Essential fatty acid deficiency profiles in idiopathic immunoglobulin A nephropathy

The profiles of fatty acids (FAs) of plasma phospholipids (the compartment reflecting the essential FA status of tissue lipids), nonesterified FAs (the precursor pool for autacoid synthesis), urine protein excretion, and glomerular filtration rate were measured before and after supplementation with fish oil in 15 patients with immunoglobulin A nephropathy. In the FA profiles, there was deficient 18:3 omega 3 (alpha-linolenic acid), the parent compound of omega 3 polyunsaturated FA, and deficient chain elongation products of both omega 3 and omega 6 polyunsaturated FAs with replacement by saturated and monounsaturated short-chain, odd-chain, and branched-chain FAs, producing significant loss of omega 3 FA. These alterations indicate nutritional or functional (omega 3) and metabolic (omega 6) deficiencies. Additionally, the mean melting point of the FAs was significantly increased, implying an inherent decrease in cell membrane fluidity. Enhancement of 20: 5 omega 3 (eicosapentaenoic acid) and 22:6 omega 3 (docosahexaenoic acid) and suppression of 20:4 omega 6 (arachidonate) after supplementation with fish oil were accompanied by important decreases in proteinuria and improved glomerular filtration rate. Omega-3 polyunsaturated FAs may favorably influence immunoglobulin A nephropathy through a modulation of the pathologic actions of the omega 6 eicosanoids and other diverse actions on various mediators produced by an initial immune injury.