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Health News Archive 24 - Lupus and Autoimmune Disease
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Omega-3 Fatty Acid Benefits Lupus Patients

A double-blind, placebo-controlled study indicates that fish oil supplements in the amount of 3 grams per day may benefit patients with systemic lupus erythematosus (SLE).  The study was published in August 2004 in the Journal of Rheumatology.

In previous animal studies, fish oil supplementation had a beneficial effect on mouse models of systemic lupus erythematosus. In addition, copper can decrease the formation of lupus erythematosus cells in rats. Many previous studies in SLE patients have used heroic doses of fish oil—on the order of 9 grams per day. The current study, however, used much lower doses of fish oil.

Researchers randomly divided 52 patients with SLE into one of four treatment groups. One group received 3 grams of the Omega-3 fish-oil derived fatty acid EPA and 3 mg copper, another group received 3 grams EPA and placebo copper, a third group received 3 mg copper and placebo fish oil, and the fourth group received both placebo capsules. The researchers then measured disease activity by using the Systemic Lupus Activity Measure (SLAM-R). Researchers also took peripheral blood samples for routine hematological, biochemical, and immunological indices at the study's start, and at 6, 12, and 24 weeks.

In subjects consuming fish oil, there was a significant decline in SLAM-R score from 6.12 to 4.69 compared to subjects consuming a placebo. No significant effect on SLAM-R was observed in subjects taking copper. None of the indices measured in the blood samples were affected by either intervention.

The researchers concluded, " In the management of systemic lupus erythematosus, dietary supplementation with fish oil may be beneficial in modifying symptomatic disease activity."


Duffy EM, Meenagh GK, McMillan SA, Strain JJ, Hannigan BM, Bell AL.  The clinical effect of dietary supplementation with omega-3 fish oils and/or copper in systemic lupus erythematosus. J Rheumatol. 2004 Aug;31(8):1551-6.

The Omega-3 Fatty Acids from fish oil, EPA and DHA, are found in Omega-3 Fish Oil and Neptune Krill Oil.

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Omega-3 Fatty Acids Benefit Patients with Autoimmune and Inflammatory Diseases

Omega-3 fatty acids from fish oil can offer significant benefits to patients suffering from inflammatory and autoimmune diseases and depression, researchers concluded in the December 2002 Journal of American College Nutrition.

After reviewing the evidence, the researchers noted that animal experiments and clinical intervention studies demonstrated that the fish-oil derived omega-3s, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), act as anti-inflammatories and consequently might be useful in the management of inflammatory and autoimmune diseases. They also pointed out that patients with diseases characterized by an increased level of the proinflammatory cytokine interleukin 1 (IL-1)—such as coronary heart disease, major depression, aging and cancer—may benefit from consuming omega-3s found in fish oil.

Arthritis, Crohn's disease, ulcerative colitis and lupus erythematosis also are autoimmune diseases characterized by a high level of IL-1 and other proinflammatory substances produced by omega-6 fatty acids. It is thought that an overabundance of omega-6s and a lack of omega-3s in the diet may be responsible for inflammation. This may explain, the researchers wrote, why dietary supplementation with fish oils in clinical trials have alleviated the symptoms of several inflammatory and autoimmune diseases in humans, including rheumatoid arthritis, Crohn's disease, ulcerative colitis, psoriasis, lupus erythematosus, multiple sclerosis and migraine headaches. In fact, many of the placebo-controlled trials of fish oil in chronic inflammatory diseases reveal significant benefit, including decreased disease activity and a lowered use of anti-inflammatory drugs.

Source: Simopoulos AP. Omega-3 Fatty acids in inflammation and autoimmune diseases. J Am Coll Nutr. 2002 Dec;21(6):495-505.

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Pycnogenol as Adjunctive Therapy Helps Manage Autoimmune Disease in Lupus Patients

A pilot study, published in the December 2001 issue of Phytotherapy Research, shows the anti-inflammatory agent Pycnogenol® may prevent immune cells from over-reacting when used as an adjunctive therapy to glucocorticoids and/or hydroxychloroquine to treat Lupus patients. In the study conducted through a collaboration between the Universities of Bucharest (Romania) and Munster (Germany), 11 patients with the autoimmune disease Lupus continued their normal medication (glucocorticoids and/or hydroxychloroquine). Half (6) of the Lupus patients additionally received 120 mg Pycnogenol per day for 1 month, and 60 mg/day for the following month. The remaining five patients continued their normal medication and received a placebo, as control group.
The researchers took blood samples from the study patients and investigated the status of their immune cells. It was discovered that a particular subset of white blood cells (granulocytes) produced significantly less reactive oxygen species when patients had taken Pycnogenol. Immune cells produce reactive oxygen species as toxins to eliminate germs and other infections. In Lupus patients, these weapons are taking the body's own tissue under "friendly fire." Pycnogenol seems to calm down these over-reacting immune cells.
Lupus patients who took Pycnogenol experienced a normalizing of their immune cells suggesting that Pycnogenol may be helpful for patients diagnosed with Lupus. Specifically, in these patients, their immune cells attacked their own body tissue with less aggressiveness. Future studies will need to be conducted in order to show whether Pycnogenol may be beneficial for autoimmune diseases in general.
Another phenomenon typical in Lupus is the premature death of lymphocytes, the subset of immune cells responsible for orchestrating the body's immune response. It is believed that the failure of the immune system to distinguish between "body-own" and "foreign" is largely a consequence of the premature decay of lymphocytes. Pycnogenol significantly increased the lifetime of lymphocytes, which allows them to exert their influence to prevent the immune-system from over-reacting. This effect was significant in patients taking Pycnogenol but not in those receiving placebo.

