Influence of different supplementation on platelet aggregation in patients with rheumatoid arthritis
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Long-chain n-3 polyunsaturated fatty acids (n-3 PUFAs; eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)) have been reported to reduce platelet aggregation. Our aim was to prospectively assess the potential influence of different supplementation omega-3 PUFA on the antiplatelet effects in rheumatoid arthritis (RA) patients.
The study included 60 patients with RA at the Department of Rheumatology, Clinical Center Kragujevac. Patients were divided into three groups depending on who used concentrated fish oil only or concentrated fish oil in combination with evening primrose oil or control group without supplementation in a period of 3 months. Platelet aggregation was measured using the multiplate analyzer and expressed through the value of adenosine diphosphate (ADP) test, aranchidonic acid–induced aggregation (ASPI) test, thrombin receptor–activating peptide (TRAP) test (to assess baseline platelet aggregation), and the ratio of ADP/TRAP and ASPI/TRAP representing the degree of inhibition of platelet aggregation compared to the basal value. The platelet function analysis in whole blood was performed 18–24 h before starting supplementation and after 90 days. Considerations were taken in the representation of demographic, clinical characteristics, and laboratory parameters between the groups.
Patients who used concentrated fish oil only had a significantly lower value of the ratio of ADP/TRAP (0.68 ± 0.20) compared to patients without supplementation (0.83 ± 0.12; p = 0.008), while there was no statistically significant difference in values of other laboratory parameters of platelet function between other groups.
Co-administration of supplementation-concentrated fish oil may reduce platelet aggregation in adults with RA.
• Omega-3 PUFAs are essential for health and are known to possess anti-inflammatory properties, improving cardiovascular health as well as benefiting inflammatory diseases..
• In this paper, we report on anti-aggregation effects n-3 PUFAs and ɤ-linolenic acid in RA.
• The risk of cardiovascular morbidity and mortality is increased in RA, and dietary supplementation of n-3 PUFA may have preventive potential for the cardiovascular management in rheumatoid arthritis.
KeywordsFatty acids Platelet aggregation Rheumatoid arthritis
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- 2.Hollan I, Dessein PH, Ronda N, Wasko MC, Svenungsson E, Agewall S, Cohen-Tervaert JW, Maki-Petaja K, Grundtvig M, Karpouzas GA, Meroni PL (2015) Prevention of cardiovascular disease in rheumatoid arthritis. Autoimmun Rev pii S1568-9972(15):00135–00134. https://doi.org/10.1016/j.autrev.2015.06.004 CrossRefGoogle Scholar
- 5.Calder PC (2013) Omega-3 polyunsaturated fatty acids and inflammatory processes: nutrition or pharmacology? Br J ClinPharmacol 75(3):645–662Google Scholar
- 7.Bachmair EM, Ostertag LM, Zhang X, de Roos B (2014) Dietary manipulation of platelet function. PharmacolTher. 144(2):97–113Google Scholar
- 13.Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO III, Birnbaum NS, Burmester GR, Bykerk VP, Cohen MD, Combe B, Costenbader KH, Dougados M, Emery P, Ferraccioli G, Hazes JMW, Hobbs K, Huizinga TWJ, Kavanaugh A, Kay J, Kvien TK, Laing T, Mease P, Ménard HA, Moreland LW, Naden RL, Pincus T, Smolen JS, Stanislawska-Biernat E, Symmons D, Tak PP, Upchurch KS, Vencovský J, Wolfe F, Hawker G (2010) 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European league against rheumatism collaborative initiative. Arthritis Rheum 62:2569–2581CrossRefPubMedGoogle Scholar
- 18.Dawczynski C, Hackermeier U, Viehweger M, Stange R, Springer M, Jahreis G (2011) Incorporation of n-3 PUFA and γ-linolenic acid in blood lipids and red blood cell lipids together with their influence on disease activity in patients with chronic inflammatory arthritis--a randomized controlled human intervention trial. Lipids Health Dis 10:130CrossRefPubMedPubMedCentralGoogle Scholar
- 21.Nomura S, Inami N, Shouzu A, Omoto S, Kimura Y, Takahashi N, Tanaka A, Urase F, Maeda Y, Ohtani H, Iwasaka T (2009) The effects of pitavastatin, eicosapentaenoic acid and combined therapy on platelet-derived microparticles and adiponectinhyperlipidemic, diabetic patients. Platelets 20:16–22CrossRefPubMedGoogle Scholar
- 25.Gajos G, Zalewski J, Nessler J, Zmudka K, Undas A, Piwowarska W (2012) Polyunsaturated omega-3 fatty acids improve responsiveness to clopidogrel after percutaneous coronary intervention in patients with cytochrome P450 2C19 loss-of-function polymorphism. Kardiol Pol 70(5):439–445PubMedGoogle Scholar
- 28.Larson MK, Tormoen GW, Weaver LJ, Luepke KJ, Patel IA, Hjelmen CE, Ensz NM, McComas LS, McCarty OJ (2013) Exogenous modification of platelet membranes with the omega-3 fatty acids EPA and DHA reduces platelet procoagulant activity and thrombus formation. Am J Physiol Cell Physiol 304(3):C273–C279CrossRefPubMedGoogle Scholar
- 30.Phang M, Sinclair AJ, Lincz LF, Garg ML (2012) Gender-specific inhibition of platelet aggregation following omega-3 fatty acid supplementation. NutrMetabCardiovasc Dis 22(2):109–114Google Scholar