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Antioxidants and fatty acids in the amelioration of rheumatoid arthritis and related disorders

Published online by Cambridge University Press:  09 March 2007

L. Gail Darlington  and
Trevor W. Stone
L. Gail Darlington*
Affiliation:
Epsom General Hospital, Dorking Rd., Epsom, Surrey KT18 7EG, UK
Trevor W. Stone
Affiliation:
Institute of Biomedical and Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK
*
*Corresponding author: Dr L. G. Darlington, fax +44 01372 735 261 email gdarlington@sthelier.sghms.ac.uk
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Abstract

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The generation of reactive oxygen species (free radicals) is an important factor in the development and maintenance of rheumatoid arthritis in humans and animal models. One source of free radicals is nitric oxide produced within the synoviocytes and chondrocytes and giving rise to the highly toxic radical peroxynitrite. Several cytokines, including tumour necrosis factor-α (TNFα) are involved in the formation of free radicals, partly by increasing the activity of nitric oxide synthase. Indeed, nitric oxide may mediate some of the deleterious effects of cytokines on bone resorption. Aspirin, tetracyclines, steroids and methotrexate can suppress nitric oxide synthase. Dietary antioxidants include ascorbate and the tocopherols and beneficial effects of high doses have been reported especially in osteoarthritis. There is also evidence for beneficial effects of β-carotene and selenium, the latter being a component of the antioxidant enzyme glutathione peroxidase. The polyunsaturated fatty acids (PUFA) include the n-3 compounds, some of which are precursors of eicosanoid synthesis, and the n-6 group which can increase formation of the pro-inflammatory cytokines TNFα and interleukin-6, and of reactive oxygen species. Some prostaglandins, however, suppress cytokine formation, so that n-3 PUFA often oppose the inflammatory effects of some n-6-PUFA. γ-linolenic acid (GLA) is a precursor of prostaglandin E1, a fact which may account for its reported ability to ameliorate arthritic symptoms. Fish oil supplements, rich in n-3 PUFA such as eicosapentaenoic acid have been claimed as beneficial in rheumatoid arthritis, possibly by suppression of the immune system and its cytokine repertoire. Some other oils of marine origin (e.g. from the green-lipped mussel) and a range of vegetable oils (e.g. olive oil and evening primrose oil) have indirect anti-inflammatory actions, probably mediated via prostaglandin E1. Overall, there is a growing scientific rationale for the use of dietary supplements as adjuncts in the treatment of inflammatory disorders such as rheumatoid arthritis and osteoarthritis.

Keywords

ArthritisOilsAntioxidantsFatty acidsFree radicals
Type
Review article
Information
British Journal of Nutrition , Volume 85 , Issue 3 , March 2001 , pp. 251 - 269
Copyright
Copyright © The Nutrition Society 2001

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