The Role of Omega-3 on the IL-6 Levels, Malondialdehyde, and Clinical Improvement in Adults with Community-Acquired Pneumonia

Dewi Astarini, Jatu Aphridasari, Ana Rima Setijadi

Abstract


Background: Acute lung parenchymal infection, known as pneumonia, can be carried on by multiple microorganisms, including bacteria, viruses, fungi, and parasites. Globally, community-acquired pneumonia is a major factor of morbidity, mortality, and health issues. Malondialdehyde (MDA) is a marker of oxidative stress in pneumonia patients, and interleukin 6 (IL-6) is a marker of inflammatory process. Effect of Omega-3 as an immunomodulator, anti-inflammatory, and antioxidant may be implemented as adjunctive therapy in patient with community-acquired pneumonia.

Methods: Clinical trial research with a true experimental method and pretest-posttest design. The study involved 30 community-acquired pneumonia patients who were admitted at Moewardi Hospital in Surakarta and Dr. Soehadi Prijonegoro Hospital in Sragen from August to September 2022 by consecutive sampling. The control group (n=15) received standard therapy, and the treatment group (n=15) received standard therapy plus Omega-3 at a dose of 1600 mg/day. IL-6 and MDA levels were measured when the subject was admitted to the hospital and there was clinical improvement.

Results: There was a significant difference in reduced IL-6 levels (P=0.001), decreased MDA levels (P=0.001), and the duration of clinical improvement (P=0.042) between the treatment group and the control group. There was a moderate correlation between the decrease in IL-6 (R=0.480) and MDA (R=0.459), while the duration of clinical improvement had a strong correlation (R=0.756) in the treatment group.

Conclusion: Supplementation of Omega-3 was effective in reducing IL-6, MDA levels, and the duration of clinical improvement in community-acquired pneumonia patients.


Keywords


Community-acquired pneumonia; CAP; Pneumonia

Full Text:

PDF

References


Koul P, Chaudhari S, Chokhani R, Christopher D, Dhar R, Doshi K, et al. Pneumococcal disease burden from an Indian perspective: Need for its prevention in pulmonology practice. Lung India. 2019;36(3):216–25.

Tejada S, Romero A, Rello J. Community-acquired pneumonia in adults: What’s new focusing on epidemiology, microorganisms and diagnosis? Erciyes Medical Journal. 2018;40(4):177–83.

Jindal SK, Guleria R. Epidemiology and risk factors of pneumonia. In: Jindal SK, Guleria R, editors. World clinics: Pulmonary & critical care medicine: Pneumonias. New Delhi: JP Medical Ltd; 2013. p. 1–11.

Cillóniz C, Cardozo C, García-Vidal C. Epidemiology, pathophysiology, and microbiology of communityacquired pneumonia. Ann Res Hosp. 2018;2(1):1–1.

Rombauts A, Abelenda-Alonso G, Cuervo G, Gudiol C, Carratalà J. Role of the inflammatory response in community-acquired pneumonia: Clinical implications. Expert Rev Anti Infect Ther. 2022;20(10):1261–74.

Gammone MA, Riccioni G, Parrinello G, D’orazio N. Omega-3 polyunsaturated fatty acids: Benefits and endpoints in sport. Nutrients. 2019;11(1):46.

Sarkar K, Sil PC. Infectious lung diseases and endogenous oxidative stress. Oxidative Stress in Lung Diseases. 2019;1:125–48.

Mao C, Yuan JQ, Lv Y Bin, Gao X, Yin ZX, Kraus VB, et al. Associations between superoxide dismutase, malondialdehyde and all-cause mortality in older adults: A community-based cohort study. BMC Geriatr. 2019;19(1):1–9.

Xu W, Zhao T, Xiao H. The implication of oxidative stress and AMPK-Nrf2 antioxidative signaling in pneumonia pathogenesis. Front Endocrinol (Lausanne). 2020;11:400.

Ghadiri M, Yung AE, Haghi M. Role of oxidative stress in complexity of respiratory diseases. Role of Oxidative Stress in Pathophysiology of Diseases. 2020;67–92.

