Fish Oil, Statins, and Neural Disease

The "statins" make up a class of cholesterol lowering drugs. Fish oil (oil derived from fish) is rich in certain fatty acids. Both types of compounds can have powerful positive and protective effects in the brain.

A study just now coming out (to be published in Brain Research Reviews) looks at the biochemical effects of statins and fish oil in the brain in detail. The study makes specific recommendations for further research, and concludes with a proposal that the way we classify certain neural pathologies be reconsidered to take into account the complex biochemical pathways that produce them rather than their clinical presentation.

"Neural Membrane" is essentially the stuff amongst which neurons float. Neural membrane is made of proteins and various lipids, and there is quite a complex structure to the way these molecules are arranged and how they interact. Damage to neural tissues often involves damage to the neural membrane ... this may be in some cases more important than damage to the neuron itself ... and repair of tissue, and return of normal neural function, often involves and is, in fact, facilitated by changes in the neural membrane.
A review by Farooqui et al ("Comparison of biochemical effects of statins and fish oil in brain: The battle of the titans") suggests that these compounds have "antioxidant, anti-inflammatory, and anti-apoptotic properties" which contribute to their utility in treating neurological disorders. The authors "speculate that there is an overlap between neurochemical events associated with neural cell injury in stroke and neurodegenerative diseases."

Now, this study needs some very serious translation to be used by anyone other than a very specialized researcher. I read it about five times and I'm pretty sure I understand it, but I'm also pretty sure that this is one of the best examples I've ever seen of scientists not making their point at all clear.

It has been suggested that the reason medical researchers (in particular) write in such an obtuse manner is because they don't want people to actually understand what they are saying ... as a kind of preemptive cover-up. I never thought that was a very good explanation for crappy writing in the medical fields. This paper supports my interpretation, because it is an explict effort to encourage research in a particular area for a particular purpose. This paper would be much more useful if it was clearly written and, perhaps, could be mined for useful phrases and paragraphs in grant writing by prospective researchers. As it is, it can barely be understood.

The paper reviews current research and models of cause and effect among molecules and tissues involving the interaction between lipids that are ingested as statins or as fish oils, and neural tissues. Both types of ingestible substance are shown to have protective effects on the blood supply system in tissues in general, including neural tissues.

Statins may have the effect of increasing or enhancing neural plasticity, neurogenesis, and overall repair after stroke (in rats, anyway). Some but not all of these effects arise from the effect statins have on cholesterol. Statins also affect gene expression and other bimolecular systems.

Fish oils provide compounds (fatty acids, etc.) that are very important in brain function, but that are hard to obtain or synthesize in situ in sufficient quantity, especially in large-brained organisms such as humans.

The paper discusses the difference between "western diets" and a presumed, or estimated, "paleolithic" diet, with respect to these fatty acids. The ratio of Omega 6 to Omega 3 fatty acids in the typical American diet is about 15-1, but the alleged ratio in the "Paleolithic" diet is 1:1.

This shift in ratio is not good. The result may be cardiovascular disease, autoimmune diseases, and neurodegenerative diseases. This is why the American Heart Association recommends fish oil supplements, or the regular consumption of fish.

The study concludes:

Statins and fish oil are potent cholesterol-lowering drugs. In addition to their cholesterol-lowering properties, statins and fish oil exert a number of [positive] effects ...

[W]e propose that statins and ingredients of fish oil have [specific positive] effects in brain tissue. [One implication of this research is that] sudden withdrawal of statin treatment may acutely impair vascular function and increase morbidity and mortality in patients with vascular disease...

[F]ish oil reduces the inflammatory response [in damaged neural tissue], has positive effects on eyesight, and increases tolerance to organ transplantation by improving the function of the graft and preventing impaired cellular immunity ...Statins and fish oil also prevent neurodegeneration and improve learning and memory. They reduce the risk of stroke and dementia.

... a diet fortified with Ï-3 fatty acids can play an important role in meeting the demands for optimal health. Increasing the intake of food containing Ï-3 is an important strategy for decreasing the incidence of chronic cardiovascular and neurodegenerative diseases. ... In light of the heterogeneity of human neurodegenerative diseases, the new insights based on genomics, proteomics, and lipidomics may lead to a redefinition and subdivision of human neurodegenerative diseases based on biochemical criteria rather than clinical presentation ... This information would facilitate the development of new treatments for neurodegenerative and neuropsychiatric diseases.

That last part is, I think, the most important aspect of this paper. It is normal for disease characterization, treatment, and research to follow upon a symptom based concept of the disease itself. But this can lead to severely limited understaning of the disease or diseases. Possibly the first major re-working of how we think of disease based on what causes the disease rather than what it "looks like" was the germ theory itself. Disorders of the blood and other bodily fluids could be caused, it turned out by the same agents as diseases of the respiratory system.

Farooqui et al's paper, should it be widely read and actually parsed by researchers in diet, cellular process, neural generation and neuropathology, will have its largest effect if it causes a rethinking of how we classify, think about, and work out causal and curative models for neural diseases.

But what about the "Battle of the Titans" mentioned in the title of the paper? Don't ask ... it wasn't mentioned after that.

FAROOQUI, A. A., ONG, W., HORROCKS, L. A., CHEN, P. & FAROOQUI, T. (2007): Comparison of biochemical effects of statins and fish oil in brain: The battle of the titans.. Brain Res Rev, , .