Arachidonic acid

Arachidonic acid
Names
IUPAC name
(5Z,8Z,11Z,14Z)-5,8,11,14-Eicosatetraenoic acid
Systematic IUPAC name
(5Z,8Z,11Z,14Z)-Icosa-5,8,11,14-tetraenoic acid[1]
Other names
5,8,11,14-all-cis-Eicosatetraenoic acid; all-cis-5,8,11,14-Eicosatetraenoic acid; Arachidonate
Identifiers
506-32-1 YesY
3DMet B00061
1713889
ChEBI CHEBI:15843 YesY
ChEMBL ChEMBL15594 YesY
ChemSpider 392692 YesY
DrugBank DB04557 N
EC Number 208-033-4
2391
Jmol interactive 3D Image
KEGG C00219 N
MeSH Arachidonic+acid
PubChem 444899
RTECS number CE6675000
UNII 27YG812J1I YesY
Properties
C20H32O2
Molar mass 304.47 g·mol−1
Density 0.922 g/cm3
Melting point −49 °C (−56 °F; 224 K)
Boiling point 169 to 171 °C (336 to 340 °F; 442 to 444 K) at 0.15 mmHg
log P 6.994
Acidity (pKa) 4.752
Hazards
R-phrases R19
NFPA 704
Flammability code 1: Must be pre-heated before ignition can occur. Flash point over 93 °C (200 °F). E.g., canola oil Health code 1: Exposure would cause irritation but only minor residual injury. E.g., turpentine Reactivity code 0: Normally stable, even under fire exposure conditions, and is not reactive with water. E.g., liquid nitrogen Special hazards (white): no codeNFPA 704 four-colored diamond
1
1
0
Flash point 113 °C (235 °F; 386 K)
Except where otherwise noted, data are given for materials in their standard state (at 25 °C [77 °F], 100 kPa).
N verify (what is YesYN ?)
Infobox references

Arachidonic acid (AA, sometimes ARA) is a polyunsaturated omega-6 fatty acid 20:4(ω-6). It is structurally related to the saturated arachidic acid found in peanut oil (L. arachis – peanut).[2]

Chemistry

In chemical structure, arachidonic acid is a carboxylic acid with a 20-carbon chain and four cis-double bonds; the first double bond is located at the sixth carbon from the omega end.

Some chemistry sources define 'arachidonic acid' to designate any of the eicosatetraenoic acids. However, almost all writings in biology, medicine and nutrition limit the term to all-cis-5,8,11,14-eicosatetraenoic acid.

Biology

Arachidonic acid is a polyunsaturated fatty acid present in the phospholipids (especially phosphatidylethanolamine, phosphatidylcholine, and phosphatidylinositides) of membranes of the body's cells, and is abundant in the brain, muscles, and liver. Skeletal muscle is an especially active site of arachidonic acid retention, accounting for roughly 10-20% of the phospholipid fatty acid content on average.[3]

In addition to being involved in cellular signaling as a lipid second messenger involved in the regulation of signaling enzymes, such as PLC-γ, PLC-δ, and PKC-α, -β, and -γ isoforms, arachidonic acid is a key inflammatory intermediate and can also act as a vasodilator.[4] (Note separate synthetic pathways, as described in section below.)

Conditionally essential fatty acid

Arachidonic acid in the human body usually comes from dietary animal sources—meat, eggs, dairy—or is synthesized from linoleic acid.

Arachidonic acid is not one of the essential fatty acids. However, it does become essential if there is a deficiency in linoleic acid or if there is an inability to convert linoleic acid to arachidonic acid, which is required by most mammals. Some mammals lack the ability to—or have a very limited capacity to—convert linoleic acid into arachidonic acid, making it an essential part of their diets. Since little or no arachidonic acid is found in common plants, such animals are obligate carnivores; the cat is a common example.[5][6] A commercial source of arachidonic acid has been derived, however, from the fungus Mortierella alpina.[7]

Synthesis and cascade in humans

Eicosanoid synthesis.

