Effects of omega-3 supplementation on telomere length, inflammation, and oxidative stress in women with systemic lupus erythematosus: Protocol for a randomized double-blind placebo-controlled trial

IF 0.3 Q4 NUTRITION & DIETETICS

CAHIERS DE NUTRITION ET DE DIETETIQUE Pub Date : 2026-08-01 Epub Date: 2026-09-24 DOI:10.1016/j.cnd.2026.08.072

Beatriz G. Carvalho, Eduardo F. Borba, Marcelo M. Rogero, Carolina F. Nicoletti

{"title":"Effects of omega-3 supplementation on telomere length, inflammation, and oxidative stress in women with systemic lupus erythematosus: Protocol for a randomized double-blind placebo-controlled trial","authors":"Beatriz G. Carvalho, Eduardo F. Borba, Marcelo M. Rogero, Carolina F. Nicoletti","doi":"10.1016/j.cnd.2026.08.072","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by persistent inflammation, oxidative stress, immune dysregulation, and accelerated cellular aging. Telomere shortening has been associated with disease progression and immunosenescence in SLE. Omega-3 polyunsaturated fatty acids (PUFAs), particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), may exert anti-inflammatory and antioxidant effects; however, their impact on telomere biology in women with SLE remains unclear.</div></div><div>Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by persistent inflammation, oxidative stress, immune dysregulation, and accelerated cellular aging. Telomere shortening has been associated with disease progression and immunosenescence in SLE. Omega-3 polyunsaturated fatty acids (PUFAs), particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), may exert anti-inflammatory and antioxidant effects; however, their impact on telomere biology in women with SLE remains unclear.</div><div><h3>Objective</h3><div>To evaluate the effects of omega-3 supplementation on leukocyte telomere length, inflammatory pathways, and oxidative stress biomarkers in women with SLE in remission.</div></div><div>To evaluate the effects of omega-3 supplementation on leukocyte telomere length, inflammatory pathways, and oxidative stress biomarkers in women with SLE in remission.</div><div><h3>Methods</h3><div>This study is a randomized, double-blind, placebo-controlled, parallel-group clinical trial involving women aged 18–45 years with SLE in remission and healthy controls. Participants will be randomized (1:1) to receive either omega-3 supplementation (3,600mg/day EPA+DHA) or placebo for 12 weeks. The primary outcome is relative leukocyte telomere length, assessed by quantitative PCR using the telomere-to-single-copy gene (T/S) ratio. Secondary outcomes include inflammatory signaling pathways in peripheral blood mononuclear cells, oxidative stress biomarkers, antioxidant capacity, disease activity, anthropometric parameters, dietary intake, and physical activity. Outcomes will be assessed at baseline and after the intervention. The study was approved by the local Ethics Committee (CAAE: 92044025.6.0000.0068) and registered at ClinicalTrials.gov (<span><span>NCT07393399</span><svg><path></path></svg></span>).</div></div><div>This study is a randomized, double-blind, placebo-controlled, parallel-group clinical trial involving women aged 18–45 years with SLE in remission and healthy controls. Participants will be randomized (1:1) to receive either omega-3 supplementation (3,600mg/day EPA+DHA) or placebo for 12 weeks. The primary outcome is relative leukocyte telomere length, assessed by quantitative PCR using the telomere-to-single-copy gene (T/S) ratio. Secondary outcomes include inflammatory signaling pathways in peripheral blood mononuclear cells, oxidative stress biomarkers, antioxidant capacity, disease activity, anthropometric parameters, dietary intake, and physical activity. Outcomes will be assessed at baseline and after the intervention. The study was approved by the local Ethics Committee (CAAE: 92044025.6.0000.0068) and registered at ClinicalTrials.gov (<span><span>NCT07393399</span><svg><path></path></svg></span>).</div><div><h3>Preliminary results</h3><div>Before supplementation, women with SLE presented significantly shorter leukocyte telomere length than healthy controls (T/S ratio: 1.126±0.080 vs. 1.170±0.076; <em>P</em>        <0.001) and erythrocyte sedimentation rate of 25.34±16.98 versus 6.25±1.09mm/h (<em>P</em>      <0.001). Based on these findings, we expect that 12 weeks of omega-3 supplementation (3,600mg/day EPA+DHA) will improve inflammatory and oxidative stress biomarkers while preserving leukocyte telomere length compared with placebo.</div></div><div>Before supplementation, women with SLE presented significantly shorter leukocyte telomere length than healthy controls (T/S ratio: 1.126±0.080 vs. 1.170±0.076; <em>P</em>        <0.001) and erythrocyte sedimentation rate of 25.34±16.98 versus 6.25±1.09mm/h (<em>P</em>      <0.001). Based on these findings, we expect that 12 weeks of omega-3 supplementation (3,600mg/day EPA+DHA) will improve inflammatory and oxidative stress biomarkers while preserving leukocyte telomere length compared with placebo.</div><div><h3>Conclusion</h3><div>This trial may provide novel insights into the role of omega-3 supplementation as an adjunct nutritional strategy targeting inflammation, oxidative stress, and cellular aging in SLE.</div></div><div>This trial may provide novel insights into the role of omega-3 supplementation as an adjunct nutritional strategy targeting inflammation, oxidative stress, and cellular aging in SLE.</div>","PeriodicalId":43722,"journal":{"name":"CAHIERS DE NUTRITION ET DE DIETETIQUE","volume":"61 ","pages":"Pages e39-e40"},"PeriodicalIF":0.3000,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"CAHIERS DE NUTRITION ET DE DIETETIQUE","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0007996026001483","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/9/24 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by persistent inflammation, oxidative stress, immune dysregulation, and accelerated cellular aging. Telomere shortening has been associated with disease progression and immunosenescence in SLE. Omega-3 polyunsaturated fatty acids (PUFAs), particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), may exert anti-inflammatory and antioxidant effects; however, their impact on telomere biology in women with SLE remains unclear.

