饮食和补充Omega-3多不饱和脂肪酸在缓解多发性硬化症患者慢性疲劳中的作用

Emiliya M. Ovcharova, M. Danovska, Diana L. Marinova, D. Pendicheva, P. Tonchev, Nicholas M. Shepherd
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摘要

多发性硬化症(Multiple sclerosis, MS)是一种慢性中枢神经系统自身免疫性脱髓鞘疾病,病因不明,多因素,临床症状多变,严重程度不一,治疗效果有限。作者得出结论,免疫系统在发病机制中起作用,许多现代治疗以免疫系统为靶点。在临床医生中,并不是每个患者都会以相同的方式发展,并且不同患者的MS临床病程之间存在很大的可变性。现代治疗方法已显示可减少新发病变和临床复发,但在阻止病变处潜在的神经退行性变、小范围局部炎症、慢性脱髓鞘以及轴突和神经元损伤方面缺乏有效性。膳食代谢物具有深远的全身性影响。有研究表明,饮食在帮助改变免疫系统功能、促进调节而不是炎症方面发挥着重要作用。多不饱和脂肪酸通过转化为抗炎前列腺素E1和E2来减少炎症,而抗炎前列腺素E1和E2会影响细胞因子的产生、白细胞的迁移和其他免疫系统成分。地中海式饮食是一种低饱和脂肪,高多不饱和脂肪和单不饱和脂肪,富含水果和蔬菜,低加工食品(低盐含量)的饮食。吃地中海式饮食有助于减轻疲劳(据患者报告),并有利于改变临床病程。
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Role of Diet and Supplementation with Omega-3 Polyunsaturated Fatty Acids for Managing Chronic Fatigue in Patients with Relapsing-Remitting Multiple Sclerosis
Summary Multiple sclerosis (MS) is a chronic autoimmune demyelinating disease of the central nervous system (CNS) with unclear and multifactorial etiology, variable clinical symptoms with different severity, and treatment with limited efficacy. Authors conclude that the immune system has a role in pathogenesis, and many modern therapies target the immune system. Among clinicians, it is accepted that not every patient will progress in the same way, and there is high variability between clinical courses of MS in different patients. Modern therapies have shown to reduce new lesions and clinical relapses but lack effectiveness at halting underlying neurodegeneration at lesions, the localized inflammation on a small scale, chronic demyelination, and axonal and neuronal damage. Dietary metabolites have far-reaching and systemic effects. It has been suggested that diet can play an essential role in helping to modify immune system function to promote regulation as opposed to inflammation. Polyunsaturated fatty acids decrease inflammation through conversion into anti-inflammatory prostaglandins E1 and E2, which affect cytokine production, leukocyte migration, and other immune system components. The Mediterranean style diet is a diet low in saturated fats, high in polyunsaturated and monounsaturated fats, rich in fruits and vegetables, and low in processed foods (low salt content). Eating a Mediterranean-style diet can help reduce fatigue (as reported by patients) and change the clinical course favorably.
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