Arachidonic acid is freed from a phospholipid molecule by the enzyme phospholipase A2 (PLA2), which cleaves off the fatty acid, but can also be generated from DAG by diacylglycerol lipase.[4]

Arachidonic acid generated for signaling purposes appears to be derived by the action of a phosphatidylcholine-specific cytosolic phospholipase A2 (cPLA2, 85 kDa), whereas inflammatory arachidonic acid is generated by the action of a low-molecular-weight secretory PLA2 (sPLA2, 14-18 kDa).[4]

Arachidonic acid is the precursor that is metabolized by various enzymes to a wide range of biologically and clinically important eicosanoids and metabolites of these eicosanoids:

The production of these derivatives and their action in the body are collectively known as the "arachidonic acid cascade"; see essential fatty acid interactions and the enzyme and metabolite linkages given in the previous paragraph for more details.

PLA2 activation

Further information: Phospholipase_A2 § Regulation

PLA2, in turn, is activated by ligand binding to receptors, including:

Furthermore, any agent increasing intracellular calcium may cause activation of some forms of PLA2.[19]

PLC activation

Further information: Phospholipase C § Activation

Alternatively, arachidonic acid may be cleaved from phospholipids after phospholipase C (PLC) cleaves off the inositol trisphosphate group, yielding diacylglycerol (DAG), which subsequently is cleaved by DAG lipase to yield arachidonic acid.[18]

Receptors that activate this pathway include:

PLC may also be activated by MAP kinase. Activators of this pathway include PDGF and FGF.[19]

Arachidonic acid in the body

Muscle growth

Through its conversion to active components such as the prostaglandin PGF2alpha and PGE2 after physical exercise, arachidonic acid is necessary for the repair and growth of skeletal muscle tissue.[20]

Brain

Arachidonic acid is one of the most abundant fatty acids in the brain, and is present in similar quantities to docosahexaenoic acid (DHA). The two account for approximately 20% of its fatty acid content.[21] Like DHA, neurological health is reliant upon sufficient levels of arachidonic acid. Among other things, arachidonic acid helps to maintain hippocampal cell membrane fluidity.[22] It also helps protect the brain from oxidative stress by activating peroxisome proliferator-activated receptor gamma.[23] ARA also activates syntaxin-3 (STX-3), a protein involved in the growth and repair of neurons.[24]

Arachidonic acid is also involved in early neurological development. In one study funded by the U.S. National Institute of Child Health and Human Development, infants (18 months) given supplemental arachidonic acid for 17 weeks demonstrated significant improvements in intelligence, as measured by the Mental Development Index.[25] This effect is further enhanced by the simultaneous supplementation of ARA with DHA.

In adults, the disturbed metabolism of ARA contributes to neurological disorders such as Alzheimer's disease and Bipolar disorder.[26] This involves significant alterations in the conversion of arachidonic acid to other bioactive molecules (overexpression or disturbances in the ARA enzyme cascade).

Alzheimer's disease

Studies on arachidonic acid and the pathogenesis of Alzheimer's disease is mixed, with one study of AA and its metabolites that suggests they are associated with the onset of Alzheimer's disease,[27] whereas another study suggests that the supplementation of arachidonic acid during the early stages of this disease may be effective in reducing symptoms and slowing the disease progress.[28] Additional studies on arachidonic acid supplementation for Alzheimer's patients are needed. Another study indicates that air pollution is the source of inflammation and arachidonic acid metabolites promote the inflammation.[29]

Bodybuilding supplement

Arachidonic acid is marketed as an anabolic bodybuilding supplement in a variety of products. Supplementation of arachidonic acid (1,500 mg/day for 8 weeks) has been shown to increase lean body mass, strength, and anaerobic power in experienced resistance-trained men. This was demonstrated in a placebo-controlled study at the University of Tampa. Thirty men (aged 20.4 ± 2.1 years) took arachidonic acid or a placebo for 8 weeks, and participated in a controlled resistance-training program. After 8 weeks, Lean Body Mass (LBM) had increased significantly, and to a greater extent, in the ARA group (1.62 kg) vs. placebo (0.09 kg) (p<0.05). The change in muscle thickness was also greater in the ARA group (.47 cm) than placebo (.25 cm) (p<0.05). Wingate anaerobic power increased to a greater extent in ARA group as well (723.01 to 800.66 W) vs. placebo (738.75 to 766.51 W). Lastly, the change in total strength was significantly greater in the ARA group (109.92 lbs.) compared to placebo (75.78 lbs.). These results suggest that ARA supplementation can positively augment adaptations in strength and skeletal muscle hypertrophy in resistance-trained men.[30]

