Dr. Puri on Omega Fatty Acids to fight Viral Activity
The next part of the Phoenix Rising newsletter dealt with Dr. Puri's findings.
Using LRT As An Antiviral Therapy in the U.K. by Cort Johnson
- Puri, B. 2006. Long chain polyunsaturated fatty acids and the path of physiology of myalgic encephalitis (chronic fatigue syndrome). Journal of Clinical Pathology
- Puri, B. 2004. The use of eicosapentaenoic acid in the treatment of chronic fatigue syndrome. Prostaglandins, Leukotrienes, and essential fatty acids 70, 399-401.
- Puri, B., Holmes, J., and G. Hamilton. 2004. Eicosapentaenoic acid-rich fatty acid supplementation in chronic fatigue syndrome associated with symptom remission and structural brain changes. Int J . Clin Pract 58, 297-299.
- Puri, B. 2003. The clinical advantages of cold-pressed non-raffinated evening primrose oil over refined preparations. Medical Hypotheses 62, 116-118.
- Puri, B., Counsel, S., Hamilton, G., Richardson, A., Horrobin, D. 2001. Eicosapentaenoic acid in treatment resistant depression associated with symptom remission, structural brain changes and reduced neuronal phospholipids turnover. IJCP 55, 56-564.
Dr. Basant Puri of Hammermith Hospital in London has published a series of short papers on the effects of fatty acid (lipid) supplementation in chronic fatigue syndrome and other diseases over the past several years. He has also published a book on CFS that outlines for the public his research and treatment plans for CFS. A pioneer in the use of NMR brain scans in CFS, he believes his (and others) findings of increased choline levels in the cerebral cortex and basal ganglia of CFS patients probably indicate a central nervous system infection is present. (see Choline on the Brain).
Dr. Puri believes these high choline levels reflect viral interference with the enzyme responsible for putting together the lipids found in our membranes. These phospholipids should have either N-6 or N-3 longchain polyunsaturated fatty acids should be attached to them. If I am reading this correctly, a polar head made up of choline, serine, or inositol should be attached at the end of these phospholipids chains.
The enzyme used to synthesize the N-6 and N-3 polyunsaturated acids (delta-6-desaturase) can, however, be inhibited by viruses. Dr. Puri believes that viral activity in the central nervous system of CFS patients leaves choline molecules that would otherwise be attached to these polyunsaturated chains free, and it is these free choline particles are being picked that by these brain scans. This, of course, also suggests that the cellular membranes in these areas may have lower than normal levels of essential fatty acids.
Interestingly, gene expression studies of infectious mononucleosis patients who came down with CFS found that over half of the genes that were overexpressed in these patients were involved in fatty acid metabolism and mitochondrial functioning. The pathogen under discussion, EBV, actually uses one of the fatty acids in our cellular membranes to replicate.
Consequences of low fatty acid levels - why is it important to have adequate levels of polyunsaturated fatty acids in our cellular membranes? It turns out that not all lipids are the same; some lipids are more apt to promote an inflammatory reaction than others. The fatty acid evening primrose oil (EPO) is rich in, for instance, y-linolenic acid, is less likely to be transformed into arachidonic acid (AA) which sits at the beginning of the inflammatory reaction.
Building up levels of good lipids that are less likely to be converted to AA could therefore lead to reduced inflammation, oxidative stress, immune activation, etc. Dr. Puri believes this could explain why EPO was reported to be helpful in rheumatoid arthritis patients. Interestingly, the y-linolenic or good fatty acid pathway appears to be inhibited in many chronic diseases including viral infections, diabetes, and cardiovascular diseases, as well as aging.
Dr. Puris protocol, then, helps CFS patients recover from the damage caused by viral activity in their central nervous system by providing the essential fatty acids the viruses inhibit; it does not bring a halt to the viral activity.
The Omega 3 Fatty Acids From Wikipedia
Omega-3 fatty acids are polyunsaturated fatty acids classified as essential because they cannot be synthesized in the body and must be obtained from food. Important omega-3 fatty acids in human nutrition are: α-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). Eicosapentaenoic acid is an omega 3 fatty acid found in fish oils of cod liver, herring, mackerel, salmon, menhaden and sardine.
