Omega 3 (n-3) fatty acids down-regulate nuclear factor-kappa B (NF-κB) gene and blood cell adhesion molecule expression in patients with homozygous sickle cell disease

Chronic inflammation and reduced blood levels of omega-3 fatty acids (n - 3) are known characteristics of sickle cell disease (SCD).The anti-inflammatory properties of n - 3 fatty acids are well recognized.Omega-3 treated (n = 24), hydroxyurea (HU) treated (n = 18), and n - 3 untreated (n = 21) homozygous SCD patients (HbSS) and healthy (HbAA) controls (n = 25) matched for age (5-16. years), gender and socioeconomic status were studied. According to age (5-10) or (11-16) years, two or three capsules containing 277.8. mg docosahexaenoic (DHA) and 39.0. mg eicosapentaenoic (EPA) or high oleic acid placebo (41%) were assigned to n - 3 treated and n - 3 untreated groups, respectively. Hydroxyurea treated group was on dosage more than 20. mg/kg/day. The effect of supplementation on systemic and blood cell markers of inflammation was investigated.The n - 3 treated group had higher levels of DHA and EPA (p < 0.001) and lower white blood cell count and monocyte integrin (p < 0.05) compared with the n - 3 untreated. No difference was detected between the two groups regarding C-reactive protein, granulocytes integrin and selectin, plasma tumour necrosis factor-α and interleukin-10. The n - 3 treated group had lowered nuclear factor-kappa B (NF-κB) gene expression compared to n - 3 untreated and HU treated groups (p < 0.05).This study provides evidence that supplementation with n - 3 fatty acids may ameliorate inflammation and blood cell adhesion in patients with SCD.