An earlier clinical study examining the effects of 1,000 mg/day of arachidonic acid for 50 days found supplementation to enhance anaerobic capacity and performance in exercising men. During this study, a significant group–time interaction effect was observed in Wingate relative peak power (AA: 1.2 ± 0.5; P: -0.2 ± 0.2 W•kg-1, p=0.015). Statistical trends were also seen in bench press 1RM (AA: 11.0 ± 6.2; P: 8.0 ± 8.0 kg, p=0.20), Wingate average power (AA:37.9 ± 10.0; P: 17.0 ± 24.0 W, p=0.16), and Wingate total work (AA: 1292 ± 1206; P: 510 ± 1249 J, p=0.087). AA supplementation during resistance-training promoted significant increases in relative peak power with other performance related variables approaching significance. These findings support the use of AA as an ergogenic.[31]

Dietary arachidonic acid and inflammation

Under normal metabolic conditions, increased consumption of arachidonic acid will not cause inflammation unless lipid peroxidation products are mixed in. Arachidonic acid is metabolized to both proinflammatory and anti-inflammatory eicosanoids during and after the inflammatory response, respectively. Arachidonic acid is also metabolized to anti-inflammatory eicosanoids during and after physical activity to promote growth.[32] However, the evidence is mixed. Some studies giving between 840 mg and 2,000 mg per day to healthy individuals for up to 50 days have shown no increases in inflammation or related metabolic activities.[32][33][34][35] However, others show that increased arachidonic acid levels are actually associated with reduced pro-inflammatory IL-6 and IL-1 levels and increased anti-inflammatory tumor necrosis factor-beta.[36] This may result in a reduction in systemic inflammation.

Arachidonic acid does still play a central role in inflammation related to injury and many diseased states. How it is metabolized in the body dictates its inflammatory or anti-inflammatory activity. Individuals suffering from joint pains or active inflammatory disease may find that increased arachidonic acid consumption exacerbates symptoms, presumably because it is being more readily converted to inflammatory compounds. Likewise, high arachidonic acid consumption is not advised for individuals with a history of inflammatory disease, or who are in compromised health. Of note, while ARA supplementation does not appear to have proinflammatory effects in healthy individuals, it may counter the anti-inflammatory effects of omega-3 fatty acid supplementation.[37]

Health effects of arachidonic acid supplementation

Arachidonic acid supplementation in daily dosages of 1,000–1,500 mg for 50 days has been well tolerated during several clinical studies, with no significant side effects reported. All common markers of health, including kidney and liver function,[34] serum lipids,[38] immunity,[39] and platelet aggregation[33] appear to be unaffected with this level and duration of use. Furthermore, higher concentrations of ARA in muscle tissue may be correlated with improved insulin sensitivity.[40] Arachidonic acid supplementation of the diets of healthy adults appears to offer no toxicity or significant safety risk.

While studies looking at arachidonic acid supplementation in sedentary subjects have failed to find changes in resting inflammatory markers in doses up to 1,500 mg daily, strength-trained subjects may respond differently. One study at Baylor University reported a significant reduction in resting inflammation (via marker IL-6) in young men supplementing 1,000 mg/day of arachidonic acid for 50 days in combination with resistance training. This suggests that rather being pro-inflammatory, supplementation of ARA while undergoing resistance training may actually improve the regulation of systemic inflammation.[41]

A meta-analysis by Cambridge University looking for associations between heart disease risk and individual fatty acids reported a significantly reduced risk of heart disease with higher levels of EPA and DHA (Omega-3 fats), as well as the Omega-6 Arachidonic Acid.[42] A scientific advisory from the American Heart Association has also favorably evaluated the health impact of dietary omega-6 fats, including arachidonic acid.[32] The group does not recommend limiting this essential fatty acid. In fact, the paper recommends individuals follow a diet that consists of at least 5–10% of calories coming from omega-6 fats, including arachidonic acid. It suggests dietary ARA is not a risk factor for heart disease, and may play a role in maintaining optimal metabolism and reduced heart disease risk. It is, therefore, recommended to maintain sufficient intake levels of both omega-3 and omega-6 fatty acids for optimal health.