Ishihara T, Yoshida M, Arita M. Omega-3 fatty acid-derived mediators that control inflammation and tissue homeostasis. Int Immunol. 2019;31(9):559–67.

Hinojosa CA, Gonzalez-Juarbe N, Rahman MM, Fernandes G, Orihuela CJ, Restrepo MI. Omega-3 fatty acids in contrast to omega-6 protect against pneumococcal pneumonia. Microb Pathog. 2020;141:103979.

Voufo RA, Kouotou AE, Tatah NJ, TeTo G, Gueguim C, Ngondé CME, et al. Relation between interleukin-6 concentrations and oxidative status of HIV infected patients with /or at risk of Kaposi disease in Yaounde. Virol J. 2023;20(1):1–8.

Neganova M, Liu J, Aleksandrova Y, Klochkov S, Fan R. Therapeutic Influence on Important Targets Associated with Chronic Inflammation and Oxidative Stress in Cancer Treatment. Cancers (Basel). 2021;13(23):6062.

Arab Sadeghabadi Z, Abbasalipourkabir R, Mohseni R, Ziamajidi N. Investigation of oxidative stress markers and antioxidant enzymes activity in newly diagnosed type 2 diabetes patients and healthy subjects, association with IL-6 level. J Diabetes Metab Disord. 2019;18(2):437–43.

Hirano T. IL-6 in inflammation, autoimmunity and cancer. Int Immunol. 2021;33(3):127–48.

Ramirez JA, Wiemken TL, Peyrani P, Arnold FW, Kelley R, Mattingly WA, et al. Adults hospitalized with pneumonia in the United States: Incidence, epidemiology, and mortality. Clin Infect Dis. 2017;65(11):1806–12.

Perhimpunan Dokter Paru Indonesia. Pneumonia komunitas. In: Pneumonia komunitas: Pedoman diagnosis dan penatalaksanaan di Indonesia. 2nd ed. Jakarta: FKUI; 2014. p. 3–37.

Satici C, Demirkol MA, Sargin Altunok E, Gursoy B, Alkan M, Kamat S, et al. Performance of pneumonia severity index and CURB-65 in predicting 30-day mortality in patients with COVID-19. Int J Infect Dis. 2020;98:84–9.

Baskaran V, Murray RL, Hunter A, Lim WS, McKeever TM. Effect of tobacco smoking on the risk of developing community acquired pneumonia: A systematic review and meta-analysis. PLoS One. 2019;14(7):e0220204.

Zhou J, He W, Liang J, Wang L, Yu X, Bao M, et al. Association of interleukin-6 levels with morbidity and mortality in patients with coronavirus disease 2019 (COVID-19). Jpn J Infect Dis. 2021;74(4):293–8.

Liu F, Li L, Xu M Da, Wu J, Luo D, Zhu YS, et al. Prognostic value of interleukin-6, C-reactive protein, and procalcitonin in patients with COVID-19. J Clin Virol. 2020;127.

Khattab AA, El-Mekkawy MS, Shehata AM, Whdan NA. Clinical study of serum interleukin-6 in children with community-acquired pneumonia. Egyptian Pediatric Association Gazette. 2018;66(2):43–8.

Andrijevic I, Matijasevic J, Andrijevic L, Kovacevic T, Zaric B. Interleukin-6 and procalcitonin as biomarkers in mortality prediction of hospitalized patients with community acquired pneumonia. Ann Thorac Med. 2014;9(3):162–7.

Yudhawati R, Yuniawati E. Correlation of serum interleukin-6 level and pneumonia severity index score in patient with community-acquired pneumonia. Journal of Advanced Pharmacy Education and Research. 2021;11(3):58–62.

Faizah AK, Kresnamurti A. Evaluation of antiinflammatory activity of marine omega-3 in rats. Indonesian Journal of Pharmaceutical and Clinical Research. 2019;2(2):1–5.

Gutiérrez S, Svahn SL, Johansson ME. Effects of omega-3 fatty acids on immune cells. Int J Mol Sci. 2019;20(20):5028.

