Fish-derived lipids increase anti-inflammatory IL-10 in endometriosis, with mixed pain and QoL effects
Background
Endometriosis is a chronic, estrogen-dependent inflammatory disorder characterized by pain and immune dysregulation, often leading to significant reductions in quality of life. Current treatments frequently fall short in addressing the complex interplay of inflammation, metabolism, and pain pathways. Omega-3 (n-3) fatty acids and other fish-derived bioactive lipids are known for their potential to modulate inflammation and metabolic processes. This study aimed to investigate whether supplementing a healthy diet with these fish-derived lipids could improve inflammatory markers, gut inflammation, pain, and overall quality of life in affected women, addressing a key gap in adjunctive therapies.
Study Design
This 12-week randomized controlled trial involved 46 women with confirmed endometriosis. Participants were assigned to one of two groups: a control group (CG) receiving a Healthy Eating Plate diet alone, or an intervention group (IG) receiving the same diet supplemented with fish-derived lipids (FDLs). Primary outcomes included serum cytokine concentrations, specifically IL-1β, IL-6, IL-8, IL-10, and TNF-α, measured via ELISA. Fecal calprotectin levels were also assessed as a marker of gut inflammation. Secondary outcomes focused on pain intensity, quantified using the visual analog scale (VAS), and health-related quality of life, evaluated with the Endometriosis Health Profile-30 (EHP-30).
Results
The intervention group (IG) demonstrated a significant increase in anti-inflammatory IL-10 levels (pg/mL), rising from 32.5 ± 51.5 to 265 ± 508 (p = 0.024). An adjusted effect analysis (ANCOVA) further confirmed this increase, showing a 5.07-fold change (95% CI: 1.32-19.48, p = 0.019). Other measured cytokines exhibited heterogeneous responses, and fecal calprotectin levels remained unchanged across both groups. While EHP-30 Pain scores improved within both the CG (p = 0.016) and IG (p = 0.002), no significant between-group differences or adjusted effects were observed (all p > 0.05). Similarly, VAS scores decreased within the IG from 5.0 ± 2.1 to 4.3 ± 2.1 (p = 0.011), but again, no significant between-group differences were found in the overall change or ANCOVA (all p > 0.05).
Key Findings
- Fish-derived lipids (FDLs) significantly increased anti-inflammatory
IL-10levels in women with endometriosis (adjusted effect 5.07-fold, p = 0.019). - FDLs led to a 2.11x higher rate of
VASpain responders (≥1-point decrease) compared to control (73.9% vs. 34.8%, p = 0.014). VASpain scores decreased within the FDL group from 5.0 ± 2.1 to 4.3 ± 2.1 (p = 0.011).- No significant between-group differences were observed for overall
EHP-30pain scores orVASscore changes. - Other inflammatory cytokines and fecal
calprotectinlevels remained largely unchanged or showed heterogeneous responses.
Why It Matters
Fish-derived lipids may serve as a valuable adjunctive therapy for endometriosis by specifically targeting immune dysregulation and enhancing anti-inflammatory pathways. The significant increase in IL-10 suggests a direct immunomodulatory effect, which is crucial given the inflammatory nature of endometriosis. While overall pain and quality of life improvements were not universally significant, the 2.11x higher VAS responder rate in the FDL group indicates that a substantial subset of patients experienced clinically meaningful pain reduction. This finding suggests that FDLs could be integrated into existing protocols, potentially benefiting individuals whose pain is driven by specific inflammatory profiles. Future research should focus on identifying biomarkers to predict which patients are most likely to respond to FDL supplementation, optimizing dosing, and exploring combination therapies to maximize therapeutic impact.
endometriosis
fish-derived-lipids
omega-3
inflammation
il-10
pain