promega and Psoriasis

Since eicosanoids have been implicated in the pathogenesis of psoriasis, less potent eicosanoid mediators derived from fish oil might improve psoriasis. Using a double-blind, randomized, parallel design, 18 patients with stable, plaque psoriasis received capsules of either fish oil or identical-appearing placebo olive oil for 15 weeks, with concomitant sub-erythemal UVB in weeks 3 to 11. At the conclusion of phototherapy, and 4 weeks later, patients in the fish oil group had a greater decrease in the total body surface area of psoriasis and more improvement compared to patients in the olive oil group. The improvement in the fish oil group was statistically significantly greater for all parameters compared to the change in the olive oil group. The apparent safety and general health-promoting features of fish oil could provide an ideal adjunctive therapy for psoriasis.

Topics: Adult; Aged; Clinical Trials as Topic; Docosahexaenoic Acids; Double-Blind Method; Drug Combinations; Eicosapentaenoic Acid; Fatty Acids, Unsaturated; Female; Fish Oils; Humans; Male; Middle Aged; Psoriasis; Random Allocation; Time Factors; Ultraviolet Therapy

Topics: Administration, Topical; Docosahexaenoic Acids; Drug Combinations; Eicosapentaenoic Acid; Fatty Acids, Unsaturated; Fish Oils; Humans; Pilot Projects; Psoriasis

28 patients with stable chronic psoriasis completed a trial in which they were randomly allocated to receive either 10 fish-oil capsules ('MaxEPA') or 10 placebo capsules (olive oil) daily. Patients were specifically instructed not to change their normal diet. After 8 weeks' treatment there was a significant lessening of itching, erythema, and scaling in the active treatment group, with a trend towards an overall decrease in body surface area affected. No change occurred in the placebo group.

Topics: Administration, Oral; Adult; Docosahexaenoic Acids; Double-Blind Method; Drug Combinations; Drug Evaluation; Eicosapentaenoic Acid; Fatty Acids, Unsaturated; Female; Fish Oils; Humans; Male; Psoriasis; Random Allocation

Several studies have indicated that certain lipoxygenation products of arachidonic acid, particularly leukotriene B4 (LTB4), may be involved in psoriatic pathophysiology. One way of inhibiting the formation of LTB4 is to replace arachidonic acid in phospholipids with eicosapentaenoic acid. Eicosapentaenoic acid is converted into LTB5, which has a lower biologic activity than LTB4. In the present study psoriatic patients were put on a low-fat diet supplemented with dietary fish oil (Max-EPA 30 ml daily), a source of eicosapentaenoic acid, for 4 months. Twenty-six out of 30 patients with psoriasis vulgaris completed the study. Moderate or excellent improvement was observed in 58% of the patients, while mild improvement or no change was observed in 19% and 23%, respectively. The capacity of peripheral blood neutrophils to synthesize LTB4 and LTB5 in vitro was determined after stimulation with A23187. Before the study, negligible amounts of LTB5 were formed. After 1 month the average of LTB5/LTB4 ratio was 0.42. No further increase of the LTB5/LTB4 ratio was found. There existed no relationship between the clinical response and the LTB5/LTB4 ratio. The results of the present study suggest that dietary fish oil supplementation may be used in the therapy in psoriasis. However, studies defining the dose and the quality of fish oils are imperative.

Topics: Adolescent; Adult; Aged; Child; Dietary Fats; Docosahexaenoic Acids; Drug Combinations; Eicosapentaenoic Acid; Fatty Acids, Unsaturated; Female; Fish Oils; Humans; Leukotriene B4; Male; Middle Aged; Neutrophils; Psoriasis

Ten patients with psoriasis resistant to conventional topical treatment were given dietary supplements of fish oil, providing approximately 12 g of eicosapentaenoic acid daily for a period of at least 6 weeks. In eight patients there was a modest improvement in their psoriasis, the principal effects being a diminution of erythema and scaling. The dietary treatment resulted in a substantial inhibition of leukotriene B4 production by the peripheral blood polymorphonuclear leukocytes in vitro. The discrepancy between the high degree of inhibition of leukotriene B4 synthesis and the modest therapeutic effect suggests that leukotriene B4 is not the only mediator involved in the development of the psoriatic lesion. Furthermore, the in vivo cutaneous levels of leukotriene B4 might not have been inhibited to the same extent as the polymorphonuclear leukocyte levels in vitro. Further studies on the use of fish oil supplements, both on their own and in conjunction with other forms of treatment in psoriasis are warranted. It will also be important to determine whether the altered profile of 5-lipoxygenase products found in the blood is also seen in the skin.

Topics: Adult; Arachidonate 5-Lipoxygenase; Blood Platelets; Chromatography, High Pressure Liquid; Dietary Fats, Unsaturated; Docosahexaenoic Acids; Drug Combinations; Eicosapentaenoic Acid; Fatty Acids; Fatty Acids, Unsaturated; Female; Fish Oils; Humans; Male; Middle Aged; Neutrophils; Psoriasis; Thromboxane B2