Immunological disease dose-responses of fish consumption

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Original author: Henna Karvonen, Foodfiles Ltd 2006.

Evidence on the effects of fish on autoimmune diseases, infections and immunonutrition. There are relatively many studies conducted on these health conditions, but data for most of the conditions is insufficient for drawing conclusions on efficacy or dose-response effect. This is due to heterogeneity of these diseases and furthermore very limited evidence on comparable endpoint measurements between various studies on certain condition.

Ecological, descriptive and cross-sectional studies Cohort and case-control studies Exposure data from cohort and case-control studies Interventions Exposure data from interventions Comments (Population based studies are on the incidence or risk of the disease, interventions on the treatment.)
Rheumatoid arthritis ++ + Omega-3 fatty acids +++ Fish oil Endpoints in interventions: Tender joints, morning stiffness, use of NSAID/corticosteroids Results promising, at least 3 meta-analyses have quantified the effect
Asthma ++ + Fish ++ Fish oil The results from epidemiological studies suggested that fish consumption is beneficially associated with lung function and prevalence of asthma, but currently there is no readily available data estimating the dose-response effect. In clinical trials supplementation does not consistently improve severity of symptoms, lung functions, airway responsiveness or medication use in asthmatic patients.
Atopic dermatitis ++ + Fish ++ Fish oil Recent meta-analysis found no evidence on the effectiveness of supplementation in the treatment of AD. Epidemiological data suggests preventive effect, but currently the data is likely to be insufficient for estimating dose-response effect.
Biomarkers of inflammation (TNF-α, IL-1, IL-6, eicosanoids) ++ + Fish, omega-3 fatty acids ++ Fish oil Quantifiable data from controlled trials exists both on healthy individuals and patients. However quantifying the clinical significance of the changes in inflammatory markers is a complicated task.
Inflammatory bowel disease
Crohn’s disease + + Fish + Fish oil End points in interventions: clinical and endoscopic score, relapse
Ulcerative colitis + + Fish ++ Fish oil Endpoints in interventions: Clinical and endoscopic score, relapse/ remission, requirement for immunosuppressive agents
Kidney transplantation N.A. N.A. ++ Fish oil Endpoints in interventions: mortality, graft survival, lipid metabolism
Ig A nephropathy N.A. N.A. ++ Fish oil Endpoints in interventions: end stage renal failure, serum creatinine level, proteinuria, renal tissue damage
Psoriasis + - + Fish oil In interventions fish oils have been use as primary treatment or as concomitant therapy
Systemic inflammatory response (in surgery, trauma or critical illness) N.A. N.A. ++ Fish oil Only little data on hard endpoints like mortality or length of hospital stay, most of the data on biomarkers

- No data, + Initial findings, ++ Replicate studies, +++ Plenty of data


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