Omega-3 mechanism of action in inflammation and endoplasmic reticulum stress in mononuclear cells from overweight non-alcoholic fatty liver disease participants: study protocol for the "Brazilian Omega Study" (BROS)-a randomized controlled trial.

The low-grade inflammation is pivotal in obesity and its comorbidities; however, the inflammatory proteins are out of target for traditional drug therapy. Omega-3 (ω3) fatty acids can modulate the downstream signaling of Toll-like receptor (TLR) and tumor necrosis factor-α receptor (TNFα) through GPR120, a G-protein-coupled receptor, a mechanism not yet elucidated in humans. This work aims to investigate if the ω3 supplementation, at a feasible level below the previously recommended level in the literature, is enough to disrupt the inflammation and endoplasmic reticulum stress (ER-stress), and also if in acute treatment (3 h) ω3 can activate the GPR120 in peripheral blood mononuclear cells (PBMC) and leukocytes from overweight non-alcoholic fatty liver disease (NAFLD) participants. The R270H variant of the Ffar4 (GPR120 gene) will also be explored about molecular responses and blood lipid profiles. A triple-blind, prospective clinical trial will be conducted in overweight men and women, aged 19-75 years, randomized into placebo or supplemented (2.2 g of ω3 [EPA+DHA]) groups for 28 days. For sample calculation, it was considered the variation of TNFα protein and a 40% dropout rate, obtaining 22 individuals in each group. Volunteers will be recruited among patients with NAFLD diagnosis. Anthropometric parameters, food intake, physical activity, total serum lipids, complete fatty acid blood profile, and glycemia will be evaluated pre- and post-supplementation. In the PBMC and neutrophils, the protein content and gene expression of markers related to inflammation (TNFα, MCP1, IL1ß, IL6, IL10, JNK, and TAK1), ER-stress (ATF1, ATF6, IRE1, XBP1, CHOP, eIF2α, eIF4, HSP), and ω3 pathway (GPR120, ß-arrestin2, Tab1/2, and TAK1) will be evaluated using Western blot and RT-qPCR. Participants will be genotyped for the R270H (rs116454156) variant using the TaqMan assay. It is hypothesized that attenuation of inflammation and ER-stress signaling pathways in overweight and NAFLD participants will be achieved through ω3 supplementation through binding to the GPR120 receptor. TRIAL REGISTRATION: ClinicalTrials.gov #RBR-7x8tbx. Registered on May 10, 2018, with the Brazilian Registry of Clinical Trials.

Influência da suplementação de carboidrato na função imune de judocas durante o treinamento / Influence of carbohydrate supplementation in the immune response of judoists during training

O objetivo deste trabalho foi investigar os efeitos da suplementação de carboidrato, durante uma sessão de treino, sobre a função imune de atletas de judô. Dezesseis judocas do sexo masculino foram submetidos a duas sessões de treinamento de 120 minutos cada, com três dias de intervalo entre elas. Na primeira sessão, oito judocas, separados de forma aleatória, foram suplementados (3mL/kg peso corporal) com solução carboidratada (grupo CHO) e os demais, com solução placebo (grupo PLA), de forma duplo-cega. Na segunda sessão os tratamentos foram invertidos. O número de leucócitos, linfócitos, monócitos, eosinófilos, neutrófilos, os níveis de cortisol e as concentrações de glicose e lactato foram medidos em repouso (Pré-E), imediatamente após (Pós-E) e uma hora após o término da sessão de treino (1h pós-E). Os resultados mostraram que a glicemia aumentou (p < 0,05) durante a sessão de treino no grupo CHO e reduziu-se (p < 0,05) no grupo PLA. O cortisol aumentou (p < 0,05) durante a sessão de treino, independente do tipo de solução consumida, bem como durante a recuperação no grupo PLA. O consumo de CHO resultou em menor (p < 0,05) leucocitose, quando comparado com o PLA, nos períodos Pós-E e 1h Pós-E. A elevação da concentração de lactato sangüíneo decorrente do exercício correlacionou-se positivamente com o aumento dos leucócitos (r = 0,86, p < 0,001) nos dois grupos. Concluiu-se que a ingestão de bebida carboidratada por atletas de judô durante uma sessão de treino resultou em menor perturbação da contagem total de leucócitos e suas subclasses: linfócitos, monócitos, eosinófilos e neutrófilos. Esses resultados sugerem proteção à saúde imunológica de judocas fomentada por essa estratégia nutricional.

The aim of this study was to investigate the effects of carbohydrate supplementation on the immunological function of judoists during a training session. Sixteen male judo athletes were submitted to two 120 min training sessions within 3 days interval. In the first session eight athletes randomly chosen were supplemented (3mL/kg body weight) with a carbohydrate solution (CHO group) while the others ingested a placebo solution (PLA group) in a randomized and double blind way. In the second session, treatments were inverted. Leukocyte, lymphocyte, monocyte, eosinophil and neutrophil were counted and blood levels of cortisol, glucose and lactate were assessed at rest (Pre-E), immediately after the training session (Post-E) and one hour after the training session (1h Post-E). The results showed that the blood glucose levels increased during the training session when athletes were given CHO and decreased when they ingested PLA. Cortisol levels increased during the training session in both conditions and decreased 1h Post-E. Athletes consuming CHO presented a reduced number of leukocytes when compared to those ingesting PLA in both Post-E and 1h Post-E periods. The increase in blood lactate concentration in response to exercise training was positively correlated with the increase in the leukocyte number (r = 0. 86, p<0.001) in both conditions. It was concluded that CHO supplementation during a judo training session resulted in less disturbance of total leukocytes. It suggests that such nutritional strategy protected the athletes' immunological health.