Atopic and non-atopic effects of fish oil supplementation during pregnancy
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Atopic and non-atopic effects of fish oil supplementation during pregnancy. / Bisgaard, Hans; Mikkelsen, Marianne; Rasmussen, Morten Arendt; Sevelsted, Astrid; Schoos, Ann Marie Malby; Brustad, Nicklas; Eliasen, Anders U.; Thorsen, Jonathan; Chawes, Bo; Gürdeniz, Gözde; Morin, Andreanne; Stark, Ken; Stokholm, Jakob; Ober, Carole; Pedersen, Casper Emil Tingskov; Bønnelykke, Klaus.
In: Thorax, Vol. 78, No. 12, 2023, p. 1168–1174.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Atopic and non-atopic effects of fish oil supplementation during pregnancy
AU - Bisgaard, Hans
AU - Mikkelsen, Marianne
AU - Rasmussen, Morten Arendt
AU - Sevelsted, Astrid
AU - Schoos, Ann Marie Malby
AU - Brustad, Nicklas
AU - Eliasen, Anders U.
AU - Thorsen, Jonathan
AU - Chawes, Bo
AU - Gürdeniz, Gözde
AU - Morin, Andreanne
AU - Stark, Ken
AU - Stokholm, Jakob
AU - Ober, Carole
AU - Pedersen, Casper Emil Tingskov
AU - Bønnelykke, Klaus
N1 - Publisher Copyright: © Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2023
Y1 - 2023
N2 - Background: We recently conducted a double-blinded randomised controlled trial showing that fish-oil supplementation during pregnancy reduced the risk of persistent wheeze or asthma in the child by 30%. Here, we explore the mechanisms of the intervention. Methods: 736 pregnant women were given either placebo or n-3 long-chain polyunsaturated fatty acids (LCPUFAs) in the third trimester in a randomised controlled trial. Deep clinical follow-up of the 695 children in the trial was done at 12 visits until age 6 years, including assessment of genotype at the fatty acid desaturase (FADS) locus, plasma fatty acids, airway DNA methylation, gene expression, microbiome and metabolomics. Results: Supplementation with n-3 LCPUFA reduced the overall risk of non-atopic asthma by 73% at age 6 (relative risk (RR) 0.27 (95% CI 0.06 to 0.85), p=0.042). In contrast, there was no overall effect on asthma with atopic traits (RR 1.42 (95% CI 0.63 to 3.38), p=0.40), but this was significantly modified by maternal FADS genotype and LCPUFA blood levels (interaction p<0.05), and supplementation did reduce the risk of atopic asthma in the subgroup of mothers with FADS risk variants and/or low blood levels of n-3 LCPUFA before the intervention (RR 0.31 (95% CI 0.11 to 0.75), p=0.016). Furthermore, n-3 LCPUFA significantly reduced the number of infections (croup, gastroenteritis, tonsillitis, otitis media and pneumonia) by 16% (incidence rate ratio 0.84 (95% CI 0.74 to 0.96), p=0.009). Conclusions: n-3 LCPUFA supplementation in pregnancy showed protective effects on non-atopic asthma and infections. Protective effects on atopic asthma depended on maternal FADS genotype and n-3 LCPUFA levels. This indicates that the fatty acid pathway is involved in multiple mechanisms affecting the risk of asthma subtypes and infections. Trial registration number: NCT00798226.
AB - Background: We recently conducted a double-blinded randomised controlled trial showing that fish-oil supplementation during pregnancy reduced the risk of persistent wheeze or asthma in the child by 30%. Here, we explore the mechanisms of the intervention. Methods: 736 pregnant women were given either placebo or n-3 long-chain polyunsaturated fatty acids (LCPUFAs) in the third trimester in a randomised controlled trial. Deep clinical follow-up of the 695 children in the trial was done at 12 visits until age 6 years, including assessment of genotype at the fatty acid desaturase (FADS) locus, plasma fatty acids, airway DNA methylation, gene expression, microbiome and metabolomics. Results: Supplementation with n-3 LCPUFA reduced the overall risk of non-atopic asthma by 73% at age 6 (relative risk (RR) 0.27 (95% CI 0.06 to 0.85), p=0.042). In contrast, there was no overall effect on asthma with atopic traits (RR 1.42 (95% CI 0.63 to 3.38), p=0.40), but this was significantly modified by maternal FADS genotype and LCPUFA blood levels (interaction p<0.05), and supplementation did reduce the risk of atopic asthma in the subgroup of mothers with FADS risk variants and/or low blood levels of n-3 LCPUFA before the intervention (RR 0.31 (95% CI 0.11 to 0.75), p=0.016). Furthermore, n-3 LCPUFA significantly reduced the number of infections (croup, gastroenteritis, tonsillitis, otitis media and pneumonia) by 16% (incidence rate ratio 0.84 (95% CI 0.74 to 0.96), p=0.009). Conclusions: n-3 LCPUFA supplementation in pregnancy showed protective effects on non-atopic asthma and infections. Protective effects on atopic asthma depended on maternal FADS genotype and n-3 LCPUFA levels. This indicates that the fatty acid pathway is involved in multiple mechanisms affecting the risk of asthma subtypes and infections. Trial registration number: NCT00798226.
KW - asthma
KW - respiratory infection
U2 - 10.1136/thorax-2022-219725
DO - 10.1136/thorax-2022-219725
M3 - Journal article
C2 - 37696621
AN - SCOPUS:85172396767
VL - 78
SP - 1168
EP - 1174
JO - Thorax
JF - Thorax
SN - 0040-6376
IS - 12
ER -
ID: 369212504