Arachidonic acid is not carcinogenic, and studies show dietary level is not associated (positively or negatively) with risk of cancers.[43][44][45][46] ARA remains integral to the inflammatory and cell growth process, however, which is disturbed in many types of disease including cancer. Therefore, the safety of arachidonic acid supplementation in patients suffering from cancer, inflammatory, or other diseased states is unknown, and supplementation is not recommended.

See also

References

  1. ↑ http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=231
  2. ↑ "Dorland's Medical Dictionary – 'A'". Archived from the original on 11 January 2007. Retrieved 2007-01-12.
  3. ↑ Smith, GI; Atherton, P; Reeds, DN; Mohammed, BS; Rankin, D; Rennie, MJ; Mittendorfer, B (Sep 2011). "Omega-3 polyunsaturated fatty acids augment the muscle protein anabolic response to hyperinsulinaemia-hyperaminoacidaemia in healthy young and middle-aged men and women.". Clinical science (London, England : 1979) 121 (6): 267–78. doi:10.1042/cs20100597. PMID 21501117.
  4. 1 2 3 Baynes, John W.; Marek H. Dominiczak (2005). Medical Biochemistry 2nd. Edition. Elsevier Mosby. p. 555. ISBN 0-7234-3341-0.
  5. ↑ MacDonald, ML; Rogers, QR; Morris, JG (1984). "Nutrition of the Domestic Cat, a Mammalian Carnivore". Annual Review of Nutrition 4: 521–62. doi:10.1146/annurev.nu.04.070184.002513. PMID 6380542.
  6. ↑ Rivers, JP; Sinclair, AJ; Craqford, MA (1975). "Inability of the cat to desaturate essential fatty acids". Nature 258 (5531): 171–3. Bibcode:1975Natur.258..171R. doi:10.1038/258171a0. PMID 1186900.
  7. ↑ Production of life'sARA™, www.lifesdha.com/
  8. ↑ J. Biol. Chem. 248:5673; 1973
  9. ↑ Prostaglandins Other Lipid Mediat. 2002 Aug;68-69:115-28
  10. ↑ Biochim Biophys Acta. 2015 Apr;1851(4):340-355. doi: 10.1016/j.bbalip.2014.10.008
  11. ↑ Proc Natl Acad Sci U S A. 1997 Jun 10;94(12):6148-52
  12. ↑ J Physiol Sci. 2012 May;62(3):163-72. doi: 10.1007/s12576-012-0196-9.
  13. ↑ Eur J Pharmacol. 2015 Aug 5;760:49-63. doi: 10.1016/j.ejphar.2015.03.083
  14. ↑ Proc Natl Acad Sci U S A. 2008 Jan 15;105(2):680-5. doi: 10.1073/pnas.0710127105
  15. ↑ J Chromatogr B Analyt Technol Biomed Life Sci. 2014 Aug 1;964:26-40. doi: 10.1016/j.jchromb.2014.03.015
  16. ↑ FEBS J. 2013 May;280(9):1874-94. doi: 10.1111/febs.12152
  17. ↑ Walter F., PhD. Boron (2003). Medical Physiology: A Cellular And Molecular Approaoch. Elsevier/Saunders. p. 108. ISBN 1-4160-2328-3.
  18. 1 2 3 4 5 6 Walter F., PhD. Boron (2003). Medical Physiology: A Cellular And Molecular Approaoch. Elsevier/Saunders. p. 103. ISBN 1-4160-2328-3.
  19. 1 2 3 4 5 6 Walter F., PhD. Boron (2003). Medical Physiology: A Cellular And Molecular Approaoch. Elsevier/Saunders. p. 104. ISBN 1-4160-2328-3.
  20. ↑ Trappe, TA; Fluckey, JD; White, F; Lambert, CP; Evans, WJ (2001). "Skeletal muscle PGF(2)(alpha) and PGE(2) in response to eccentric resistance exercise: influence of ibuprofen acetaminophen". The Journal of Clinical Endocrinology and Metabolism 86 (10): 5067–70. doi:10.1210/jc.86.10.5067. PMID 11600586.
  21. ↑ Crawford, MA; Sinclair, AJ (1971). "Nutritional influences in the evolution of mammalian brain. In: lipids, malnutrition & the developing brain". Ciba Foundation symposium: 267–92. PMID 4949878.
