of the rats did not reveal any difference in the absorption area between the experimental and the control groups. Such results suggest therefore an antioxidant effect of the phenolic substances identified in the spices on the &#969;3 and &#969;6 fatty acids, this effect being possible directly (1) on the food (oil) , (2) modification of the profile fatty acids, (3) oxidation protection tissues and, (4) inhibition of enzymes of eicosanoids biosinthesys.

Introdução: A terapia antirretroviral (ART) mudou o curso da Aids, porém está associada a alterações metabólicas e aumento do risco de doenças cardiovasculares. Objetivo: Avaliar o efeito da suplementação com ácidos graxos ômega-3 de origem marinha no perfil lipídico, na homeostase da glicose, na distribuição de gordura corporal e nos marcadores inflamatórios de adultos com HIV em ART. Métodos: Artigo 1. Trata-se de uma revisão sistemática da literatura com metanálise. Realizou-se busca por ensaios clínicos na base de dados PubMed; 33 artigos foram localizados, seis cumpriram os critérios de inclusão e quatro apresentavam qualidade metodológica adequada. Foi realizada metanálise com efeitos fixos e descrição das diferenças de médias sumárias (DMS (IC95 por cento )). Artigos 2 e 3. Trata-se de um ensaio clínico aleatorizado e controlado. Foram recrutados 120 adultos com idade entre 19 e 64 anos, de ambos os sexos. Os indivíduos alocados no grupo intervenção foram suplementados por 24 semanas com 3g de óleo de peixe/dia (900mg de ácidos graxos ômega-3) e indivíduos alocados no grupo controle receberam placebo (óleo de soja). Resultados: Artigo 1. Após 8-16 semanas de intervenção com 900-3360mg de ácidos graxos ômega-3/dia, observou-se redução de -80,34mg/dL (IC 95 por cento : -129,08 a -31,60) nas concentrações de triglicérides. A análise agregada de estudos com média de concentração de triglicérides > 300mg/dL no baseline e intervenção com 1800-2900mg de ácidos graxos ômega-3/dia resultou em redução de -129,72mg/dL (IC95 por cento : -206,54 a -52,91). Artigos 2 e 3. Foram considerados nas análises dados de 83 sujeitos. Os modelos multinível não revelaram relação estatisticamente significante entre a suplementação com óleo de peixe e as mudanças longitudinais nas concentrações de triglicérides (p=0,335), LDL-C (p= 0,078), HDL-C (p=0,383), colesterol total (p=0,072), apo B (p=0,522), apo A1 (p=0,420), razão LDL-C/apo B (p=0,107), índice homa-2 IR (p=0,387), IMC (p=0,068), circunferência da cintura (p=0,128), relação cintura/quadril (p=0,359), PCR ultra sensível (p=0,918), fibrinogênio (p=0,148), e fator VIII (p=0,073). Conclusões: Artigo 1. Diferentes doses de ácidos graxos ômega-3 reduziram modo significativo as concentrações de triglicérides, confirmando a potencial aplicabilidade desse nutriente no tratamento da hipertrigliceridemia em pessoas que vivem com HIV em ART. Artigos 2 e 3. Uma dose relativamente baixa de óleo de peixe para pessoas que vivem com HIV em ART não alterou o perfil lipídico, a homeostase da glicose, a distribuição de gordura corporal e a concentração de marcadores inflamatórios. Recomenda-se, em estudos subseqüentes, a avaliação do efeito de doses mais elevadas, bem como a determinação de marcadores inflamatórios mais sensíveis / Background: Although the antiretroviral therapy (ART) revolutionized the care of HIV-infected subjects, it has been associated with metabolic abnormalities and increased risk of cardiovascular diseases. Aims: To review the effects of marine omega-3 fatty acids on lipid profile, insulin resistance and inflammatory markers in subjects living with HIV on ART. Methods: Paper 1. Thirty three articles were found in a PubMed search; six met the inclusion criteria; and four of them were considered of adequate quality and included. Meta-analysis with fixed effects was performed and weighted mean differences (WMD (95 per cent CI)) were described. Paper 2 and 3. The study was conducted in an HIV/Aids care centre affiliated to the Medical School, University of Sao Paulo. This was a randomized controlled trial that assessed the effects of 3g fish oil/day (900mg of omega-3 fatty acids) or 3g soy oil/day (placebo). A hundred and twenty subjects aged between 19 and 64 years were recruited. The statistical analyses were performed in Stata 9. Results: Paper 1. Data from 83 subjects were included in the analyses. The overall reduction on triglyceride concentrations after 8-16 weeks of treatment with 900-3360mg of omega-3/day was WMD=-80.34mg/dL (95 per cent CI: -129.08 to -31.60). The pooled result of studies with mean triglyceride > 300 mg/dL at baseline and 1800-2900mg omega-3/day was WMD=-129.72mg (95 per cent CI: -206.54 to -52.91). Paper 2 and 3. Multilevel analyses revealed no statistically significant relationships between fish oil supplementation and the longitudinal changes in triglyceride (p= 0.335), LDL-C (p= 0.078), HDL-C (p= 0.383), total cholesterol (p=0.072), apo B (p= 0.522), apo A1 (p=0.420), LDL-C/apo B ratio (p=0.107), homa-2 IR index (p=0.387), BMI (p=0.068), waist circumference (p=0.128), waist/hip ratio (p=0.359), hs-CRP (p=0.918), fibrinogen (p=0.148), and VIII factor (p=0.073). Conclusions: Paper 1. Different doses of omega-3 fatty acids reduced significantly triglyceride concentrations confirming the potential applicability of this nutrient on the management of hypertriglyceridemia in HIV-infected subjects on ART. Paper 2 and 3. A relatively low dose of fish oil for HIV subjects on ART did not change lipid profile, insulin resistance, body fat distribution, and inflammatory markers. Further investigations should considerer the assessment of higher doses and more sensitivity inflammatory markers