Background and aims To evaluate whether a regimen of corticosteroids and cyclophosphamide, and methods designed to enhance endothelial NO synthesis and augment antioxidant defenses can lead to long-lasting remission of lupus and other autoimmune diseases.

Methods Patients with established lupus, dermatomyositis and rheumatoid arthritis are seelcted for the study. Their plasma phospholipid content of unsaturated fatty acids, nitric oxide, anti-oxidants and cytokines are measured before and after treatment.

Results Plasma phospholipid content of arachidonic, eicosapentaenoic and docosahexaenoic acids (AA, EPA and DHA respectively) were found to be low and so also plasma nitric oxide levels and anti-oxidants with a concomitant increase in plasma IL-6 and TNF concentrations. These patients were given pulses of methylprednisolone and cyclophosphamide based on their disease status and response to therapy followed by oral supplementation of GLA/EPA/DHA daily.

Conclusions All patients who entered the study went in to full remission that was found to be associated with restoration of plasma phospholipid content of AA/EPA/DHA, antioxidants and nitric oxide and cytokines to normal. All these patients were in full remission even after stopping immunosuppressive drugs but are continuing GLA/EPA/DHA orally.