source: American Society of Pediatric Hematology/Oncology

year: 2016

authors: Ahmed Daak, West Palm Beach, Kebreab Ghebremeskel, Mustafa Elbashir

Background: Chronic inflammation, coagulation activation and oxidative stress are increasingly recognized as the major determining factors of acute and chronic clinical manifestations of sickle cell disease (SCD). Several lines of evidence indicate that the anti-inflammatory, anti-aggregatory and anti-oxidant long chance omega-3 fatty acids (n-3) could be a safe and effective modifying therapy for SCD.

Objectives: To demonstrate the clinical and biochemical effects of n-3 fatty acids (DHA and EPA) treatment on SCD.

Design/Method: One hundred forty patients with homozygous SCD (aged 2-24) were randomly assigned and received, daily, 1 (age 2–4 y), 2 (age 5–10 y), 3 (age 11–16), or 4 (age >17 y) omega-3 capsules containing 277.8 mg docosahexaenoic (DHA) and 39.0 mg eicosapentaenoic (EPA) or placebo for 1 year. The rates of clinical vaso-occlusive crisis, hemolytic events, blood transfusion rate, were assessed. The effect of n-3 treatment on markers of inflammation, blood cells adhesion, oxidative stress, coagulation and intravascular hemolysis was investigated.

Results: Omega-3 treatment reduced the median rate of clinical vaso-occlusive events (P> 0.0001), severe anemia (P > 0.05), blood transfusion (0.05), white blood cell count (P> 0.05), plasma lactate dehydrogenase (LDH) , nuclear factor-kappa B (NF-κB) gene expression in buffy coat, expression of monocyte integrin and D-dimer (p>0.05). Omega-3 fatty acid group had significantly higher vitamin E plasma levels. Treatment with n-3 had no significant effect on plasma hs-CRP and plasma plasma tumor necrosis factor-α (TNF-α), (p>0.05).

Conclusion: These findings suggest that treatment with omega-3 fatty acids can be an effective therapeutic option for patents with sickle cell disease.

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