Oil supplementation with a special combination of n-3 and n-6 long-chain polyunsaturated fatty acids does not protect for exercise induced asthma: a double-blind placebo-controlled trial

M Dreßler, D Fussbroich, L Böhler, E Herrmann, N Benker, M Tytyk, J Schulze, R Schubert, C Beermann, S Zielen, M Dreßler, D Fussbroich, L Böhler, E Herrmann, N Benker, M Tytyk, J Schulze, R Schubert, C Beermann, S Zielen

Abstract

Background: Many patients suffering from exercise-induced asthma (EIA) have normal lung function at rest and show symptoms and a decline in FEV1 when they do sports or during exercise-challenge. It has been described that long-chain polyunsaturated fatty acids (LCPUFA) could exert a protective effect on EIA.

Methods: In this study the protective effect of supplementation with a special combination of n-3 and n-6 LCPUFA (sc-LCPUFA) (total 1.19 g/ day) were investigated in an EIA cold air provocation model.

Primary outcome measure: Decrease in FEV1 after exercise challenge and secondary outcome measure: anti-inflammatory effects monitored by exhaled NO (eNO) before and after sc-LCPUFA supplementation versus placebo.

Results: Ninety-nine patients with exercise-induced symptoms aged 10 to 45 were screened by a standardized exercise challenge in a cold air chamber at 4 °C. Seventy-three patients fulfilled the inclusion criteria of a FEV1 decrease > 15% and were treated double-blind placebo-controlled for 4 weeks either with sc-LCPUFA or placebo. Thirty-two patients in each group completed the study. Mean FEV1 decrease after cold air exercise challenge and eNO were unchanged after 4 weeks sc-LCPUFA supplementation.

Conclusion: Supplementation with sc-LCPUFA at a dose of 1.19 g/d did not have any broncho-protective and anti-inflammatory effects on EIA.

Trial registration: Clinical trial registration number: NCT02410096. Registered 7 February 2015 at Clinicaltrial.gov.

Keywords: Double-blind placebo-controlled trial; Exercise challenge; Exercise-induced asthma; Exhaled nitric oxide; Forced expiratory volume in 1 s; Long-chain polyunsaturated fatty acids.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of study design with assessments
Fig. 2
Fig. 2
Max. FEV1 decrease and exhaled NO before and after sc-LCPUFA or placebo supplementation. Data for FEV1 decrease (a) Total n = 64; b) Adult n = 34; c) Children n = 30) and eNO (d), e), f)) were presented as median, 25%/75% percentile and min/max. The P-values were calculated with the Mann-Whitney-test. Results were considered as statistically significant when P < 0.05. None of the results were significant. The exact values for median and 25%/75% percentile are presented separately in Table 1 supplement
Fig. 3
Fig. 3
Frequency of the side effects during the sc-LCPUFA or placebo supplementation. The frequency of the side effects “salbutamol use”, “dyspnoe”, “bloating”, “belching” and “diarrhea” during the sc-LCPUFA or placebo supplementation are shown. Data were presented as median, 25%/75% percentile and min/max. The P-value was calculated with Mann-Whitney-test. Results were considered as statistically significant when P < 0.05. The frequency of the side effect “belching” showed a significant difference (P = 0.005) between the two groups, all the other side effects showed no significant difference between the interventional and placebo group
Fig. 4
Fig. 4
EPA, DHA and AA in plasma and blood cells before and after sc-LCPUFA or placebo supplementation. Data (n = 64) were presented as mean ± SD. The exact values for mean ± SD are presented separately in Table 2 in the Supplement. Intra-group and inter-group comparisons were calculated by One-Way ANOVA with post-hoc Bonferroni analysis. Results were considered as statistically significant when p < 0.05 (*** P < 0,001, ** P < 0.01, * P < 0.05)

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