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Omega-3 fatty acids are a group of essential fatty acids, which play an important role in the immune function of the body. Much as our body needs these, it is unable to manufacture them. So we rely on our diet to provide them. We need several essential fatty acids. Usually we get them from soybean, olive oil, flax seeds, peanuts, etc. Of late, scientists have discovered that omega-3 fatty acids are important immunomodulators and oily fish, like salmon, are their richest source.
Essential fatty acids form an important part of the membrane or surface of every cell in our body. Whenever the body is challenged by a foreign substance, like a microbe, interactions take place at the cell surface that involve the fatty acids. The result is the production of many chemicals. Depending on the type of essential fatty acid, the resulting chemicals may produce harm or benefit to the body.
Scientists have discovered that if there are more omega-6 fatty acids in the membranes of inflammatory cells, chemicals produced increase the inflammatory response and induce damage. But if there are more omega-3 fatty acids in the cell membrane, the resulting chemicals blunt the inflammatory response and protect the body.
Every day we face hundreds of microbes, through our food, air and water. If our cells have more omega-3 fatty acids, our body will come to less harm from fighting these invaders.
The nature of this fight changes to a big war in severely ill patients. These are the patients who have undergone major surgeries, organ transplants or are suffering from serious infections. Sometimes the infection is so overwhelming that all organ systems are affected. Such cases are said to be in sepsis.
Usually, such patients are unable to tolerate food taken orally or through stomach tubes. Hence, they rely on total parenteral nutrition, or TPN, for all their nutrition. TPN includes glucose, proteins, vitamins, minerals and also fats. Fats are a source of calories and essential fatty acids.
For many years, soybean oil or olive oil used to be the fat emulsion used in TPN. But studies showed that soybean is not rich in omega-3 fatty acids. So fat emulsions containing fish oil were introduced, which are rich in omega-3 fatty acids.
For many years this fish oil emulsion was used just as a nutritional supplement, as a component of TPN. But some clinicians made exciting discoveries which led them to believe that fish oil is a magic potion.
In June 2002, Dr. Atul Ingale, nephrologist from Mumbai, India, came across a seriously ill patient suffering from a rare parasitic infestation. His kidneys were in failure and he was in sepsis. Although he was put on high antibiotics and in intensive care, he did not respond at all for almost five days.
Ingale realised that only a strong immunomodulator could save this man. He was aware of the fish oil emulsion but never before had it been used outside of TPN. But weighing the benefits against the risks, he dared to infuse his dying patient with fish oil for five days in a row.
Much to his surprise, the patient started responding to all the treatments and walked home within a week! For the first time in history, fish oil was used to improve the responsiveness to drugs in a case of sepsis.
Following that, Ingale made a short study with 25 patients in an intensive care unit. The miraculous effects of fish oil were repeated. This study proved, for the first time in the world, that for a patient in sepsis, fish oil helps to decrease the inflammation, improve the immunity and increase the responsiveness to antibiotics. In short, fish oil can cure sepsis.
Around the same time, at the other end of the world, a young man of 17 was fighting for his life after a bone marrow transplant for leukemia. In Boston General Hospital in the United States, this youngster was suffering from complications of his surgery. He was put on TPN but the fat administered to him was soybean and he developed an allergy to it. So he went on for a long time without any fat.
Soon he developed essential fatty acid deficiency. This was an additional complication to his already critical health state. The doctors decided to infuse him with fish oil, to fight the deficiency. Much to everyone's delight, he started responding to all treatments. His body accepted the transplant and his general condition improved remarkably. The boy, who was on his death bed, recovered and is now doing well in college.
Once again, it was proven that fish oil has special effects when given in high doses to a critically ill patient. Studies show that in a very sick person, the body's primary reaction is that of a strong inflammatory reaction. This leads to the release of strong chemicals in huge quantities that do a lot of harm to the body.
After this, somehow, the body fails to produce any fighter chemicals, when are then needed. Omega-3 fatty acids have been proven to counteract both these responses. While they dampen the exaggerated inflammatory response in the initial stages, they also blunt the immune suppression in the later stages.
After the sunshine recovery of the teenager, Dr. Mark Puder and Kathleen Gura from the Boston General Hospital conducted some rodent experiments in their laboratory. Dr. Puder, a pediatric surgeon, was on the lookout for a fat emulsion that would protect the livers of babies on TPN. His patients, operated on for an intestinal condition called short gut syndrome, were dying of liver failure due to TPN. Apparently the soybean oil was damaging their livers. The experiments showed encouraging results and Puder took the courageous decision to infuse fish oil into the little babies. The response was astounding. The babies stopped dying of liver failure. It proved that fish oil is safe in babies and has liver protective properties.
Many studies have been conducted in the past seven to eight years, and they have repeatedly confirmed the magical effects of fish oil. They have proven that fish oil improves the responsiveness to treatments. Patients recover faster and this cuts their ICU stay by as much as 21 percent. Patients require fewer antibiotics and are discharged from the hospital much earlier. Surgeons observe that there are fewer cases of re-operation if fish oil is used after major operations.
Studies conducted in the Department of Dermatology and Andrology at the University of Giessen in Germany, have shown that fish oil infusions hastened the recovery in patients with psoriasis (a condition with marked scaliness and itchiness of skin) and atopic dermatitis (an allergic skin disease).
More studies have been conducted on patients in septic shock, a life-threatening condition, in the Department of Internal Medicine at Giessen, Germany. They have asserted the impact of fish oil on improving immunity and decreasing inflammation.
Every year 750,000 cases of sepsis are diagnosed worldwide. The mortality of these patients is around 30-60 percent. Use of fish oil in the management of these cases can make a big difference to these numbers.
An early discharge from the ICU and hospital means huge reductions in medical expenses. Fewer antibiotics means reduced expenses and decreased risk of drug resistance and minimal intestinal complications from antibiotic abuse.
So far, fish is the only source of this omega-3 fatty acid rich emulsion. Studies are under way to manufacture these abundantly, at lower costs, using DNA recombinant technology.
More and more experts are conducting experiments and studies to evaluate the role of this wonder fluid in treating various medical conditions: orthopedicians, psychiatrists, endocrinologists ... everyone. Fish oil seems to have added an exciting dimension to the management of complicated cases once deemed beyond help.
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(Dr. Pradnya Kulkarni is a clinical pathologist. She worked as a consultant pathologist in a private laboratory in Pune before moving to Hong Kong with her husband and young daughter. She is also a freelance writer, focusing on medical issues of public concern. ©Copyright Pradnya Kulkarni.)
