Eicosapentaenoic Acid: An inflammatory Omega-3 fat with potential clinical applications.

Author: Babcock T, Helton WS, et al.,
Source: Nutrition 16 (2000):1116 - 1118,
Publication Date: 1/1/2000

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The potential benefit for including v-3 (n-3) fatty acids in the normal diet has been supported by clinical evidence of reduced cardiovascular disease for people consuming a diet containing deep-water fish and fish oil. Evaluation of Eskimos, whose diets derive a large portion of dietary calories from v-3–containing fish, demonstrated a significantly lower rate of cardiovascular disease associated mortality and malignancies compared to Western populations.2 Further evidence in support of v-3 fatty acid dietary consumption is derived from experimental studies demonstrating eicosapentaenoic acid (EPA)-mediated antiinflammatory and anticachexiogenic benefits. Proinflammatory cytokines (specifically tumor necrosis factor [TNF] and interleukin-1 [IL-1]) are the proximal secondary pathway mediators of the multistep cascade that regulates the metabolic response to inflammation after a primary pathway stimulus, (injury, infection, malignancy, etc.).5 It is generally accepted that the prolonged and inappropriate production and release of proinflammatory cytokines result in clinically evident metabolic abnormalities of anorexia, weight loss, and lean body mass catabolism that as a whole describe the syndrome of cachexia. A logical approach to attenuate the development of cachexia, and in particular cancer-associated cachexia, would be to reduce or inhibit the propagation of secondary pathway intermediates such as proinflammatory cytokines and arachidonic acid (AA) metabolism intermediates (prostaglandins, prostacyclins, thromboxanes, etc.). Therefore, in our evaluation of new therapies for the treatment of patients with cancer associated cachexia it would be ideal to use a readily available low-cost and non-toxic agent that would reduce the production and release of inflammatory mediators. In support of this effort, several experimental and clinical studies have demonstrated a benefit for consuming a diet supplemented specifically with EPA, one of the primary v-3 fatty acids found in fish oils. In animal models and for patients with progressive malignancy, EPA supplementation promotes weight maintenance, improves food intake, inhibits tumor growth, and may improve survival. These observations suggest a potential role for EPA in the clinical management of patients with progressive malignancy and justify the need for clinical trials. Exciting as these early observation have been, much work remains to be done. In the present paper the significant evidence supporting the role for EPA as a potential agent for the treatment of cancer-associated cachexia is presented.