Effects of fish oil on immune function in males with human immunodeficiency virus infection
Bell, Stacey Jane
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Malnutrition is an ubiquitous problem for patients with the human immunodeficiency virus (HIV) infection. There is supportive evidence to show that supplemental dietary fish oil (FO) is beneficial for patients with burns, cancer, and HIV infection. These effects include: Curtailing cytokine release in response to an infection and altering prostaglandin production so that the less suppressive prostaglandin (PG) E3 replaces the immunosuppressive PGE(2). The purpose of this dissertation is to explore the effect of FO in HIV seropositive patients. Nineteen, homosexual males, With HIV infection and CD(4) counts from 200 to 600 were randomized to FO or safflower oil (SO) food bars for 6 weeks. At baseline, week 3, and week 6, blood was obtained lo assess: l) incorporation of omega-3 fatty acids in the fatty acids of the phospholipids of the plasma and peripheral blood mononuclear cells (PBMC), 2) stimulation of isolated PBMC with lipopolysaccharide (LPS) and measure PGE(2),tumor necrosis factor (TNF)-[alpha], and interleukin (IL)-6 concentrations. The omega-3 fatty acid, docosahexaenoic acid (DHA), incorporated into the fatty acids of the phospholipids of the plasma and PBMC by week 3 and week 6. There was significantly (P [less than] 0.05) less PGE(2) released at week 3 and week 6 in the FO but not SO group when the data were expressed as the difference from baseline comparing like concentrations of LPS. There was no effect of diet on PGE(2),TNF-[alpha], and IL-6 release from PBMC, but there was a significant (P = 0.000) effect of the concentration of LPS using analysis of variance. However, in the FO group at week 6, significantly (P = 0.05) more TNF-α was released from stimulated PBMC compared to baseline stimulated cells. Week 6, IL-6 spontaneous release was significantly (P[less than] 0.05) greater than baseline and week 3 spontaneous release. The stimulated PBMC released significantly (P = 0.02) more IL-6 at week 6 in the FO group than in the SO group. Although the CD, counts significantly (P = 0.008) in the FO group, the decrease was not relaled to diet; rather it was likely that the FO group was more malnourished as evidenced by significantly lower hemoglobin and hematocrit levels at baseline. These data demonstrated that the omega-3 fatty acids from the food bar were able to become incorporated after 3 weeks and allowed for less PGE(2) to be released from PBMC. There were more cytokines released in response to LPS and spontaneously, perhaps as a result of decreasing the highly suppressive PGE(2) which allowed a negative feed-back effect to occur. However, other studies have shown both PGE(2) and cytokines to fall with prolonged feeding of omega-3 fats. Possible explanations for this divergence is a dose effect, that not enough omega-3 fatty acids incorporated or that the FO was not given over a long enough period. It is less likely, but possible, that the results seen are unique to HIV infection.
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