Sjogrens syndrome treatments

Gamma linolenic acid (GLA)

GLA found to have beneficial effects for dry eye in multiple controlled trials.    Macri et al, 2003; Kokke et al, 2008.

GLA has been shown to increase tear production in Sjogren's syndrome.   GLA increases levels of PGE1, a potent anti-inflammatory eicosanoid  present in tears, the lacrimal glands and the conjunctiva.  Aragona et al, 2005

For beneficial effect, it is necessary to supplement an appropriate balancing amount of omega-3 EPA concurrently with omega-6 GLA.    GLA is the precursor to DGLA, which produces anti-inflammatory PGE1. The presence of EPA in cell membranes inhibits the Δ5d enzyme that would otherwise convert DGLA into AA into the predominately inflammatory Series 2 prostaglandins and thromboxane. Pilkington et al, 2014

Essential fatty acid (EFA) conversion chart

How to supplement EFAs

References

 Aragona P, Bucolo C, Spinella R, et al. (2005) Systemic Omega-6 essential fatty acid treatment and PGE1 tear content in Sjogren’s syndrome patients. Investigative Ophthalmology and Visual Science;46:4474- 4479.

Macri A, Giuffrida S, Amico V, Lester M, Traverso CE. (2003) Effect of linoleic acid and gamma-linolenic acid on tear production, tear clearance and on the ocular surface after photorefractive keratectomy.Graefes Arch Clin Exp Ophthalmol. 241:561-566.

Kokke KH, et al. (2008) Oral omega-6 essential fatty acid treatment in contact lens associated dry eye."Contact Lens and Anterior Eye. 31:141-146.

Pilkington, S. M., Rhodes, L. E., Al-Aasswad, N. M., Massey, K. A., & Nicolaou, A. (2014). Impact of EPA ingestion on COX- and LOX-mediated eicosanoid synthesis in skin with and without a pro-inflammatory UVR challenge--report of a randomised controlled study in humans. Molecular nutrition & food research, 58(3), 580-590.