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Crohn's disease is associated with altered bone turnover that may be influenced by nutritional status, the systemic inflammatory response, cytokine production by circulating (peripheral blood) mononuclear cells (PBMC) and antioxidant micronutrient intake. High-dose fish oil is associated with reductions in disease relapse and inflammatory markers, and modulates PBMC function. The effect of fish oil plus antioxidants on bone turnover and PBMC function (the production of interferon-gamma and prostaglandin E2) in Crohn's disease was investigated in a randomised-controlled trial. Patients with currently or recently raised biochemical markers of inflammation (C-reactive protein > or = 6.9 mg/l or erythrocyte sedimentation rate > or =18 mm/h) received fish oil (providing 2.7 g/d EPA and DHA) and antioxidants (vitamins A, C and E, and Se) (n 31) or placebo (n 30) for 24 weeks. Bone turnover was assessed by measuring the concentrations of urinary deoxypyridinoline (bone resorption) and serum osteocalcin (bone formation). Fish oil plus antioxidants were associated with increases in EPA, DHA Se in plasma (all P < 0.01), and with a reduction in interferon-gamma production by mitogen-stimulated PBMC, which demonstrated a negative correlation with deoxypyridinoline/creatinine:osteocalcin ratio (r - 0.33, P = 0.009). There were no differences between the groups at 24 weeks in the response of deoxypyridinoline or osteocalcin or their ratio, or in nutritional status. Dietary supplementation in Crohn's disease with high intakes of EPA and DHA, as fish oil, plus antioxidants was associated with a modulated production of interferon-gamma by PBMC but not altered indices of bone turnover.

Original publication

DOI

10.1079/bjn20051466

Type

Journal article

Journal

The British journal of nutrition

Publication Date

08/2005

Volume

94

Pages

253 - 261

Addresses

Institute of Human Nutrition, School of Medicine, University of Southampton, Tremona Road, Southampton, SO16 6YD, UK. tt2@soton.ac.uk

Keywords

Leukocytes, Mononuclear, Humans, Bone Resorption, Crohn Disease, Fatty Acids, Unsaturated, Fish Oils, Vitamins, Amino Acids, C-Reactive Protein, Osteocalcin, Biological Markers, Antioxidants, Blood Sedimentation, Double-Blind Method, Osteogenesis, Middle Aged, Female, Male, Interferon-gamma