ALPHA-LINOLENIC ACID IN THE TREATMENT OF RHEUMATOID-ARTHRITIS - A DOUBLE-BLIND, PLACEBO-CONTROLLED AND RANDOMIZED STUDY - FLAXSEED VS SAFFLOWER SEED

In rheumatoid arthritis various pro-inflammatory metabolites of arachi donic acid (AA), such as leukotriene B-4 (LTB(4)) and prostaglandin E( 2) (PGE(2)), contribute to tissue destruction and pain. In contrast to AA, which is an omega-6 fatty acid, the omega-3 fatty acids, after ha ving been liberated from the cell membrane phospholipids, are further converted into the non- or anti-inflammatory eicosanoids LTB(5) and PG I(3). AA concentration is an important regulatory step in the synthesi s of both prostanoids and leukotriens. Dietary supplementation with ei cosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) has therefore been used to decrease the ratio of AA to EPA or DHA to obtain benefic ial clinical effects. EPA and DHA are found in animal fat and are quit e expensive compared to their precursor alpha-linolenic acid (alpha-LN A) found in flaxseed oil. We, therefore, performed a placebo-controlle d trial with alpha-LNA in 22 patients with rheumatoid arthritis, using a linoleic acid preparation as a placebo. After a 3-month follow-up, the treatment group showed an increased bleeding time, but the clinica l, subjective (global assessment, classification of functional status, joint score index, visual analogue scale, pain tendereness score) and laboratory parameters (haemoglobin, erythrocyte sedimentation rate, C -reactive protein) did not show any statistical alterations. AA, EPA a nd DHA did not change either in spite of a significant increase in alp ha-LNA in the treatment group.