Abstract
BackgroundSeveral studies have been focusing on the effect of omega-3 polyunsaturated fatty acids on modulation of inflammatory markers in several cardiopathies. Although immunoregulatory dysfunction has been associated to the chronic cardiac involvement in Chagas disease, there is no study examining the effects of omega-3 supplementation in these patients. We investigated the effects of omega-3 PUFAs on markers of inflammation and lipid profile in chronic Chagas cardiomyopathy patients.MethodsThe present study was a single-center double-blind clinical trial including patients with chronic Chagas cardiomyopathy. Patients were randomly assigned to receive omega-3 PUFAs capsules (1.8g EPA and 1.2g DHA) or placebo (corn oil) during an 8-week period. Cytokines, fasting glucose, lipid, and anthropometric profiles were evaluated.ResultsForty-two patients (23 women and 19 men) were included in the study and there were only two losses to follow-up during the 8-week period. Most of sociodemographic and clinical characteristics were similar between the groups at baseline, except for the cytokines IL-1β, IL-6, IL-8, IL-10, IL-17α, and IFNγ. The omega-3 PUFAs group demonstrated greater improvements in serum triglycerides (−21.1 vs. −4.1; p = 0.05) and IL-10 levels (−10.6 vs. −35.7; p = 0.01) in comparison to controls after 8 weeks of intervention. No further differences were observed between groups.ConclusionOmega-3 PUFAs supplementation may favorably affect lipid and inflammatory profile in chronic Chagas cardiomyopathy patients, demonstrated by a decrease in triglycerides and improvements on IL-10 concentration. Further studies examining the clinical effects of omega-3 fatty acids supplementation in chronic Chagas cardiomyopathy are necessary.Trial registrationNCT01863576.
Highlights
Several studies have been focusing on the effect of omega-3 polyunsaturated fatty acids on modulation of inflammatory markers in several cardiopathies
The majority of patients were in use of beta-blockers (69.1%) and 85% were in use of angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers with no major treatment differences between groups (81%, n = 17 for control and 90.5%, n = 19 for intervention), except the omega-3 polyunsaturated fatty acids (PUFAs) intervention
Compliance levels were high for both groups, with no statistical differences to the percentage of ingested capsules at the end of followup (92.6% for placebo vs. 94.4% for omega-3 PUFAs; p = 0.41)
Summary
Several studies have been focusing on the effect of omega-3 polyunsaturated fatty acids on modulation of inflammatory markers in several cardiopathies. Immunoregulatory dysfunction has been associated to the chronic cardiac involvement in Chagas disease, there is no study examining the effects of omega-3 supplementation in these patients. We investigated the effects of omega-3 PUFAs on markers of inflammation and lipid profile in chronic Chagas cardiomyopathy patients. The degree of heart dysfunction is associated with a progressive inflammatory reaction, which is characterized by a myocarditis with multifocal mononuclear inflammatory infiltrates, a varied degree of myocardium fibrosis, a constant low-grade tissue parasitism, and a low or undetectable parasitemia [7,8,9,10]. The unbalance between excessive proinflammatory cytokines and decreased anti-inflammatory cytokines produces a low-grade pro-inflammatory state that could be associated to the progression of disease and the increased morbidity and mortality rates among these patients [11, 12]
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