{"id":1693,"date":"2022-03-04T19:38:12","date_gmt":"2022-03-04T19:38:12","guid":{"rendered":"https:\/\/lam.unitedforclinicalnutrition.com\/pt-br\/?p=1693"},"modified":"2022-06-01T10:18:24","modified_gmt":"2022-06-01T13:18:24","slug":"oleo-de-peixe-terapia-adjuvante-em-pacientes-com-covid-19","status":"publish","type":"post","link":"https:\/\/lam.unitedforclinicalnutrition.com\/pt-br\/oleo-de-peixe-terapia-adjuvante-em-pacientes-com-covid-19\/","title":{"rendered":"\u00d3leo de peixe: terapia adjuvante em pacientes com Covid-19?"},"content":{"rendered":"

Como se sabe, mais do que uma s\u00edndrome respirat\u00f3ria, a Covid-19 \u00e9 uma doen\u00e7a capaz de afetar o organismo de m\u00faltiplas formas em raz\u00e3o da chamada \u201ctempestade de citocina\u201d no corpo, que provoca um grave quadro inflamat\u00f3rio. Sendo assim, a administra\u00e7\u00e3o parenteral com \u00e1cidos graxos poli-insaturados, como o \u00f4mega 3<\/strong>, vem sendo fortemente discutida como terapia adjuvante em pacientes hospitalizados com Covid-191<\/a><\/strong>, visto que j\u00e1 h\u00e1 consenso sobre os benef\u00edcios do manejo de \u00f3leo de peixe em pacientes cr\u00edticos, com redu\u00e7\u00e3o do tempo de UTI, resolu\u00e7\u00e3o de processos inflamat\u00f3rios e menores taxas de infec\u00e7\u00f5es sist\u00eamicas<\/p>\n

Por que a suplementa\u00e7\u00e3o com \u00f3leo de peixe poderia ser ben\u00e9fica a pacientes com Covid-19?<\/h2>\n

Conforme j\u00e1 mencionado, a Covid-19 \u00e9 uma doen\u00e7a que n\u00e3o atinge de forma grave necessariamente os pacientes que j\u00e1 tinham hist\u00f3rico de problemas respirat\u00f3rios. Crit\u00e9rios como idade avan\u00e7ada, obesidade, diabetes tipo 2, hipertens\u00e3o e s\u00edndrome metab\u00f3lica s\u00e3o agravantes que favorecem a hiperinflama\u00e7\u00e3o1<\/a>.<\/p>\n

A resposta inflamat\u00f3ria \u00e9 consequ\u00eancia da produ\u00e7\u00e3o exacerbada de citocinas. A resolu\u00e7\u00e3o do quadro, contudo, depende da a\u00e7\u00e3o de grupos lip\u00eddicos de mol\u00e9culas chamados de mediadores pr\u00f3-resolutivos especializados (SPMs).<\/p>\n

Os SPMs, reconhecidos por seu potencial anti-inflamat\u00f3rio, inclusive pela revista Nature<\/a>, caracterizam-se por serem lip\u00eddios, e n\u00e3o prote\u00ednas, e t\u00eam a fun\u00e7\u00e3o de acelerar o processo de limpeza e regenera\u00e7\u00e3o de tecidos, permitindo o retorno da homeostase2<\/a>. Sua sintetiza\u00e7\u00e3o, todavia, depende de \u00e1cidos graxos poli-insaturados de cadeia longa (PUFAS), como o \u00e1cido eicosapentan\u00f3ico (EPA) e \u00e1cido docosahexaen\u00f3ico (DHA), ambos da fam\u00edlia do \u00f4mega 3, subst\u00e2ncia em que o \u00f3leo de peixe \u00e9 bastante rico.<\/strong><\/p>\n

Torrinhas et al. mencionam que os SPMs participam do \u201csequestro\u201d de citocinas pr\u00f3-inflamat\u00f3rias e da remo\u00e7\u00e3o de microrganismos invasivos, proporcionando a restaura\u00e7\u00e3o da estrutura e a homeostase do tecido.<\/p>\n

Os autores apontam, ainda, que EPA e DHA podem inibir a s\u00edntese de citocinas pr\u00f3-inflamat\u00f3rias, modulando a ativa\u00e7\u00e3o de fatores de transcri\u00e7\u00e3o g\u00eanica e desestabilizando a dom\u00ednios lip\u00eddicos da membrana (os \u201crafts\u201d de membrana)<\/strong>. Vale lembrar, nesse caso, que a enzima conversora de angiotensina 2, um receptor usado por SARS-CoV-2 para entrar nas c\u00e9lulas humanas, est\u00e1 localizada nesses dom\u00ednios lip\u00eddicos da membrana3<\/a>.<\/p>\n

