Protective Effect of Fish Oil Supplementation on Exercise-Induced Bronchoconstriction in Asthma

• Published in: Chest Vol. 129; no. 1; pp. 39 - 49
• Main Authors: Mickleborough, Timothy D., Lindley, Martin R., Ionescu, Alina A., Fly, Alyce D.
• Format: Journal Article
• Language: English
• Published: Northbrook, IL Elsevier Inc 01.01.2006; American College of Chest Physicians
• Subjects: Adult; Airway management; Asthma; Asthma - metabolism; Asthma - physiopathology; Asthma - prevention & control; Biological and medical sciences; Bronchoconstriction - drug effects; Cardiology. Vascular system; Chronic obstructive pulmonary disease, asthma; Cross-Over Studies; Cytokines; Diet; Dietary Supplements; Double-Blind Method; eicosanoids; Eicosapentaenoic Acid - analogs & derivatives; Eicosapentaenoic Acid - metabolism; Exercise; Exercise Test - adverse effects; exercise-induced asthma; Fatty acids; Female; Fish oils; Fish Oils - therapeutic use; Follow-Up Studies; Forced Expiratory Volume - drug effects; Humans; Inflammation; Leukocyte Count; Leukotriene B4 - analogs & derivatives; Leukotriene B4 - metabolism; Male; Medical sciences; Metabolites; Physical fitness; Pneumology; polyunsaturated fatty acids; Sputum - cytology; Sputum - metabolism; Treatment Outcome; Tumor necrosis factor-TNF; Variance analysis; AA; PGD2; IL; PUFA; CI; PGF2; polyunsaturated fatty acids; TNF; eicosanoids; AUC0–60; LTE4; ANOVA; LA; exercise-induced asthma; EPA; LTB5; LTB4; cytokines; LTC4; diet; DHA; PMNL; EIB; Lung disease; Respiratory disease; Cytokine; Polyunsaturated fatty acid; Cardiovascular disease; Fish oil; Bronchoconstriction; Diet therapy; Diet; Eicosanoid; Bronchus disease; Obstructive pulmonary disease; Supplementation; Protection
• DOI: 10.1378/chest.129.1.39
• ISSN: 0012-3692

Previous research has demonstrated that fish oil supplementation has a protective effect on exercise-induced bronchoconstriction (EIB) in elite athletes, which may be attributed to its antiinflammatory properties. Since EIB in asthma involves proinflammatory mediator release, it is feasible that fish oil supplementation may reduce the severity of EIB in asthmatic subjects. To determine the efficacy of fish oil supplementation on severity of EIB in subjects with asthma. Randomized, double-blind, crossover study. Lung function and exercise testing in a university research laboratory. Sixteen asthmatic patients with documented EIB entered the study on their normal diet and then received either fish oil capsules containing 3.2 g of eicosapentaenoic acid and 2.0 g of docohexaenoic acid (fish oil diet, n = 8) or placebo capsules (placebo diet, n = 8) daily for 3 weeks. At the beginning of the study (normal diet) and at the end of each treatment phase, the following pre-exercise and postexercise measures were assessed: (1) pulmonary function; (2) induced sputum differential cell count percentage and proinflammatory eicosanoid metabolite (leukotriene C4 [LTC4]-leukotriene E4 [LTE4] and prostaglandin D2 [PGD2]) and cytokine (interleukin [IL]-1β and tumor necrosis factor [TNF]-α) concentrations; and (3) eicosanoid metabolites leukotriene B4 (LTB4) and leukotriene B5 (LTB5) generation from activated polymorphonuclear leukocytes (PMNLs). On the normal and placebo diet, subjects exhibited EIB. However, the fish oil diet improved pulmonary function to below the diagnostic EIB threshold, with a concurrent reduction in bronchodilator use. Induced sputum differential cell count percentage and concentrations of LTC4-LTE4, PGD2, IL-1β, and TNF-α were significantly reduced before and following exercise on the fish oil diet compared to the normal and placebo diets. There was a significant reduction in LTB4 and a significant increase in LTB5 generation from activated PMNLs on the fish oil diet compared to the normal and placebo diets. Our data suggest that fish oil supplementation may represent a potentially beneficial nonpharmacologic intervention for asthmatic subjects with EIB.