Borage oil reduction of rheumatoid arthritis activity may be mediated by increased cAMP that suppresses tumor necrosis factor-alpha

Int Immunopharmacol. 2001 Nov;1(12):2197-9. doi: 10.1016/s1567-5769(01)00146-1.


Recent double blind studies have shown some benefit of borage oil in treatment of rheumatoid arthritis. Tumor necrosis factor-alpha has been shown to be a central mediator of inflammatory and joint destructive processes in rheumatoid arthritis. In this paper, evidence from published research is reviewed that indicates gamma linolenic acid component of borage oil increases prostaglandin E levels that increase cAMP levels that in turn suppress tumor necrosis factor-alpha synthesis. If this biochemical path of borage oil is correct then (1) concomitant non-steroidal anti-inflammatory drug use would tend to undermine borage oil effects, and (2) borage oil would be contraindicated in pregnancy given the teratogenic and labor inducing effects of prostaglandin E agonists.

Publication types

  • Review

MeSH terms

  • Abortion, Spontaneous / chemically induced
  • Alprostadil / biosynthesis
  • Anti-Inflammatory Agents, Non-Steroidal / pharmacology
  • Antirheumatic Agents / adverse effects
  • Antirheumatic Agents / pharmacology
  • Antirheumatic Agents / therapeutic use*
  • Arthritis, Rheumatoid / drug therapy*
  • Borago / chemistry*
  • Contraindications
  • Cyclic AMP / physiology*
  • Dinoprostone / biosynthesis
  • Double-Blind Method
  • Drug Interactions
  • Female
  • Humans
  • Phytotherapy*
  • Plant Oils / adverse effects
  • Plant Oils / pharmacology
  • Plant Oils / therapeutic use*
  • Pregnancy
  • Randomized Controlled Trials as Topic
  • Second Messenger Systems / drug effects*
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors*
  • Tumor Necrosis Factor-alpha / biosynthesis
  • gamma-Linolenic Acid / pharmacology
  • gamma-Linolenic Acid / therapeutic use


  • Anti-Inflammatory Agents, Non-Steroidal
  • Antirheumatic Agents
  • Plant Oils
  • Tumor Necrosis Factor-alpha
  • gamma-Linolenic Acid
  • Cyclic AMP
  • Alprostadil
  • borage oil
  • Dinoprostone