ω-3 polyunsaturated fatty acids use for optimization of children inflammatory joints diseases treatment

Abstract

The use of additional treatment methods in inflammatory joints disease therapy is very important. But the main principles of diet therapy for patients with rheumatoid joint inflammation and reactive arthritis and possibility of focused impact on disease activity by means of alimentary factors have not still been formed out. The aim of the investigation was to study the effect of diet therapy including ω-3 polyunsaturated fatty acids (PUFAs) on joint syndrome evidence and on bone turnover markers of children with inflammatory joint diseases. With parents' agreement children aged 5-16 hospitalized with inflammatory joint diseases (53 with juvenile rheumatoid arthritis and 35 with reactive arthritis) were enrolled in this research. According to the treatment mode 2 subgroups were separated in each group: the first subgroup underwent backbone therapy, the second - backbone therapy along with ω-3 PUFAs (cod liver oil 1000 mg containing 115 mg of docosahexaenoic and 23 mg of eicosapentaenoic acids). Children aged 3-5 years received 1 capsule 2 times a day, over 6 years old - 1 capsule 3 times per day with meals for 3 months. Disease activity, joint syndrome evidence (counting of joint pain, Ritchie index, number of inflammatory joints, morning stiffness duration) and biochemical values of connective tissue metabolism were estimated while being introduced into research and at the end of treatment. More apparent improvement of joint syndrome indexes at the end of supervision was diagnosed in the groups undergoing backbone therapy along with ω-3 PUFAs. Statistically significant (p<0.05) reduce of morning stiffness time by 3 fold vs 2 fold in children treated with basic therapy, reduce of joint index by 2.9-5.7 fold vs 2.0-3.8 fold, the number of inflammatory joints by 4.5-5.8 fold vs 2.0-2.3 fold, blood serum level of hydroxyl proline and antibodies to rumalon were observed in main groups of patients. Disease activity index DAS 4 decreased in the group undergoing backbone therapy by 0.44 (p<0.05) and in the group undergoing modified therapy - by 1.20 (p<0.05). No adverse effects of PUFAs have been observed. It was concluded that ω-3 PUFAs increased the action of basic therapy favoring advances in inflammatory process activity control, provided decrease of non-steroidal antiinflammatory drugs (NSAID) intake and proved to be an important supplement in diet therapy of children inflammatory joints diseases.