Objective

To evaluate the effects of omega-3 supplementation on leukocyte telomere length, inflammatory pathways, and oxidative stress biomarkers in women with SLE in remission.

Methods

This study is a randomized, double-blind, placebo-controlled, parallel-group clinical trial involving women aged 18–45 years with SLE in remission and healthy controls. Participants will be randomized (1:1) to receive either omega-3 supplementation (3,600 mg/day EPA + DHA) or placebo for 12 weeks. The primary outcome is relative leukocyte telomere length, assessed by quantitative PCR using the telomere-to-single-copy gene (T/S) ratio. Secondary outcomes include inflammatory signaling pathways in peripheral blood mononuclear cells, oxidative stress biomarkers, antioxidant capacity, disease activity, anthropometric parameters, dietary intake, and physical activity. Outcomes will be assessed at baseline and after the intervention. The study was approved by the local Ethics Committee (CAAE: 92044025.6.0000.0068) and registered at ClinicalTrials.gov (NCT07393399).

Preliminary results

Before supplementation, women with SLE presented significantly shorter leukocyte telomere length than healthy controls (T/S ratio: 1.126 ± 0.080 vs. 1.170 ± 0.076; P = 0.001). Baseline inflammatory markers were also elevated, with C-reactive protein of 5.87 ± 9.03 mg/dL versus 0.23 ± 0.04 mg/dL (P < 0.001) and erythrocyte sedimentation rate of 25.34 ± 16.98 versus 6.25 ± 1.09 mm/h (P < 0.001). In contrast, baseline total oxidant status (TOS) was 2.32 ± 1.38 vs. 2.58 ± 1.096 (P < 0.001). Based on these findings, we expect that 12 weeks of omega-3 supplementation (3,600 mg/day EPA + DHA) will improve inflammatory and oxidative stress biomarkers while preserving leukocyte telomere length compared with placebo.

Conclusion

This trial may provide novel insights into the role of omega-3 supplementation as an adjunct nutritional strategy targeting inflammation, oxidative stress, and cellular aging in SLE.

