Retinopathy of prematurity (ROP) and arachidonic acid
- Retinopathy of prematurity (ROP) is associated with low level of arachidonic acid (omega-6) in children.
- Providing children with arachidonic acid will raise the levels and reduce the risk of retinopathy of prematurity.
- Retinopathy of prematurity is an eye disease that occurs among premature babies.
A clear link between retinopathy of prematurity (ROP) and low levels of the fatty acid arachidonic acid has been found by recent research at the Sahlgrenska Academy, Sweden.
Their findings give hope for a new way to protect extremely premature babies from impaired vision or blindness resulting from the eye disease retinopathy of prematurity (ROP).
‘According to this research, blindness in premature babies (retinopathy of prematurity) is associated with low level of arachidonic acid (omega-6). Providing children with sufficient amount of omega-6 could reduce the risk of retinopathy of prematurity.’
"Seeing such a strong connection between arachidonic acid levels and ROP is something that is entirely new. However we looked at the data, it's always low levels of arachidonic acid that is most clearly associated with the disease," says Chatarina Löfqvist, an associate professor in experimental ophthalmology and the first author of the article.
"What we believe and hope is that providing the children with arachidonic acid will raise the levels and reduce the amount of ROP to minimize the risk of children becoming blind," she continues.
Every year thousands of children in Sweden are screened for ROP, a disease that afflicts extremely premature babies whose retinal blood vessels have not fully developed. The children can be visually impaired, and in the worst cases become blind, due to retinal detachment.
Level of arachidonic acid as biomarker for retinopathy of prematurity
Consequently, finding biomarkers for the disease has been an important goal. In the current study, the research team investigated the levels of about twenty different fatty acids in the blood of ninety children born before twenty-eight weeks of pregnancy at Sahlgrenska University Hospital in Gothenburg.
The fact that arachidonic acid so clearly stood out surprised the research team led by Professor Ann Hellström. The fatty acid belongs to the omega-6 polyunsaturated fatty acid family, which at high levels is associated with inflammation and heart disease in adults. During the fetal period, however, the situation may be different.
"Arachidonic acid seems to be of special importance during the whole pregnancy as a building block for membranes," Ann Hellström says. "The mother provides the fetus with arachidonic acid, which is at a much lower level in her own blood compared to the fetal levels. Therefore, we believe that it's important that the premature babies receive this fatty acid as a supplement."
Taking the study further
The hypothesis will now be tested in a new study involving 210 children at neonatal units in three Swedish cities; Gothenburg, Lund and Stockholm. Children will be given a supplement with a combination of DHA, an omega-3 polyunsaturated fatty acid, which is also important for the construction of blood vessels and nerve tissue, and arachidonic acid, an omega-6 polyunsaturated fatty acid. At present the latter is not included in the nutritional supplements that premature babies receive immediately after birth.
"Many times new treatments are introduced on the basis of intuition and opinion, but the evidence is not always there," Ann Hellström observes. "Now we have something entirely new to go on, a fatty acid that we had not at all expected to be important in fetal growth. However we found it by systematically surveying all fatty acids to find evidence of which were involved in development in both healthy and sick infants."
- Chatarina A. Löfqvist, Svetlana Najm et al. Association of Retinopathy of Prematurity With Low Levels of Arachidonic Acid A Secondary Analysis of a Randomized Clinical Trial, JAMA Ophthalmology doi:10.1001/jamaophthalmol.2017.6658