  22. ↑ Fukaya, T.; Gondaira, T.; Kashiyae, Y.; Kotani, S.; Ishikura, Y.; Fujikawa, S.; Kiso, Y.; Sakakibara, M. (2007). "Arachidonic acid preserves hippocampal neuron membrane fluidity in senescent rats". Neurobiology of Aging 28 (8): 1179–1186. doi:10.1016/j.neurobiolaging.2006.05.023. PMID 16790296.
  23. ↑ Wang, ZJ; Liang, CL; Li, GM; Yu, CY; Yin, M (2006). "Neuroprotective effects of arachidonic acid against oxidative stress on rat hippocampal slices". Chemico-biological interactions 163 (3): 207–17. doi:10.1016/j.cbi.2006.08.005. PMID 16982041.
  24. ↑ Darios, F; Davletov, B (2006). "Omega-3 and omega-6 fatty acids stimulate cell membrane expansion by acting on syntaxin 3". Nature 440 (7085): 813–7. Bibcode:2006Natur.440..813D. doi:10.1038/nature04598. PMID 16598260.
  25. ↑ Birch, Eileen E; Garfield, Sharon; Hoffman, Dennis R; Uauy, Ricardo; Birch, David G (2007). "A randomized controlled trial of early dietary supply of long-chain polyunsaturated fatty acids and mental development in term infants". Developmental Medicine & Child Neurology 42 (3): 174. doi:10.1111/j.1469-8749.2000.tb00066.x.
  26. ↑ Rapoport, SI (2008). "Arachidonic acid and the brain". The Journal of nutrition 138 (12): 2515–20. PMC 3415870. PMID 19022981.
  27. ↑ Amtul, Z.; Uhrig, M.; Wang, L.; Rozmahel, R. F.; Beyreuther, K. (2012). "Detrimental effects of arachidonic acid and its metabolites in cellular and mouse models of Alzheimer's disease: Structural insight". Neurobiology of Aging 33 (4): 831.e21–31. doi:10.1016/j.neurobiolaging.2011.07.014. PMID 21920632.
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  30. ↑ Ormes, Jacob. "Effects of Arachidonic Acid Supplementation on Skeletal Muscle Mass, Strength, and Power". NSCA ePoster Gallery. National Strength and Conditioning Association.
  31. ↑ Roberts, MD; Iosia, M; Kerksick, CM; Taylor, LW; Campbell, B; Wilborn, CD; Harvey, T; Cooke, M; Rasmussen, C; Greenwood, Mike; Wilson, Ronald; Jitomir, Jean; Willoughby, Darryn; Kreider, Richard B (2007). "Effects of arachidonic acid supplementation on training adaptations in resistance-trained males". Journal of the International Society of Sports Nutrition 4: 21. doi:10.1186/1550-2783-4-21. PMC 2217562. PMID 18045476.
  32. 1 2 3 Harris, WS; Mozaffarian, D; Rimm, E; Kris-Etherton, P; Rudel, LL; Appel, LJ; Engler, MM; Engler, MB; Sacks, F (2009). "Omega-6 fatty acids and risk for cardiovascular disease: a science advisory from the American Heart Association Nutrition Subcommittee of the Council on Nutrition, Physical Activity, and Metabolism; Council on Cardiovascular Nursing; and Council on Epidemiology and Prevention". Circulation 119 (6): 902–7. doi:10.1161/CIRCULATIONAHA.108.191627. PMID 19171857.
  33. 1 2 Nelson, GJ; Schmidt, PC; Bartolini, G; Kelley, DS; Kyle, D (1997). "The effect of dietary arachidonic acid on platelet function, platelet fatty acid composition, and blood coagulation in humans". Lipids 32 (4): 421–5. doi:10.1007/s11745-997-0055-7. PMID 9113631.
  34. 1 2 Changes in whole blood and clinical safety markers over 50 days of concomitant arachidonic acid supplementation and resistance training. Wilborn, C, M Roberts, C Kerksick, M Iosia, L Taylor, B Campbell, T Harvey, R Wilson, M. Greenwood, D Willoughby and R Kreider. Proceedings of the International Society of Sports Nutrition (ISSN) Conference June 15–17, 2006. http://arachidonic.com/ARA-baylorsafety.pdf
