DHA may combat acute pancreatitis, but hyperlipidaemia patients should avoid high doses: Review
Acute pancreatitis, which entails sudden pancreatic inflammation, is linked to increased cytokine production and typically leads to higher lipid peroxide levels in the pancreatic tissues, as well as multiple organ dysfunction.
While certain aspects of the pathogenesis of human acute pancreatitis are still unclear, oxidative stress is known as a major risk factor.
Earlier research has shown that DHA, an omega-3 polyunsaturated fatty acid, has anti-inflammatory and antioxidant effects on certain cells, and can inhibit "oxidative stress-mediated inflammatory signalling required for cytokine expression in experimental acute pancreatitis".
Based on this, researchers from South Korea's Yonsei University conducted a review to determine DHA's effectiveness against acute pancreatitis.
Alpha of the omegas
They found that DHA had been shown to lower serum triglyceride levels, thereby inhibiting the development of hypertriglyceridaemic acute pancreatitis.
Daily pharmacological doses of 3g to 4g of omega-3 fatty acids can reduce triglycerides in hypertriglyceridaemia patients, and DHA in particular has been found to be more efficacious than EPA and other omega-3 fatty acids.
The researchers stated that DHA's ability to reduce serum triglyceride could warrant adding it to lipid-lowering drugs such as statins, which has been found to alleviate hypertriglyceridaemic acute pancreatitis.
They also wrote that DHA "upregulates the expression of antioxidant enzymes, including catalase, glutathione peroxidase, and manganese superoxide dismutase", and "may prevent and / or inhibit the development of acute pancreatitis by suppressing the inflammatory signalling pathways in the pancreatic tissues".
Furthermore, DHA had previously been shown to inhibit inflammatory signalling activated by reactive oxygen species (ROS), as well as inflammatory cytokine expression in rats with cerulein-induced acute pancreatitis.
Balance is key
However, the researchers also said that "high DHA concentrations increase cytosolic calcium ions, which activates protein kinase C and may induce hyperlipidaemic acute pancreatitis".
As such, it added that hyperlipidaemia patients should steer clear of high doses of DHA, in order to prevent the acute pancreatitis from developing.
The researchers concluded: "Combination of DHA and lipid-lowering drugs like statins may reduce the development of hypertriglyceridaemic acute pancreatitis by decreasing triglyceride levels. On the other hand, a high concentration of DHA may promote inflammation, which may cause hyperlipidaemic acute pancreatitis.
"An understanding of how DHA interferes with inflammatory mediators is important for determining the effects of DHA when it is used in combination with traditional therapy for inhibiting inflammation in the pancreatic tissues."
Source: International Journal of Molecular Sciences
"A Mini-Review on the Effect of Docosahexaenoic Acid (DHA) on Cerulein-Induced and Hypertriglyceridemic Acute Pancreatitis"
Authors: Yoo Kyung Jeong, Hyeyoung Kim