查看原文本刊更多论文

补充omega-3对女性系统性红斑狼疮患者端粒长度、炎症和氧化应激的影响：随机双盲安慰剂对照试验方案

系统性红斑狼疮（SLE）是一种慢性自身免疫性疾病，以持续炎症、氧化应激、免疫失调和细胞加速老化为特征。端粒缩短与SLE的疾病进展和免疫衰老有关。Omega-3多不饱和脂肪酸（PUFAs），特别是二十碳五烯酸（EPA）和二十二碳六烯酸（DHA），可能具有抗炎和抗氧化作用；然而，它们对女性SLE患者端粒生物学的影响尚不清楚。系统性红斑狼疮（SLE）是一种以持续炎症、氧化应激、免疫失调和细胞加速老化为特征的慢性自身免疫性疾病。端粒缩短与SLE的疾病进展和免疫衰老有关。Omega-3多不饱和脂肪酸（PUFAs），特别是二十碳五烯酸（EPA）和二十二碳六烯酸（DHA），可能具有抗炎和抗氧化作用；然而，它们对女性SLE患者端粒生物学的影响尚不清楚。目的评估补充omega-3对缓解期SLE患者白细胞端粒长度、炎症途径和氧化应激生物标志物的影响。评估补充omega-3对缓解期SLE患者白细胞端粒长度、炎症途径和氧化应激生物标志物的影响。方法：本研究是一项随机、双盲、安慰剂对照、平行组临床试验，纳入18-45岁SLE缓解期女性患者和健康对照组。参与者将随机（1:1）接受omega-3补充剂（3600毫克/天EPA + DHA）或安慰剂，为期12周。主要结果是相对白细胞端粒长度，通过使用端粒与单拷贝基因（T/S）比率的定量PCR评估。次要结局包括外周血单核细胞中的炎症信号通路、氧化应激生物标志物、抗氧化能力、疾病活动性、人体测量参数、饮食摄入和身体活动。结果将在基线和干预后进行评估。该研究已获得当地伦理委员会批准（CAAE: 92044025.6.0000.0068），并在ClinicalTrials.gov注册（NCT07393399）。本研究是一项随机、双盲、安慰剂对照、平行组临床试验，涉及18-45岁SLE缓解期女性和健康对照组。参与者将随机（1:1）接受omega-3补充剂（3600毫克/天EPA + DHA）或安慰剂，为期12周。主要结果是相对白细胞端粒长度，通过使用端粒与单拷贝基因（T/S）比率的定量PCR评估。次要结局包括外周血单核细胞中的炎症信号通路、氧化应激生物标志物、抗氧化能力、疾病活动性、人体测量参数、饮食摄入和身体活动。结果将在基线和干预后进行评估。该研究已获得当地伦理委员会批准（CAAE: 92044025.6.0000.0068），并在ClinicalTrials.gov注册（NCT07393399）。初步结果补充前，SLE女性白细胞端粒长度明显短于健康对照组（T/S比：1.126±0.080∶1.170±0.076;P = 0.001）。基线炎症标志物也升高，c反应蛋白为5.87±9.03 mg/dL，而非0.23±0.04 mg/dL (P < 0.001)，红细胞沉降率为25.34±16.98，而非6.25±1.09 mm/h （P < 0.001）。相比之下，基线总氧化状态（TOS）为2.32±1.38 vs. 2.58±1.096 （P < 0.001）。基于这些发现，我们预计与安慰剂相比，12周的omega-3补充（3600毫克/天EPA + DHA）将改善炎症和氧化应激生物标志物，同时保持白细胞端粒长度。在补充前，SLE女性的白细胞端粒长度明显短于健康对照组（T/S比：1.126±0.080∶1.170±0.076;P = 0.001）。基线炎症标志物也升高，c反应蛋白为5.87±9.03 mg/dL，而非0.23±0.04 mg/dL (P < 0.001)，红细胞沉降率为25.34±16.98，而非6.25±1.09 mm/h （P < 0.001）。相比之下，基线总氧化状态（TOS）为2.32±1.38 vs. 2.58±1.096 （P < 0.001）。基于这些发现，我们预计与安慰剂相比，12周的omega-3补充（3600毫克/天EPA + DHA）将改善炎症和氧化应激生物标志物，同时保持白细胞端粒长度。结论：本试验可能为补充omega-3作为针对SLE炎症、氧化应激和细胞衰老的辅助营养策略的作用提供新的见解。该试验可能为补充omega-3作为针对SLE炎症、氧化应激和细胞衰老的辅助营养策略的作用提供新的见解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

CAHIERS DE NUTRITION ET DE DIETETIQUE NUTRITION & DIETETICS-

CiteScore

0.60

自引率

33.30%

发文量

审稿时长

65 days

期刊介绍： Les Cahiers de nutrition et de diététique sont le lieu de communication reconnu pour les médecins spécialistes de la nutrition, les diététiciens, les professionnels et les chercheurs de agro-alimentaire, les enseignants et les étudiants. Les Cahiers de nutrition et de diététique abordent les sujets se rapportant à la biologie générale, à la médecine et à la nutrition, aux aliments, aux comportements alimentaires, à la diététique pratique, ainsi que des thèmes variés : activité physique, apports nutritionnels conseillés, dénutrition, alcool, obésité de enfant, aliments à effet santé, plaisir alimentaire, restauration collective, goûters et collations, allergies alimentaires...