Estresse oxidativo<\/h4>\n

Evitar o estresse oxidativo seria outro benef\u00edcio da suplementa\u00e7\u00e3o enteral do \u00f3leo de peixe em pacientes com Covid-19. <\/strong>Isso porque o estresse oxidativo via infec\u00e7\u00f5es por v\u00edrus RNA pode contribuir para eventos com apoptose (morte celular programada), perda da fun\u00e7\u00e3o imunol\u00f3gica e replica\u00e7\u00e3o viral. Em contrapartida, a administra\u00e7\u00e3o de \u00f3leo de peixe junto a antioxidantes, como vitamina C e E, levaram a resultados como redu\u00e7\u00e3o de mortalidade, menor risco de fal\u00eancia org\u00e2nica, menor tempo de ventila\u00e7\u00e3o mec\u00e2nica, al\u00e9m de redu\u00e7\u00e3o de tempo de interna\u00e7\u00e3o em UTI.4<\/a>,5<\/a>,6<\/a>,7<\/a><\/sup>.<\/p>\n

Veja abaixo o esquema que demonstra, mais detalhadamente, os benef\u00edcios e efeitos adversos da suplementa\u00e7\u00e3o com \u00f3leo de peixe.<\/p>\n

\"\"<\/p>\n

 <\/p>\n

\u00d3leo de peixe em quadros cardiovasculares e tromb\u00f3ticos de pacientes com Covid-19<\/h4>\n

Outra importante atua\u00e7\u00e3o do \u00f3leo de peixe seria na gera\u00e7\u00e3o (via EPA) de eicosan\u00f3ides que s\u00e3o funcionalmente menos intensos e, ainda, antitromb\u00f3ticos1<\/a>. Evid\u00eancias sugerem que uma maior ingest\u00e3o de n-3 PUFAs teria efeitos ben\u00e9ficos <\/strong>sobre os perfis lip\u00eddicos, substituindo \u00e1cidos graxos saturados e reduzindo n\u00edveis de triglicer\u00eddeos, estabilizando assim as placas ateroscler\u00f3ticas e reduzindo a incid\u00eancia de forma\u00e7\u00e3o de trombos8<\/a>,9<\/a>,10<\/a><\/sup><\/strong>.<\/p>\n

H\u00e1 tamb\u00e9m a hip\u00f3tese de que os efeitos cardioprotetores de \u00e1cidos graxos ricos em \u00f4mega 3 sejam atribu\u00eddos \u00e0s suas propriedades imunomoduladoras. Especialmente, evid\u00eancias crescentes demonstram a capacidade de n-3 PUFAs em reduzir os n\u00edveis circulantes de quimiocinas inflamat\u00f3rias, citocinas e os metab\u00f3litos pr\u00f3-inflamat\u00f3rios derivados de n-6 PUFAs11<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

Como se sabe, mais do que uma s\u00edndrome respirat\u00f3ria, a Covid-19 \u00e9 uma doen\u00e7a capaz de afetar o organismo de m\u00faltiplas formas em raz\u00e3o da chamada \u201ctempestade de citocina\u201d no corpo, que provoca um grave quadro inflamat\u00f3rio. Sendo assim, a administra\u00e7\u00e3o parenteral com \u00e1cidos graxos poli-insaturados, como o \u00f4mega 3, vem sendo fortemente discutida como […]<\/p>\n","protected":false},"author":1,"featured_media":1610,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[49,9],"tags":[65,131,132,133,134,135,99,136,137],"class_list":["post-1693","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-artigo-5","category-nutricao-parenteral","tag-covid-19","tag-dha","tag-epa","tag-estresse-oxidativo","tag-inflamacao","tag-oleo-de-peixe","tag-omega-3","tag-sars-cov-2","tag-spms"],"acf":[],"yoast_head":"\n\u00d3leo de peixe: terapia adjuvante em pacientes com Covid-19<\/title>\n<meta name=\"description\" content=\"Evid\u00eancias indicam que potencial anti-inflamat\u00f3rio do \u00f3leo de peixe reverteria tempestade de citocinas provocada pelo SARS-CoV-2, 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