The Efficacy of Omega-3 and Cholecalciferol Supplementation On Il-23 Production in the Airways of Cystic Fibrosis Patients Infected by Pseudomonas aeruginosa - A Pilot Study
Introduction: Polyunsaturated fatty acids (PUFA) supplementation is thought to reduce inflammation in cystic fibrosis. Likewise vitamin D has immunoregulatory properties. The aim of the study was to compare the effect of cholecalciferol supplementation to cholecalciferol with omega-3 supplementation on the inflammatory response of CF patients infected with P.aeruginosa. Methods: This was a double-blind, cross-over trial. Twenty-three CF patients (aged 6 – 19) infected by P. aeruginosa were randomised to received: cholecalciferol 1000IU or cholecalciferol 1000IU and omega – 3 1000 mg daily for three months. The levels of IL-23 and IL-17A in the exhaled breath condensate (EBC), calcium-phosphorus balance and serum lipid balance were measured. Data were analysed using means of Stata/Special Edition, release 14.2. Results: The level of IL-23 in EBC significantly decreased in vitamin D + omega-3 group from 9,39 pg/mL (± SD = 6,40 pg/mL) to 7,33 pg/mL (± SD = 3,88 pg/mL) (p = 0.023); there was no change in vitamin D group (p = 0.630). The blood concentration of 25OHD significantly increased in both groups: in vitamin D group form 24,64 ng/mL (± SD = 8,31 ng/mL) to 29,41 ng/mL (± SD = 7,78 ng/mL) (P < 0,001) and in vitamin D +omega-3 group from 24,31 ng/mL (± SD = 8,28 ng/mL) to 30,67 ng/mL (± SD = 8,01 ng/mL) (P < 0,001). Conclusions: Omega-3 supplementation with cholecalciferol may provide some benefits and modulate the immunity response in airway CF patients with chronic P. aeruginosa infection reflected as reduction of the level of IL-23 in EBC.