Influence of ω-3 polyunsaturated fatty acids on the structure of immunocompetent cell membranes and the parameters of cellular and humoral immunity in children with rheumatoid arthritis

Background
ω-3 polyunsaturated fatty acids (ω-3 PUFA) in treatment of inflammations were presented in many clinical studies. Although inflammatory responses are carried out by a wide spectrum of cells, CD4 T-cells are crucial in the etiology of many chronic inflammatory diseases, e.g. inflammatory bowel disease, systemic lupus erythematosus, psoriatic arthritis and obesity. In light of recent concerns over the safety of non-steroidal anti-inflammatory drugs (NSAIDs), the alternatives, such as bioactive agents, are becoming more attractive. In order for these agents to be recognized by mainstream medicine, the mechanisms of anti-inflammatory effect of bioactive agents, such as ω-3 PUFA, should be fully revealed.

Objectives
The aim of the research was to evaluate the influence of ω-3 PUFA on immunocompetent cell membranes and the parameters of cellular and humoral immunity in children with rheumatoid arthritis (RA).

Material and methods
With the consent of their parents, 53 children hospitalized with RA and 15 healthy children 5–16 years of age were enrolled in the research. The children were randomized into 2 groups: the first group of the examined patients underwent backbone therapy, the second – backbone therapy with ω-3 PUFA. Immunity parameters (CD3, CD4, CD8, CD16, CD22, IgA, IgM, IgG, IL-1, IL-4, IL-6, amount of circulating immune complexes (CIC) in blood serum) were evaluated, as well as the metastructure of lymphocytes was investigated morphologically at the beginning of the investigation and after treatment.

Results and discussion
A more apparent improvement of immune parameters was demonstrated in the groups undergoing backbone therapy supplemented with ω-3 PUFA. Statistically significant differences between the parameters of the two treatment methods were verified: IgA (2.27 ± 0.14) and (1.96 ± 0.02) g/l (р ≤ 0.01), IgM (1.94 ± 0.11) and (1.64 ± 0.05) g/l (р ≤ 0.01), CD8 (17.85 ± 0.33) and (19.33 ± 0.16)% (р ≤ 0.001), CD22 (10.9 ± 0.2) and (10.42 ± 0.09)% (р ≤ 0.01), IL-1 (118.55 ± 5.22) and (97.69 ± 3.14) pg/ml (р ≤ 0.001), IL-4 (113.05 ± 5.15) and (92.63 ± 2.78) pg/ml (р ≤ 0.001). ω-3 PUFA stabilize lymphocyte cell membranes and activate the organoid level of intracellular regeneration.

Conclusions
ω-3 PUFA increase the effect of backbone therapy and has proven to be an important supplement in the diet therapy of children with RA.