Pycnogenol - Lupus Study Details
The SLE disease activity index (SLEDAI), serum anti-dsDNA antibodies, fibrinogen, C-reactive protein levels, erythrocyte sedimentation rate, production of reactive oxygen species (ROS) by neutrophils, spontaneous apoptosis and p56(lck) specific activity in peripheral blood lymphocytes were evaluated. Pycnogenol treatment caused a significant reduction of ROS production, apoptosis, p56(lck) specific activity and erythrocyte sedimentation rate. In addition, the decrease of SLEDAI was significant in the Pycnogenol treated group compared with the placebo group (p = 0.018).
Pycnogenol and Immunology Studies
These actions of Pycnogenol on immune cells are in agreement with various studies by Benjamin Lau (Loma Linda University) and Lester Packer (University of California, Berkeley), whose studies demonstrated that Pycnogenol is an anti-inflammatory and prevents immune cells from over-reacting. In one study Lester Packer has described a possible benefit of Pycnogenol for psoriasis, an inflammatory skin disorder. In another clinical study with human volunteers he demonstrates that Pycnogenol taken orally can prevent inflammation of the skin in response to UV-irradiation (sunburn).
Lupus Background
Lupus erythematosus represents a particular type of autoimmune disease, which often can be recognized by a butterfly-shaped rash over the cheeks. This gives people something of a wolf-like appearance, and this gave the disease its name (Lupus (latin) = wolf). Lupus usually develops between the age of 15-35, and more than 90% of patients are women.
A commonality between Lupus and other autoimmune diseases is that the immune system mistakenly recognizes body components as foreign and attacks them, as if they were invading bacteria or viruses. The body develops antibodies against parts of its own body, and immune cells excrete toxic substances causing destruction of the body’s own organs and tissues.
In the case of Lupus, the result is a chronic inflammation of skin, blood vessels, joints, kidneys, and other tissues. The first symptoms resemble those of arthritis, with swollen and painful fingers and other joints. Typically there are periodic flare-ups followed by periods of remission. The severity of Lupus ranges from mild to life threatening forms. Currently, Lupus cannot be cured and medical treatment involves turning-down the immune system in general (e.g. with glucocorticoids) to prevent it from attacking its own tissue.

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Krill Oil Shows Promise in Suppression of Autoimmune Murine Lupus

Researchers have previously reported that hybrid New Zealand female mice fed a diet enriched in omega-3 lipid-rich fish oil versus omega-6 lipid-rich corn oil show delayed development of autoimmune lupus nephritis and longer life span. The present study was carried out to explore the possible beneficial effects of oil from Antarctic krill (Euphausia superba) as an alternative source of omega-3 lipids. 

Mice were fed a nutritionally adequate semipurified diet supplemented with either 10% krill oil or 10% corn oil. Cross-sectional studies were carried out on kidneys and spleens at 3.5 and 6.5 months of age. Study results indicate that Krill Oil prolonged life span to a greater degree than corn oil (CO, 266.7 days plus or minus 12.5; KO, 330.2 days plus or minus 19.2; P<0.001) and delayed the onset of proteinuria. 

Splenocytes from Krill Oil mice displayed greater proliferative responses to mitogen, and significantly lower Pgp-1+ cells in both CD4+ and CD8+ T cell subsets. Lipid extracts of splenocytes from Krill Oil fed mice revealed higher levels of eicosapentaenoic (omega-3 EPA) and docosahexaenoic (omega-3 DHA) acids. EPA suppresses prostaglandin synthesis. Further, Northern blot analysis showed decreased expression of the oncogene c-ras (1.5-fold, P<0.05) in the spleens of Krill Oil fed mice. The expression of transforming growth factor beta1 was higher in spleen cell extracts (3.5-fold; P<0.025), but lower in kidney extracts (5.97- fold; P<0.025) of Krill Oil fed mice. 

The data indicate that dietary supplementation with Krill Oil modulates expression of TGFbeta in an organ specific manner. In the spleen, TGFbeta could be immunosuppressive, whereas its expression in the kidney may be pathological and proinflammatory. In summary, dietary Krill Oil, like fish oil, can suppress the development of autoimmune murine lupus, and its effects on inflammatory mediators are organ specific.

Source: Nutrition Research (USA), 1996, 16/3 (489-503)

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