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Rheumatology 1999; 38: 948-952
© 1999 British Society for Rheumatology

Changes in plasma free fatty acid concentrations in rheumatoid arthritis patients during fasting and their effects upon T-lymphocyte proliferation

D. A. Fraser1,3, J. Thoen1, A. C. Rustan2, Ø. Førre1 and J. Kjeldsen-Kragh3

1 Centre for Rheumatic Diseases, Akersbakken 27, Rikshospitalet, 0172 Oslo,
2 Department of Pharmacology, University of Oslo and
3 Department of Immunology and Transfusion Medicine, Ullevaal University Hospital, N-0407 Oslo, Norway

Correspondence to: D. A. Fraser, Department of Immunology and Transfusion Medicine, Ullevaal University Hospital, N-0407 Oslo, Norway.

Objective. To measure whether changes in the concentrations of circulating free fatty acids (FFAs) after a 7 day fast in rheumatoid arthritis (RA) patients would inhibit in vitro T-lymphocyte proliferation.

Methods. The concentration and composition of plasma FFAs were measured in nine RA patients at the conclusion of a 7 day fast. A FFA mixture was made up based on these findings (20% linoleic, 43% oleic, 10% stearic, 27% palmitic acid). Mitogen-induced lymphocyte proliferative responses were measured after co-culture of peripheral blood mononuclear cells (PBMC) from healthy individuals in the presence of increasing concentrations of this FFA mixture (from 0 to 2000 µM) and in the presence of FFA mixtures where the relative proportions of fatty acids varied.

Results. Both the concentration of the FFA mixture and the ratio between the unsaturated and saturated fatty acids significantly influenced in vitro lymphocyte proliferation (P<0.0001). Unexpectedly, the highest concentrations of the FFA mixture increased lymphocyte proliferation. At equimolar concentrations (600 µM), manipulating the amounts of oleic and linoleic fatty acids relative to stearic and palmitic fatty acids had a potent inhibitory effect upon lymphocyte proliferation.

Conclusion. Fasting-associated increases in total plasma FFA concentrations do not inhibit, but rather enhance, in vitro lymphocyte proliferation. An inhibitory effect could only be achieved by manipulating the balance between the unsaturated and saturated fatty acids.

KEY WORDS: Rheumatoid arthritis, Fasting, Fatty acids, Lymphocyte proliferation.


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