In 1963 it was discovered that the omega-6 arachidonic acid is converted by the body into pro-inflammatory agents called prostaglandins. By 1979 researchers had discovered prostaglandins are also converted into what are now known as eicosanoids (thromboxanes, prostacyclins and the leukotrienes). The eicosanoids, which have important biological functions, typically have a short active lifetime in the body. However if the rate of synthesis exceeds the rate of metabolism, the excess eicosanoids may have deleterious effects.
Researchers found that omega-3 is also converted into eicosanoids, but at a much slower rate. If both omega-3 and omega-6 are present, they will "compete" to be transformed, so the amount of omega-3 present is directly related to a decrease in the rate of eicosanoid production.
This competition was recognized as important when it was found that thromboxane one of the eicosanoids - is a factor in the clumping of platelets, which leads to thrombosis. The leukotrienes were similarly found to be important in immune/inflammatory-system response, and therefore relevant to arthritis, lupus, and asthma.
These discoveries led to greater interest in finding ways to control the synthesis of omega-6 eicosanoids; one way being, of course, the consumption of greater amounts of foods high in omega-3 fatty acids.
The western diet is heavily skewed towards Omega 6 fatty acid consumption. For more of what appears to be a pretty good discussion of the pros and cons of omega 3/omega 6 consumption see the rest of the Wikipedia article
http://en.wikipedia.org/wiki/Omega-3_fatty_acid
This is not, however, the end of the LRT story. Dr. Puris analyses of unrefined
evening primrose oil, a source of omega 6 fatty acids, indicate that it contains substances called tripertenes are a) free radical scavengers, and b) inhibit two inflammatory enzymes called cyclo-oxygenase and neutrophil elastase.
EPO supplementation, then, appears to be able to reduce inflammation in several ways; by repairing cell membrane damage, by building healthy cell membranes that are less likely to initiate the inflammatory processs when injured, by reducing free radical levels and by inhibiting the inflammatory enzymes.
The Treatment Regime - Dr. Puri uses high-dose eicosapentaeonic (EP) fatty acid supplementation in CFS (10-12 capsules of eye q; 930 mg. EPA (omega 3), 290 mg. docahexanoic acid (omega 6), 100 mg. gamma linolenic acid (omega 6) + 16 mg. Vit. E daily. The sources of these fatty acids are fish oils (omega 3s) and unrefined, cold pressed evening primrose oil (omega 6).
Treatment results - one CFS patient with high fatigue, poor sleep, muscle pain, and low mood who was almost totally confined to a wheelchair after six years of CFS began to go into remission about six to eight weeks into the program. At 16 weeks her depression score had dropped from 27 to 3 (!) and she reported that her sleep was much improved. Her muscle pain, however, was unchanged.
Comments from a group of four CFS patients after 12 weeks of therapy ranged from the startling the fogginess of the brain was gone completely and the for the first time a feeling of well being was experienced to the beneficial I am able to communicate during a relapse.
Dr. Puri also tells a remarkable story of a 20 year old who in the seven years after the appearance of his depressive symptoms, had not only not responded to anti-depressants, antipsychotics, lithium, paroxetine and hypnosis but had over time become severely suicidal. One month after starting 4 g of eicosapentoaenoic acid a day his unceasing suicidal thoughts had disappeared. Nine months later all his symptoms had disappeared, his depression rating, formerly at 32, was now zero and a brain scan indicated that substantial changes had occurred.
Like the other treatments discussed in the edition Eye Q does not appear to cure CFS but its use may help ameliorate the symptoms of CFS.
Eye Q is made by a U.K. company, Equazen. It contains high levels of omega 3 and low levels of omega 6 fatty acids (from evening primrose oil) as well as an antioxidant, vitamin E. You can learn more about Eye Q at
http://www.equazen.com/default.aspx?pid=23
