Old Remedy Offers New Hope in Rheumatoid Arthritis

      BUFFALO, N.Y., Nov. 2 (UPI) -- A combination of fish oil and vitamin E -- a common health-food supplement -- may become a standard weapon in the battle against rheumatoid arthritis.

      A team led by researcher Jaya Venkatraman discovered that autoimmune-prone mice fed fish oil and vitamin E had significantly lower levels of pro-inflammatory proteins than did control mice. The initial study, published last December, was selected as best scientific paper of the year by the American College of Nutrition.

      While human trials suggest fish oil can help ward off certain kinds of heart disease and autoimmune conditions, researchers are not clear why, said Venkatraman, associate professor in the department of physical therapy, exercise and nutrition sciences at the State University of New York, Buffalo. That''s where animal studies become important.

      Venkatraman''s research uncovered what she believes may be the broad mechanism by which vitamin-E-supplemented fish oil calms the overactive immune system. Abnormal inflammation, a symptom of hyperstimulated immunity, is characteristic of the 2 million Americans who suffer from rheumatoid arthritis.

      The mouse model was developed for the study of autoimmune diseases because the mice are genetically predisposed to develop such conditions. They overexpress a gene that causes immunological abnormalities -- that is, the gene, which codes for one kind of pro-inflammatory proteins, is turned on too often. The proteins, called cytokines, lead to the joint swelling and destruction of cartilage in diseases such as rheumatoid arthritis and lupus.

      "The protective anti-inflammatory role of fish oil and other vitamins has been established in a number of clinical studies," said Dr. Lenore Buckley, a rheumatologist at Virginia Commonwealth University in Richmond. "Still, this mouse model is a good one to use in really exploring the question because it has been specifically engineered for that purpose."

      Venkatraman told United Press International she began the research by wondering whether fish oil and vitamin E might affect the concentrations of specific pro- and anti-inflammatory cytokines in blood serum. Fish oil contains polyunsaturated fats and it oxidizes unless given with an antioxidant like vitamin E.

      She looked at four groups of mice. Two groups received fish oil with one of two levels vitamin E. Two control groups received the same two levels of vitamin E, but in corn oil, which generally causes autoimmune disorders to worsen.

      The mice given fish oil and a higher dose of Vitamin E had the fewest specific pro-inflammatory cytokines of all, noted Venkatraman.

      Furthermore, their data showed vitamin E, while it doesn''t appear to have a strong independent benefit in these diseases, enhances the effect of fish oil.

      "You may not be able to prevent rheumatoid arthritis with fish oil and vitamin E, but the adjunct treatment may delay symptoms and allow a patient to reduce the dosage of whatever medication he is taking," said Venkatraman, who is continuing to characterize precisely which cytokines are affected by the nutritional supplements and how.

      The study, particularly with its new recognition, is expected to provoke more research into the role of specific fatty acids and antioxidants in the treatment of autoimmune disease.

      Despite the growing reports of its benefits, however, it is difficult to know how many rheumatoid arthritis patients are taking fish oil.

      "I find that patients are reluctant to tell their doctors when they are getting such supplements from a health food store," says Dr. Dinesh Shah, a rheumatologist at Kaiser-Permanente Medical Center in Los Angeles. "They may think a doctor is going to tell to stop or laugh at them. Generally, they only tell you when they feel a supplement is really starting to make them feel better, and then they want you to know about it."

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