PM2.5-induced Cardiovascular Health Effects and Potential Therapeutic Mechanisms of Omega-3 Fatty Acid Supplementation: A Scoping Review

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Hunt, Kirstin Lynn. PM2.5-induced Cardiovascular Health Effects and Potential Therapeutic Mechanisms of Omega-3 Fatty Acid Supplementation: A Scoping Review (Under the direction of Dr. Jennifer Richmond-Bryant). Recent studies have found that long-term exposure to air pollution, especially particulate matter (PM), was associated with increased morbidity and mortality. The peer-reviewed literature has shown that short-term exposure to PM2.5 (PM < 2.5 μm) can cause adverse cardiovascular effects and mortality. The mechanisms by which PM2.5 can initiate adverse cardiovascular health effects are still being investigated, but evidence suggests that inflammation, oxidative stress, and modulation of the cardiac autonomic nervous system (ANS) play a prominent role in vascular and endothelial dysfunction. Dietary supplementation with omega-3 fatty acids (O3FAs), including fish oil, have been found to reduce the risk of cardiovascular disease through anti-inflammatory and antioxidant mechanisms. Growing scientific evidence suggests supplementation with O3FAs, including fish oils, could protect against the adverse effects of PM2.5. This scoping review aims to highlight the current scientific studies purporting that O3FA supplementation can mitigate the adverse effects of PM2.5. An initial search of PubMed and Web of Science was conducted on January 31, 2021, with no date or location restrictions. A constraint included only papers published in English. The author supplemented this by searching reference lists of articles and performing a grey literature search on Google Scholar. Eligibility criteria were defined by a Population Exposure Comparison Outcome (PECO) statement to develop the study question and to aid in the selection process. The PECO framework included populations of human, animal, and in vitro systems with exposures to PM, PM2.5, PM10-2.5, concentrated ambient PM, diesel particulate matter, and black carbon. Comparison populations were supplemented with O3FAs or fish oil, but not limited to combinations with other supplements. Outcomes included cardiovascular diseases, vascular effects, and endothelial function. Twelve studies were identified that met the eligibility criteria. Eleven of the 12 studies observed protective cardiovascular health benefits from supplementation with O3FAs after PM2.5 exposure, including reduced inflammation and oxidative stress biomarkers. However, one study found that olive oil supplements improved endothelial function instead of fish oil. This review did not compare the studies' supplementation dosage of O3FAs or fish oil. Further research is needed to address the supplementation of fish oil to determine the optimum dosage for protection. This review suggests supplementation with O3FAs could be a cost-effective way to protect against cardiovascular injury due to PM2.5 exposure.