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Use of fish oil in parenteral nutrition: rationale and reality

Use of fish oil in parenteral nutrition: rationale and reality
Use of fish oil in parenteral nutrition: rationale and reality
Excessive or inappropriate inflammation and immunosuppression are components of the response to surgery, trauma, injury and infection in some individuals and can lead, progressively, to sepsis and septic shock. The hyperinflammation is characterised by the production of inflammatory cytokines, arachidonic acid-derived eicosanoids and other inflammatory mediators, while the immunosuppression is characterised by impairment of antigen presentation and of T-helper lymphocyte type-1 responses. Long-chain n-3 fatty acids from fish oil decrease the production of inflammatory cytokines and eicosanoids. They act both directly (by replacing arachidonic acid as an eicosanoid substrate and by inhibiting arachidonic acid metabolism) and indirectly (by altering the expression of inflammatory genes through effects on transcription factor activation). Thus, long-chain n-3 fatty acids are potentially useful anti-inflammatory agents and may be of benefit in patients at risk of hyperinflammation and sepsis. As a consequence, an emerging application for n-3 fatty acids, in which they may be added to parenteral (or enteral) formulas, is in surgical or critically-ill patients. Parenteral nutrition that includes n-3 fatty acids appears to preserve immune function better than standard formulas and appears to diminish the extent of the inflammatory response. Studies to date are suggestive of clinical benefits from these approaches, especially in patients post surgery, although evidence of clinical benefit in patients with sepsis is emerging.
fish oil, inflammation, immune function, parenteral nutrition, sepsis
0029-6651
264-277
Calder, Philip C.
1797e54f-378e-4dcb-80a4-3e30018f07a6
Calder, Philip C.
1797e54f-378e-4dcb-80a4-3e30018f07a6

Calder, Philip C. (2006) Use of fish oil in parenteral nutrition: rationale and reality. Proceedings of the Nutrition Society, 65 (3), 264-277. (doi:10.1079/PNS2006500).

Record type: Article

Abstract

Excessive or inappropriate inflammation and immunosuppression are components of the response to surgery, trauma, injury and infection in some individuals and can lead, progressively, to sepsis and septic shock. The hyperinflammation is characterised by the production of inflammatory cytokines, arachidonic acid-derived eicosanoids and other inflammatory mediators, while the immunosuppression is characterised by impairment of antigen presentation and of T-helper lymphocyte type-1 responses. Long-chain n-3 fatty acids from fish oil decrease the production of inflammatory cytokines and eicosanoids. They act both directly (by replacing arachidonic acid as an eicosanoid substrate and by inhibiting arachidonic acid metabolism) and indirectly (by altering the expression of inflammatory genes through effects on transcription factor activation). Thus, long-chain n-3 fatty acids are potentially useful anti-inflammatory agents and may be of benefit in patients at risk of hyperinflammation and sepsis. As a consequence, an emerging application for n-3 fatty acids, in which they may be added to parenteral (or enteral) formulas, is in surgical or critically-ill patients. Parenteral nutrition that includes n-3 fatty acids appears to preserve immune function better than standard formulas and appears to diminish the extent of the inflammatory response. Studies to date are suggestive of clinical benefits from these approaches, especially in patients post surgery, although evidence of clinical benefit in patients with sepsis is emerging.

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More information

Published date: 2006
Keywords: fish oil, inflammation, immune function, parenteral nutrition, sepsis

Identifiers

Local EPrints ID: 60962
URI: https://eprints.soton.ac.uk/id/eprint/60962
ISSN: 0029-6651
PURE UUID: 27203488-44e0-4ace-9ee8-97353cd3b39e

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Date deposited: 24 Sep 2008
Last modified: 13 Mar 2019 20:29

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