Doaei S, Gholami S, Rastgoo S, Gholamalizadeh M, Bourbour F, Bagheri SE, et al. The effect of omega-3 fatty acid supplementation on clinical and biochemical parameters of critically ill patients with COVID-19: A randomized clinical trial. J Transl Med. 2021;19(1):128.

Cui X, Gong J, Han H, He L, Teng Y, Tetley T, et al. Relationship between free and total malondialdehyde, a well-established marker of oxidative stress, in various types of human biospecimens. J Thorac Dis. 2018;10(5):3088–197.

Marrocco I, Altieri F, Peluso I. Measurement and clinical significance of biomarkers of oxidative stress in humans. Oxid Med Cell Longev. 2017;2017.

Koyuncu P, Koyuncu A, Ülkar SE. Evaluation of nitric oxide metabolism and malondialdehyde levels as an indicator of oxidant stress in malign and parapneumonic pleural effusion. Journal of Surgery and Medicine. 2021;5(3):311–4.

Buonocore D, Verri M, Giolitto A, Doria E, Ghitti M, Dossena M. Effect of 8-week n-3 fatty-acid supplementation on oxidative stress and inflammation in middle- and long-distance running athletes: A pilot study. J Int Soc Sports Nutr. 2020;17(1):55.

Heshmati J, Morvaridzadeh M, Maroufizadeh S, Akbari A, Yavari M, Amirinejad A, et al. Omega-3 fatty acids supplementation and oxidative stress parameters: A systematic review and meta-analysis of clinical trials. Pharmacol Res. 2019;149:104462.

Sharma S, Chhibber S, Mohan H, Sharma S. Dietary supplementation with omega-3 polyunsaturated fatty acids ameliorates acute pneumonia induced by Klebsiella pneumoniae in BALB/c mice. Can J Microbiol. 2013;59(7):503–10.

Lima Rocha JÉ, Mendes Furtado M, Mello Neto RS, da Silva Mendes AV, Brito AK da S, Sena de Almeida JOC, et al. Effects of fish oil supplementation on oxidative stress biomarkers and liver damage in hypercholesterolemic rats. Nutrients. 2022;14(3):426.

Meiyanti M, Yohana , Margo E, Chudri J, Pusparini ,, Faradilla MA. Factors associated with plasma malondialdehyde levels in people over 40 years. Journal of Drug Delivery and Therapeutics. 2023;13(7):52–6.

Suhartika E, Amir Z, Sinaga BYM, Eyanoer PC. Perbedaan kadar malondialdehid (MDA) Dalam darah pasien tuberkulosis paru dengan penyakit diabetes melitus, tuberkulosis paru tanpa diabetes melitus dan orang sehat di Medan. Jurnal Respirologi Indonesia. 2014;34(1):219–24.

Mas-Bargues C, Escrivá C, Dromant M, Borrás C, Viña J. Lipid peroxidation as measured by chromatographic determination of malondialdehyde. Human plasma reference values in health and disease. Arch Biochem Biophys. 2021;709:108941.




DOI: https://doi.org/10.36497/jri.v44i1.402

Refbacks

  • There are currently no refbacks.




Copyright (c) 2024 Dewi Astarini, Jatu Aphridasari, Ana Rima Setijadi


INDEXING & PARTNER

SINTA Garuda Indonesian Scientific Journal Database (ISJD) Indonesia One Search (IOS) Crossref

ROAD-ISSN Dimensions Google Scholar 

 

Jurnal Respirologi Indonesia
pISSN: 0853-7704 - eISSN: 2620-3162
Address: Jalan Cipinang Bunder No. 19, Cipinang, Pulogadung, Jakarta Timur, DKI Jakarta 13240, Indonesia
Phone: +62-21-2247-4845
Email: editor@jurnalrespirologi.org


An official publication by
the Indonesian Society of Respirology (ISR)

Creative Commons License
Creative Commons Attribution-NonCommercial 4.0 International License

Statcounter