  35. ↑ Pantaleo, P; Marra, F; Vizzutti, F; Spadoni, S; Ciabattoni, G; Galli, C; La Villa, G; Gentilini, P; Laffi, G (2004). "Effects of dietary supplementation with arachidonic acid on platelet and renal function in patients with cirrhosis". Clinical science 106 (1): 27–34. doi:10.1042/CS20030182. PMID 12877651.
  36. ↑ Ferrucci, L; Cherubini, A; Bandinelli, S; Bartali, B; Corsi, A; Lauretani, F; Martin, A; Andres-Lacueva, C; Senin, U; Guralnik, JM (2006). "Relationship of plasma polyunsaturated fatty acids to circulating inflammatory markers". The Journal of Clinical Endocrinology and Metabolism 91 (2): 439–46. doi:10.1210/jc.2005-1303. PMID 16234304.
  37. ↑ Li, B; Birdwell, C; Whelan, J (1994). "Antithetic relationship of dietary arachidonic acid and eicosapentaenoic acid on eicosanoid production in vivo". Journal of lipid research 35 (10): 1869–77. PMID 7852864.
  38. ↑ Nelson, GJ; Schmidt, PC; Bartolini, G; Kelley, DS; Phinney, SD; Kyle, D; Silbermann, S; Schaefer, EJ (1997). "The effect of dietary arachidonic acid on plasma lipoprotein distributions, apoproteins, blood lipid levels, and tissue fatty acid composition in humans". Lipids 32 (4): 427–33. doi:10.1007/s11745-997-0056-6. PMID 9113632.
  39. ↑ Kelley, DS; Taylor, PC; Nelson, GJ; MacKey, BE (1998). "Arachidonic acid supplementation enhances synthesis of eicosanoids without suppressing immune functions in young healthy men". Lipids 33 (2): 125–30. doi:10.1007/s11745-998-0187-9. PMID 9507233.
  40. ↑ Borkman, M; Storlien, LH; Pan, DA; Jenkins, AB; Chisholm, DJ; Campbell, LV (1993). "The relation between insulin sensitivity and the fatty-acid composition of skeletal-muscle phospholipids". The New England Journal of Medicine 328 (4): 238–44. doi:10.1056/NEJM199301283280404. PMID 8418404.
  41. ↑ Roberts, MD; Iosia, M; Kerksick, CM; Taylor, LW; Campbell, B; Wilborn, CD; Harvey, T; Cooke, M; Rasmussen, C; Greenwood, M; Wilson, R; Jitomir, J; Willoughby, D; Kreider, RB (Nov 28, 2007). "Effects of arachidonic acid supplementation on training adaptations in resistance-trained males.". Journal of the International Society of Sports Nutrition 4: 21. doi:10.1186/1550-2783-4-21. PMC 2217562. PMID 18045476.
  42. ↑ Chowdhury, R; Warnakula, S; Kunutsor, S; Crowe, F; Ward, HA; Johnson, L; Franco, OH; Butterworth, AS; Forouhi, NG; Thompson, SG; Khaw, KT; Mozaffarian, D; Danesh, J; Di Angelantonio, E (Mar 18, 2014). "Association of dietary, circulating, and supplement fatty acids with coronary risk: a systematic review and meta-analysis.". Annals of internal medicine 160 (6): 398–406. doi:10.7326/M13-1788. PMID 24723079.
  43. ↑ Schuurman, AG; Van Den Brandt, PA; Dorant, E; Brants, HA; Goldbohm, RA (1999). "Association of energy and fat intake with prostate carcinoma risk: results from The Netherlands Cohort Study". Cancer 86 (6): 1019–27. doi:10.1002/(SICI)1097-0142(19990915)86:6<1019::AID-CNCR18>3.0.CO;2-H. PMID 10491529.
  44. ↑ Leitzmann, MF; Stampfer, MJ; Michaud, DS; Augustsson, K; Colditz, GC; Willett, WC; Giovannucci, EL (2004). "Dietary intake of n-3 and n-6 fatty acids and the risk of prostate cancer". The American journal of clinical nutrition 80 (1): 204–16. PMID 15213050.
  45. ↑ Astorg, P (2005). "Dietary fatty acids and colorectal and prostate cancers: epidemiological studies". Bulletin du cancer 92 (7): 670–84. PMID 16123006.
  46. ↑ Whelan, J; McEntee, MF (2004). "Dietary (n-6) PUFA and intestinal tumorigenesis". The Journal of nutrition 134 (12 Suppl): 3421S–3426S. PMID 15570048.

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