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Year : 1999  |  Volume : 31  |  Issue : 4  |  Page : 247-264

Pharmacology and therapeutic potential of the n-3 polyunsaturated fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in fish oils

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Hazra Avijit

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Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are long-chain, polyunsaturated fatty acids of the n-3 series (n-3 PUFAs) obtained primarily from marine fish oils. They are reported to possess numerous health benefits. Taken orally, they are absorbed through lymphatic pathways, circulate largely in serum lipoproteins and distribute fairly widely in tissues. They are incorporated into cellular membrane lipids and compete with arachidonic acid in eicosanoid metabolism pathways. The biotransformation products may themselves be pharmacologically active. Reduced serum triglyceride level is the most consistent hypolipidemic action of EPA and DHA. They may reduce the severity of angina and prevent ischemia-induced ventricular fibrillation and sudden cardiac death. Although unable to arrest restenosis following coronary balloon angioplasty, animal experiments do indicate an antiatherogenic role. An antithrombotic effect, attributed to altered platelet function and possible modulation of the fibrinolytic system, and modest antihypertensive action, are also possible. Antiproliferative and cytotoxic influences have been noted on various cell lines and inhibition of mammary tumorigenesis has been documented in animal studies. Various anti-inflammatory effects have also been reported, such as in psoriasis and ulcerative colitis. However, the non-cardiovascular indications require further clinical exploration. Desirable changes occur at a threshold dose of around 2 g/day of n-3 PUFAs. Higher doses may have more pronounced effects but with the potential risks of upsetting the oxidant-antioxidant balance in the body and producing a higher incidence of nausea, eructation and diarrhoea. Other reported adverse reactions are uncommon. Fish oil preparations are generally well tolerated. Overall, EPA and DHA are desirable dietary supplements for maintaining cardiovascular health, notably in ischemic heart disease, and show promise in some non-cardiovascular disorders too.


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