Dietary Fish Oil and Cytokine and Eicosanoid Production During Human Immunodeficiency Virus Infection

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Abstract
Background : Dietary fish oil (FO) has been shown to modulate the immune system. The purpose of this study was to explore the effects of FO supplementation on the production of dienoic eicosanoids and cytokines in patients with human immunodeficiency virus (HIV) infection. Methods: This was a randomized, prospective, double‐blind study that included homosexual males with HIV infection. Patients were asked to consume voluntarily five food bars daily containing FO (n = 10) or safflower oil (SO) (n = 9) for 6 weeks. At baseline and week 6, plasma was obtained to measure incorporation of ω‐3 fatty acids. At baseline, week 3, and week 6, measurements were made of changes in dienoic eicosanoids and cytokines from lipopolysaccharide (LPS)‐stimulated peripheral blood mononuclear cells (PBMC) or spontaneously releasing cells. Results: In the FO group but not the SO group, there was increased incorporation of the ω‐3 fatty acid docosahexaenoic acid (DHA) into the phospholipids of the fatty acids of the plasma. In the FO group, there was a significant decrease (p =.01) in 6‐keto prostaglandin (PG) F1α released from PBMC. There was a significant increase (p =.01) in interleukin (IL)‐6 released from the PBMC in the FO group between baseline and week 3 and between week 3 and week 6. At week 6, there was significantly more IL‐6 (p =.01) released from the PBMC in the FO group compared with the SO group. There was no change in CD4 cell counts by analysis of variance. Conclusions: The FO‐containing food bars were well tolerated and allowed incorporation of ω‐3 fatty acids to occur. Despite evidence of significant metabolic effects on eicosanoid and cytokine production, widespread clinical use of FO for HIV‐infected patients is not warranted without further study, particularly given the trend toward a decline in CD4 cell numbers at this dose and with this type of fish oil. (Journal of Parenteral and Enteral Nutrition 20:43–49, 1996)