E-EPA in ulcerative colitis

Omega-3 fatty acids have been suggested as a treatment for ulcerative colitis (UC). However, the efficacy of Omega-3 against UC has not been examined in children. Therefore, the Japanese authors investigated the effects of E-EPA on fatty acid composition and leukotriene (LT) production in children with UC.
For 2 months the authors administered highly purified EPA ethyl ester (E-EPA) (1.8 g/d) to children with UC in remission. Colonic mucosal histology, fatty acid composition of erythrocyte membrane phospholipids, and LTB4 production by leukocytes and colonic mucosa were measured before and 2 months after the initiation of EPA-E treatment.
No patients relapsed during the study period, and no significant differences were detected in laboratory findings obtained before and 2 months after the initiation of E-EPA ingestion. There were no significant differences in mucosal histologic scores before and 2 months after E-EPA treatment. The EPA levels in erythrocyte membranes 2 months after the initiation of E-EPA treatment were significantly higher than before treatment, but the other fatty acids showed no significant changes. LTB4 production by leukocytes and rectal mucosa after 2 months of E-EPA treatment was significantly lower than before treatment.
E-EPA treatment increased the levels of EPA in erythrocytes and decreased LTB4 levels produced by leukocytes and colonic mucosa. To assess the concomitant clinical changes, we should examine the long-term effects of EPA-E ingestion on the maintenance of remission in children with UC.

In an accompanying editorial, professor Ángel Gil (University of Granada, Spain) stresses that E-EPA is an efficient and well-tolerated treatment for ulceratice colitis in children. E-EPA seems to be safer as the current pharmacological therapy.