Randomization to Omega-3 Fatty Acid Supplementation and Endothelial Function in COPD: The COD-Fish Randomized...

Area of Science:

• Cardiovascular Medicine
• Pulmonology
• Nutritional Science

Background:

• Endothelial dysfunction is implicated in the pathology of chronic obstructive lung disease (COPD).
• Omega-3 (n-3) polyunsaturated fatty acids (PUFAs) are known to improve endothelial function in other conditions.
• The effect of n-3 PUFA supplementation on endothelial function in COPD has not been previously investigated.

Purpose of the Study:

• To investigate the efficacy of n-3 PUFA supplementation in improving systemic endothelial function in patients with COPD.
• To conduct a pilot randomized, placebo-controlled, double-blind, phase 2 superiority trial.

Main Methods:

• Adults with moderate-to-severe stable COPD were randomized to receive daily high-dose fish oil (n-3 PUFA) or placebo for 6 months.
• The primary outcome measure was the percentage change in brachial artery flow-mediated dilation (FMD) from baseline to 6 months.
• Secondary endpoints included peripheral arterial tonometry, endothelial microparticles (EMPs), 6-minute walk distance, respiratory symptoms, and pulmonary function tests.

Main Results:

• Six-month supplementation with n-3 PUFAs did not significantly alter FMD compared to placebo (p=0.59).
• A significant increase in CD31+ EMPs was observed in the n-3 PUFA group (p=0.04).
• More participants in the n-3 PUFA group reported a clinically significant improvement in respiratory symptoms (St George's Respiratory Questionnaire score reduction ≥ 4 points) compared to placebo (p=0.01).

Conclusions:

• Six months of n-3 PUFA supplementation did not improve systemic endothelial function in individuals with COPD.
• Observed changes in EMPs and respiratory symptom scores suggest potential biological and clinical effects of n-3 PUFAs in COPD that merit further investigation.