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Associations of Plasma Omega-3 Fatty Acids with Progression and Survival in Pulmonary Fibrosis.
Associations of Plasma Omega-3 Fatty Acids with Progression and Survival in Pulmonary Fibrosis. Chest Kim, J. S., Ma, S. F., Ma, J. Z., Huang, Y., Bonham, C. A., Oldham, J. M., Adegunsoye, A., Strek, M. E., Flaherty, K. R., Strickland, E., Udofia, I., Mooney, J. J., Ghosh, S., Maddipati, K., Noth, I. 2023Abstract
Pre-clinical experiments suggest protective effects of omega-3 fatty acids and their metabolites in lung injury and fibrosis. Whether higher intake of omega-3 fatty acids is associated with disease progression and survival in humans with pulmonary fibrosis is unknown.What are the associations of plasma omega-3 fatty acid levels (a validated marker of omega-3 nutritional intake) with disease progression and transplant-free survival in pulmonary fibrosis?Omega-3 fatty acid levels were measured from plasma samples of patients with clinically-diagnosed pulmonary fibrosis from the Pulmonary Fibrosis Foundation (PFF) Patient Registry (n=150), University of Virginia (UVA) (n=58), and University of Chicago (UC) (n=101) cohorts. The N-3 index (docosahexaenoic acid [DHA] + eicosapentaenoic acid [EPA]) was the primary exposure variable of interest. Linear-mixed effects models with random intercept and slope were used to examine associations of plasma omega-3 fatty acid levels with changes in forced vital capacity (FVC) and diffusing capacity for carbon monoxide (DLCO) over a period of 12 months. Cox proportional hazards models were used to examine transplant-free survival. Stratified analyses by telomere length were performed in the UC cohort.Majority of the cohort were patients with IPF (88%) and men (74%). One-unit increment in log-transformed N-3 index plasma level was associated with a change in DLCO of 1.43 ml/min/mmHg per 12 months (95% CI 0.46-2.41) and a hazard ratio for transplant-free survival of 0.44 (95% CI 0.24-0.83). Cardiovascular disease history, smoking, and antifibrotic usage did not significantly modify associations. Omega-3 fatty acid levels were not significantly associated with changes in FVC. Higher EPA plasma levels were associated with longer transplant-free survival among UC participants with shorter telomere length (p-value for interaction=0.02).Further research is needed to investigate underlying biological mechanisms and whether omega-3 fatty acids are a potential disease-modifying therapy.
View details for DOI 10.1016/j.chest.2023.09.035
View details for PubMedID 37866772