Published in the latest issue of the FASEB Journal, researchers from the University of California, Los Angeles (UCLA), and the Buck Institute for Research on Aging hypothesized that active ingestion (phagocytosis) of Ab1–42 peptides by macrophages (a type of white blood cell) prevents brain amyloidosis, and thus maintains cognition.
The hypothesis came from years of examining the underlying immunity-related defect of Alzheimer’s, and exploring immune approaches with lipid mediators to destruct Ab1–42. They examined the effects of omega-3 supplementation on macrophage phenotype, phagocytosis, and MMSE in patients with ‘subjective and objective defects in memory.’
Patients voluntarily taking ‘Smartfish’ nutritional drink
This study examined 18 patients with mild cognitive impairment who have voluntarily been taking a multi-target nutritional drink from Smartfish, a Norwegian nutrition company that provided the beverages as well as some funding for this study.
“Fifteen patients had the initial diagnosis of mild cognitive impairment…and 3 patients the diagnosis of subjective cognitive impairment, according to subjective complaints and subtle cognitive defects,” the researchers wrote.
The Smartfish beverage in the study was a 200ml emulsion containing 100mg DHA and 1000mg EPA in nano-sized emulsion droplets, both Pure arctic 360 by Denomega. It also contained 5g whey protein (Lacoprodan DI-7017 by Arla Foods), 0.2g lactose, 18g carbohydrate from pomegranate and chokeberry juice, 10μg vitamin D3 stabilized with tocopherol (DSM Nutritional Products), and 150mg resveratrol (resVida, DSM).
According to the researchers, this beverage was chosen because previous studies have shown its “success in controlled trials of behavioral problems and obesity management.”
Timeline and study design
The study was an observation of patients with mild cognitive impairment over the course of just under three years (2.9 months). Patients were examined at each clinic visit in 1-3 month intervals by testing macrophage type, level of Ab1–42 phagocytosis, and MMSE score.
Patient ages ranged from 54 to 88, and included both men and women, with various types and levels of cognitive impairment. In sum, baseline markers (MMSE score, phenotypes, etc.) were highly heterogeneous.
Results: Beverage made small improvement of cognitive level
The researchers wrote that the examination led to “clinically and statistically significant findings, but limited by the study design and low number of patients.”
Highlights include small improvement of cognitive level among patients with ApoE e3/e3 genotype (a 2.2 point increase in MMSE score), whereas patients with genotype ApoE e3/e4 did not change.
“These results are limited by the small sample size; lack of randomization design to omega-3s vs. a placebo; intermittent compliance with omega-3 supplementation due to travel by [three patients]; and diagnostic heterogeneity at baseline,” the researchers wrote.
However, they pressed that the results “suggest a new immulogic approach to the widespread public health problem of dementia,” as supplementation with omega-3 “brings into personalized clinical practice the immune benefits expected from v-3 mediators called resolvins, and the results suggest a relationship between the improvements of innate immunity and cognition.”
The researchers argued that these results are a pilot for larger controlled studies of omega-3 and cognitive impairment.
Source: The FASEB Journal
Published online, doi: 10.1096/fj.201600677RR
Increased intermediate M1-M2 macrophage polarization and improved cognition in mild cognitive impairment patients on v-3 supplementation
Authors: S. Famenini, et al